Awareness of cancer and its associated factors for parents of adolescents and young adults: A cross-sectional study.

Cancer is a common health problem worldwide. Early cancer education for adolescents and young adults (AYAs) is important for the prevention or early detection of cancer. In this questionnaire-based cross-sectional study, we examined the cancer awareness among parents of AYAs. Japanese adults with junior or senior high school children were included in this study. The cancer awareness measure (CAM) was used to assess cancer awareness, and the survey was conducted in December 2021. Warning signs, barriers to seeking help, and risk factors were surveyed using an online anonymous questionnaire. In addition, personal information, the presence of other cancer survivors, attendance at cancer seminars, conversations with children about cancer, interest in cancer education for children, and previous cancer screening were surveyed. A t-test or Spearman correlation coefficient was used to compare the total CAM scores for the individual factors. The relationship between cancer-screening behavior and individual factors was analyzed using the χ2 test. In addition, multiple regression analysis or logistic regression analysis was used to identify the factors influencing cancer awareness or cancer-screening behavior. Responses were obtained from the 612 participants. The mean CAM score was 3.7 for cancer warning signs, 4.3 for barriers to seeking help, and 6.5 for risk factors. Cancer warning signs were associated with gender and the presence of a spouse, family member, or friend who had experienced cancer. Barriers to seeking help were associated with age, gender, and education, while risk factors were associated with gender, education, and conversations about cancer with children. Moreover, these scores were associated with each cancer screening behavior. Cancer awareness among Japanese adults with AYAs was influenced by gender, academic background, occupation, the presence of cancer survivors around them, and whether they had conversations about cancer with their children, as well as their cancer screening behavior.

Cancer awareness and its related factors among junior high and high school teachers in Japan: a cross-sectional survey.

BACKGROUND: The early detection and prevention of many cancers is possible. Therefore, public awareness about cancer risk factors and warning signs must be increased to ensure early diagnosis. Although Japan has implemented mandatory cancer education in junior high and high schools, few studies have evaluated teachers' cancer awareness. This study aimed to determine Japanese junior high and high school teachers' awareness of cancer and related factors. METHODS: This cross-sectional study obtained data through an online questionnaire survey using questions from the Cancer Awareness Measure (CAM) developed by Cancer Research UK. Thirty items were selected from three CAM modules: cancer risk factors, cancer warning signs, and barriers to seeking help. Descriptive statistics were used for socio-demografic data and CAM module questions. The χ2 test was performed on the relationship between cancer awareness and socio-demographic data. Multiple logistic regression analysis was used to identify factors influencing cancer awareness. RESULTS: Respondents included 316 junior high school and 463 high school teachers (541 men; 238 women; average age = 48.2 years; average teaching experience = 23.5 years). An average of 5.41 out of 11 cancer risk factors were recognized. More than 70% of teachers recognized smoking, exposure to another person's cigarette smoke, and having a close relative with cancer as risk factors. On average, 4.52 out of 9 cancer warning signs were recognized. More than 50% of teachers recognized the warning signs of unexplained lump or swelling, unexplained weight loss, and unexplained bleeding. Barriers to seeking help had a low average score of 4.51 out of 20. However, the most commonly recognized "barriers to seeking help" were "too busy to make time," "difficult to make an appointment," "worried about what the doctor might find," and "too scared." Moreover, the common factors that affected awareness of cancer risk factors and cancer warning signs were gender and cancer experience of relatives. Factors that affected awareness of "barriers to seeking help" were "participation in cancer-related workshops," age, gender, and cancer experience of relatives. CONCLUSIONS: Cancer awareness education should consider interventions that can improve knowledge of the symptoms and signs related to cancer without increasing the awareness of barriers to seeking help.

Details of Cancer Education Programs for Adolescents and Young Adults and Their Effectiveness: A Scoping Review.

The purpose of this review was to establish what cancer education programs have been carried out aimed at adolescents and young adults (AYAs) and what outcomes they achieved. The databases used were MEDLINE, CINAHL, and Web of Science, and the search period was set as 2011-2020. The extracted literature was evaluated for quality using the Joanna Briggs Institute's critical appraisal tools. The subjects of the analysis were 29 studies: 10 randomized controlled trials and 19 quasi-experimental designs. Regarding the varieties of cancers found in the data, in descending order, 10 documents looked at cervical cancer, 9 looked at cancer in general, and 4 looked at breast cancer. Most studies focused on AYAs exclusively, with just three studies involving their parents simultaneously. Many studies used lecture-based intervention, with information technology-based interventions using websites and cell phones. Topics included in the program were cancer epidemiology, cancer risk factors, cancer warning signs and symptoms, prevention methods, and screening methods. After the intervention, all studies showed statistically significant improvements in at least one outcome measure, which included knowledge and awareness of cancer, health beliefs, and intent to take preventive action, demonstrating a basis for educational intervention. Educating AYAs about cancer at a time when their ways of life are becoming more concrete can be expected to have a positive impact on cancer preventing behaviors in adulthood, increase their parents' awareness of cancer, and have a positive impact on behavior around screening.

Expectations of respiratory physicians from psychologists in palliative care for patients with non-cancer respiratory diseases.

