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2016| January-March | Volume 3 | Issue 1
Online since
March 7, 2016
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ORIGINAL ARTICLES
Introduction of Situation, Background, Assessment, Recommendation into Nursing Practice: A Prospective Study
Meera S Achrekar, Vedang Murthy, Sadhana Kanan, Rani Shetty, Mini Nair, Navin Khattry
January-March 2016, 3(1):45-50
DOI
:10.4103/2347-5625.178171
Objective:
The aim of the study was to introduce and evaluate the compliance to documentation of situation, background, assessment, recommendation (SBAR) form.
Methods:
Twenty nurses involved in active bedside care were selected by simple random sampling. Use of SBAR was illustrated thru self-instructional module (SIM). Content validity and reliability were established. The situation, background, assessment, recommendation (SBAR) form was disseminated for use in a clinical setting during shift handover. A retrospective audit was undertaken at 1
st
week (A1) and 16
th
week (A2), post introduction of SIM. Nurse's opinion about the SBAR form was also captured.
Results
: Majority of nurses were females (65%) in the age group 21-30 years (80%). There was a significant association (
P
= 0.019) between overall audit scores and graduate nurses. Significant improvement (
P
= 0.043) seen in overall scores between A1 (mean: 23.20) and A2 (mean: 24.26) and also in "Situation" domain (
P
= 0.045) as compared to other domains. There was only a marginal improvement in documentation related to patient's allergies and relevant past history (7%) while identifying comorbidities decreased by 40%. Only 70% of nurses had documented plan of care. Most (76%) of nurses expressed that SBAR form was useful, but 24% nurses felt SBAR documentation was time-consuming. The assessment was easy (53%) to document while recommendation was the difficult (53%) part.
Conclusions:
SBAR technique has helped nurses to have a focused and easy communication during transition of care during handover. Importance and relevance of capturing information need to be reinforced. An audit to look for reduced number of incidents related to communication failures is essential for long-term evaluation of patient outcomes. Use of standardized SBAR in nursing practice for bedside shift handover will improve communication between nurses and thus ensure patient safety.
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New Insights into Potential Prevention and Management Options for Chemotherapy-Induced Peripheral Neuropathy
Janet Schloss, Maree Colosimo, Luis Vitetta
January-March 2016, 3(1):73-85
DOI
:10.4103/2347-5625.170977
Objective:
Neurological complications such as chemotherapy-induced peripheral neuropathy (CIPN) and neuropathic pain are frequent side effects of neurotoxic chemotherapy agents. An increasing survival rate and frequent administration of adjuvant chemotherapy treatments involving neurotoxic agents makes it imperative that accurate diagnosis, prevention, and treatment of these neurological complications be implemented.
Methods:
A consideration was undertaken of the current options regarding protective and treatment interventions for patients undergoing chemotherapy with neurotoxic chemotherapy agent or experience with CIPN. Current knowledge on the mechanism of action has also been identified. The following databases PubMed, the Cochrane Library, Science Direct, Scopus, EMBASE, MEDLINE, CINAHL, CNKI, and Google Scholar were searched for relevant article retrieval.
Results:
A range of pharmaceutical, nutraceutical, and herbal medicine treatments were identified that either showed efficacy or had some evidence of efficacy. Duloxetine was the most effective pharmaceutical agent for the treatment of CIPN. Vitamin E demonstrated potential for the prevention of cisplatin-IPN. Intravenous glutathione for oxaliplatin, Vitamin B6 for both oxaliplatin and cisplatin, and omega 3 fatty acids for paclitaxel have shown protection for CIPN. Acetyl-L-carnitine may provide some relief as a treatment option. Acupuncture may be of benefit for some patients and Gosha-jinki-gan may be of benefit for protection from adverse effects of oxaliplatin induced peripheral neuropathy.
Conclusions:
Clinicians and researchers acknowledge that there are numerous challenges involved in understanding, preventing, and treating peripheral neuropathy caused by chemotherapeutic agents. New insights into mechanisms of action from chemotherapy agents may facilitate the development of novel preventative and treatment options, thereby enabling medical staff to better support patients by reducing this debilitating side effect.
