Impact of Effective Intravesical Therapies on Quality of Life in Patients with Non-Muscle Invasive Bladder Cancer: A Systematic Review.

BACKGROUND: Conventional and newly emerged intravesical modalities have demonstrated prophylactic effectiveness that may improve quality of life (QoL) in non-muscle invasive bladder cancer. The purpose of this study is to analyze existing QoL evidence in patients receiving any form of intravesical therapy. METHODS: A PubMed search without time restriction was conducted to identify all relevant studies in accordance with the PICOT question. Additionally, a search was also performed in the Cochrane library database, Internet, and citation. The CONSORT 2010 checklist and STROBE statement checklist were used to evaluate the risk of bias of the included studies. RESULTS: A total of 24 eligible articles were included, which consisted of 11 interventional and 13 observational studies. Intravesical therapy with Bacillus Calmette-Guérin (BCG) or certain chemotherapeutic agents worsens symptom burdens and functional performance during the initial induction phase while continuous improved is observed throughout the maintenance treatment and beyond. Hyperthermia has shown a positive trend in enhancing QoL of patients receiving intravesical chemotherapy, which requires more investigations. However, QoL data were unavailable for other forms of immunotherapy, immune checkpoint inhibitors, electromotive drug administration, and photodynamic therapy. CONCLUSIONS: Limited studies suggested the long-term positive impact of intravesical BCG immunotherapy and chemotherapy. However, existing evidence was lacking to clarify the impact of many emerging intravesical therapies that have suggested to be effective and safe, which demands treatment-specific QoL studies.

Challenges of university nursing transfer students in an Asian context: a qualitative study.

OBJECTIVES: To explore the social and academic experiences of nursing transfer students' (NTSs) in an Asian context. DESIGN: A descriptive qualitative study design using focus groups and individual interviews with Chinese NTSs. The data were transcribed verbatim and analysed by using qualitative content analysis. SETTING: A university offering preregistration nursing programmes in Hong Kong. PARTICIPANTS: Chinese NTSs studying in a 3-year special pattern within a 5-year Bachelor of Nursing programme in a university in Hong Kong. RESULTS: Four main categories were identified: 'expectations about study at the beginning of the programme', 'challenges during transition', 'coping by prioritising' and 'our world is small'. The NTSs had clear goals for becoming professional nurses and consequently aimed at higher academic achievements throughout the study. They anticipated enjoying university life at the beginning of their study; however, the challenges caused by heavy study workloads and transition from passive to independent learning approaches, compounded by the limited time of 3-year study, forced them to develop coping strategies to reconcile and prioritise their preconceived notions, academic pursuits, social engagements and personal well-being. Their high prioritisation of good academic performance confined their university lives to the small world of the academic arena. CONCLUSIONS: The study identified challenges faced by NTSs in adjusting to university study. Suggestions are offered to different stakeholders to address the issues at individual, institutional and government levels so as to enhance NTSs' learning experiences at university.

Psychometric Evaluation of the Workstyle Short Form among Nursing Assistants with Work-Related Musculoskeletal Symptoms.

The Workstyle Short Form (24 items) (WSF-24) has been tested for its psychometric properties on work-related upper-extremity musculoskeletal symptoms (WRUEMSs) among office workers. However, the impact of workstyle should not only be limited to WRUEMSs and the sedentary workforce. The purpose of this study was to test the psychometric properties of the modified 24-item Chinese WSF (C-WSF-24) to identify work-related musculoskeletal symptoms (WRMSs) in various body parts among nursing assistants (NAs) working in nursing homes. Four hundred and thirty-nine NAs participated in the study. The results of the factor analysis were that a four-factor solution (working through pain, social reactivity at work, demands at work and breaks) accounted for 56.45% of the total variance. Furthermore, validation against known groups showed that the total score and subscale scores of the C-WSF-24 had the ability to discriminate between NAs with and without WRMSs in various body parts (such as low back and lower extremities). Additionally, C-WSF-24 had a statistically significant association with the contributing factors to WRMSs. This is the first study to examine the psychometric properties of the C-WSF-24 in the non-sedentary workforce, with a focus on various body parts of WRMSs. The results demonstrated that C-WSF-24 is reliable and valid for assessing WRMSs in various body parts among NAs.

Prevalence of and Factors Associated with Work-Related Musculoskeletal Symptoms in Nursing Assistants Working in Nursing Homes.

