Research Electronic Data Capture (REDCap) in an outpatient oncology surgery setting to securely email, collect, and manage survey data.

BACKGROUND: Nursing interventions in the post-operative time period including psychological and emotional support, adverse event education, and instructions for follow-up care contribute patient satisfaction, safety, and quality of life. However, the time spent in the post-anesthesia care unit (PACU) and hospital continues to shorten around the world to reduce health care spending and improve patient outcomes. Nurses conducting research during the important post-operative recovery period need to utilize unique techniques and emerging technologies to contact, recruit and collect data outside of the hospital setting including the Research Electronic Data Capture (REDCap) platform. AIMS: This paper describes the feasibility and acceptability, facilitators and barriers of the software application, REDCap, to complete a repeated-measures, descriptive correlational study in patients undergoing outpatient breast cancer surgeries. METHODS & MATERIALS: The recruitment, data collection and storage were completed utilizing the secure REDCap Platform. The Institutional Research Board (IRB)-approved study was a repeated-measures, descriptive, correlational study with data collection at three time points. The data points aligned with important transitions and routine visits to improve data collection feasibility and increase relevance to clinical practice. RESULTS: The sample consisted of women diagnosed with breast cancer undergoing breast conserving surgery between August 15 and October 15, 2020. There were 123 potential participants, of which 76 started the surveys and 75 participated (61%) responded and participated in the study on Post-operative Day 1. Fifty-nine participants (78%) completed the surveys on post-operative Day 14. DISCUSSION: As the frequency of outpatient treatment increases, nurses conducting post-operative research will need to collect the data outside of the hospital setting. CONCLUSION: Email provides a method of studying new phenomena by recruiting participants, providing information about the study, and collecting results in a non-traditional setting. REDCap provides a method to facilitate nursing research through a securely encrypted integrated process.

Distress, Pain, and Coping Strategies in Patients Undergoing Breast-Conserving Surgery: A Scoping Literature Review.

PROBLEM IDENTIFICATION: Most patients with breast cancer are diagnosed at an early stage, when surgery remains the primary treatment. This scoping literature review explores the frequency and severity of symptoms; which patients are at the highest risk for pain, nausea, and distress; and the relationships between coping strategies and these symptoms. LITERATURE REVIEW: This review included articles found in the MEDLINE®, CINAHL®, PubMed®, PsycINFO®, APA PsycArticles®, and Cochrane Library databases and published from 2010 through 2022, using combinations of the following keywords: coping, cancer, distress, surgery, and breast. DATA EVALUATION: Initial search results yielded 111 research articles, and 13 were included in the review. Extracted data included the purpose, study design, sample size, time point, instrument, and conclusion. SYNTHESIS: Nausea, pain, and distress are substantial problems for women following breast cancer surgery. The relationships among predictors, pain, nausea, and distress are clear, but the direction and strength of these relationships remain unknown. A better understanding of the relationships among these factors is important to improve the experience of women with breast cancer. IMPLICATIONS FOR RESEARCH: Nursing research should focus on developing targeted interventions to reduce these symptoms.

Perioperative pain, psychological distress, and immune function in men undergoing prostatectomy for cancer of the prostate.

Prostate cancer is a leading malignancy in men, and prostatectomy is widely used for its treatment. Psychological distress and pain are commonly experienced in the perioperative period, and both can contribute to suppression of the immune response to cancer. This study evaluated perioperative pain, psychological distress, and immune function in men undergoing prostatectomy. Men were evaluated prior to surgery, 1 and 2 days postoperatively and 4-6 weeks postoperatively. Compared to cancer-free men, the prostatectomy group reported increased perceived stress, depression, confusion, and anxiety prior to surgery. During the 2 postoperative days, mood disturbance and anxiety persisted and were accompanied by mild elevations in pain and reduced vigor. At 4-6 weeks postoperative, mood, pain, and immune function were similar to those of the cancer-free group; however, the prostatectomy group continued to report significant elevations in anxiety. Natural killer cell activity (NKCA) was significantly reduced on Day 1 after prostatectomy, but by postoperative Day 2, NKCA returned to a level similar to that of the cancer-free group. The reduction in NKCA was not accompanied by changes in circulating immune cells, demonstrating that this reduction represented a functional change in NKCA. No correlations between immune variables and pain or psychological variables were found, suggesting that the postoperative reduction in NKCA was likely the result of the physical stress of the surgical experience. Suppression of immune defenses during the critical postoperative period can place cancer patients at risk for nascent tumor seeding. Additional interventions are needed to reduce this risk.