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EDITORIALS
Patient Care and Outcomes: Why Cancer Care Should Screen for Distress, the 6th Vital Sign
Barry D Bultz
January-March 2016, 3(1):21-24
DOI
:10.4103/2347-5625.178163
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MINI REVIEWS
Cancer Prehabilitation for Patients Starting from Active Treatment to Surveillance
Shiow-Ching Shun
January-March 2016, 3(1):37-40
DOI
:10.4103/2347-5625.178169
The purpose of this brief summary is to introduce the concept of cancer prehabilitation and the role of oncology nurses in prehabilitation care. Cancer prehabilitation has been defined by Sliver and Baima (2013) as "a process on the cancer continuum of care that occurs between the time of cancer diagnosis and the beginning of acute treatment." The evidence supports the notion that prehabilitation programs can improve physical and psychological health outcomes and decrease overall health care costs. The care model for cancer prehabilitation should include timely and efficient assessment throughout the care continuum with a focus on improving outcomes in cancer at every stage. During the cancer journey, three types of assessment with different aims are included: (1) prehabilitation assessment pretreatment, (2) rehabilitation assessment at early post treatment, and (3) health promotion assessment at the end of treatment. Specific prehabilitation assessment and interventions for treatment-related complications or major side-effects should be considered. Teaching, counseling, discharge planning, and coordination should also be part of an oncology nurse's role in cancer prehabilitation. It is suggested that cancer care managers or navigators be trained in the assessment of their patients' physical and psychological status once the cancer diagnosis has been identified and the patient has decided to receive active treatment, especially for those waiting for surgery at home. Oncology nurses could increase their competence with prehabilitation care by gaining knowledge about cancer-related treatments and their outcomes for specific cancers and by strengthening the ability to assess the functional status and psychological distress of their patients.
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REVIEW ARTICLES
Meeting An Unmet Need in Metastatic Colorectal Carcinoma with Regorafenib
Barbara Melosky
January-March 2016, 3(1):58-65
DOI
:10.4103/2347-5625.178174
Colorectal cancer is a global issue, affecting men and women equally. Over the last 25 years, advances in therapy and multidisciplinary care have led to improvements in survival for those with colorectal cancer. Despite these advances, more therapeutic options are needed for those being treated for this disease.Regorafenib is an oral drug that is a new therapeutic option for our patients. The CORRECT and CONCUR trials demonstrate the efficacy of regorafenib in the last line setting. This article summarizes some of the regorafenib clinical trial data and discusses the strategies to help manage the side effects of this drug including patient education, dose reductions and interruptions, and monitoring hypertension and liver function.
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ORIGINAL ARTICLES
Barriers to Colorectal Cancer Screening in Primary Care Settings: Attitudes and Knowledge of Nurses and Physicians
Joshua Kanaabi Muliira, Melba Sheila D'Souza, Samira Maroof Ahmed, Salim Nasser Al-Dhahli, Fahad Rashid Matar Al-Jahwari
January-March 2016, 3(1):98-107
DOI
:10.4103/2347-5625.177391
Objective:
Healthcare providers (HCPs) play a critical role in reducing colorectal cancer (CRC) related morbidity and mortality. This study aimed at exploring the attitudes and knowledge of nurses and physicians working in primary care settings regarding CRC screening.
Methods:
A total of 142 HCPs (57.7% nurses and 42.3% physicians) participated in a cross-sectional survey. Data were collected using a Self-administered Questionnaire. The participants were clinically experienced (mean = 9.39 years; standard deviation [SD] = 6.13), regularly taking care of adults eligible for CRC screening (62%) and had positive attitudes toward CRC screening (83.1%). Most participants (57%) had low levels of knowledge about CRC screening (mean = 3.23; SD = 1.50). The participants were most knowledgeable about the recommended age for initiating screening (62.7%) and the procedures not recommended for screening (90.8%).
Results:
More than 55% did not know the frequency of performing specific screening procedures, the upper age limit at which screening is not recommended, and the patients at high-risk for CRC. There were no significant differences between nurses' and physicians' attitudes and knowledge. The participants' perceptions about professional training (odds ratio [OR] = 2.17,
P
= 0.003), colonoscopy (OR = 2.60,
P
= 0.014), and double-contrast barium enema (OR = 0.53,
P
= 0.041), were significantly associated with knowledge about CRC screening.
Conclusions:
The inadequate knowledge levels among nurses and physicians may be one of the barriers affecting CRC screening. Enhancing HCPs knowledge about CRC screening should be considered a primary intervention in the efforts to promote CRC screening and prevention.
