foun~at of Pain and Symptom Manal~ement 591

Abstract Pain is an understudied problem in frail elderly patients, especially those with cognitive impairment, delirium, or dementia

Developing a National Implementation Strategy to accelerate Uptake of Evidence-Based Family Caregiver Support in Us Cancer Centers

OBJECTIVE: Characterize key factors and training needs of U.S. cancer centers in implementing family caregiver support services. METHODS: Sequential explanatory mixed methods design consisting of: (1) a national survey of clinicians and administrators from Commission-on-Cancer-accredited cancer centers (N = 238) on factors and training needed for establishing new caregiver programs and (2) qualitative interviews with a subsample of survey respondents (N = 30) to elicit feedback on survey findings and the outline of an implementation strategy to facilitate implementation of evidence-based family caregiver support (the Caregiver Support Accelerator). Survey data was tabulated using descriptive statistics and transcribed interviews were analyzed using thematic analysis. RESULTS: top factors for developing new caregiver programs were that the program be: consistent with the cancer center\u27s mission and strategic plan (87%), supported by clinic leadership (86.5%) and providers and staff (85.7%), and low cost or cost effective (84.9%). top training needs were how to: train staff to implement programs (72.3%), obtain program materials (63.0%), and evaluate program outcomes (62.6%). Only 3.8% reported that no training was needed. Qualitative interviews yielded four main themes: (1) gaining leadership, clinician, and staff buy-in and support is essential; (2) cost and clinician burden are major factors to program implementation; (3) training should help with adapting and marketing programs to local context and culture; and (4) the Accelerator strategy is comprehensive and would benefit from key organizational partnerships and policy standards. CONCLUSION: Findings will be used to inform and refine the Accelerator implementation strategy to facilitate the adoption and growth of evidence-based cancer caregiver support in U.S. cancer centers

Oxford Textbook of Palliative Nursing

xxiii, 699 hlm.; 25 c

Quality of Life among Long-Term Cancer Survivors

Thanks to advances in cancer diagnosis and treatment, there are now more than 10 million cancer survivors in the United States. Successful treatment of cancer has resulted in increased demands on survivors and has had diverse effects on the quality of life (QOL) of patients and their families. A model of QOL encompassing dimensions of physical, psychological, social, and spiritual well-being has been applied to illustrate the multidimensional needs of cancer survivors and the necessity of comprehensive care extending over the long term. Data from a recent survey of members of the National Coalition of Cancer Survivorship (NCCS) is presented, along with a summary of issues compiled by the NCCS that merit future attention

Portraits Of Cancer Survivorship. A Glimpse Through The Lens Of Survivor\u27S Eyes

Cancer survivorship is a tumultuous experience of balancing the elation of surviving life-threatening illness with the demands of chronic health concerns and altered life meaning. Increased awareness of the needs of cancer survivors is enhanced by large studies of this growing population, but also by appreciation of individual stories of survivorship. \u27Portraits\u27 of survival, in the form of personal narratives, contribute to our understanding of the experience of cancer. Select portraits from a study exploring quality of life in cancer survivorship are shared to convey themes of rendering an old life, transition to a different life, and living an altered life after cancer diagnosis