Virtual reality bringing a new reality to postthoracotomy lung cancer patients via a home-based exercise intervention targeting fatigue while undergoing adjuvant treatment.

BACKGROUND: Little is known about rehabilitation for postthoracotomy non-small cell lung cancer (NSCLC) patients. This research uses a perceived self-efficacy-enhancing light-intensity exercise intervention targeting a priority symptom, cancer-related fatigue (CRF), for postthoracotomy NSCLC patients. This article reports on phase II of a 2-phase study. Phase I focused on initiation and tolerance of exercise during the 6 weeks immediately after thoracotomy, whereas phase II addressed maintenance of exercise for an additional 10 weeks including participants initiating and completing chemotherapy and/or radiation therapy. OBJECTIVE: The objective of this study was to investigate the feasibility, acceptability, and preliminary efficacy of an exercise intervention for postthoracotomy NSCLC patients to include those initiating and completing adjuvant therapy. INTERVENTIONS/METHODS: A single-arm design composed of 7 participants postthoracotomy for NSCLC performed light-intensity exercises using an efficacy-enhancing virtual-reality approach using the Nintendo Wii Fit Plus. RESULTS: Despite most participants undergoing chemotherapy and/or radiation therapy, participants adhered to the intervention at a rate of 88% with no adverse events while giving the intervention high acceptability scores on conclusion. Likewise, participants' CRF scores improved from initiation through the conclusion of the intervention with perceived self-efficacy for walking at a light intensity continuously for 60 minutes, improving significantly upon conclusion over presurgery values. CONCLUSIONS: Postthoracotomy NSCLC patients maintained exercise for an additional 10 weeks while undergoing adjuvant therapy showing rehabilitation potential because the exercise intervention was feasible, safe, well tolerated, and highly acceptable showing positive changes in CRF self-management. IMPLICATIONS FOR PRACTICE: A randomized controlled trial is needed to further investigate these relationships.

Identification of need for an evidence-based nurse-led assessment and management protocol for radiation dermatitis.

BACKGROUND: Radiation therapy is used globally as a standard treatment for many forms of cancer. Skin damage or radiation dermatitis is the most common effect of radiation therapy. OBJECTIVES: The study aims were to survey nurses to identify methods used to screen, manage, and monitor acute skin reactions within the radiation departments of an urban, northeastern teaching hospital and its network facilities and identify strategies to establish a mechanism for ongoing communication among the nurses to develop and implement an evidence-based protocol. METHODS: Using an online self-report survey format (SurveyMonkey), radiation nurses were asked to describe their current practice related to assessing and monitoring radiation dermatitis, areas of expertise, skin assessment tools used, frequency of skin assessment, and interventions used to manage patients with radiation dermatitis. RESULTS: Twenty-two radiation nurses (100%) representing all 8 facilities within the network responded. Tools to assess patients' skin, the frequency of skin assessments, and products used to manage skin reactions varied among the nurses. Nurses also assessed patients for additional factors including nutritional status, presence of other diseases, and medications. CONCLUSIONS: Our results validated the need for a system-wide approach to manage patients undergoing radiation therapy, specifically a skin care protocol that defines type and frequency of skin assessments as well as recommends treatments for prevention and management of common skin conditions. IMPLICATIONS FOR PRACTICE: The establishment of a standard method of assessing the skin will improve quality of care provided in the radiation departments and potentially limit patient complications and costs.

Predictors of the trajectories of self-reported attentional fatigue in women with breast cancer undergoing radiation therapy.

PURPOSE/OBJECTIVES: To examine how attentional fatigue changed from the time of simulation to four months after the completion of radiation therapy and to investigate whether specific variables predicted initial levels and trajectories of attentional fatigue. DESIGN: Descriptive, longitudinal study. SETTING: Two radiation therapy departments. SAMPLE: 73 women with breast cancer who received primary or adjuvant radiation therapy. METHODS: Participants completed questionnaires prior to, during, and after radiation therapy. Descriptive statistics and hierarchical linear modeling were used for data analysis. MAIN RESEARCH VARIABLES: Attentional fatigue; demographic, clinical, and symptom characteristics. FINDINGS: Large amounts of interindividual variability were found in the trajectories of attentional fatigue. At baseline, higher levels of attentional fatigue were associated with younger age, not working, a higher number of comorbidities, and higher levels of trait anxiety. The trajectory of attentional fatigue improved over time for women with higher body mass index at baseline. CONCLUSIONS: This study is the first to identify predictors of interindividual variability in attentional fatigue in women with breast cancer undergoing radiation therapy. The predictors should be considered in the design of future correlational and interventional studies. IMPLICATIONS FOR NURSING: Nurses could use knowledge of the predictors to identify patients at risk for higher levels of attentional fatigue. In addition, nurses could use the information to educate patients about how attentional fatigue may change during and following radiation therapy for breast cancer.

Quality of life among mastectomy patients receiving radiotherapy.

A descriptive study was conducted to describe the quality of life among mastectomy patients receiving radiotherapy. There were 20 mastectomy patients receiving radiotherapy at Oncology Hospital of Peking Union Medical College, and the First, and the Second Teaching Hospital of Beijing Medical University, in Beijing according to the criteria. The instrument used for data collection was Quality of Life Index-Cancer Version (QLI-CV). Finding of the study revealed that the quality of life among mastectomy patients had changed a little during the course of radiotherapy. Within four domains,family domain received the highest satisfaction, while psychological/spiritual domain seeded to get the lowest satisfaction in this group of people. The findings of the study may provide the baseline knowledge for understand quality of life among mastectomy patients.