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REVIEW ARTICLES
Achieving Excellence in Palliative Care: Perspectives of Health Care Professionals
Margaret I Fitch, Tracey DasGupta, Bill Ford
January-March 2016, 3(1):66-72
DOI
:10.4103/2347-5625.164999
Caring for individuals at the end of life in the hospital environment is a challenging proposition. Understanding the challenges to provide quality end of life care is an important first step in order to develop appropriate approaches to support and educate staff members and facilitate their capacity remaining "caring." Four studies were undertaken at our facility to increase our understanding about the challenges health professionals experience in caring for patients at end of life and how staff members could be supported in providing care to patients and families: (1) In-depth interviews were used with cancer nurses (
n
= 30) to explore the challenges talking about death and dying with patients and families; (2) Surveys were used with nurses (
n
= 27) and radiation therapists (
n
= 30) to measure quality of work life; (3) and interprofessional focus groups were used to explore what it means "to care" (five groups held); and (4) interprofessional focus groups were held to understand what "support strategies for staff" ought to look like (six groups held). In all cases, staff members confirmed that interactions concerning death and dying are challenging. Lack of preparation (knowledge and skill in palliative care) and lack of support from managers and colleagues are significant barriers. Key strategies staff members thought would be helpful included: (1) Ensuring all team members were communicating and following the same plan of care, (2) providing skill-based education on palliative care, and (3) facilitating "debriefing" opportunities (either one-on-one or in a group). For staff to be able to continue caring for patients at the end of life with compassion and sensitivity, they need to be adequately prepared and supported appropriately.
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SHORT REPORTS
Brief Introduction of Medical Insurance System in China
Yong-Yi Chen, Xiang-Hua Xu, Gao-Ming Liu, Gui-Ping Xiang
January-March 2016, 3(1):51-53
DOI
:10.4103/2347-5625.178172
China has one of the largest numbers of cancer patients. The huge expenses of medical care for cancer patients has brought heavy economic burden to the family. This paper briefly introduces the tumor medical insurance situation in China from the construction and composition of China's medical security system, the access of cancer patients to get health insurance, the challenges and developmental trend of China's medical security system, and two case studies that highlight different financial situations.
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EDITORIALS
Vision of Professional Development of Oncology Nursing in the World
Stella Aguinaga Bialous
January-March 2016, 3(1):25-27
DOI
:10.4103/2347-5625.178164
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SHORT REPORTS
Health Insurance for Cancer Care in Asia: Thailand
Pongpak Pittayapan
January-March 2016, 3(1):54-57
DOI
:10.4103/2347-5625.178173
Thailand has a universal multi-payer system with two main types of health insurance: National Health Security Office or public health insurance and private insurance. National health insurance is designed for people who are not eligible to be members of any employment-based health insurance program. Although private health insurance is also available, all Thai citizens are required to be enrolled in either national health insurance or employees' health insurance. There are many differences between the public health insurance and private insurance. Public health insurance, therefore, initiates programs that offer many sets of benefit packages for high-cost care. For cancer care, cover screening, curative treatment such as surgery, chemotherapy, radiation together with supportive and palliative care.
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MINI REVIEWS
Creating a Culture of Professional Development for Oncology Nursing in Asia
Myungsun Yi
January-March 2016, 3(1):30-32
DOI
:10.4103/2347-5625.177392
The importance of professional development of oncology nursing in Asia is growing along with growth in the cancer burden and disparity in cancer incidence and mortality between more- and less-developed regions, the latter of which includes most Asian countries. This paper proposes ways to advance the oncology nursing in terms of education, practice, and research in Asia. It also describes major challenges expected in developing and implementing a unique professional role for oncology nurses in Asia. This study will provide insights for Asian oncology nurses in developing culturally sensitive oncology nursing practices with limited health care resources.
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ORIGINAL ARTICLES
Awareness of Skin Cancer, Prevention, and Early Detection among Turkish University Students
Ziyafet Ugurlu, Sevcan Avcı Işık, Berrak Balanuye, Elif Budak, Nalân Özhan Elbaş, Sultan Kav
January-March 2016, 3(1):93-97
DOI
:10.4103/2347-5625.170969
Objective:
The aim of this study was to determine the awareness about skin cancer, prevention, and early detection among university students.
