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2016| July-September | Volume 3 | Issue 3
Online since
September 6, 2016
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REVIEW ARTICLES
Exploring oncology nurses' grief: A self-study
Lisa C Barbour
July-September 2016, 3(3):233-240
DOI
:10.4103/2347-5625.189817
Oncology nursing, like many other nursing fields, often provides nurses with the opportunity to get to know their patients and their families well. This familiarity allows oncology nurses to show a level of compassion and empathy that is often helpful to the patient and their family during their struggle with cancer. However, this familiarity can also lead to a profound sense of grief if the patient loses that struggle. This self-study provided me the opportunity to systematically explore my own experience with grief as an oncology nurse, helping me to identify specific stressors and also sources of stress release.
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Effectiveness of physical, psychological, social, and spiritual intervention in breast cancer survivors: An integrative review
Di Wei, Xiang-Yu Liu, Yong-Yi Chen, Xin Zhou, Hui-Ping Hu
July-September 2016, 3(3):226-232
DOI
:10.4103/2347-5625.189813
Factors affecting the health outcomes of cancer patients have gained extensive research attention considering the increasing number and prolonged longevity of cancer survivors. Breast cancer survivors experience physical, psychological, social, and spiritual challenges. This systematic literature review aims to present and discuss an overview of main issues concerning breast cancer survivors after treatment. Treatment-related symptoms as well as psychosocial and spiritual aspects of breast cancer survivors are evaluated. Moreover, the benefits of intervention for emotional, physical, social, and spiritual needs of the patient during the survivorship are investigated. This review also proposes avenues for future studies in this field and develops a new, integrated, and complete interpretation of findings on the holistic well-being of women with breast cancer. Thus, this study provides clinicians with a more comprehensive source of information compared with individual studies on symptom experiences.
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Nurses' knowledge and attitudes toward complementary therapies for cancer: A review of the literature
Juliana Christina, Wendy Abigail, Lesley A Cuthbertson
July-September 2016, 3(3):241-251
DOI
:10.4103/2347-5625.189816
Complementary therapies (CTs) are nonconventional supportive therapies, which are used by the patients with cancer. The use of CTs has been known to alleviate symptoms as a result of chemotherapy and to improve quality of life. However, if CTs are inappropriately used, there may be adverse reactions or no effect resulting in poor support of the cancer treatment. Nurses play an important role in supporting patients with cancer who often seek information regarding CTs. Within their scope of practice, it is expected that nurses have sufficient knowledge about the safety and effective use of CTs, and positive attitudes toward supporting patients who wish to use CTs. This review aims to examine existing literature regarding nurses' knowledge and attitudes toward CTs for patients with cancer. English language articles obtained from recognized nursing and midwifery databases such as CINAHL, Google Scholar, Medline, ProQuest Central, and Scopus for the period between 2002 and 2015 were searched. A total of 96 articles were retrieved using the search terms with only 13 eligible articles meeting the inclusion criteria. Three major themes were identified by the thematic analysis of reviewed studies: nurses' knowledge about CTs, nurses' attitudes toward CTs, and sources information about CTs. The majority of studies investigating nurses' knowledge and attitudes toward the use of CTs for oncology was conducted in developed countries. Overall, it was identified that nurses need to improve their knowledge and skills about CTs so that they were more confident to assist patients in integrating conventional treatment and CTs for cancer management.
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ORIGINAL ARTICLES
Evaluating sexual nursing care intervention for reducing sexual dysfunction in Indonesian cervical cancer survivors
Yati Afiyanti, Imami Nur Rachmawati, Ariesta Milanti
July-September 2016, 3(3):266-271
DOI
:10.4103/2347-5625.189812
Objective:
This study aims to describe the factors affecting successful nursing care intervention on sexuality.
Methods:
A one-group pre- and post-test design was used. Fifty-three cervical cancer survivors and their spouses were administered with nursing care intervention on sexuality in three sessions and evaluated after 6 weeks.
Results:
Sexual intervention reduced dyspareunia symptoms, improved vaginal lubrication, improved sexual satisfaction, and enhanced sexual arousal, sexual desire, and orgasm among cancer survivors and their spouses. The other influencing factors also simultaneously contributed to the success of nursing care intervention.
