32 research outputs found

    Cancer Prehabilitation for Patients Starting from Active Treatment to Surveillance

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    The purpose of this brief summary is to introduce the concept of cancer prehabilitation and the role of oncology nurses in prehabilitation care. Cancer prehabilitation has been defined by Sliver and Baima (2013) as "a process on the cancer continuum of care that occurs between the time of cancer diagnosis and the beginning of acute treatment." The evidence supports the notion that prehabilitation programs can improve physical and psychological health outcomes and decrease overall health care costs. The care model for cancer prehabilitation should include timely and efficient assessment throughout the care continuum with a focus on improving outcomes in cancer at every stage. During the cancer journey, three types of assessment with different aims are included: (1) prehabilitation assessment pretreatment, (2) rehabilitation assessment at early post treatment, and (3) health promotion assessment at the end of treatment. Specific prehabilitation assessment and interventions for treatment-related complications or major side-effects should be considered. Teaching, counseling, discharge planning, and coordination should also be part of an oncology nurse′s role in cancer prehabilitation. It is suggested that cancer care managers or navigators be trained in the assessment of their patients′ physical and psychological status once the cancer diagnosis has been identified and the patient has decided to receive active treatment, especially for those waiting for surgery at home. Oncology nurses could increase their competence with prehabilitation care by gaining knowledge about cancer-related treatments and their outcomes for specific cancers and by strengthening the ability to assess the functional status and psychological distress of their patients

    PhD

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    dissertationThe main purposes of this descriptive, repeated measures methodological study were to (a) examine the psychometric properties (reliabilities and validities) of the Chinese versions of the Cancer Fatigue Scale (C-CFS), the Fatigue Symptom Inventory (C-FSI), and the Schwartz Cancer Fatigue Scale-revised (C-SCFS-r) in cancer outpatients receiving chemotherapy and (b) evaluate the instruments in terms of the ease of use, sensitivity to change, and cultural appropriateness (i.e., semantic equivalence, content equivalence, and conceptual equivalence) for Taiwanese cancer outpatients. Convenience sampling was used to recruit cancer outpatients receiving chemotherapy in a clinical setting in northern Taiwan. Data were collected twice: on the day when cancer patients were receiving chemotherapy treatment (T1), and 2 days posttreatment at home (T2). Two hundred forty-three cancer outpatients were recruited at T1 and 149 patients completed T2. Findings indicated that the three scales had good internal consistency (Cronbach's alphas for three total scales > .80), were brief (less than 6 min to complete), valid (confirmed by convergent, divergent, and discriminant validity), and feasible measures (completion rates > 97%) of fatigue for use with Taiwanese cancer patients. However, 27% of cancer patients reported that the C-FSI was difficult for them to complete. The content in the three scales were relevant to the phenomena of fatigue but did not represent the whole concept of fatigue in Taiwan. Only the C-CFS was similar to the original construct. The three scales were sensitive to change over 2 days. Cohen's effect sizes for the C-CFS, C-SCFS-r, and C-FSI were 0.87, 0.90, and 0.70, respectively. Glass's effect sizes for the C-CFS, C-SCFS-r, and C-FSI were 1.02, 1.40, and 0.65, respectively. The scores for the 'small change' group for the C-CFS, C-SCFS-r and C-FSI were .51, .73, and 1.11, respectively. Even though the three translated scales have been validated, further study is needed to explore the experience of fatigue among cancer patients in Taiwan from the patients' perspective. This study helps support the psychometric properties of the three scales and also emphasizes the importance of assessing scales' cultural appropriateness in a specific population

    Relationship between Hope and Fatigue Characteristics in Newly Diagnosed Outpatients with Cancer