Methods:
This descriptive cross-sectional study was carried out with 404 students in a university located in Ankara, the capital city of Turkey. A 35-item questionnaire was used for data collection.
Results:
Less than half of the students (37.9%) had knowledge about skin cancer mostly through the internet (24.5%) and media (24.1%). Half of them aware of the risk factors; mostly as avoiding direct exposure to the Sun between 10 am and 4 pm (45.3%); smoking and alcohol (38.4%); having fair skin color (34.9%); and ultraviolet light exposure (25.7%). Only one-third of them (32.9%) are knowledgeable about skin cancer signs and symptoms, such as a change in color and appearance of the nevus/moles (24%). The majority of the responders (77.3%) did not know about screening tests for skin cancer and only 18 (4.5%) students were practicing skin self-examination.
Conclusions:
This study showed a lack of knowledge about skin cancer, prevention, and early detection among university students and reported the need for educational interventions to raise awareness in this target group.
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EDITORIALS
Building Capacity for Cancer Nursing Research and Evidence-Based Practice: the Cancer Nursing Professorial Precinct Initiative
Raymond Chan, Alanna Geary, Patsy Yates, Gillian Nasato
January-March 2016, 3(1):28-29
DOI
:10.4103/2347-5625.178166
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ORIGINAL ARTICLES
The Oncology Nurse Prescribing: A Catalonian Survey
Paz Fernández-Ortega, Sandra Cabrera-Jaime, Joan María Estrada-Masllorens
January-March 2016, 3(1):108-114
DOI
:10.4103/2347-5625.177395
Objective:
This study identifies the capability, knowledge, and satisfaction of oncology nurses in Spain after approval of the nurse prescribing law in 2006.
Methods:
A descriptive cross-sectional study was conducted among 140 nurses in three cancer centers in Catalonia, Spain, by using convenience sampling method. The principal variables of this study were nurse satisfaction, knowledge about what products nurses are allowed to prescribe, the nurses' perception of their own prescribing ability, and their opinion on education and training needs with regard to the new approved law. The secondary variables included years of professional experience, place of work, and sociodemographic variables. Data were collected during a 3 months period by using a piloted 29-item self-assessment questionnaire.
Results:
Analyses of univariate and bivariate data showed that 82.2% of the nurses were aware of the approved law, but 94.2% indicated that they lack information about it. The mean satisfaction with the approval of the law was 6.64 ± 1.76 (numerical scale 0-10). In addition, 68.1% and 55.1% of the nurses were prepared to prescribe medical devices and drugs, respectively. To date, 61.1% of the nurses prescribe medical devices and 66% prescribe pharmacological products daily.
Conclusions:
Nurses expressed general satisfaction with the approval of the Law 29/2006. Nurses currently provide prescriptions, but widespread knowledge of the allowed prescriptions is lacking.
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Complementary Therapy for Cancer Survivors: Integrative Nursing Care
Kazuko Onishi
January-March 2016, 3(1):41-44
DOI
:10.4103/2347-5625.178170
Objective:
The number of cancer patients who survive more than 5 years after the completion of their initial treatment is increasing. Oncology nurses must consider the needs of long-term cancer survivors in addition to those of cancer patients undergoing treatment because cancer survivors experience anxiety over several issues, including the risk of recurrence and progression of cancer status and symptom management.
Methods:
We tried to examine the effect of complementary therapy (CT) to reduce anxiety. The experimental study compared an intervention group (5 males and 68 females) that underwent four CTs and a control group (5 males and 56 females) that received no intervention. The intervention group practiced the CTs in their home for 20 min/day, 2 days/week, for 8 weeks, for a total of 16 times, whereas the control group performed their usual routines. Stress response scale-18 (SRS-18) scores consisting of three subscales (depression-anxiety, temper-anger, and lethargy) were compared between the groups and across time within each group.
Results:
The intervention group reduced depression and anxiety significantly than the control group. Furthermore, the intervention group expressed the following positive feedback: "being able to relax," "being distracted from their worries and anxieties," "being able to sleep," "feeling more in-touch with reality," and "wanting to continue the practice."
Conclusions:
The study might accurately reflect the perspectives of women with cancer because the majority of the patients were women. Meanwhile, the result suggests that CTs might be useful for long-term cancer survivors who experience anxiety that influence their quality of life.
