The role of a dedicated Oncology Nurse Navigator in the surgical oncology pathways: 1 year experience from a General Surgery Unit in central Italy with follow up.

The Nurse Navigator is a highly specialized nurse with technical and non-technical skills that offers individualized assistance to cancer patients, their family and caregivers to overcome health system barriers and facilitate access to care. This role was introduced in the General Surgery Unit of the Madonna del Soccorso Hospital in San Benedetto del Tronto from 1st January 2023. The primary endpoint is to compare the times taken for each step of the diagnostic-therapeutic pathway comparing the study group followed by Oncology Nurse Navigator (ONN) and the group not followed by this role. The secondary endpoints, only for the study group, were the number of patient contacts with the ONN and the time slots; the number of examinations and consultations organized by ONN; the evaluation of patient satisfaction at discharge; the number and type of problems noted during follow-up contact at 7 and 30 days after discharge. A prospective court study with historical control was conducted from 1st January 2023 in Madonna del Soccorso Hospital, Italy. The study group consists of all cancer patients cared for by ONN. The control group was created by selecting the same number of patients as the study group but taken care of in the previous 3 years (from 2020 to 2022) and, therefore, without the presence of the Nurse Navigator. The control group data come from clinical documentation. The number and time slots of contact with the ONN were recorded through the use of a company mobile phone active 24/7 through phone calls and messages. The number of examinations and consultations is known through online requests. The satisfaction assessment was carried out through the use of externally validated questionnaire Patient Satisfaction with Cancer Care (PSCC). The follow-up was performed by telephone and recorded on documentation according to established parameters. A total of 200 patients were analyzed. Both the study and control groups included 100 patients each. The average time between the first contact with the patient and the execution of the diagnostic test was 7 days in the cases compared to 28 days in the control group. The waiting time for the Multi-Disciplinary Team discussion (MDT) was 3 days for the study group compared to 6 days in the control group. The average time taken for the first oncological visit was 3 days in the study group compared to 18 days in the controls. The time from first contact to the operating session was 20 days compared to 45 in controls. Each patient had an average of 10 phone calls with the ONN. For all patients accompanied at the first diagnosis, at least 2 radiological and laboratory tests were organized. Oncology appointment for treatment evaluations after delivery of the histological report was communicated within a maximum of 3 working days. A patient satisfaction questionnaire achieved a response rate of 100%, with an average score of 87.0/90. The telephone follow-up had a response rate of 100% of patients and revealed a decrease in problems at the 30-day check-up compared to that of 7 days after discharge. (Activity of Daily Living 20% vs 8%; nutritional problems 40% vs 21%, pain 18% vs 2%; surgical wounds 45% vs 1%; mobilization 8% vs 0%). The data demonstrate that ONN service improves the quality and outcomes of surgical oncology patients' pathway. The professional role of the ONN, with predefined technical and non-technical skills, should also be officially recognized by the healthcare system and hospital administration.

Theory of health promotion for sexual and gender minority populations with cancer.

BACKGROUND: Structural factors (e.g., cisheteronormativity) promote minority stressors, which generate healthcare disparities among sexual and gender minority (SGM) populations (also known as lesbian, gay, bisexual, transgender, queer, intersexual, asexual, and other sexual and gender-expansive persons--LGBTQIA+) with cancer. The individual's biological, behavioral, social, and psychological response to minority stressors will vary throughout their life course. However, there is a lack of empirical and theoretical guidance for conceptualizing health outcomes among SGM subgroups. PURPOSE: To propose a nursing theory for the health promotion of SGM populations with cancer. METHODS: Walker and Avant's strategies for theoretical derivation were followed. RESULTS: I present the definition, theoretical assumptions, concepts, propositions, and implications for practice, education, research, and policy of the derived theory. DISCUSSION AND CONCLUSION: The theory provides a nursing framework to understand and address the multilevel impact of minority stress on the health of SGM individuals throughout their cancer care continuum.

Precision Health Symptom Science in Oncology Nursing.

Precision health is an emerging approach to predicting, preventing, treating, and managing disease. A goal of precision health symptom science research is the reliable prediction of patients' symptom burden to optimize robu.