Conclusions:
Nursing care intervention on sexuality could be a part of supportive nursing care and an important aspect in standard nursing care for cancer patients in Indonesia.
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The effect of complementary therapy for hospital nurses with high stress
Kazuko Onishi, Mayumi Tsujikawa, Kayo Inoue, Kazue Yoshida, Shina Goto
July-September 2016, 3(3):272-280
DOI
:10.4103/2347-5625.189810
Objective:
This study was to examine the effect of complementary therapy (CT) for nurses with high stress levels. It was taken before we employ this technique for cancer survivors because cancer patients are a heterogeneous group that requires substantial resources to investigate.
Methods:
A quasi-experimental design with five groups was employed for this study. The groups were examined whether there were effects for reducing the stress and the differences in effectiveness among four intervention groups and a nonintervention group. Stress relief was measured using pulse rate and blood pressure measurements and the short form of the profile of mood states (POMS-SF). The participants practiced the therapy for 20 min twice per week for 3 weeks. A two-way factorial analysis of variance was used to analyze the data.
Results:
The study enrolled 98 nurses (92 female and 6 male) with a mean age of 37.3 ± 10.5 years (range: 22–60 years). Fifty-nine nurses had 10 or more years of nursing experience. There were significant differences in pulse rate and the POMS-SF scores. All groups were effective for reducing the stress level of high-stress nurses, whereas four intervention CT groups were not more effective than nonintervention group.
Conclusions:
The complementary therapies were useful for nurses with high stress levels. Thus, they can be used as a self-management tool for such nurses. Afterward, we will use the CT for cancer survivors to determine whether it can improve the quality of life of cancer patients.
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Healthy eating index/alternative healthy eating index and breast cancer mortality and survival: A systematic review and meta-analysis
Makan Pourmasoumi, Razieh Karimbeiki, Nooshin Vosoughi, Awat Feizi, Reza Ghiasvand, Farzane Barak, Maryam Miraghajani
July-September 2016, 3(3):297-305
DOI
:10.4103/2347-5625.189819
Objective:
Breast cancer is the most common cancer in women worldwide. The effects of overall diet quality instead of single nutrients after breast cancer diagnosis on mortality have been a growing area of research interest. The aim of this systematic review was to investigate the relationship between the Healthy Eating Index (HEI)/the Alternative Healthy Eating Index (AHEI) and risk of breast cancer mortality or survival rates as a primary outcome, and some related inflammatory factors, as secondary outcomes among postdiagnosed women.
Methods:
This study methodology was performed based on the Preferred Reporting Item for Systematic Review and Meta-analysis statement recommendation and had been registered at PROSPERO (registration number: CRD42015015605). The systematic search was conducted in the electronic databases including PubMed, ISI, Scopus, Cochrane, and Google before July 2016. Researches that had not reported risk of breast cancer mortality or survival rates separately were excluded from the study. Similarly, this review excluded studies which only had examined the HEI or AHEI without reporting their association with the risk of mortality or survival rates.
Results:
After primary search, of 643 studies identified, 4 studies including eligible criteria were selected for the final assessment. All selected studies had been conducted in the USA and used self-report food-frequency questionnaire for diet quality assessment. In two studies HEI-2005, in one study AHEI, and in another study AHEI-2010 were applied. Meta-analysis result showed no significant association between these indexes and risk of breast cancer mortality/survival among women with this malignancy [relative risk: (RR) 1.04; 95% confidence interval (CI): 0.69–1.56;
P
= 0.87].
Conclusions:
Regarding the adherence HEI/AHEI, we found no association between mentioned indexes and risk of mortality or survival from breast cancer in women with breast cancer. However, evidence in this field is limited and inconsistence and further studies are needed.
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The experiences and perceptions of women diagnosed with breast cancer during pregnancy
Sophie Rees, Annie Young
July-September 2016, 3(3):252-258
DOI
:10.4103/2347-5625.189814
Objective:
Although much has been documented about the experience of breast cancer, the accounts of young women have been relatively neglected, despite that around 20% of the breast cancer diagnoses occur in women under the age of 50. In particular, the voices of young women diagnosed during pregnancy are missing from research. Breast cancer is the most common cancer associated with pregnancy, and it is diagnosed in about 1 in 3000 pregnancies.
