Effect of Telerehabilitation Versus In-Clinic Rehabilitation Delivery on Self-Efficacy in Breast Cancer-Related Lymphedema

Background: Individuals with breast cancer-related lymphedema (BCRL) require self-management strategies to reduce risk of infection, exacerbation, and/or progression of lymphedema. The coronavirus pandemic thrust the medical field into the world of telehealth;both patients and providers were forced to reduce in-person treatments and engage in this new platform of rehabilitation delivery. The role of telehealth in promotion of self-management for BCRL is unknown. Purpose(s): This study examines self-efficacy during cancer rehabilitation for in-clinic versus telehealth visits among individuals with BCRL during the pandemic quarantine April to November 2020. Method(s): Forty women who recently completed oncology rehabilitation for BCRL were asked to complete demographics and 2 Likert surveys, including the Exercise Self-Efficacy Scale (ESES) and the Self-Care Self-Efficacy Scale (SCSE), to compare the efficacy of telehealth versus in-person treatment modalities. Result(s): Thirty-two participants completed the survey and indicated that the percentage of telehealth visits was less than face-to-face visits. Despite this, the participants indicated numerous positive moderately strong correlations between self-care self-efficacy and exercise self-efficacy for both types of visits (P <.05). Limitation(s): Self-report surveys by a convenience sample, multifactorial characteristics of rehabilitation treatment across modes, and varying severity of lymphedema may limit study findings. Conclusion(s): Telehealth provided safe and effective care to participants and bolstered confidence in self-care and self-management of BCRL. Data support that telehealth visits can be considered an essential part of comprehensive cancer rehabilitation care. Future research is needed to establish and optimize practice guidelines in both health delivery systems.Copyright © 2023 Lippincott Williams and Wilkins. All rights reserved.

Principles of management for patients with oral cancer during the COVID-19 pandemic

The outbreak of coronavirus disease 2019 (COVID-19) affects the world. It is highly contagious and spreads quickly. COVID-19 severely increases the medical burden and interferes with our normal work. This article introduces our experience on treat oral cancer patients during the epidemic. The negative impact can be minimized through reasonable and orderly arrangement.Copyright © 2021 The Authors

The current developments in oncology nursing: A review

Cancer has become one of the major causes of death in the growing world population, affecting people irrespective of their age, sex and culture. Cancer diagnosis and therapy is a distressing procedure and affects the physical, emotional and mental well-being of the patient. Many studies have reported that cancer has a long-term impact on patient's lives leading to mood dysfunction, heart problems and chemotherapy toxicity. Modern-day healthcare systems are moving towards a patient-oriented approach and are designed around the patient's well-being, needs and preferences. Oncology nurses form the fundamental part of this system and provide the patient with the much-needed care, support and hope for life. Oncology nursing has developed and evolved briefly in the recent few decades due to the advancement in treatment procedures. As cancer care continues to progress, nurses play a vital role in the field of oncology. Specialized oncology nurses are providing clinical care, or as nurse researchers leading revolutionary oncology research. The future of oncology nursing is optimistic. Nursing care for cancer patients not only requires guidance through medication and treatment, but also offers encouragement and motivation to the patients. The present review provides an insight into the nursing care of cancer patients, its brief history, advancements and the current practices of oncology nursing. Future prospects of oncology nursing have also been discussed in detail.Copyright © 2022, Kuwait Medical Association. All rights reserved.

Strategies for covid-19 pandemic phase in oncological rehabilitation

Introduction: Cancer, lymphoma and leukemia are life-threatening diseases, ofen with curative therapies, high risk of recurrence and stressful symptoms that require immediate, quality-assured care across the entire supply chain, including rehabilitation. The protection against uncontrolled infection in the Covid-19 pandemic must be focused along the entire route of supply chain. Method(s): Before recommendations and rules issued by national, regional and local authorities were enacted we started organizing a pandemic schedule in rehabilitation in February 2020. A holistic approach is necessary in dealing with this unprecedented event. Terefore we have to roll out preemptive/proactive and reactive strategies to improve recognition of, and response to clinical deterioration in the context of the Covid-19 pandemic. Basis for our considerations was the Epidemiological Bulletins of RKI (Germany) from 2017 (Infuenza Infection) and new from 2020 (Covid-19). The WHO declared Covid-19, a new disease, different from other viruses such as Severe Acute Respiratory Syndrome (SARS), Middle East Resp. Syndrome (MERS) and Infuenza as a "pandemic" on 12th march 2020. Result(s): First we checked invitation letters, contacted leadership, occupier and regional health department. We checked, increased and expanded our protective and diagnostic equipment. We trained employees and patients in extended hygiene measures and created different schedules. All relevant pandemic rules were implemented before they were ofcially initiated. Our pandemic response plan includes infrastructure and equipment, workforce training, planning and support, communication plans, infection control, transport and transfer polices. We adapted rehab therapies for cancer survivors. We developed and implied workfows for every responsible situation. Over a period from February to May 2020, we were able to successfully maintain of high-quality cancer rehabilitation in a reduced number. We also conceived an isolation area in our clinic and used it in collaboration with the regional health department. Conclusion(s): The timely roll-out of universal pandemic rules in rehabilitation, including training and controls, enables the continuation of high-quality cancer rehabilitation and thus will contribute to the stabilization of the supply chain of cancer diseases even in pandemic times. However, all measures should be able to be implemented in isolation from considerations of possible economic consequences.