Bridging the Gap: Standardizing Orientation to Improve Vacancy and Turnover Rates of Ambulatory Oncology Nurses.

This article describes standardizing ambulatory oncology nursing orientation within an academic comprehensive cancer center to reduce turnover rates. The nursing professional development specialist created a standardized orie.

Promoting End-of-Life Care and Healthcare Worker Well-Being: Implementing the 3 Wishes Project in an Oncology Intensive Care Unit.

This scholarly project implemented the 3 Wishes Project (3WP), which aims to fulfill the final wishes of dying critically ill patients, in a 16-bed tertiary intensive care unit (ICU). The project assessed outcomes through sur.

ONS Past President Johnson's Legacy Leaves Impact on Global Cancer Community.

Oncology Nursing Society (ONS) Past President Judi L. Johnson, PhD, RN, FAAN, dedicated her career to guiding cancer education, patient- centered care, and oncology nursing excellence. On Saturday, April 20, 2024, Johnson pas.

How Can the Impact of Cancer Create Positive Change?

When something is impactful, we say that it alters us, touches us, changes us. We say that it has had a great influence on our lives. This, too, is true of my experience. Although I had been caring for others as an oncology n.

WITHDRAWN: "The closest touch to death in psychiatric nursing practice": Experiences of nursing students in a psycho-oncology unit.

his article has been withdrawn at the request of the Editor. The Publisher apologizes for any inconvenience this may cause. The full Elsevier Policy on Article Withdrawal can be found at https://www.elsevier.com/about/policies/article-withdrawal.

How can we approach preoperative frailty and related factors in patients with cancer? A scoping review.

AIM: To identify factors related to preoperative frailty in patients with cancer and map the tools that measure frailty. DESIGN: A Scoping review. METHODS: This scoping review based on Arksey and O'Malley's framework. Articles from CINAHL, PubMed, EMBASE, and PsycINFO databases published between January 2011 and April 2021. The searched keywords were concepts related to 'cancer', 'frailty' and 'measurement'. RESULTS: While 728 records were initially identified, 24 studies were eventually selected. Research on frailty was actively conducted between 2020 and 2021. Factors related to preoperative frailty were age (22.9%), sex (11.4%), body mass index (11.4%) and physical status indicators (54.3%). The most common result of preoperative frailty was postoperative complications (35.0%). 24 instruments were used to measure frailty. IMPLICATIONS FOR PATIENT CARE: Selecting an appropriate preoperative frailty screening tool can help improve patient postoperative treatment outcomes. IMPACT: There are many instruments for assessing preoperative frailty, each evaluating a multi-dimensional feature. We identified the frailty screening tools used today, organized the factors that affect frailty, and explored the impact of frailty. Identifying and organizing frailty measurement tools will enable appropriate evaluation. REPORTING METHOD: PRISMA-ScR. PATIENT CONTRIBUTION: No patient or public contribution.

The role of resilience and coping strategies as predictors of well-being in breast cancer patients.

PURPOSE: This study investigated the role of resilience and coping strategies on breast cancer patients' well-being using a structural equation model. To achieve this objective, a model previously developed by Mayordomo's group was partially replicated using a longitudinal study design in an oncological sample. METHODS: The study was a longitudinal observational survey. Patients with breast cancer were recruited (N = 166). Resilience was measured with the Mexican Resilience Measurement Scale, coping strategies with the Forms of Coping and Dimensions Scale and perception of the psychological well-being with a short-form of Ryff's Scales of Psychological Well-Being at the start and end of adjuvant chemotherapy (T1 and T2 respectively). RESULTS: The results showed stability in the variables over time and revealed differences with respect to Mayordomo's model. The best predictor of well-being at T2 was well-being at T1. In addition, the model indicated that resilience had a direct impact on well-being through problem-focused coping. Indeed, resilience and problem-focused coping best explained well-being at T2. CONCLUSIONS: Both at the start and end of adjuvant chemotherapy for breast cancer, problem-focused coping positively predicted resilience, which in turn was a positive predictor of well-being. On the other hand, emotion-focused coping showed no association with resilience or well-being. As part of the multidisciplinary cancer team, oncology nurses have a key role to play in promoting resilience and problem-focused coping as an important goal of psychosocial interventions in breast cancer patients.

