Mindful Breathing: Effects of a Five-Minute Practice on Perceived Stress and Mindfulness Among Patients With Cancer.

BACKGROUND: Cancer can cause undesired side effects that can significantly alter patients' perceived stress and mindfulness. The integration of nonpharmacologic, complementary health interventions, such as mindful breathing, is potentially useful in reducing stress and promoting the well-being of patients during treatment. OBJECTIVES: This study examined the effects of a five-minute mindful breathing practice performed three times per day for three months on perceived stress and mindfulness among patients with cancer. METHODS: This longitudinal, randomized controlled study used a two-group, pre-/post-study design. Patients with distress scores of 4 or higher were randomized into two study arms. Participants in the intervention group were educated on mindfulness and guided on how to perform a five-minute mindful breathing practice. Perceived stress and mindfulness were assessed at baseline, one month postintervention, and three months postintervention. FINDINGS: Both groups had no significant difference in perceived stress and mindfulness scores at baseline. At three months, the intervention group reported a significant reduction in stress and an increase in mindfulness.

Nursing practice environment, resilience, and intention to leave among critical care nurses.

BACKGROUND: Retaining experienced critical care nurses (CCNs) remains a challenge for health care organizations. Nursing practice environment and resilience are both seen as modifiable factors in ameliorating the impact on CCNs' intention to leave and have not yet been explored in Malaysia. AIMS AND OBJECTIVES: To assess the association between perceived nursing practice environment, resilience, and intention to leave among CCNs and to determine the effect of resilience on intention to leave after controlling for other independent variables. DESIGN: This was a cross-sectional survey. METHODS: The universal sampling method was used to recruit nurses from adult and paediatric (including neonatal) critical care units of a large public university hospital in Malaysia. Descriptive analysis and χ2 and hierarchical logistic regression tests were used to analyse the data. RESULTS: A total of 229 CCNs completed the self-administrated questionnaire. Of the nurses, 76.4% perceived their practice environment as being favourable, 54.1% were moderately resilient, and only 20% were intending to leave. The logistic regression model explained 13.1% of variance in intention to leave and suggested that being single, an unfavourable practice environment, and increasing resilience were significant predictors of nurses' intention to leave. CONCLUSION: This study found that an unfavourable practice environment is a strong predictor of intention to leave; however, further exploration is needed to explain the higher likelihood of expressing intention to leave among CCNs when their resilience level increases. RELEVANCE TO CLINICAL PRACTICE: Looking into staff allocation and equality of workload assignments may improve the perception of the work environment and help minimize intention to leave among nurses.

Oral Cryotherapy: Prevention of Oral Mucositis and Pain Among Patients With Colorectal Cancer Undergoing Chemotherapy.

BACKGROUND: Evidence remains mixed on the benefits of oral cryotherapy in the prevention of oral mucositis and pain associated with fluorouracil-based chemotherapy. OBJECTIVES: The intent of this article is to evaluate the effect of oral cryotherapy on the prevention of oral mucositis and pain among patients with colorectal cancer undergoing fluorouracil-based chemotherapy. METHODS: Using an experimental study design, the authors randomly assigned 80 patients to either the intervention (n = 40) or usual care group (n = 40). Intervention group participants received oral cryotherapy in the form of ice chips held in their mouths during chemotherapy infusion. Both groups used sodium bicarbonate mouthwash postchemotherapy until the next cycle. FINDINGS: In the usual care group, most participants reported grade 2 (moderate to life-threatening) or greater mucositis. Pain associated with mucositis was lower using oral cryotherapy, with the majority of participants in the intervention group reporting no pain.

Informational needs of breast cancer patients on chemotherapy: differences between patients' and nurses' perceptions.

BACKGROUND: Cancer and chemotherapy are sources of anxiety and worry for cancer patients. Information provision is therefore very important to empower them to overcome and adjust to the stressful experience. Thus, nurses should be aware of the informational needs of the patients throughout the course of their care. PURPOSE: The purpose of the study was to identify the important information required by breast cancer patients during the first and fourth cycles of chemotherapy from both the patients' and nurses' perceptions. METHODOLOGY: This is a longitudinal study used a questionnaire adapted from the Toronto Informational Needs Questionnaires-Breast Cancer (TINQ-BC). Some modifications were made to meet the specific objectives of the study. The study was conducted in the Chemotherapy Day Care at the University of Malaya Medical Centre (UMMC), Malaysia. A total of 169 breast cancer patients who met the inclusion criteria, and 39 nurses who were involved in their care were recruited into the study. RESULTS: The overall mean scores at first and fourth cycle of chemotherapy were 3.91 and 3.85 respectively: i.e., between 3 (or important) and 4 (or very important), which indicated a high level of informational needs. There was no significant difference in information needed by the breast cancer patients between the two cycles of chemotherapy (p=0.402). The most important information was from the subscale of disease, followed closely by treatment, physical care, investigative tests and psychosocial needs. Nurses had different views on the important information needed by breast cancer patients at both time points (p = 0.023). CONCLUSIONS: Breast cancer patients on chemotherapy have high levels of informational needs with no significant differences in information needed at first cycle as opposed to fourth cycle. There were differences between the perceptions of the breast cancer patients and the nurses on important information needed. A paradigm shift, with an emphasis on patients as the central focus, is needed to enhance the information giving sessions conducted by nurses based on the perceptions of the patients themselves.