The prevalence of work-related musculoskeletal symptoms (WRMSs) in different body parts for nursing assistants (NAs) working in nursing homes is currently unknown. The aim of this study was to determine the extent of WRMSs in nursing assistants and the factors associated with them. Four hundred and forty NAs from 52 nursing homes, recruited by convenience sampling, participated in this cross-sectional study in 2014-2015. A valid and reliable study questionnaire was used to collect data. The results of our study found that 88.4% of NAs reported at least one body part with WRMSs. These NAs reported more symptoms in the shoulders than lower back. Adverse workstyle (OR = 1.04, 95% CI = 1.01-1.08) was the only factor associated with WRMSs after adjustment for potential confounders using multivariable logistic regression. This adverse workstyle could be developed because of physical and psychological work demands. Efforts should be directed at integrating "workstyle intervention" into lifestyle physical activity training to this group of healthcare workers.

Exploring the Synergic Effects of Nursing Home Work on Work-Related Musculoskeletal Disorders Among Nursing Assistants.

Little is known about how nursing assistants (NAs) perceive the nature of their work and how their work contributes to work-related musculoskeletal disorders (WMSDs). This qualitative study addressed these gaps. Twenty-four NAs with WMSDs working in four nursing homes participated in semistructured focus group interviews. Their WMSDs were not limited to the lower back but involved several body parts. The risk factors for WMSDs included physical, psychosocial, organizational, and personal factors as well as coworkers and clients. However, it is the synergistic effects of long work hours without sufficient rest, work even with musculoskeletal pain because of staff shortages, ineffective management with insufficient prework training and inadequate equipment maintenance, and an aging workforce with strong commitment to resident care that play a crucial role in WMSDs among NAs working in nursing homes. The study found that multidimensional intervention strategies using engineering, administrative, and personal controls should be developed to reduce WMSDs among NAs working in nursing homes.

The computerized OMAHA system in microsoft office excel.

The OMAHA System was adopted as the documentation system in an interventional study. To systematically record client care and facilitate data analysis, two Office Excel files were developed. The first Excel file (File A) was designed to record problems, care procedure, and outcomes for individual clients according to the OMAHA System. It was used by the intervention nurses in the study. The second Excel file (File B) was the summary of all clients that had been automatically extracted from File A. Data in File B can be analyzed directly in Excel or imported in PASW for further analysis. Both files have four parts to record basic information and the three parts of the OMAHA System. The computerized OMAHA System simplified the documentation procedure and facilitated the management and analysis of data.

Meaning making: psychological adjustment to breast cancer by Chinese women.

Based on a study exploring the phenomenon of coping among Hong Kong Chinese women afflicted with breast cancer, from diagnosis to completion of treatment, we report the findings on meaning making by the informants. Using the grounded theory method, we conducted 35 interviews with 24 women suffering from breast cancer. Among them, we followed and interviewed 5 women thrice, from diagnosis to 3 months after completion of treatment. We noted the evolution of reframing as the key category in the adjustment process through which the women identified meaning at different points of time in the cancer experience, to achieve different outcomes. Chinese women identified a sustaining force from minimizing social disturbance during treatment. The integration of cancer into their lives after completion of treatment was achieved through positive transformation in their philosophy of life and social relationships. Nurses should aim to understand the cancer patients' interpretation of the situation, explore personally meaningful sustaining forces, and reflect on their cancer experience.

Quality of life in cervical cancer survivors: a review of the literature and directions for future research.

PURPOSE/OBJECTIVES: To describe the most current trends in quality-of-life (QOL) research in cervical cancer survivors and to discuss directions for future research. DATA SOURCES: A literature search was conducted among five electronic databases using the terms cervical or cervix cancer, quality of life, survivors, survivorship, measurement, and instruments. Articles were published either in English or Chinese from January 2005 to June 2009. DATA SYNTHESIS: Thirty-one articles were identified. The major QOL issues among cervical cancer survivors were categorized at the individual and systemic levels. The most current trends include research into the positive and negative aspects of cancer survivorship; studies that examine unhealthy lifestyle behaviors, which contribute to poor QOL; studies concerned with the impact of cervical cancer survivorship on male partners and family caregivers; and three primary types of instruments used for assessment. CONCLUSIONS: Future research directions should include (a) exploring and optimizing the positive outcomes of cervical cancer survivorship, (b) using interventions to reduce risky lifestyles or unhealthy behaviors, (c) conducting exploratory studies to determine the impact of cervical cancer survivorship on families, (d) conducting longitudinal studies to document the ongoing changes in QOL among cervical cancer survivors, and (e) developing new instruments to assess the systemic level of QOL. IMPLICATIONS FOR NURSING: Expanding the understanding of QOL and related factors in cervical cancer survivors would enable nurses to assess and develop interventions to improve QOL and overall survival outcomes for this population.