Compassion Fatigue: A Comprehensive Discussion on its Development and Repercussions Among Oncology Nurses.

OBJECTIVES: This study aimed to discuss how compassion fatigue (CF) develops and its repercussions on the personal and professional lives of oncology nurses. METHODS: A discursive article, with systematic searches were performed in seven databases to find publications on CF in oncology nurses. RESULTS: So as to better organize the findings, three categories were developed to present and discuss issues related to CF: (1) Characteristics of CF and its developments: describes the components related to CF and the manifestation of this phenomenon; (2) Repercussions of compassion fatigue: reports on the impact of CF on the personal and professional life of oncology nurses; and (3) Resources for dealing with compassion fatigue: lists interventions, sources of support, professional personal training, qualified nursing care in the face of adversity, and gratitude and recognition. CONCLUSION: the factors that trigger or protect CF are multifactorial, with the need for collective and individual interventions as a way of helping oncology nurses to protect themselves, to avoid or manage this phenomenon. CF has a direct clinical impact on the life of the oncology nurse, causing several changes. It also indirectly impacts the patient's life clinically, as it is a phenomenon that has repercussions on the provision of care. IMPLICATIONS FOR NURSING PRACTICE: CF affects the personal and professional lives of oncology nurses, so nurses need to seek resources to deal with it. Nursing staff employers and managers can use the evidence from this research to help nurses manage and protect themselves from compassion fatigue.

Development and psychometric evaluation of a tool to assess oncology nurses' occupational health needs.

BACKGROUND: Oncology nurses are confronted with various occupational hazards; consequently, it is of great importance to identify and measure their occupational health needs. Due to the fact that standard tools are not available to assess these needs, this study was conducted to develop a tool for assessing oncology nurses' occupational health needs. MATERIALS AND METHODS: This study consisted of two phases from 2020 to 2021. The first phase was item generation and tool design. The initial development of the item pool was based on the result of the qualitative study and literature search. The second phase was item reduction and psychometric evaluation of the formulated tool including, face, content, and construct validity and reliability. Construct validity was assessed using exploratory factor analysis and convergent validity with the participation of 300 oncology nurses. The reliability of the tool was assessed using internal consistency (Cronbach's alpha) and test-retest (intra-cluster correlation coefficient). RESULTS: The mean content validity index (CVI) of the tool was 0.95. The results of exploratory factor analysis showed that this tool consisted of 69 items and four factors, explaining 65.88% of the variance. The results of the convergent validity assessment showed a significant positive correlation between the mean scores of occupational health needs and occupational stress (P < 0.0001 and r = 0.40). Cronbach's alpha coefficient (0.98) and tool stability (0.98) confirmed the appropriate reliability of the tool. CONCLUSION: The developed tool is recommended as a valid and reliable tool for assessing oncology nurses' occupational health needs that can be used both in practice and in future studies.

Conclusiveness of Cochrane Reviews on Nursing Interventions for Patients with Cancer: A Systematic Analysis.

Background: This study aimed to assess the conclusiveness of Cochrane Reviews (CRs) in oncology nursing. Methods: We searched systematically for all CRs published in the Cochrane Library in the oncology nursing field between January 2014 and April 2023. We analyzed the difference between conclusive and inconclusive outcomes using the χ2 and Mann-Whitney U-tests and identified 430 articles. However, we excluded 385 articles after reviewing their titles and abstracts. We assessed 45 full-text articles for eligibility and identified 32 articles. Of the 32 articles, we extracted 19 interventions. Results: The overall outcomes were 182 cases, with 51.6% (n = 94) and 48.4% (n = 88) demonstrating conclusiveness and inconclusiveness, respectively. Regarding conclusiveness, 28.0% (n = 51) and 23.6% (n = 43) reported that the studied interventions were effective and ineffective, respectively. We found that studies on interventions related to physical activity and yoga had significantly high rates of conclusive. Compared with inconclusiveness outcomes, conclusive outcomes involved significantly more studies (p < 0.001) and patients (p < 0.001). Conclusions: Ultimately, these findings reveal that in the oncology nursing field, only 51% of the main outcomes of each nursing intervention in CRs were conclusive.

