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Seminars in Oncology Nursing Aug 2018To examine nurse communication in cancer care and offer communication strategies for quality palliative care nursing. (Review)
Review
OBJECTIVES
To examine nurse communication in cancer care and offer communication strategies for quality palliative care nursing.
DATA SOURCES
Communication strategies offered are based on the COMFORT Communication curriculum, an evidence-based communication training program.
CONCLUSION
Whole-patient assessment, a major component of palliative care, involves communication that includes eliciting the patient's story, addressing health literacy needs, being mindful of burnout, and relating to the patient and family.
IMPLICATIONS FOR NURSING PRACTICE
Quality communication skills are essential to oncology nursing, especially given their vital role in cancer care.
Topics: Communication; Comprehensive Health Care; Hospice and Palliative Care Nursing; Humans; Neoplasms; Nurse's Role; Nurse-Patient Relations; Oncology Nursing; Palliative Care; Quality of Health Care
PubMed: 30100368
DOI: 10.1016/j.soncn.2018.06.007 -
Seminars in Oncology Nursing Aug 2016To review research and evidence-based resources on skin cancer prevention and early detection and their importance for oncology nurses. (Review)
Review
OBJECTIVES
To review research and evidence-based resources on skin cancer prevention and early detection and their importance for oncology nurses.
DATA SOURCES
Journal articles, federal reports, cancer surveillance data, behavioral surveillance data.
CONCLUSION
Most cases of skin cancer are preventable. Survivors of many types of cancer are at increased risk of skin cancers.
IMPLICATIONS FOR NURSING PRACTICE
Oncology nurses can play an important role in protecting their patients from future skin cancer morbidity and mortality.
Topics: Cancer Survivors; Humans; Melanoma; Nurse's Role; Oncology Nursing; Patient Education as Topic; Risk Factors; Skin Neoplasms; Ultraviolet Rays; United States
PubMed: 27539279
DOI: 10.1016/j.soncn.2016.05.005 -
Seminars in Oncology Nursing Jun 2021To describe palliative, concurrent, and hospice care in pediatric oncology in the United States (US), we present a clinical scenario illustrating palliative and hospice... (Review)
Review
OBJECTIVES
To describe palliative, concurrent, and hospice care in pediatric oncology in the United States (US), we present a clinical scenario illustrating palliative and hospice care, including eligibility for concurrent care, insurance coverage and billing, barriers to accessing quality pediatric palliative and hospice care, and implications for oncology nursing practice.
DATA SOURCES
Peer-reviewed articles, clinical practice guidelines, professional organizations, and expert clinical opinion examining pediatric oncology, palliative care, and hospice care.
CONCLUSION
Understanding the goals of palliative and hospice care and the differences between them is important in providing holistic, goal-directed care.
IMPLICATIONS FOR NURSING PRACTICE
Oncology nurses play a pivotal role in supporting the goals of pediatric palliative care and hospice care and in educating patients and their families. Nurses form trusting relationships with pediatric oncology patients and their families and are in a position to advocate for best palliative care practices as disease progresses to end of life, including when appropriate concurrent care or hospice.
Topics: Adolescent; Child; Hospice Care; Hospice and Palliative Care Nursing; Humans; Neoplasms; Oncology Nursing; Palliative Care; United States; Young Adult
PubMed: 34175165
DOI: 10.1016/j.soncn.2021.151166 -
Journal of Clinical Nursing Jul 2019To explore nursing interventions used among patients with cancer and summarise the results of their effectiveness. The ultimate goal was to improve the quality of care... (Review)
Review
AIMS AND OBJECTIVES
To explore nursing interventions used among patients with cancer and summarise the results of their effectiveness. The ultimate goal was to improve the quality of care and provide best evidence for clinicians to refer to while developing effective nursing interventions.
BACKGROUND
Nursing interventions refer to actions that nurses take with the aim of improving the well-being of people with cancer-related health and care needs. A plethora of systematic reviews has been conducted in this research area, although with scattered results. We conducted a comprehensive review to identify and summarise the existing evidence.
METHODS
This overview of systematic reviews adheres to the PRISMA guidelines. The PubMed, CINAHL, MEDLINE and Scopus databases were searched. Nine reviews reporting findings from 112 original studies published 2007-2017 met the selection criteria. The results of intervention effectiveness were analysed using descriptive quantification and a narrative summary of the quantitative data.
RESULTS
The effectiveness of educational nursing interventions was inconsistent on quality of life (QoL), attitudes, anxiety and distress, but positive on level of knowledge, symptom severity, sleep and uncertainty. Psychosocial nursing interventions had a significant effect on spiritual well-being, meaning of life, fatigue and sleep. Psychological nursing interventions reduced cancer-related fatigue. Nursing interventions supporting patients' coping had a significant impact on anxiety, distress, fatigue, sleep, dyspnoea and functional ability. Activity-based interventions may prevent cancer-related fatigue.
CONCLUSIONS
Nursing interventions achieved significant physical and psychological effects on the lives of patients with cancer. Multidimensional nature of interventions by combining different elements reinforces the effect. Priorities for future research include identifying the most beneficial components of these interventions.