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    Purpose/Objectives: To examine the relationship between hope and fatigue (intensity, duration, and interference) in newly diagnosed patients with cancer receiving chemotherapy. Design: Cross-sectional and correlational. Setting: Oncology outpatient clinics of two medical centers in northern Taiwan. Sample: 182 patients diagnosed with various types of solid tumors in the previous six months and receiving chemotherapy treatment. Methods: Questionnaires were used to assess patients' fatigue intensity, duration, and interference, as well as level of hope and related background information before drug administration at a chemotherapy visit. The relationship between fatigue characteristics and level of hope was verified using Pearson 's correlation analysis. Main Research Variables: Hope, fatigue intensity duration, and interference. Findings: Compared to fatigue intensity, interference and its duration have a stronger association with level of hope. Further analysis of the seven individual items of fatigue interference found that interference with mood status and relations with others is significantly associated with level of hope in newly diagnosed patients. Conclusions: Fatigue duration and interference caused by fatigue, particularly in mood status and relations with others, are associated with the perception of hope in newly diagnosed patients. Implications for Nursing: Clinical nurses should assess intensity of fatigue as well as its interference and duration to better support patients' perception of hope by reducing interference caused by fatigue

    Quality of Life and Its Associated Factors in Patients with Hepatocellular Carcinoma Receiving One Course of Transarterial Chemoembolization Treatment: A Longitudinal Study

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    Objective. To (a) explore changes in physical and psychological distress and quality of life (QOL) and (b) identify the significant pre- and postdischarge factors related to changes in physical and mental domains of QOL over a period of 2 months in patients with hepatocellular carcinoma receiving one course of transarterial chemoembolization (TACE) treatment. Methods. A longitudinal prospective design was used, with participants recruited from a teaching hospital in Northern Taiwan. Data were collected three times: within 3 days prior to discharge (T0) and at the fourth (T1) and eighth (T2) weeks after discharge. A set of structured questionnaires was used to assess participants' QOL, symptom distress, anxiety, and depression. Changes in QOL and associated factors were examined using generalized estimating equations. Results. Eighty-nine patients were included in this study. Fatigue was reported to be the most distressful symptom after treatment. Overall QOL improved monthly after discharge. Change in physical QOL 2 months after TACE treatment was associated with age, diagnosis status, level of symptom distress, and depression after discharge. Change in mental QOL was significantly associated with gender, diagnosis status, and anxiety and depression after discharge. Conclusions. Health care providers should pay special attention to patients of older age, those who are male, and those who have higher levels of depression and anxiety after discharge. Designing personalized education programs before discharge for patients with newly diagnosed cancer versus those who have recurrent disease is suggested to help patients maintain a better QOL after discharge. The Oncologist 2012;17:732-73

    Unmet Supportive Care Needs of Patients With Colorectal Cancer: Significant Differences by Type D Personality

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    Purpose/Objectives: To explore the association between supportive care needs and type D personality and to identify personality traits, including negative affectivity (NA) and social inhibition (SI), and their influence on the supportive care needs of patients with colorectal cancer (CRC). ;Design: Cross-sectional, correlational survey. ;Setting: Oncology and surgical outpatient clinics at a medical center in northern Taiwan. ;Sample: 277 patients diagnosed with CRC. ;Methods: Data were collected using a set of structured questionnaires to measure supportive care needs, symptom distress, anxiety, depression, and personality traits. The associations between type D personality and supportive care needs were verified by the Mann-Whitney U test. The significant roles of personality traits were identified by generalized estimating equations, controlling for biophysical and psychological factors overall, and for the five supportive care domains. ;Main Research Variables: Supportive care needs, type D personality. ;Findings: Patients with CRC reported the most unmet needs in the health system and the information domain. Type D patients had higher needs overall and in most domains, except for sexuality needs. A higher level of NA indicated higher overall and psychological needs. A higher level of SI indicated lower needs in health system and information. ;Conclusions: The level of unmet supportive care needs of patients with CRC is highly associated with type D personality. The trait of NA alters levels of overall supportive care and psychological needs, and the trait of SI influences needs in health system and information. ;Implications for Nursing: Assessing personality traits before providing an education program is highly recommended for patients with cancer. The assessment could improve the quality of personalized education programs and better meet patient needs

    Changes in Quality of Life and Its Related Factors in Liver Cancer Patients Receiving Stereotactic Radiation Therapy

