Search

Aims: To examine the prevalence and associated factors of chemotherapy‐related cognitive impairment (CRCI) in older breast cancer survivors (BCS). Design: Systematic review. Data Sources: We searched EMBASE, PubMed, PsychInfo, CINAHL, Cochrance Library, Web of Science, CNKI and SinoMed, without language restrictions, for studies published from the establishment of the database to September 2022. Review Methods: Two researchers independently examined the full texts, data extraction and quality assessment, and any discrepancies were resolved through discussion with a third reviewer. Quality of evidence was assessed using the Newcastle‐Ottawa Scale and the Agency for Healthcare Research and Quality Scale. Results: The seven included studies showed that the estimated prevalence of CRCI in older BCS ranged from 18.6% to 27% on objective neuropsychological tests and from 7.6% to 49% on subjective cognitive assessments. The areas most affected were attention, memory, executive functioning and processing speed. CRCI was associated with 10 factors in six categories, including sociodemographic (e.g. age, education level), physiological (e.g. sleep disorders, fatigue and comorbidities), psychological (e.g. anxiety, depression), treatment modalities (e.g. chemotherapy cycles, chemotherapy regimens), genetic (e.g. APOE2, APOE4) and lifestyle factor (e.g. physical inactivity). Conclusion: CRCI is multifactorial and has a relatively high prevalence. However, the results of subjective and objective cognitive examinations were inconsistent, possibly due to variations in tools used to evaluate different definitions of CRCI. Nevertheless, as there are few published studies of older BCS, this conclusion still require verification by well‐designed studies in the future. Impact: We found that the prevalence of CRCI in older adults is relatively high and multifactorial, providing evidence for further health care for this population. No Patient or Public Contribution: There was no patient or public involvement. [ABSTRACT FROM AUTHOR]

Aim. This paper is a report of a study analysing the effect of a home-based walking exercise program on symptoms and mood distress among breast cancer women receiving chemotherapy postoperatively. Background. Treatment-related symptoms, mood distress and decline in physical activity have been identified as major complaints among cancer patients. Studies on the efficacy of home-based walking exercise for symptoms and mood did not fully describe the exercise prescriptions that could be safe and beneficial for women with breast cancer, especially these receiving adjuvant chemotherapy. Method. This is a prospective, randomized clinical trial. In 2008-2009, participants were recruited from the oncology outpatient clinic of a medical center in Taiwan, and were assigned to either the exercise group (n = 19) or the control group (n = 21). Women in the exercise group participated in a moderate-intensity home-based walking program for 12 weeks during their chemotherapy treatments. Symptoms, mood status and physical activity level were measured at baseline, 6- and 12-week follow-up. Data were analysed by two-way repeated-measures analysis of variance. Results. Women in the exercise group reported significantly lower symptom severity scores and mood disturbance compared with those in the control group throughout the study period. Conclusion. Regular moderate-intensity exercise can play an important role in improving treatment-related symptoms and mood in women with breast cancer. A home-based walking exercise program can be easily incorporated into care for women with breast cancer undergoing chemotherapy. [ABSTRACT FROM AUTHOR]

Aim: To develop and test the psychometric properties of the Taiwanese safety climate instrument suitable for nurses handling chemotherapy drugs. Design: This is an instrument development study. Method: All four stages, including questionnaire design, expert consultation, cognitive testing and psychometric validation, were used in this study. The data were collected between August and December 2018. Nurses with experience in handling chemotherapy drugs (N = 484) at one medical centre and two regional hospitals in Taiwan completed this instrument. Data were randomly split into two groups: one group (N = 237) for exploratory factor analysis and the other (N = 247) for confirmatory factor analysis. Results: The instruments' items were based on qualitative research, and the content validity index levels exceeded the acceptable value. An exploratory factor analysis revealed 43 items remaining in six factors, which accounted for 74.4% of variance. The result of the confirmatory factor analysis verified the acceptability of a 43‐item model. The composite reliability values, Cronbach's alpha values, convergent validity and discriminant validity for each factor exceeded the acceptable value. Conclusion: Most climate safety instruments used in the health care sector focus mainly on patient safety outcomes. Furthermore, there is no safety climate instrument for handling chemotherapy drugs, and there is a cultural difference. Through the development and validation process, we have developed a new instrument suitable for nurses handling chemotherapy drugs, which has good psychometric properties. Impact This instrument is valuable as its development was based on the concept of a safety climate for health care perceptions and qualitative survey findings. Hospital managers can use this instrument regularly to evaluate nurses' perceptions of the safety climate to determine the strengths and weaknesses of their workplace, thereby assisting organizational managers in proposing concrete actions. [ABSTRACT FROM AUTHOR]

