Current Issue : January - March Volume : 2017 Issue Number : 1 Articles : 7 Articles
Background: Although the importance of work for patients with cancer is nowadays more acknowledged both in\nthe literature as well as in cancer survivorship care, effective interventions targeting the return to work of these\npatients are still scarce. Therefore, we developed a nurse-led, stepped-care, e-health intervention aimed at\nenhancing the return to work of patients with cancer. The objective of this study is to describe the content of the\nintervention and the study design used to evaluate the feasibility and (cost) effectiveness of the intervention.\nMethods: We designed a multi-centre randomised controlled trial with a follow-up of 12 months. Patients who\nhave paid employment at the time of diagnosis, are on sick leave and are between 18ââ?¬â??62 years old will be eligible\nto participate. After patients have signed the informed consent form and filled in the baseline questionnaire, they\nare randomly allocated to either the nurse-led, stepped-care, e-health intervention called Cancer@Work, or care as\nusual. The primary outcome is sustainable return to work. Secondary outcomes are sick leave days, work ability,\nwork functioning, quality of life, quality of working life and time from initial sick leave to full return to work without\nextensive need for recovery. The feasibility of the Cancer@Work intervention and direct and indirect costs will be\ndetermined. Outcomes will be assessed by questionnaires at 3, 6, 9 and 12 months of follow-up.\nDiscussion: The results of this study will provide new insights into the feasibility and (cost) effectiveness of\nCancer@Work, a nurse-led, stepped-care, e-health intervention for cancer patients aimed at enhancing their return\nto work. If proven effective, the intention is to implement the Cancer@Work intervention in usual psychooncological\ncare....
Purpose/objectives: To describe the experiences of stigma and coping strategies among patients with lung cancer\nin China.\nResearch approach: Qualitative.\nSetting: The oncology department at Liaocheng Peoples Hospital.\nParticipants: A purposive sample of 17 patients experiencing stigma related to lung cancer voluntarily participated\nin data collection.\nMethodologic approach: Individual, semistructured qualitative interviews were chosen. Participants completed\nabout a 30-min focused interview. Exploratory qualitative approach guided data analysis.\nFindings: Three main thematic elements emerged from the interview data:(1) sources of stigma, such as smoking,\ndecreased ability to work, difficulties caring for self and family, damage to self-image, and cough and expectoration;\n(2) experiences of stigma, including feelings of stigma, remorse, loss of dignity, uselessness, social isolation, perceived\nexclusion, rejection, and discrimination; and (3) coping strategies, such as concealing the fact of sickness, reducing\nsocial activities, seeking medical assistance, adhering to treatment, and disclosing dissatisfaction.\nConclusions: Our results indicate the presence of perceived stigma among patients with lung cancer. Future work\nshould address the stigma associated with lung cancer and its related factors.\nInterpretation: As point-of-care providers, staff nurses are well positioned to develop effective interventions to help\npatients deal with stigma and to accomplish the goal of providing holistic nursing care....
Background: Breast cancer and its treatment-related adverse effects are harmful to physical, psychological, and\nsocial functioning, leading to health-related quality of life (HRQoL) impairment in patients. Many programs have\nbeen used with this population for HRQoL improvement; however, few studies have considered the physical,\npsychological, and social health domains comprehensively, and few have constructed multimodal standard nursing\ninterventions based on specific theories. The purpose of this trial is to examine the effect of a health belief model\n(HBM)-based multimodal standard nursing program (MSNP) on HRQoL in female patients with breast cancer.\nMethods: This is a two-arm single-blind cluster randomized controlled trial (cRCT) in clinical settings. Twelve tertiary\nhospitals will be randomly selected from the 24 tertiary hospitals in Xi�an, China, and allocated to the intervention\narm and control arm using a computer-generated random numbers table. Inpatient female patients with breast\ncancer from each hospital will receive either MSNP plus routine nursing care immediately after recruitment\n(intervention arm), or only routine nursing care (control arm). The intervention will be conducted by trained nurses\nfor 12 months. All recruited female patients with breast cancer, participating clinical staff, and trained data collectors\nfrom the 12 hospitals will be blind with respect to group allocation. Patients of the control arm will not be offered\nany information about the MSNP during the study period to prevent bias. The primary outcome is HRQoL\nmeasured through the Functional Assessment of Cancer Therapy-Breast version 4.0 at 12 months. Secondary\noutcomes include pain, fatigue, sleep, breast cancer-related lymphedema, and upper limb function, which are\nevaluated by a visual analogue scale, the circumference method, and the Constant-Murley Score.\nDiscussion: This trial will provide important evidence on the effectiveness of multimodal nursing interventions\ndelivered by nurses in clinical settings. Study findings will inform strategies for scaling up comprehensive standard\nintervention programs on health management in the population of female patients with breast cancer....
Background: Accessing cancer treatment requires First Nation peoples living in rural and remote communities to\neither commute to care, or to relocate to an urban centre for the length or part of the treatment. While Canadians\nliving in rural and remote communities must often make difficult decisions following a cancer diagnosis, such\ndecisions are further complicated by the unique policy and socio-historical contexts affecting many First Nation\npeoples in Canada. These contexts often intersect with negative healthcare experiences which can be related to\njurisdictional confusion encountered when seeking care. Given the rising incidence of cancer within First Nation\npopulations, there is a growing potential for negative health outcomes.\nMethods: The analysis presented in this paper focuses on the experience of First Nation peoples� access to cancer\ncare in the province of Manitoba. We analyzed policy documents and government websites; interviewed individuals\nwho have experienced relocation (N = 5), family members (N = 8), healthcare providers and administrators (N = 15).\nResults: Although the healthcare providers (social workers, physicians, nurses, patient navigators, and\nadministrators) we interviewed wanted to assist patients and their families, the focus of care remained informed\nby patients� clinical reality, without recognition of the context which impacts and constrains access to cancer care\nservices. Contrasting and converging narratives identify barriers to early diagnosis, poor coordination of care across\njurisdictions and logistic complexities that result in fatigue and undermine adherence. Providers and decisionmakers\nwho were aware of this broader context were not empowered to address system�s limitations.\nConclusions: We argue that a whole system�s approach is required in order to address these limitations....