Quality of life of patients undergoing chemotherapy: a tertiary care hospitalbased study from Karachi.

The quality of life (QoL) of cancer patients is of paramount concern due to the enduring effects of chemotherapy on the physical, emotional, spiritual, and social aspects of life. This study aims to examine the factors influencing QoL among cancer patients. A cross-sectional analysis encompassing 200 chemotherapy patients aged 18 and above was conducted, using self-reported surveys and clinical records. The results indicate higher social wellbeing and lower physical well-being scores. Significantly, patients in joint families, with income above Rs25,000, limited pre-diagnosis check-ups, over four chemotherapy cycles, showed better QoL. Engaging diversions like art and internet usage alleviated worries. Conversely, comorbidities correlated with lower FACT-G scores. QoL is still compromised, even with the developments of advanced cancer treatments. Managing mental, emotional, social, and physical health is vital. Future research should focus on evidence-based policies, innovative strategies, psychiatric assessments, mindfulness interventions, and exploring the impact of social interactions on QoL, aiming to enhance the wellbeing of newly diagnosed cancer patients.

Feasibility and acceptability of measuring positivity resonance in nurse-patient telehealth videoconferencing visits: A mixed-methods observational study.

AIM: To investigate the feasibility and acceptability of the training process, procedures, measures and recruitment strategies necessary for a future investigation to test the reliability and validity of using positivity resonance measures in health care encounters. BACKGROUND: Although the measurement of positivity resonance is promising, and non-participant observation is considered effective, their approaches to studying nurse-patient relationships have not been fully explored. DESIGN: A mixed-methods observational study. METHODS: Video recordings of 30 nurse-patient dyads completing telehealth video visit encounters were edited and coded using behavioural indicators of positivity resonance. A post-visit survey gathered data on the participants' perceptions of positivity resonance and the study procedures. The research team completed memos and procedural logs to provide narrative data on the study's training, coding, recruitment and operational procedures. The study included 33 persons with cancer and 13 oncology nurses engaging in telehealth video visit encounters at an academic oncology ambulatory care center located in the southeastern United States. RESULTS: Study procedures were found to be feasible and acceptable to participants. An adequate sample of participants (N = 46) were enrolled and retained in the study. Interrater reliability, as evidenced by Cohen's weighted kappa, ranged from .575 to .752 and interclass correlation coefficients >.8 were attainable within a reasonable amount of time and with adequate training. Behavioural indicators of positivity resonance were observed in all telehealth visits and reported by the participants in the perceived positivity resonance survey. The Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) checklist guided reporting. CONCLUSIONS: Designing research around the concept of positivity resonance is an innovative and feasible approach to exploring how rapport is cultivated within nurse-patient relationships. RELEVANCE TO PROFESSIONAL PRACTICE: Measuring positivity resonance may hold promise for exploring patient and nurse outcomes including trust, responsiveness, health-related behaviours, well-being, resilience and satisfaction. REPORTING METHOD: The Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) checklist guided the reporting of results to ensure that adequate details of the study were provided to ensure an accurate and complete report. PATIENT OR PUBLIC CONTRIBUTION: Planning of the research design and study procedures was done in consultation with nurse clinicians with experience with telehealth and managers responsible within the practice setting where the study was conducted. This ensured the study procedures were ethical, safe, secure and did not create unnecessary burden to the study participants. The study included collecting data from nurse and patient participants about the acceptability of the study procedures.

Humanized oncology nursing care in a person with gastric cancer: A case report.