Methods:
This study presents data from three women drawn from a larger study of women who had been diagnosed under the age of 45 and had completed their treatment for breast cancer. Semi-structured qualitative interviews were undertaken, with a methodology informed by social constructionist grounded theory and feminism.
Results:
The findings here report the ways that having breast cancer during pregnancy disrupted taken-for-granted assumptions about their pregnancies, new motherhood, and their future life course, and how this occurred within the context of gendered ideas about femininity and motherhood.
Conclusions:
Breast cancer during pregnancy has a far-reaching impact on young women's lives, and women affected may need practical support in caring for young children, and counselling may be appropriate. Further research is needed in this important area.
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PERSPECTIVE
Inclusion of palliative care in Indian undergraduate physiotherapy curriculum-course guidelines and content
Zubia Veqar
July-September 2016, 3(3):220-225
DOI
:10.4103/2347-5625.180193
According to the guidelines published by the WHO in 2010, palliative care has been defined as “an approach that improves the quality of life of patients and their families facing the problem associated with life-threatening illness, through the prevention and relief of suffering by means of early identification and impeccable assessment and treatment of pain and other problems, physical, psychosocial, and spiritual.” Intervention provided as a part of the palliative care has to be by health professionals who strictly work as a part of the multidisciplinary team and have been specifically trained to an optimal level of competency in the field. Two key problem areas in palliative care which a physiotherapist deals with are poor physical function and pain. This article deals with the following issues: (1) What is palliative care education and its importance? (2) Current scenario of palliative care in medical and allied fields internationally. (3) Current scenario of palliative care education in medical and allied fields in India. (4) Proposed curriculum guidelines for palliative care in physiotherapy.
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ORIGINAL ARTICLES
Challenges in cancer self-management of patients with limited English proficiency
Fang-Yu Chou, Lily Y Kuang, Jeannette Lee, Grace J Yoo, Lei-Chun Fung
July-September 2016, 3(3):259-265
DOI
:10.4103/2347-5625.189815
Objective:
This paper summarizes the barriers and challenges in cancer care reported from a validation project of a self-management intervention handbook from Chinese-American cancer patients with limited English proficiency (LEP).
Methods
: Seven health-care providers (HCPs) and 16 Chinese-American cancer survivors with LEP were invited to validate a self-management intervention handbook through networking sampling method. Bilingual versions were developed and validated using the repeated translation process. Online and paper-based survey and interview were conducted to collect information on the perception of barriers and experiences on cancer care. Data were analyzed by the content analysis method.
Results
: The HCPs reported a bilingual self-management handbook which is useful and feasible for patient self-management. The challenges in giving cancer care to LEP patients included: patients do not engage in discussion, different cultural health beliefs, unable to speak to patients in their primary language, and patients are less likely to discuss emotional and social challenges during treatments. The common barriers and experiences during cancer care included: limited understanding about treatment/medication and side effects, language barriers such as unable to communicate to make the decision, unable to understand information related to resources and do not know what questions to ask, and do not know what to expect during their cancer treatment.
Conclusions
: The current findings highlight the need of cancer self-management support for culturally diverse LEP cancer patients. Further research can include applying the supportive intervention to all LEP cancer patients.
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EDITORIALS
How do nurses “Think Family” and support parents diagnosed with cancer who have dependent children?
Anne Arber
July-September 2016, 3(3):214-217
DOI
:10.4103/2347-5625.189809
Many barriers exist regarding access to support and information for parents with cancer who are parenting dependent children and young people. There is little known about how nurses in acute settings support parents with dependent children. Many complexity factors exist which can increase the risk of behavioral problems in children when a parent has a cancer diagnosis. A recent study presented in this editorial identifies how there is a lack of confidence and skill experienced by specialist nurses in acute oncology settings regarding the needs and well-being of children where there is a cancer diagnosis in the family. Recommendations are identified for developing practice in this area and on increasing awareness of the needs of children and young people.