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    Purpose Due to the increasing use of stereotactic radiotherapy (SRT) in treating advanced liver cancer patients, the purpose of this longitudinal study was to explore the changes and factors related to quality of life ( QOL) in patients receiving SRT treatment. Materials and methods Liver cancer patients receiving SRT in northern Taiwan were recruited. The patients were followed up during the baseline pre-SRT and the first 6 weeks of SRT (T0 to T6) in assessing functional status and symptom severity, while depression, selected laboratory data, and QOL were assessed every 3 weeks (T0, T3, and T6). Generalized estimating equations (GEE) analysis was used to explore the significant factors related to the change in QOL. Results Ninety-nine patients with advanced liver cancer completed seven interviews. The results showed that QOL during SRT was moderate and relatively stable. Performance functional status, depression, the level of albumin, and overall symptom severity were significantly associated with changes in QOL. A further analysis of the relationships between individual symptom severity and QOL revealed that fatigue, lack of appetite, pain, and nausea were the symptoms most affecting QOL across the 6 weeks of SRT. Conclusion Liver cancer patients had stable and moderate levels of QOL during SRT. Factors related to QOL across the 6 weeks were multi- dimensional. Both overall symptom severity and selected individual symptoms were important to patients' QOL. These factors should all be carefully assessed and clinically treated to enhance liver cancer patients' QOL during SRT

    Patient-Related Barriers to Fatigue Communication in Cancer Patients Receiving Active Treatment

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    Objective. To explore barriers to reporting fatigue in cancer patients receiving active treatment and the significant factors associated with those barriers from fatigue characteristics (i.e., intensity, duration, and interference with daily life), to demographic characteristics and disease/treatment variables. Methods. Patients with various types of cancer (n = 288) were recruited from an outpatient chemotherapy center, and from seven oncology and hematology units in a teaching hospital in northern Taiwan. Data were collected using the Fatigue Management Barriers Questionnaire to explore barriers to fatigue communication. Results. Fear of distracting the doctor was rated as the highest barrier of reporting fatigue . The degree of fatigue interference with daily life by patients was associated with the willingness to report fatigue. Patients with gastrointestinal cancer experienced more barriers to reporting fatigue than those with hematological cancer. Patients without religion perceived the highest level of barriers to fatigue communication. Outpatients had higher levels of concern than inpatients. Conclusions. Discussion with patients about their high level of perceived fatigue barriers before implementing patient education is recommended. Assessing fatigue interference with daily life and identifying factors associated with barriers to reporting fatigue (i.e., type of cancer, religion, and the setting for receiving treatment) are suggested in order to provide better fatigue management in clinical settings

    The Relationship Between Coping Strategies and Type D Personality in Non Late Stage Hepatocellular Carcinoma Survivors

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    Background: Owing to the high recurrence rate of hepatocellular carcinoma, coping with the disease in the survival period can be challenging. The aims of this study were to explore the association between coping strategies and personality and to identify factors associated with coping strategies. Methods: A cross-sectional correlated design was used and patients were recruited by convenience sampling from wards and outpatient departments at a medical center in Taipei. A set of structured questionnaires was used to collect data including patients’ demographic and disease information, Symptom Distress Scale, Type D Scale-14 and the brief COPE scale. Data were analyzed by descriptive statistics and generalized estimating equations. Results: Emotion-focused strategies were the most frequently used strategies. Among the 163 participants, 31 patients had type D personality (19%) and tended not to use emotion-focused strategies. Factors associated with patients using emotion-focused strategies included female gender, non-type D personality, younger age, higher level of education, Christian/Catholic, longer duration as HBV carrier, and lower level of symptom distress. Factors associated with patients using problem-focused strategies included younger age, higher level of education, longer duration as HBV carrier, and lower level of symptom distress. Younger age was also associated with patients using malfunction strategies. Conclusions: This study showed that different factors were associated with the three types of coping strategies. We recommend that patients be screened for type D personality, so that those with higher levels of distress when managing their symptoms can be helped to have a positive coping process. Health care providers should also proactively take care of younger patients with mal-adaptation
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