Patient-Reported Experiences of Supportive Cancer Care during the COVID-19 Pandemic

Background. During the COVID-19 pandemic, people affected by cancer were in need of information about the virus and about the (self-) management of cancer symptoms and treatment. It is important to understand how patients with cancer navigated through the pandemic and to explore their experience relating to their supportive care needs. Aim. This study aimed to describe the experience of Swiss oncological patients during the COVID-19 pandemic with additional supportive cancer care. Methods. A single-center study was conducted in 2021. Patients with melanoma, breast, lung, or colon cancer who received active systemic anticancer treatment at the time of the COVID-19 pandemic and who were additionally seeing either oncology clinical nurse specialists, integrative medicine physicians, or both were included. We conducted semistructured interviews alongside the patient-reported quantitative assessment of distress and resilience. Thematic analysis was performed for the qualitative data and descriptive statistics for the quantitative data. Results. Eighteen patients with cancer were interviewed. Patients seeing an integrative medicine physician highlighted that they positively felt being addressed as a whole person during the consultations. The oncology clinical nurse specialists were perceived as the first point of contact for the patients and had more time during the pandemic compared to what the patients normally received. In general, patients did not experience delays or disruptions in their cancer treatment. As immunosuppressed and fatigued patients with cancer, they felt supported by the restrictions and hygienic measures. Access to vaccination reassured patients against the risk of infection. These results were reflected in the quantitative data, as we found moderate distress levels (M = 4.1; SD = 2.5) and high resilience scores (M = 7.5; SD = 0.9) in this patient population. Conclusion. During the COVID-19 pandemic, patients with cancer felt particularly supported by integrative medicine and cancer nurse consultations. Secured resources for nursing consultations and integrative medicine services can help to address the supportive care needs of patients with cancer

Cancer nursing research priorities: a rapid review

Abstract Purpose Identifying cancer nursing research priorities is central to influencing the direction of cancer care research. The aim of this rapid review was to explore research priorities identified by oncology nurses for cancer care delivery between 2019-2022. Methods The Preferred Reporting Items for Systematic Reviews and Meta-Analysis informed the design of the rapid review. MEDLINE, CINAHL, PUBMED, Web of Science, and Cochrane databases were searched for studies published between December 1st, 2018, and September 30th, 2022. This timeframe was chosen to account for the latest relevant evidence synthesis, as well as changes in cancer care necessitated by the COVID-19 pandemic. The Quality Assessment of Diverse Studies tool was used to appraise quality. Results Four studies met the inclusion criteria. Many of the research priorities identified were influenced by the COVID-19 pandemic. The top cancer nursing research priority identified was the role of technology in improving patient and caregiver symptoms and health outcomes. Other most prevalent research priorities were focused on symptom management, culturally sensitive palliative and psychosocial care, early/integrated palliative care, financial toxicity, modifiable risk factors related to social determinants of health, public and patient involvement in research, and oncology nurses' well-being and scope of practice. Conclusion The findings indicate a need to steer a strategic programme of cancer nursing research towards digitalisation in cancer care to meet the current needs of people living with cancer and their caregivers. However, cancer nurses' burnout, staff shortages and disparities in specialist education will hinder the implementation of certain models of care

Patient-reported experiences of cancer care related to the COVID-19 pandemic in Switzerland

Purpose This study aims to describe the experience of Swiss oncological patients during the COVID-19 pandemic. Methods A national multi-center study including five hospitals covering the three main language regions of Switzerland was conducted between March and July 2021. Patients with melanoma, breast, lung, or colon cancer receiving active systemic anti-cancer treatment at the time of the COVID-19 pandemic were included. We conducted semi-structured telephone or onsite interviews alongside the administration of distress and resilience-validated questionnaires. Thematic analysis was performed for the qualitative data and descriptive statistics for the quantitative data. Results Sixty-two cancer patients with a mean age of 61 (SD=14) (58% female) were interviewed. Based on the interviews, we identified that the experience of having cancer during the COVID-19 pandemic was related to five dimensions: psychological, social, support, healthcare, and vaccination. Three themes transverse the five dimensions: (a) needs, (b) positive changes, and (c) phases of the pandemic. In general, patients did not experience delays or disruptions in their cancer treatment nor felt additionally burdened by the pandemic. Lockdown and isolation were reported as mixed experiences (positive and negative), and access to vaccination reassured patients against the risk of infection and instilled hope to return to normalcy. Additionally, we found low distress levels (M=2.9; SD=2.5) and high resilience scores (M=7; SD=1.3) in these patients. Conclusion Swiss patients with cancer did not express major needs or disruptions in their care during this period of the COVID-19 pandemic. Results identify the mixed experiences of patients and highlight the high resilience levels

Patient and public involvement in research: Reflections and experiences of doctoral cancer nurse researchers in Europe

Purpose Early career researchers lack guidance about patient and public involvement (PPI). The overall aim of the study was to explore the knowledge and experiences of using PPI in research among doctoral students who are registered nurses. Methods This qualitative study included findings generated from reflective essays and focus groups involving ten registered cancer nurses who are undertaking doctoral research. The study has two stages of data collection. Participants initially wrote a reflective essay using a set of guiding questions to structure a response which was subsequently analysed. Two focus groups were then conducted to provide further insight into the themes identified in the reflective essays. Reflective thematic analysis was used to identify, name, and define the final themes. Results There were ten participants from seven countries and were at various stages of their doctoral study. Analysis of data from reflective essays (n = 10) and focus groups (n = 2) identified four themes namely, (a) evolving recognition and appreciation of PPI, (b) embracing PPI and impact on doctoral studies, (c) the influence of the research environment, and (d) the need to empower doctoral students to integrate PPI in their research journey. Conclusion Participants reported differing experiences of PPI awareness showing disparity in guidance about PPI for junior researchers across Europe. We recommend provision of early PPI training for doctoral students to support and encourage involvement of patients and the public in their research. Opportunities for sharing PPI experiences to help improve PPI culture in research environments that support doctoral students should be explored

