Treatment-Related Decisional Conflict, Quality of Life, and Comorbid Illness in Older Adults with Cancer

As the aging population in the nation increases, cancer diagnoses in this age group will also increase. The many chronic medical conditions associated with older adults are confounded by a diagnosis of cancer. Older adults with cancer are at risk for physical, psychological, and functional decline as a result of not only the cancer, but also the cancer treatment. In their current research agenda, the Oncology Nursing Society identified the need for research related to multiple comorbidities in older adults with cancer. This study utilized a cross-sectional, descriptive, correlational study design to explore the relationships between and among treatment-related decisional conflict, quality of life, and comorbidity in older adults with cancer. Oncology nurses recruited a sample size of 200 for this study from outpatient medical oncology, radiation oncology, and palliative care practices. Using an anonymous survey method, participants completed three psychometrically-sound instruments, including the Decisional Conflict Scale, Self-Administered Comorbidity Questionnaire, and the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire. Bivariate relationships existed between increased levels of decisional conflict and increased quality of life (p = .009) and quality of life and comorbidity (p = .001). All six regression models achieved significance (p \u3c .001). Statistically significant relationships were identified in each of the six regression models. Positive relationships existed between decisional conflict and financial problems, physical function, and global health status/quality of life. Increased emotional function may be predictive of decreased decisional conflict in all of the regression models. Other negative relationships existed between decisional conflict and cognitive function, diarrhea, spiritual support, insomnia, year diagnosed, fatigue, and nausea/vomiting. With their focus on patient-centered care, oncology nurses are a crucial component of the multidisciplinary cancer team that can empower older cancer patients to communicate their values and preferences regarding cancer treatment. Additionally, this study underscores the importance of oncology nurses being prepared to provide high-quality care to geriatric patients with multiple comorbidities. Given the paucity of research on the impact of cancer and its treatment on older adults, there are no published studies that address all of these variables. In light of the regression analyses, further research is needed with regard to emotional function, spiritual support, and symptom management in the setting of decision making in older adults with cancer. Poster presented at: Oncology Nursing Society 42nd Annual Congress in Denver, COhttps://jdc.jefferson.edu/nursingposters/1007/thumbnail.jp

The impact of participation in Oncology Nursing Society Leadership Development Institute on sustainable leadership

The Oncology Nursing Society (ONS) realized many years ago that it would take skilled, qualified leaders in oncology nursing to sustain the specialty of oncology care for years to come. With the nursing shortage and shortage in leadership, it is imperative to examine the impact of attending a leadership program on the future of oncology nursing. The control group and study group of identified oncology nurses were sent the Oncology Nurses Sustainable Leadership Survey Instrument via email from the Oncology Nursing Society. The control group of oncology registered nurses had not yet started the ONS Leadership Development Institute fellowship program. The study group of oncology registered nurses were those participants who had completed the ONS Leadership Development Institute fellowship program within the past 10 years. Results of the survey found that the study group was slightly older with a mean age of 50.29 years. The majority of respondents were female, Caucasian, married, held a master’s degree in nursing, and are employed full time. Both groups indicated that they mentor licensed and non licensed personnel. Both groups consistently practice the ANA Standards of Professional Performance, Standard 15 on Leadership on an occasional to regular basis. A T-test indicated their was no statistically significant differences between the control and study group on ANA Standards of Professional Performance, Standard 15, Leadership. Both groups participate in health care programs, early detection programs, and patient education programs thereby implementing strategies to increase cancer awareness and reduce the cancer burden. This participation increased after attending LDI. Honesty was viewed as the most positive trait for leadership with support of Authentic Leadership styles. Communication was viewed by both groups as the most important leadership skill. Succession planning was advocated by both the control and study group. A leadership role greatly contributed to the personal nursing satisfaction of the oncology registered nurses from both groups. Once leadership training is initiated, oncology registered nurses will continue to obtain additional leadership education in a variety of formats and presentations. Additionally they will obtain additional leadership positions or more responsibilities

Control of Pain and Dyspnea in Patients with Oncologic Disease in Acute Care: Non-Pharmacological Interventions