RELEVANCE TO CLINICAL PRACTICE
Implementation of these nursing interventions into clinical practice is important to improve patients' knowledge and QoL as well as reducing various symptoms and side effects related to cancer and its treatment.
Topics: Adaptation, Psychological; Anxiety; Fatigue; Humans; Neoplasms; Oncology Nursing; Quality of Life; Systematic Reviews as Topic
PubMed: 30585667
DOI: 10.1111/jocn.14762 -
Seminars in Oncology Nursing Aug 2018To highlight the importance, challenges, and evolution of advance care planning for patients with cancer. (Review)
Review
OBJECTIVE
To highlight the importance, challenges, and evolution of advance care planning for patients with cancer.
DATA SOURCES
Peer-reviewed journal articles and clinical guidelines.
CONCLUSION
Advance care planning is fundamental to support the personhood of patients with advanced cancer. Patients must be encouraged by physicians and nurses to articulate what matters and provides meaning to them as they live, cope, and receive treatment for their cancer.
IMPLICATIONS FOR NURSING PRACTICE
Nurses can facilitate advance care planning and primary palliative care, to support patients and families to make informed and value-concordant decisions regarding cancer and end-of-life treatments.
Topics: Advance Care Planning; Comprehensive Health Care; Hospice and Palliative Care Nursing; Humans; Neoplasms; Nurse-Patient Relations; Oncology Nursing; Pain Management; Palliative Care; Quality of Health Care
PubMed: 30100366
DOI: 10.1016/j.soncn.2018.06.012 -
Revista Da Escola de Enfermagem Da U S P 2022To present the definition of "symptom cluster" in cancer patients and to reflect on the theory, assessment, outcomes, and interventions for symptom management, based on...
OBJECTIVE
To present the definition of "symptom cluster" in cancer patients and to reflect on the theory, assessment, outcomes, and interventions for symptom management, based on the perspective of advanced practices in oncology nursing.
METHOD
Theoretical-reflective study that presents and discusses possibilities for managing "symptom clusters" through advanced practices in oncology nursing.
RESULTS
The term "symptom cluster" can be defined as a set of two or more related symptoms. The theoretical concepts and models that can help in its understanding are: Theory of Unpleasant Symptoms, Theory of Symptom Management, concept of self-efficacy and Theory of symptom self-management. Advanced practice nurses have the skills to manage "symptom clusters," optimizing outcomes and positively influencing the quality of life of cancer patients.
CONCLUSION
Advanced practice nurses have the essential characteristics to design, to implement and to evaluate intervention protocols aimed at the management of "symptom clusters" in cancer patients.
Topics: Humans; Neoplasms; Oncology Nursing; Palliative Care; Quality of Life; Syndrome
PubMed: 35766922
DOI: 10.1590/1980-220X-REEUSP-2021-0452en -
Clinical Journal of Oncology Nursing Feb 2020This issue of the Clinical Journal of Oncology Nursing (CJON) contains the inaugural installment of STAT, a visually compelling one-page review about oncologic...
This issue of the Clinical Journal of Oncology Nursing (CJON) contains the inaugural installment of STAT, a visually compelling one-page review about oncologic emergencies or other clinical care issues that require urgent nursing attention. The reasons for STAT are simple. The need for nurses to have accessible and timely references to support clinical practice is well established. Studies consistently confirm that time management is a core nursing competency. To best manage that time, nurses who have ready access to foundational clinical care content can better affect patient outcomes.
Topics: Adult; Emergency Medical Services; Female; Humans; Male; Middle Aged; Nursing Staff, Hospital; Oncology Nursing; Time Management
PubMed: 31961837
DOI: 10.1188/20.CJON.7 -
Revista Brasileira de Enfermagem 2019to identify, in scientific productions, nursing interventions in palliative care in children and adolescents with cancer. (Review)
Review
OBJECTIVE
to identify, in scientific productions, nursing interventions in palliative care in children and adolescents with cancer.
METHOD
integrative review of the literature through the databases: CINAHL, MEDLINE, IBECS, LILACS and SCIELO, carried out in October and November 2017.
RESULTS
we analyzed 18 articles that met the inclusion criteria. The results showed that, among the articles selected, Brazil is the country with the largest number of publications and that interventions such as music therapy, massage, ludic application, early consultation of palliative care, social interventions and physical exercises aimed at the resolution of a specific symptom obtained better results when compared to interventions that aimed at the comprehensiveness of palliative care.
FINAL CONSIDERATION
we conclude that greater emphasis should be given to palliative care in academic and professional training and that further studies in search of the best evidence should be conducted to support nursing Evidence-Based Practices.
Topics: Evidence-Based Practice; Humans; Nursing Care; Oncology Nursing; Palliative Care; Pediatric Nursing
PubMed: 31017219
DOI: 10.1590/0034-7167-2018-0121 -
Nurse Education in Practice Jan 2016The benefits of effective communication in an oncology setting are multifold and include the overall well-being of patients and health professionals, adherence to...