Aims: To examine patient-caregiver concordances about psychological distress among Chinese patients with breast cancer undergoing chemotherapy and identify factors related to concordance among patients and family caregivers. Design: Cross-sectional study. Methods: From October 2019 to June 2020, 137 patient-caregiver dyads were enrolled. Sociodemographic information, the distress thermometer (including the problem list), the Distress Disclosure Index and the Family Adaptability and Cohesion Evaluation Scale were used to collect data. Data were analysed using intraclass correlation coefficients (ICC), kappa statistics, two related samples test, chi-square tests and/or Fisher's exact tests and binary logistic regression. Results: Overall, fair agreement was identified between patients' and caregivers' reports (intraclass correlation coefficients [ICC] = .528). Patients reported significantly higher psychological distress scores than paired caregiver reports. Lower psychological distress concordance was found among patients with comorbidities (odds ratio [OR], 0.352; 95% confidence interval [CI], 0.155-0.798) and lower levels of self-disclosure (OR, 0.402; 95% CI, 0.186-0.868). Conclusion: There was relatively low concordance between patients' reports and caregivers' perceptions of psychological distress. Family caregivers tended to underestimate patients' psychological distress. A comorbid condition and lower levels of self-disclosure contributed to this bias. Impact: Having an awareness of the incongruence between patient and caregiver may help healthcare providers better interpret caregiver assessments. Healthcare providers should reinforce patient-caregiver dyadic psychosocial education to improve concordance. More psychological care and substantial emotional support should be provided for Chinese breast cancer patients undergoing chemotherapy by family caregivers and healthcare providers. [ABSTRACT FROM AUTHOR]

li x.-m., zhou k.-n., yan h., wang d.-l. & zhang y.-p. (2011) Effects of music therapy on anxiety of patients with breast cancer after radical mastectomy: a randomized clinical trial. Journal of Advanced Nursing 68(5), 1145-1155. Abstract Aim. This paper is a report of a clinical trial of the effects of music therapy on anxiety of female breast cancer patients following radical mastectomy. Background. There is insufficient evidence on the effects of music therapy on state anxiety of breast cancer patients following radical mastectomy. Methods. A Hall's Core, Care, and Cure Model-based clinical trial was conducted in 120 female breast cancer patients from March to November 2009. A randomized controlled design was utilized. The patients were randomly allocated to the experimental group ( n = 60) received music therapy in addition to routine nursing care, and the control group ( n = 60) only received routine nursing care. A standardized questionnaire and the State Anxiety Inventory were applied. The primary endpoint was the state anxiety score measured at pretest (on the day before radical mastectomy) and at three post-tests (on the day before patients were discharged from hospital, the second and third time of admission to hospital for chemotherapy respectively). Results. The pretest score revealed that the majority of the patients had a moderate level (77·5%) and 15% had severe level of state anxiety. The repeated-measure ancova model analysis indicated that the mean state anxiety score was significantly lower in the experimental group than those in the control group at each of the three post-test measurements. The mean difference between the experimental and control group together with 95% confidence intervals were −4·57 (−6·33, −2·82), −8·91 (−10·75, −7·08) and −9·69 (−11·52, −7·85) at the 1st post-test, 2nd post-test and 3rd post-test respectively. Conclusion. Music therapy is found to have positive effects on decreasing state anxiety score. [ABSTRACT FROM AUTHOR]

