Impact of Tobacco Quitlines on Smoking Cessation in Persons With Mental Illness: A Systematic Review.

Persons with mental illness smoke at rates two to four times higher than do persons without mental illness and comprise 30.9% of the U.S. tobacco market. Given the prevalence of mental illness and the known detrimental effects of tobacco, concerted efforts are needed to promote the use of evidence-based treatment options. We conducted a systematic review of studies that examined the impact of tobacco quitline interventions in this population. Results revealed an overall positive impact of cessation services delivered via a tobacco quitline. More research is needed to determine intervention components and patient characteristics that are associated with cessation success.

Sleep disorders in breast cancer survivors.

PURPOSE: The purpose of this study was to evaluate the feasibility, acceptability, and initial results of a structured assessment of sleep disorders in breast cancer survivors (BCS). Our goal was to determine whether the assessment could be easily used and whether it would capture problems suggestive of one or more underlying sleep disorders that require referral to a specialist for diagnostic validation through polysomnography and appropriate specialty treatment. METHODS: A cross-sectional, feasibility study using convenience sampling. RESULTS: A total of 38 BCS completed the study. Recruitment procedures were adequate in finding eligible BCS, however, procedures used to establish possible patterns of sleep disorders (e.g., interview) were not feasible for screening for sleep disorders in the clinical setting due to the time it took to complete each interview. A total of seven sleep disorder categories were identified in the data with the majority of women having at least one possible sleep disorder. CONCLUSIONS: Study findings suggest that population-based screening for sleep disorders in clinical practice should be a priority for BCS reporting chronic sleep problems.

The SPADE Symptom Cluster in Primary Care Patients With Chronic Pain.

OBJECTIVES: Sleep disturbance, pain, anxiety, depression, and low energy/fatigue, the SPADE pentad, are the most prevalent and co-occurring symptoms in the general population and clinical practice. Co-occurrence of SPADE symptoms may produce additive impairment and negatively affect treatment response, potentially undermining patients' health and functioning. The purpose of this paper is to determine: (1) prevalence and comorbidity (ie, clustering) of SPADE symptoms; (2) internal reliability and construct validity of a composite SPADE symptom score derived from the Patient-Reported Outcomes Measurement Information System (PROMIS) measures; and (3) whether improvement in somatic symptom burden represented by a composite score predicted subsequent measures of functional status at 3 and 12 months follow-up. METHODS: Secondary analysis of data from the Stepped Care to Optimize Pain care Effectiveness study, a randomized trial of a collaborative care intervention for Veterans with chronic pain. RESULTS: Most patients had multiple SPADE symptoms; only 9.6% of patients were monosymptomatic. The composite PROMIS symptom score had good internal reliability (Cronbach's alpha=0.86) and construct validity and strongly correlated with multiple measures of functional status; improvement in the composite score significantly correlated with higher scores for 5 of 6 functional status outcomes. The standardized error of measurement (SEM) for the composite T-score was 2.84, suggesting a 3-point difference in an individual's composite score may be clinically meaningful. DISCUSSION: Brief PROMIS measures may be useful in evaluating SPADE symptoms and overall symptom burden. Because symptom burden may predict functional status outcomes, better identification and management of comorbid symptoms may be warranted.

State of the Science: Taxane-Induced Musculoskeletal Pain.