Abstract Objective: To identify non-pharmacological strategies in the control of pain and dyspnea, in patient with oncological disease, in acute care. Methodology: Question in PI[C]O format was used and search at EBSCO (MEDLINE with Full TEXT; CINAHL, Plus with Full Text; British Nursing Index) retrospectively from 2009 to 2015. We included also guidelines by reference entities: Oncology Nursing Society (2011) National Comprehensive Cancer Network and Cancer Care Ontario, resulting in a total of 15 articles. Results: The gold standard for an adequate symptom control is a systematized assessment. Non-pharmacological measures: psycho-emotional support, hypnosis, counseling/training/ instruction, therapeutic adherence, music therapy, massage, relaxation techniques, telephone support, functional and respiratory reeducation increase health gains. Conclusion: The control of oncologic pain and dyspnea require a comprehensive and multimodal approach

Control of Pain and Dyspnea in Patients with Oncologic Disease in Acute Care: Non-Pharmacological Intervention

Objective: To identify non-pharmacological strategies in the control of pain and dyspnea, in patient with oncological disease, in acute care. Methodology: Question in PI[C]O format was used and search at EBSCO (MEDLINE with Full TEXT; CINAHL, Plus with Full Text; British Nursing Index) retrospectively from 2009 to 2015. We included also guidelines by reference entities: Oncology Nursing Society (2011) National Comprehensive Cancer Network and Cancer Care Ontario, resulting in a total of 15 articles. Results: The gold standard for an adequate symptom control is a systematized assessment. Non-pharmacological measures: psycho-emotional support, hypnosis, counseling/training/ instruction, therapeutic adherence, music therapy, massage, relaxation techniques, telephone support, functional and respiratory reeducation increase health gains. Conclusion: The control of oncologic pain and dyspnea require a comprehensive and multimodal approach

Personal protective equipment for health care workers who work with hazardous drugs

"Health care workers who handle hazardous drugs are at risk of skin rashes, cancer, and reproductive disorders. NIOSH recommends that employers provide appropriate personal protective equipment (PPE) to protect workers who handle hazardous drugs in the workplace." - NIOSHTIC-2"The principal authors of this document were Thomas H. Connor and Laurence D. Reed, National Institute for Occupational Safety and Health; Martha Polovich, Oncology Nursing Society; Melissa A. McDiarmid, University of Maryland; Melissa M. Leone, Apria Healthcare; and Luci A. Power, University of California Medical Center, San Francisco. John J. Whalen, under a contract with the Public Health Service, Division of Federal Occupational Health, served as the lead writer/editor." - p. [3]Includes bibliographical references (p. [3])

Development of Evidence Based Medical Surveillance Program Recommendations for At-Risk Employees

Background: Nearly eight million United States healthcare workers are potentially exposed to hazardous drugs (HDs) in their workplace. This exposure puts staff at increased risk of acute myeloid leukemia, breast cancer, rectal cancer, and fetal anomalies. Despite evidence-based guidelines for handling HDs, preventative measures are inadequate surveillance. Purpose: This project sought to evaluate current policies and procedures regarding HD exposure workplace practices at large academic medical centers in the Northeast, improve education of HD exposure, and develop a standardized medical surveillance program (MSP) at one large academic health network. Methods: Large academic medical centers in the Northeast were contacted to provide information about current workplace practices. Semi-structured interviews (N=14) were conducted to determine current workplace practices & policies at each (N=14) institution. Data from interviews, current policies and procedures was evaluated to create a proposed MSP. Data was presented to stakeholders. A post-presentation survey and discussion informed feasibility and determined next steps for implementation. Results: Information from 14 medical centers was analyzed. The post-presentation survey identified obstacles for implementation including: Need for an occupational medicine provider; A record keeping system; Monitoring on an ongoing basis; and Defining population at-risk to survey. Eight of nine stakeholders filled out the post-presentation survey. All respondents supported development of a standardized MSP. 87.5% of respondents advocated for hiring of an occupational medicine provider to successfully implement an MSP. Conclusion: Stakeholders supported development of a standardized MSP within the target academic health network and advocated for an occupational medicine provider at each institution in the network for successful implementation. The data from this study will guide policy change & future implementation of an MSP

Oncology Navigation: Improving the Patient Experience

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