Chinese nurses' attitudes and beliefs toward sexuality care in cancer patients.

BACKGROUND: The importance of having nurses address patients' sexuality concerns is emphasized by a growing body of literature. Most relevant studies were conducted in Western cultural settings. OBJECTIVE: The purpose of this study was to describe Chinese nurses' attitudes and beliefs regarding sexuality care in cancer patients. METHODS: A descriptive and correlation design was adopted. Data were collected by an inventory of Sexuality Attitudes and Beliefs Survey. RESULTS: Oncology nurses (n = 199) were recruited from a tumor hospital in China. The study results indicate that most Chinese nurses (76.4%) perceived sexuality as too private an issue to discuss with cancer patients, and 63.8% assumed that most cancer patients lacked interest in sexuality because of their illnesses. The results also show that most nurses (77.9%) did not make time to discuss sexuality issues with patients, and nearly 70% did not feel confident and comfortable discussing cancer patients' sexuality concerns. CONCLUSION: Helping nurses overcome barriers to addressing patients' sexuality concerns requires a careful assessment of their attitudes and beliefs. This study added insights into Chinese nurses' attitudes and beliefs surrounding the sexuality issues of cancer patients. IMPLICATIONS FOR PRACTICE: In this study, nurses reported that they were less likely to make time to discuss sexuality issues with cancer patients; thus, future research needs to identify specific factors keeping nurses from incorporating sexuality care into practice. Additionally, most nurses felt less confident and uncomfortable in addressing cancer patients' sexuality concerns. More training related to sexuality care is needed for Chinese nurses.

Quality of life measurement in women with cervical cancer: implications for Chinese cervical cancer survivors.

BACKGROUND: Women with cervical cancer now have relatively good 5-year survival rates. Better survival rates have driven the paradigm in cancer care from a medical illness model to a wellness model, which is concerned with the quality of women's lives as well as the length of survival. Thus, the assessment of quality of life among cervical cancer survivors is increasingly paramount for healthcare professionals. The purposes of this review were to describe existing validated quality of life instruments used in cervical cancer survivors, and to reveal the implications of quality of life measurement for Chinese cervical cancer survivors. METHODS: A literature search of five electronic databases was conducted using the terms cervical/cervix cancer, quality of life, survivors, survivorship, measurement, and instruments. Articles published in either English or Chinese from January 2000 to June 2009 were searched. Only those adopting an established quality of life instrument for use in cervical cancer survivors were included. RESULTS: A total of 11 validated multidimensional quality of life instruments were identified from 41 articles. These instruments could be classified into four categories: generic, cancer-specific, cancer site-specific and cancer survivor-specific instruments. With internal consistency varying from 0.68-0.99, the test-retest reliability ranged from 0.60-0.95 based on the test of the Pearson coefficient. One or more types of validity supported the construct validity. Although all these instruments met the minimum requirements of reliability and validity, the original versions of these instruments were mainly in English. CONCLUSION: Selection of an instrument should consider the purpose of investigation, take its psychometric properties into account, and consider the instrument's origin and comprehensiveness. As quality of life can be affected by culture, studies assessing the quality of life of cervical cancer survivors in China or other non-English speaking countries should choose or develop instruments relevant to their own cultural context. There is a need to develop a comprehensive quality of life instrument for Chinese cervical cancer survivors across the whole survivorship, including immediately after diagnosis and for short- (less than 5 years) and long-term (more than 5 years) survivorship.

Reframing: psychological adjustment of Chinese women at the beginning of the breast cancer experience.

In this article, we present findings from a larger study that explored how Chinese women cope with breast cancer. We report on the process of early psychological adjustment, along with contextual factors and how they influence the women's coping mechanisms at the beginning of the cancer experience. Twenty-four women with diagnoses of breast cancer were interviewed. The grounded theory method was adopted in data collection and analysis. "Reframing" was the core category of the early adjustment process. Focus and approach were the two contextual conditions. Women adopted "fighting," "following the natural course," "struggling," and "bearing" modes in coping with the disease. These findings highlight the significance of focusing on coping and realizing the role of the self in creating a subjective positive interpretation, which subsequently enhances acceptance of the disease at the beginning of the cancer experience. Characteristics of the Chinese people with respect to coping include the collaborative meaning of control and the philosophy of acquiescence to fate.