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ORIGINAL ARTICLES
Problems of breast cancer survivors living in an urban area of Nepal
Abja Sapkota, Sudip Shrestha, Arun Sedhain, Sushila Koirala, Phadindra Kafle
July-September 2016, 3(3):289-296
DOI
:10.4103/2347-5625.189818
Objective:
The main objective of this study was to identify the problems of Nepalese breast cancer survivors living in an urban area who had completed their treatment for at least 6 months.
Methods:
A cross-sectional descriptive study was conducted to assess the problems of breast cancer survivors who were registered at the Nepal Cancer Support Group. Fifty-one women who were diagnosed with breast cancer (Stage 0 to III) and were currently disease-free were enrolled in the study. They were interviewed using structured interview schedule using the Breast Cancer Prevention Trial Symptom Scale. Statistical analysis was carried out with SPSS (version 16).
Results:
The mean age of the women at the time of enrollment was 47.3 years. The most common modality of treatment they received was the combination of surgery, chemotherapy, and radiotherapy (84%). Top five symptoms experienced by the survivors on the basis of frequency and severity were tiredness (61%), lack of energy (57%), forgetfulness (57%), lack of interest in sex (52%), general body aches (49%), and feeling of worrisome and anxiousness about future (49%). Women with age <45 years at diagnosis had higher mean rank score in psychological (24.7) and social problems (23.9) in comparison to women aged ≥45 years. There was a significant relationship between severe psychological (34.9 vs. 19.6;
P
= 0.001) and social problems (29.1 vs. 21.2;
P
= 0.03), with the time since primary treatment completion of <1 year.
Conclusions:
Nepalese breast cancer survivors were found to have multiple physical, psychological, and social problems and might require special attention during follow-up visits.
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Jordanian physicians' attitudes toward disclosure of cancer information and patient participation in treatment decision-making
Rana Obeidat, Huthaifah I Khrais
July-September 2016, 3(3):281-288
DOI
:10.4103/2347-5625.189811
Objective:
This study aims to determine the attitude of Jordanian physicians toward disclosure of cancer information, comfort and use of different decision-making approaches, and treatment decision making.
Methods:
A descriptive, comparative research design was used. A convenience sample of 86 Jordanian medical and radiation oncologists and surgeons practicing mainly in oncology was recruited. A modified version of a structured questionnaire was used for data collection. The questionnaire is a valid measure of physicians' views of shared decision making.
Results:
Almost 91% of all physicians indicated that the doctor should tell the patient and let him/her decide if the family should know of an early-stage cancer diagnosis. Physicians provide abundant information about the extent of the disease, the side effects and benefits of the treatment, and details of the treatment procedures. They also provided less information on the effects of treatment on the sexuality, mood, and family of the patient. Almost 48% of the participating physicians reported using shared decision making as their usual approach for treatment decision making, and 67% reported that they were comfortable with this approach. The main setting of clinical activity was the only factor associated with physicians' usual approach to medical decision making. Moreover, age, years of experience, and main setting of clinical activity were associated with physicians' comfort level with the shared approach.
Conclusions
: Although Jordanian physicians appreciate patient autonomy, self-determination, and right to information, paternalistic decision making and underuse of the shared decision-making approach persist. Strategies that target both healthcare providers and patients must be employed to promote shared decision making in the Jordanian healthcare system.
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EDITORIALS
Cancer cachexia and its impact on patient dignity: What nurses need to know
Susan McClement
July-September 2016, 3(3):218-219
DOI
:10.4103/2347-5625.189808
Noted physician, Sr. William Osler, is credited with saying, “Care more particularly for the individual patient than for the special features of the disease”. Osler understood that each patient for whom we care is first and foremost a person, who also happens to be living with a particular illness. In addition to understanding the nature of the patient's illness, therefore, it is also critically important that we come to understand the patient's unique story and set of circumstances. Doing so allows us to engage with patients in a way that affirms their sense of dignity and personhood. Drawing on the exemplar of cancer cachexia, this editorial reminds clinicians of the importance of Osler's sage advice to attend to patient dignity and personhood, and provides nurses with direction about how they can do that in practice.
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AONS NEWS
AONS News
July-September 2016, 3(3):306-308
DOI
:10.4103/2347-5625.189820
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EDITORIALS
Happy birthday: We are two years old
Judith (Judi) Johnson
July-September 2016, 3(3):211-213
DOI
:10.4103/2347-5625.189807
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