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AONS NEWS
Nurses of Asia: Reflection from Asian Oncology Nursing Society Conference 2015
Jimvert I Camarillo
January-March 2016, 3(1):13-16
DOI
:10.4103/2347-5625.175179
Another significant milestone from the Executive Board and the Organizing Committee of the Asian Oncology Nursing Society (AONS) transpired last November 20-21, 2015. The 2
nd
AONS Conference was held in Seoul, South Korea under the theme of "Flying the Spirits of Asian Oncology Nursing." A total of 687 delegates from USA, Canada, Australia, Romania, and Asian Region supported this groundbreaking event. The objective of this 2-day conference was to facilitate sharing of expertise in the field of oncology nursing from the academe to clinical practice and to research. The issues that have been discussed in this 2-day symposium were Professional Development of Oncology Nursing, Quality of Life, Putting Evidence into Practice, Nursing Research, and Health Insurance for Cancer Care in Asia.
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Cover Story
Judith (Judi) Johnson
January-March 2016, 3(1):0-0
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EDITORIALS
Building Capacity For Evidenced-Based Practice at the Unit Level Using Oncology Nursing Society Putting Evidence Practice
Margaret Barton-Burke
January-March 2016, 3(1):17-20
DOI
:10.4103/2347-5625.178162
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GUEST EDITORIAL
Special Issue on Asian Oncology Nursing Society Conference 2015
Judith (Judi) Johnson
January-March 2016, 3(1):10-12
DOI
:10.4103/2347-5625.178161
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MINI REVIEWS
Development and Implementation of Evidence-Based Practice in Cancer Care: Challenges and Opportunities
Winnie K.W. So
January-March 2016, 3(1):33-36
DOI
:10.4103/2347-5625.178168
The cancer burden is a global problem, and oncology nurses should be accountable for delivering safe and effective cancer care and providing the best possible experience for patients. The development and application of evidence-based practice in cancer care is an effective strategy in achieving this goal; however, the journey in which such practice involves may encounter various challenges. In this article, the author discusses her own experience, successful and unsuccessful of such a journey. Both challenges and opportunities are identified, and suggestions put forward for making collaborative efforts.
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NEWS
Meet the APJON Editorial Board
January-March 2016, 3(1):1-9
DOI
:10.4103/2347-5625.178167
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ORIGINAL ARTICLES
Name Recognition to Identify Patients of South Asian Ethnicity within the Cancer Registry
Savitri Singh-Carlson, Frances Wong, Gurpreet Oshan, Harajit Lail
January-March 2016, 3(1):86-92
DOI
:10.4103/2347-5625.170224
Objective:
The goal of this project was to develop a list of forenames and surnames of South Asian (SA) women that could be used to identify SA breast cancer patients within the cancer registry. This list was compiled, evaluated, and validated to ensure comprehensiveness, accuracy, and applicability of SA names.
Methods:
This project was conducted by Canadian researchers who are immersed in conducting behavioral studies with SA women diagnosed with cancer in the province of British Columbia. Recruiting SA cancer patients for research can be a difficult task due to social and cultural factors. Methods used by other researchers to identify ethnicity related unique names were employed to filter surnames and forenames that were not common to this ethnic group. Co-author (Gurpreet Oshan) of SA ethnicity rigorously identified and deleted multiple lists and redundant entries along with common English forenames which resulted in a list of 16,888 SA forenames. All co-authors of Indian ethnicity (Gurpreet Oshan, Savitri Singh-Carlson, Harajit Lail) were involved in critiquing and manually reviewing the names list throughout this process. Comprehensive lists of SA surnames and women's forenames were reviewed to identify those that were unique to SA ethnicity. Accuracy was ensured by constantly filtering the redundancy by using an Excel program which helped to illustrate the number of times each name was spelled in different ways.
Results:
The final lists included 9112 surnames and 16,888 forenames of SA ethnicity. On the basis of the surname linkage only, the sensitivity of the list was 76.6%, specificity was 62.9%, and the positive predictive value was 58.5%. On the basis of both the surname and forename linkage, the specificity of the list was 88.6%. These lists include variations in spelling forenames and surnames as well.
Conclusions:
The list of surnames and forenames can be useful tools to identify SA ethnic groups from large population database in healthcare-related research. Ethnicity-specific population research is important in order to help identify how cancer care should be delivered for the SA population, as well as for planning and provision of other related health services. We are willing to share this list upon request to the authors.
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