Cancer impacts the person's physical health, psychosocial and spiritual wellbeing. The humanization of care is an essential element to achieve integral wellbeing of the individual. The aim of this article is to present a clinical case, using the nursing process with the NANDA, NOC and NIC taxonomies, and based on the principles of Watson's theory of humanized care. The participant is a 45-year-old woman with gastric cancer in palliative stage. The assessment was performed using Gordon's functional patterns and the Watson Caritas Patient Score scale to evaluate the care received previously in the health system. Eight nursing diagnoses were identified, prioritizing 3 diagnoses using the clinical reasoning web (decisional conflict, anxiety, and ineffective self-management of health). Expected outcomes and nursing interventions were planned and implemented through moments of care using health education through tele-nursing and the intentional use of Caritas processes of care in the transpersonal relationship. The results were evaluated with the scales of the indicators and anxiety was also evaluated with the Beck Anxiety Inventory. Health education in oncology nursing contributed to improve informed decision making, reducing anxiety and providing emotional support to facilitate self-management of health. The participant perceived as humanized care throughout the sessions, reflected in the final evaluation with the Watson Caritas Patient Score scale.

Fatores preditores associados a ocorrência de lesão por pressão em pacientes em cuidados paliativos oncológicos / Predictive factors associated with the occurrence of pressure injuries in patients undergoing cancer palliative care / Factores predictivos asociados con la aparición de lesiones por presión en pacientes sometidos a cuidados paliativos oncológicos

Objetivo: Avaliar os fatores preditores para ocorrência de lesão por pressão em pacientes oncológicos em cuidados paliativos. Métodos: Estudo epidemiológico observacional, analítico, com delineamento transversal e abordagem quantitativa. A coleta de dados foi realizada com 105 participantes, no período de maio a outubro de 2019, em uma Clínica de Cuidados Paliativos Oncológicos de um Centro de Alta Complexidade em Oncologia. Os foram inseridos no software Biostat 5.0, em que foi realizada primeiramente a análise de regressão logística univariada, e posteriormente foram selecionadas as variáveis para a regressão logística múltipla e assim definiram-se os fatores preditivos para lesão por pressão. Resultados: A prevalência identificada foi de 19,04% para lesão por pressão. A maioria da amostra eram mulheres (60%), com idade menor que 70 anos (70%). Dois terços apresentavam risco muito alto (15%), para lesão por pressão segundo a Escala de Braden, e possuíam como diagnóstico primário câncer de próstata (20%), seguido de colo uterino (15%). Conclusão: A presença de lesão medular e o uso de fralda descartável demonstrou forte correlação com o desenvolvimento de lesão por pressão, sendo estes os fatores preditivos identificados neste estudo. Conhecer o perfil desses pacientes auxilia na elaboração e sistematização das condutas de enfermagem, visando melhor qualidade e segurança no cuidado. (AU)

Objective: To evaluate the predictive factors for the occurrence of pressure injuries in cancer patients undergoing palliative care. Methods: Observational, analytical, cross-sectional epidemiological study with a quantitative approach. Data collection was carried out with 105 participants, from May to October 2019, in an Oncology Palliative Care Clinic of a High Complexity Oncology Center. The data were entered into the Biostat 5.0 software, in which the univariate logistic regression analysis was first performed, and then the variables for the multiple logistic regression were selected, thus defining the predictive factors for pressure injury. Results: The identified prevalence was 19.04% for pressure injuries. Most of the sample were women (60%), aged under 70 years (70%). Two-thirds were at very high risk (15%) for pressure injury according to the Braden Scale, and had prostate cancer as a primary diagnosis (20%), followed by cervix (15%). Conclusion: The presence of spinal cord injury and the use of a disposable diaper showed a strong correlation with the development of pressure injury, which are the predictive factors identified in this study. Knowing the profile of these patients helps in the elaboration and systematization of nursing procedures, aiming at better quality and safety in care. (AU)