Updates in Cancer Rehabilitation Telehealth.

Purpose of Review: To describe the various uses of telehealth as it applies to cancer rehabilitation and to review recent findings since the onset of the COVID-19 pandemic. Recent Findings: Telehealth has numerous applications in cancer rehabilitation including physiatry services, skilled therapies, exercise interventions, symptom management, and support groups. Numerous studies have shown that regular physician and skilled therapy services can be provided through telehealth platforms, though certain clinical situations may require in-person visits. Telehealth exercise-based interventions are feasible, safe, and can improve quality of life. Telehealth also may be an effective tool in symtom management and as a medium for support groups. Summary: Telemedicine and telehealth platforms are effective tools in the field of cancer rehabilitation that not only provide increased safety and convenience for a burdened patient population but may also hold the potential to elevate beyond the current standard of care.

Breast cancer survivors' physical activity and experiences while transitioning to a virtual cardiovascular rehabilitation program during a pandemic (COVID-19).

Breast cancer accounts for 25% of all cancers among Canadian females. Despite successes of decreased mortality, adverse treatment effects, such as cardiotoxicity, contribute to a sedentary lifestyle and decreased quality of life. Physical activity (PA) is a possible therapy for the late effects; however, COVID-19 restricted access to in-person cardiovascular rehabilitation (CR) programs. The purposes are as follows: (1) compare PA of breast cancer survivors' in-person CR to virtual CR following a transition during COVID-19 and (2) compare the PA of the pandemic cohort to a matched cohort who had completed the program in 2018/2019; (3) explore survivors' experiences of transitioning to and engaging in virtual CR. Mixed methods included analysis of CR PA data from a pandemic cohort (n = 18) and a 2018/2019 cohort (n = 18) and semi-structured focus group interviews with the pandemic cohort (n = 9) in the context of the PRECEDE-PROCEED model. After the transition, there were no significant differences in mean activity duration, frequency, and cumulative activity (expressed as MET-minutes) (p > 0.05). However, variation of PA duration doubled following the transition from in-person to virtual (p = 0.029), while for the 2018/2019 cohort, variation remained unchanged. Focus groups revealed that women valued their CR experiences pre-COVID-19 and had feelings of anxiety during the transition. Perceived factors affecting participation were environmental, personal, and behavioural. Recommendations for virtual programs were to increase comradery, technology, and professional guidance. PA experiences during a transition to virtual care prompted by a pandemic vary among breast cancer survivors. Targeting individualised strategies and exercise prescriptions are important for improving PA programs and patient outcomes.

A Targeted Approach to Post-Mastectomy Pain and Persistent Pain following Breast Cancer Treatment.

Persistent pain following treatment for breast cancer is common and often imprecisely labeled as post-mastectomy pain syndrome (PMPS). PMPS is a disorder with multiple potential underlying causes including intercostobrachial nerve injury, intercostal neuromas, phantom breast pain, and pectoralis minor syndrome. Adding further complexity to the issue are various musculoskeletal pain syndromes including cervical radiculopathy, shoulder impingement syndrome, frozen shoulder, and myofascial pain that may occur concurrently and at times overlap with PMPS. These overlapping pain syndromes may be difficult to separate from one another, but precise diagnosis is essential, as treatment for each pain generator may be distinct. The purpose of this review is to clearly outline different pain sources based on anatomic location that commonly occur following treatment for breast cancer, and to provide tailored and evidence-based recommendations for the evaluation and treatment of each disorder.