BACKGROUND: Cancer survival rates are improving, but this increased survivorship is offset by persistent treatment-related symptoms. Taxane-induced musculoskeletal pain (TIMP) is 1 treatment-related symptom likely undermining cancer survivors' health-related quality of life. OBJECTIVE: The specific aims of this review were to evaluate (1) the conceptual clarity of TIMP, (2) descriptions of the TIMP symptom experience, (3) contextual variables influencing TIMP, and (4) the impact of TIMP on selected outcomes. METHODS: A systematic approach conducted in PubMed yielded 688 articles, and 12 articles included evaluable data related to TIMP. RESULTS: On average, 2 to 4 terms signifying TIMP were used; among the terms arthralgia, myalgia, and bone pain, the range of TIMP prevalence estimates varied from 1.3% to 94%. Intensity was measured in all studies, most commonly (50% of studies) using the National Cancer Institute Common Toxicity Criteria. Contextual variables and the impact of TIMP on outcomes were addressed in only 17% and 42% of studies, respectively. CONCLUSIONS: Research to date has involved inconsistent use of terms signifying TIMP. Assessment of TIMP has been largely limited to intensity, with few studies evaluating contextual variables influencing TIMP or the impact of TIMP on outcomes. More comprehensive TIMP assessment is necessary in future research. IMPLICATIONS FOR PRACTICE: In order to improve patient-reported outcomes in cancer care, control of treatment-related symptoms is essential. Further research about TIMP will address national priorities for generating new knowledge to advance symptom science and will be directly relevant to the care of cancer survivors undergoing taxane-based chemotherapy.

Lung Cancer Screening Participation: Developing a Conceptual Model to Guide Research.

PURPOSE: To describe the development of a conceptual model to guide research focused on lung cancer screening participation from the perspective of the individual in the decision-making process. METHODS: Based on a comprehensive review of empirical and theoretical literature, a conceptual model was developed linking key psychological variables (stigma, medical mistrust, fatalism, worry, and fear) to the health belief model and precaution adoption process model. RESULTS: Proposed model concepts have been examined in prior research of either lung or other cancer screening behavior. To date, a few studies have explored a limited number of variables that influence screening behavior in lung cancer specifically. Therefore, relationships among concepts in the model have been proposed and future research directions presented. CONCLUSION: This proposed model is an initial step to support theoretically based research. As lung cancer screening becomes more widely implemented, it is critical to theoretically guide research to understand variables that may be associated with lung cancer screening participation. Findings from future research guided by the proposed conceptual model can be used to refine the model and inform tailored intervention development.

A systematic review of nonpharmacologic interventions for treatment-related symptoms in women with ovarian cancer.

BACKGROUND: Women with ovarian cancer have a continued high symptom burden in comparison to other cancer survivors secondary to ongoing chemotherapy treatment. Prolonged or ineffective management of treatment-related symptoms can contribute to treatment noncompliance, worsening of symptoms, and reduced health-related quality of life. OBJECTIVES: This review of the literature was conducted to describe experimental and quasi-experimental research addressing nonpharmacologic interventions for the treatment-related symptoms of sleep disturbance, pain, anxiety, depression, and low energy or fatigue in women with ovarian cancer and to critique the quality of interventions. METHODS: A systematic search of the literature was conducted in PubMed and yielded 136 articles. Eight articles met the inclusion criteria and were evaluated. FINDINGS: Nonpharmacologic interventions for treatment-related symptoms were complex, with an average of 4.4 components. Intervention delivery, setting, and exposure varied widely across studies. Only three studies contained details sufficient to replicate the intervention. Lack of clarity in intervention reporting may explain perceptions of clinically inefficacious symptom management in this context. Greater attention to reporting would facilitate better translation of interventions into practice and when addressing complex cancer symptom clusters.

Psychosocial Interventions for Adolescents and Young Adults with Cancer.

OBJECTIVES: To summarize and evaluate the studies published since 2007 on psychosocial interventions designed for adolescents and young adults (AYA) with cancer. DATA SOURCES: PubMed, Ovid, and PsycINFO. CONCLUSION: Our review confirms that the development and evaluation of psychosocial interventions for AYA is still in its infancy. Only five studies were identified and these generally had small samples and limited results. IMPLICATIONS FOR NURSING PRACTICE: It is important for nurses to assess the needs of AYA. Incorporating creative ways for AYA to express their needs and self-reflect seems to be critically important and may help AYA cope positively with the cancer experience.