Objetivo: Evaluar los factores predictivos de la ocurrencia de lesiones por presión en pacientes oncológicos sometidos a cuidados paliativos. Métodos: Estudio epidemiológico observacional, analítico, transversal con enfoque cuantitativo. La recolección de datos se realizó con 105 participantes, de mayo a octubre de 2019, en una Clínica de Cuidados Paliativos Oncológicos de un Centro Oncológico de Alta Complejidad. Los datos se ingresaron en el software Biostat 5.0, en el cual se realizó primero el análisis de regresión logística univariante, y luego se seleccionaron las variables para la regresión logística múltiple, definiendo así los factores predictivos de lesión por presión. Resultados: La prevalencia identificada fue del 19,04% para las lesiones por presión. La mayoría de la muestra fueron mujeres (60%), menores de 70 años (70%). Dos tercios tenían un riesgo muy alto (15%) de lesión por presión según la escala de Braden y tenían cáncer de próstata como diagnóstico primario (20%), seguido del cuello uterino (15%). Conclusión: La presencia de lesión medular y el uso de pañal desechable mostró una fuerte correlación con el desarrollo de lesión por presión, que son los factores predictivos identificados en este estudio. Conocer el perfil de estos pacientes ayuda en la elaboración y sistematización de los procedimientos de enfermería, buscando una mejor calidad y seguridad en la atención. (AU)

Oncology Nursing for the Future: Multisector Planning Is Needed.

Assessing the landscape for oncology nursing of the future, the biggest problem that faces the specialty is that of workforce shortages. On the practice side, nursing turnover, resignations, and early retirements have contrib.

Spiritual Needs and Influencing Factors of Postoperative Breast Cancer Women Undergoing Chemotherapy: A Cross-Sectional Study.

Purpose: The purpose of the study was to determine the status of spiritual needs and influencing factors of postoperative breast cancer (BC) women undergoing chemotherapy. Participants and Methods: This study is a cross-sectional study. A total of 173 participants completed a general information questionnaire and a Chinese version of the Spiritual Needs Scale at the Guangxi Medical University Cancer Hospital. Data were collected by purposive sampling from December 2022 to April 2023. Data were analyzed by descriptive statistics, independent t-test, ANOVA, non-parametric test, and logistic regression analysis. Results: The spiritual needs of postoperative BC women undergoing chemotherapy were at a high level (84.20 ± 12.86). The need for "hope and peace" was considered paramount and the need for a "relationship with transcendence" was considered the least important. Significant differences were found in the following: spiritual needs total score (P=0.040) and "hope and peace" (P=0.021) in education level; "love and connection" in disease stage (P=0.021); "meaning and purpose" in education level (P=0.013), household income (P=0.012), and payment method (P=0.015); "relationship with transcendence" in religion (P<0.001); and "acceptance of dying" in marital status (P=0.023). The level of education was the influencing factor of spiritual needs (OR=1.50, P=0.005), especially for "hope and peace" (OR=1.50, P=0.012). Conclusion: The spiritual need of postoperative BC Chinese women undergoing chemotherapy is at a high level and should receive more attention. In clinical work, nurses should fully assess the spiritual needs of patients and meet their specific needs. Results may help nurses to develop targeted and comprehensive spiritual intervention strategies according to the characteristics of patients.

Anxiety Levels in Brazilian Women with Metastatic Breast Cancer Undergoing Palliative Chemotherapy: A Prospective Study.

OBJECTIVE: This study aimed to assess anxiety levels among women with metastatic breast cancer undergoing palliative chemotherapy. METHODS: A descriptive, prospective study was conducted at an oncology hospital in southern Brazil from September 2021 to October 2022. A total of 123 adult women receiving outpatient palliative chemotherapy were included in the study. Anxiety levels were evaluated using the State-Trait Anxiety Inventory at baseline, the fifth week, and the eleventh week of treatment. Data were analyzed using Kruskal-Wallis, Mann-Whitney, and Multiple General Regression Models. RESULTS: Women with advanced breast cancer had an average trait-anxiety score of 48.24±5.92. A progressive improvement in anxiety scores was observed throughout the treatment evaluation stages (44.90±5.89; 43.37±5.34; 42.58±5.75), with a significant difference between the evaluations (p=0.008). Significant correlations were found between trait-anxiety and work situation (p=0.010) and ovarian metastasis (p=0.022). The adjusted general regression model also showed statistical significance for baseline evaluation with offspring (p=0.045) and education level (p=0.041). CONCLUSION: Women with breast cancer undergoing palliative chemotherapy exhibited high trait-anxiety scores, which decreased significantly over the course of treatment.