The benefits of effective communication in an oncology setting are multifold and include the overall well-being of patients and health professionals, adherence to treatment regimens, psychological functioning, and improvements in quality of life. Nevertheless, there are substantial barriers and communication challenges reported by oncology nurses. This study was conducted to present a summary of communication challenges faced by oncology nurses. From November 2012 to March 2014, 121 inpatient nurses working in the oncology setting participated in an online pre-training qualitative survey that asked nurses to describe common communication challenges in communicating empathy and discussing death, dying, and end-of-life (EOL) goals of care. The results revealed six themes that describe the challenges in communicating empathically: dialectic tensions, burden of carrying bad news, lack of skills for providing empathy, perceived institutional barriers, challenging situations, and perceived dissimilarities between the nurse and the patient. The results for challenges in discussing death, dying and EOL goals of care revealed five themes: dialectic tensions, discussing specific topics related to EOL, lack of skills for providing empathy, patient/family characteristics, and perceived institutional barriers. This study emphasizes the need for institutions to provide communication skills training to their oncology nurses for navigating through challenging patient interactions.
Topics: Communication; Family; Hospitalization; Humans; Nurse-Patient Relations; Oncology Nursing; Qualitative Research; Surveys and Questionnaires; Terminal Care
PubMed: 26278636
DOI: 10.1016/j.nepr.2015.07.007 -
JAMA Internal Medicine Nov 2021Guidelines recommend early specialty palliative care for all patients with advanced cancer, but most patients lack access to such services. (Randomized Controlled Trial)
Randomized Controlled Trial
IMPORTANCE
Guidelines recommend early specialty palliative care for all patients with advanced cancer, but most patients lack access to such services.
OBJECTIVE
To assess the effect of CONNECT (Care Management by Oncology Nurses to Address Supportive Care Needs), a primary palliative care intervention delivered by oncology nurses, on patient outcomes.
DESIGN, SETTING, AND PARTICIPANTS
This cluster randomized clinical trial of the CONNECT intervention vs standard care was conducted from July 25, 2016, to October 6, 2020. Participants were adult patients with metastatic solid tumors who were undergoing oncological care and for whom an oncologist would agree with the statement "would not be surprised if the patient died in the next year." The trial was conducted at 17 community oncology practices in western Pennsylvania. Data analyses adhered to the intention-to-treat principle.
INTERVENTIONS
The CONNECT intervention included 3 monthly visits with an existing infusion room nurse who was trained to address symptoms, provide emotional support, engage in advance care planning, and coordinate care.
MAIN OUTCOMES AND MEASURES
The primary outcome was quality of life. At baseline and 3 months, participants completed assessments of quality of life (Functional Assessment of Chronic Illness Therapy-Palliative care: score range, 0-184, with higher scores indicating better quality of life), symptom burden (Edmonton Symptom Assessment Scale: score range, 0-90, with higher scores indicating greater symptom burden), and mood symptoms (Hospital Anxiety and Depression Scale [HADS]: score range, 0-21, with higher scores indicating substantial anxiety and depression). Linear mixed-effects models were used to estimate adjusted mean differences in 3-month outcomes. Preplanned, intensity-adjusted analyses were conducted.
RESULTS
A total of 672 patients were enrolled (mean [SD] age, 69.3 [10.2] years; 360 women [53.6%]). The mean (SD) number of CONNECT visits completed was 2.2 (1.0). At 3 months, no difference in mean (SD) quality-of-life score was found between the CONNECT and standard care groups (130.7 [28.2] vs 134.1 [28.1]; adjusted mean difference, 1.20; 95% CI, -2.75 to 5.15; P = .55). Similarly, there was no difference between groups in 3-month mean (SD) symptom burden (23.2 [16.6] vs 24.0 [16.1]; adjusted mean difference, -2.64; 95% CI, -5.85 to 0.58; P = .11) or mood symptoms (HADS depression subscale score: 5.1 [3.4] vs 4.8 [3.7], adjusted mean difference, -0.08 [95% CI, -0.71 to 0.57], P = .82; HADS anxiety subscale score: 5.7 [3.9] vs 5.4 [4.2], adjusted mean difference, -0.31 [95% CI, -0.96 to 0.33], P = .34). Intensity-adjusted analyses revealed a larger estimated treatment effect for patients who received a full dose (3 visits) of the CONNECT intervention.
CONCLUSIONS AND RELEVANCE
This cluster randomized clinical trial found that a primary palliative care intervention that was delivered by oncology nurses did not improve patient-reported outcomes at 3 months. Primary palliative care interventions with a higher dose intensity may be beneficial for most patients with advanced cancer who lack access to palliative care specialists.
TRIAL REGISTRATION
ClinicalTrials.gov Identifier: NCT02712229.
Topics: Anxiety; Depression; Female; Health Services Accessibility; Humans; Male; Middle Aged; Needs Assessment; Neoplasms; Nurse's Role; Oncology Nursing; Outcome Assessment, Health Care; Palliative Care; Patient Outcome Assessment; Quality of Life; Symptom Assessment
PubMed: 34515737
DOI: 10.1001/jamainternmed.2021.5185