Background: This study aimed to identify the resilience and burnout status of nurses working in the field of\noncology.\nMethods: This descriptive study was conducted with 140 oncology nurses. The data were collected using a sociodemographic\nattributes form, Resilience Scale for Adults, and the Maslachââ?¬â?¢s Burnout Inventory. Percentage ratios,\nmean and median values, Kruskalââ?¬â??Wallis test, Mannââ?¬â??Whitney U test, correlation analysis, and multiple stepwise linear\nregression analysis were used to evaluate the data.\nResults: The Maslachââ?¬â?¢s Burnout Inventory total median score was 49.00. The emotional exhaustion median score was\n24.00, the depersonalization median score was 9.00, and the personal accomplishment median score was 16.00. The\nResilience Scale for Adults total median score was 134.00. The median resilience subscale scores, such as structural\nstyle, perception of future, family cohesion, self-perception, social competence, and social resources, were 16.00,\n16.00, 24.00, 25, 23, and 31, respectively. A relationship existed between emotional exhaustion and perception of\nfuture; depersonalization and structured style and self-perception; and personal accomplishment and structured style,\nperception of future, and self-perception. Multiple stepwise linear regression analysis revealed a significant relationship\nbetween the number of years in the field and emotional exhaustion and depersonalization scores. Moreover, a\nsignificant relationship between structured style variables and personal accomplishment scores was observed.\nConclusions: This study demonstrated the relationship between burnout and resilience situations among the\noncology nurses. The results can be used to plan individual and organizational interventions to increase resilience\nand reduce the experience of burnout by developing measures such as improving communication skills, providing\neducation on stress management and coping strategies, using social resources, and organizing programs that provide\npsychological support....
Background: It is generally recognized that existential concerns must be addressed to promote the dignity of\npatients with advanced cancer. A number of interventions have been developed in this regard, such as dignity\ntherapy and other life review interventions (LRI). However, so far, none have focused on a positive approach or\nevaluated its effects on dignity and personal growth. This study aims to explore the feasibility of Revie �, a life\nreview intervention comprising a positive, patient-centered approach, and to determine potential changes of\npatients� sense of dignity, posttraumatic growth, and satisfaction with life.\nMethods: A mixed method study will be performed, which includes specialized nurses and 40 patients with advanced\ncancer in an ambulatory and in-patient setting of a Swiss university hospital. Quantitative methods involve a single\ngroup, pre- and post-intervention, and outcome measurements include the Patient Dignity Inventory, the\nPosttraumatic Growth Inventory, and the Satisfaction with Life Scale. Feasibility data relating to process, resource, and\nscientific elements of the trial will also be collected. A semi-directed interview will be used to collect qualitative data\nabout the process and the participants� experiences of the intervention. In this way, enhanced quantitative-qualitative\nevidence can be drawn from outcome measures as well as individual, contextualized personal views, to help inform\nresearchers about the plausibility of this complex intervention before testing its effectiveness in a subsequent full trial.\nDiscussion: Patient dignity is a goal of quality end-of-life care. To our knowledge, this is the first trial to evaluate the\nrole of a life review intervention that is focused on personal growth and on changes relating to the experience of\nhaving cancer.\nThis study will evaluate the feasibility of a novel intervention, Revie �, which we hope will contribute to promote the\ndignity, personal growth, and overall life satisfaction of patients with advanced cancer...
Background: Distress in patients with cancer influences their quality of life. Worldwide, screening on distress with\nthe Distress Thermometer (DT) in patients with cancer is recommended. However, the effects of the use of the DT\non the psychosocial wellbeing of the patient are unknown. A study to assess the psychosocial consequences of the\nsystematic use of the DT and its discussion by a nurse as compared to the usual care provided to outpatients who\nare treated for primary breast cancer is needed.\nMethods/design: The effectiveness of a nurse-led intervention with the DT will be tested in a non-blinded\nrandomized controlled trial. Patients treated with curative intent for breast cancer will be recruited from the\nRadboud University Medical Center. The intervention consists of the DT together with discussion of the results\nwith the patient by a trained oncology nurse added to the usual care. Patients will be randomly allocated (1:1)\nto either receive usual care or the usual care plus the intervention. Primary outcome measure is global quality\nof life measured with the EORTC QLQ-C30. The functional and symptom scales of the EORTC QLQ-C30 and BR23,\nHospital Anxiety and Depression Scale, Impact of Event Scale, Illness Cognition Questionnaire and DT (baseline\nand final measurement only) will be used to measure secondary outcomes. Questionnaires are obtained in both\narms at baseline, after completion of each type of cancer treatment modality and during follow up, with a three\nand six months� interval during the first and second year respectively.\nDiscussion: This study will be the first randomized controlled longitudinal study about the effectiveness of the\nDT as nurse led-intervention. In case of proven effectiveness, future implementation and standardization of use\nof the DT as part of routine care will be recommended...
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