BACKGROUND: Psychological symptoms are common in patients with non-malignant respiratory disease (NMRD). Psychologists can likely play a role in NMRD palliative care. We aimed to explore the expectations of respiratory physicians from psychologists in NMRD palliative care. METHODS: An ad hoc questionnaire was developed based on a free-descriptive questionnaire survey among respiratory physicians from four hospitals in Japan. Using this questionnaire, we surveyed respiratory physicians from eight hospitals in Japan and assessed their expectations of psychologists' support and outcomes. Expectations were compared between physicians with and without experience of working with psychologists. RESULTS: The quantitative questionnaire was completed by 129 physicians. Data analysis from 108 participants revealed that the highly expected support included "getting early information on patients' psychological distress" (97.2%) and "counseling family members regarding anxiety caused by changes in patient's condition" (96.3%). Physicians also expected "relief in patient's psychological distress" (96.3%) and "providing the psychological support that families need" (95.4%) from psychologists. Compared to physicians with experience of working with psychologists, those without expected more in terms of "giving specific advice on the way of communication and psychological support" (p = 0.035) and "providing psychological support for difficult-to-handle patients and families on behalf of other medical staff" (p = 0.036). CONCLUSIONS: Respiratory physicians may expect relief of psychological distress experienced by patients and their families from psychologists by getting information about their distress and providing psychological support. These results may be useful for psychologists to provide palliative care for patients with NMRD in collaboration with respiratory physicians.

Evaluation of Appropriateness of A Nursing Intervention Program to Promote Pain Self-Management for Adult Outpatients with Cancer Pain.

OBJECTIVE: This study aimed to develop a nursing intervention program structured to promote pain self-management for adult outpatients with cancer pain to enable coping with cancer pain-related problems and evaluate the appropriateness and clinical applicability of the program. METHODS: A questionnaire survey was conducted with two pharmacists and ten oncology nursing specialists using a questionnaire created by the authors. The questionnaire comprised of 23 items asking about the appropriateness of the program, clinical applicability, and feasibility of instruction materials, rated by 5-point scales. RESULTS: We collected 11 responses. The mean score of all the 23 items was 4.3 (standard deviation [SD] 0.6), the mean scores of the items were 4.4 (SD 0.6) for the appropriateness of the program, 4.2 (SD 0.5) for the clinical applicability of the program, and 4.3 (SD 0.7) for the feasibility of the instruction materials. The participants provided comments that the program made it easier to select patients for intervention and tasks that patients and nurses can share. Some comments pointed out that the program should be improved to allow patients who need the same intervention several times. Based on these comments, we modified the program partially and completed the first edition of the cancer pain self-management (CPSM) program. CONCLUSIONS: The findings suggest that the CPSM program may be considered appropriate and clinically applicable from the point of view of pharmacists and oncology nurses. Further studies are needed to verify the effects and usefulness of the program in clinical settings.

A Concept Analysis of Self-Management of Cancer Pain.

The objective of the study was to conduct a concept analysis of "self-management of cancer pain" to develop a theoretical definition of the concept and identify its attributes, antecedents, and outcomes. The Rodgers' evolutionary model of concept analysis was used. Literature published from January 2000 to February 2017 containing the terms, "cancer pain" and "self-management" in their title and/or abstract was assessed. Twenty-seven studies were selected for this analysis. Self-management of cancer pain is defined as "the process in which patients with cancer pain make the decision to manage their pain, enhance their self-efficacy by solving problems caused by pain, and incorporate pain-relieving strategies into daily life, through interactions with health-care professionals." The attributes of self-management of cancer pain were classified into the following five categories: Interaction with health-care professionals, decision-making to pain management, process for solving pain-related problems, self-efficacy, and incorporating strategies for pain relief into daily life. The antecedents were classified into the following seven categories: Physical functions, cognitive abilities, motivation, undergoing treatment for pain, receiving individual education, receiving family and health-care professionals' support, and health literacy. The outcomes were classified into the following three categories: pain relief, well-being, and empowerment. The attributes of self-management of cancer pain can be used as components of nursing practice to promote patient self-management of cancer pain. The categories of antecedents can be used as indicators for nursing assessment, and the outcomes can be used as indicators for evaluations of nursing intervention.

[The role of an oncology certified nurse specialist in a palliative care team].

At Osaka National Hospital, we established a hospital based palliative care team in July 2004. The team provided consultation to 355 patients (189 males and 166 females). Even though consultation was requested from every department, the department of surgery requested most with 100 cases, of which a request for lung (16%) and gastric (13%) cancer patients were asked fairly often. Some of the consultation requests were 177 in pain control, 221 in psychiatric and 91 in physical related symptoms, respectively. The department of surgery requested PCT intervention most frequently. Finally, a total of 115 patients had died, 81 were discharged and 36 were continually treated with cancer chemotherapy as an outpatient basis. OCNS have a major role in coordination with the PCT and primary team, and intervene directly in the CNS's specialty area. To provide more appropriate care services with the primary team, the OCNS should assume more responsibility for promoting a support relationship with the staff and to enhance staff skills.

[Palliative care team support services by the hospital for home palliation].

At Osaka National Hospital, we opened a palliative care team (PCT) since July 2004. The PCT advises the symptom management of cancer patients and supports patients' decision making. By March 2006, 355 consecutive cancer patients referred to the PCT, including 221 patients with psychiatric symptoms. The duration of the treatments for psychiatric symptoms were extended longer than for physical symptoms (physical symptoms: 47.7 days, depression: 60.4, delirium: 56.0, adjustment disorders: 57.4; p < 0.05). The reasons for this prolongation are that psychiatric symptoms (especially delirium) are often overlooked, and that home doctors and visiting nurses often hesitate to take on the home medical care because of unfamiliarity with them. The management of psychiatric symptoms at home is important for appropriate end-of-life care. The PCT and regional doctors have to work closely in cooperating with the successive palliation when the patient is transformed to home medical care.