Describing adverse events in Swiss hospitalized oncology patients using the Global Trigger Tool

The occurrence rate of adverse events (AEs) related to care among hospitalized oncology patients in Switzerland remains unknown. The primary objective of this study was to describe, for the first time, the occurrence rate, type, severity of harm, and preventability of AEs related to care, reported in health records of hospitalized hematological and solid-tumor cancer patients in three Swiss hospitals.; Using an adapted version of the validated Global Trigger Tool (GTT) from the Institute for Healthcare Improvement, we conducted a retrospective record review of patients discharged from oncology units over a 6-week period during 2018. Our convenience sample included all records from adult patients (≥18 years of age), diagnosed with cancer, and hospitalized (>24 hours). Per the GTT method, two trained nurses independently assessed patient records to identify AEs using triggers, and physicians from the included units analyzed the consensus of the two nurses. Together, they assessed the severity and preventability of each AE.; From the sample of 224 reviewed records, we identified 661 triggers and 169 AEs in 94 of them (42%). Pain related to care was the most frequent AE (n = 29), followed by constipation (n = 17). AEs rates were 75.4 per 100 admissions and 106.6 per 1000 patient days. Most of the identified AEs (78%) caused temporary harm to the patient and required an intervention. Among AEs during hospitalization (n = 125), 76 (61%) were considered not preventable, 28 (22%) preventable, and 21 (17%) undetermined.; About half of the hospitalized oncology patients suffered from at least one AE related to care during their hospitalization. Pain, constipation, and nosocomial infections were the most frequent AEs. It is, therefore, essential to identify AEs to guide future clinical practice initiatives to ensure patient safety

Personalisierte Medizin: Grundlagen für die interprofessionelle Aus-, Weiter- und Fortbildung von Gesundheitsfachleuten

Hinweise zur Ausarbeitung dieser Publikation: Die SAMW hat im Auftrag der Akademien der Wissenschaften Schweiz die thematische Plattform «Chancen und Risiken der Personalisierten Gesundheit» etabliert. In diesem Rahmen hat der SAMW-Vorstand eine Arbeitsgruppe beauftragt, das Thema der Aus-, Weiter- und Fortbildung von Gesundheitsfachleuten im Bereich «Personalisierte Medizin» zu bearbeiten

The role of CDKN1B-p27kip1 deregulation in the pathogenesis of pediatric T-cell acute lymphoblastic leukemia

T-cell acute lymphoblastic leukemia (T-ALL) accounts for 10 15% of pediatric ALL. The oncogenic transformation of T-cell precursors is driven by a broad spectrum of genetic abnormalities. We have confirmed the high frequency of heterozygous loss of the haploinsufficient tumor suppressor CDKN1B in pediatric T ALL samples as well as its reduced transcription also in patients without any evidence of CDKN1B deletions. Although we did not find a correlation between alterations in genes involved in CDKN1B regulation and frequently mutated in T ALL and low CDKN1B transcript levels, we determined that CDKN1B-deleted patients have a significantly lower incidence of CDKN2A/B deletions and preferentially arise in immature/MEF2C-dysregulated T ALL. We also show that MEF2C overexpression is not exclusively found in early immature T ALL but is significantly associated with a poor response to glucocorticoid treatment. Furthermore, we investigated the effects of two small molecule inhibitors of SKP2 alone and in combinations with other therapeutic agents in T ALL cell lines. Our results highlight the importance of defining the cell type-specific and genetic background-dependent biological effects of such compounds.La leucemia linfoblástica aguda de células T (LLA-T) representa el 10 15% de las leucemias pediátricas. La transformación oncogénica de precursores de células T es causada por un amplio espectro de complejas anomalías genéticas. En nuestro estudio hemos podido confirmar la alta frecuencia de la pérdida heterocigota del gen supresor de tumores CDKN1B en muestras de LLA-T pediátrica así como su reducida transcripción en pacientes que no mostraban evidencia de deleciones en CDKN1B. A pesar de no hallar una correlación entre alteraciones en genes involucrados en la regulación de CDKN1B, y frecuentemente mutados en LLA-T, y los bajos niveles de CDKN1B, determinamos que los pacientes que presentan deleción en CDKN1B tienen una menor incidencia de deleciones en CDKN2A/B y muestran una mayor preferencia por los subtipos inmaduros/MEF2C-desregulados de LLA-T. También demostramos que la sobrexpresión de MEF2C no se encuentra limitada exclusivamente al subtipo “precursor temprano T”, pero sí está significativamente asociada con una pobre respuesta al tratamiento con glucocorticoides. Además, investigamos los efectos de dos moléculas inhibidoras de SKP2, solas o en combinación con otros agente terapéuticos, en líneas celulares de LLA-T. Nuestros resultados resaltan la importancia de definir el trasfondo genético y especificidad celular de los efectos biológicos producidos por dichos compuestos