Aims. The present study examines the efficacy of a scalp cooling system to prevent chemotherapy-induced alopecia in people with cancer. Background. Alopecia has been established as the most distressing aspect of chemotherapy to such an extent that some patients even refrain from cytotoxic treatment. Methods. Using a quasi-experimental approach in 2007, a total number of 63 patients aged 16-59 years (mean 35 ± 5·5 years) participated in the study and were treated with an intravenous regimen of chemotherapy drug. Thirty-one patients accepting the scalp-cooling system were compared for alopecia with 32 participants who refused it. Hair loss in the participants was evaluated by nurses using World Health Organization criteria at each cycle of chemotherapy. Results. Using chi-square test differences between the two groups were statistically significant at cycles 2-6 ( P < 0·05). Twenty-four participants (77·4%) of the study group were assessed as first and second grade of alopecia in the second cycle, whereas seven participants (22·6%) of this group exhibited third and fourth grade of alopecia. However, in the control group at the same cycle, 19 participants (61·3%) were assessed with third and fourth grade of alopecia. In the Sixth cycle 15 participants (50%) of the study group and 24 participants (75%) of the control group demonstrated third and fourth grade alopecia. Conclusion. A penguin cap can be an effective method to avoid alopecia in patients receiving chemotherapy drugs. However, it is important to bear in mind that because of individual characteristics, liver function and drug regimens it is not successful in all cases. [ABSTRACT FROM AUTHOR]

Aim: Patients with gynaecological cancer often experience high levels of uncertainty in illness during chemotherapy and report unmet supportive care needs. Mobile applications (apps) are increasing being used as an easily accessible alternative to support these patients, but a lack of rigorous trials have been conducted to explore their effectiveness. Based on Mishel's uncertainty in illness theory, the Mobile Gynaecological Cancer Support (MGCS) program is an app‐based program that includes four modules: 1) weekly topics, 2) emotional care, 3) discussion centre and 4) health consultation. The aim of this study is to assess the effectiveness of MGCS for Chinese patients with gynaecological cancer receiving chemotherapy in respect of reducing uncertainty in illness and symptom distress and improving quality of life and social support. Design: A multi‐centre randomized controlled trial will be used. Methods: One hundred and sixty‐eight patients with gynaecological cancer commencing chemotherapy will be recruited from three university affiliated hospitals and assigned to the control or intervention group with block randomization. The control group will only receive routine care. The intervention group will access the MGCS program for 24 weeks and receive routine care. Health outcomes will be evaluated at baseline, 12 weeks, and 24 weeks. Repeated measures multivariate analysis of covariance (intention‐to‐treat) will be used to assess the effectiveness of MGCS. Discussion: This is the first trial to explore the effectiveness of an app‐based program for patients with gynaecological cancer using a robust and rigorous study design in China. If effective, this trial will provide evidence for an app‐based program to support these patients. Impact: The knowledge gained can be applied to develop other culturally appropriate app‐based programs for cancer groups worldwide, and provide evidence for health policymakers to allocate more resources and train staff for e‐health. Trial Registration: ChiCTR2000033678 (Chinese Clinical Trial Registry Registered 08 June, 2020). [ABSTRACT FROM AUTHOR]

Copyright of Journal of Advanced Nursing (John Wiley & Sons, Inc.) is the property of John Wiley & Sons, Inc. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Aims To explore family members' experiences when their loved one is undergoing chemotherapy treatment as an outpatient for newly diagnosed colorectal cancer and to develop an explanatory theory of how they process their main concern. Background Most individuals with cancer are now treated as outpatients and cared for by family members. International research highlights the many side effects of chemotherapy, which in the absence of specific information and/or experience can be difficult for family members to deal with. Unmet needs can have an impact on the health of both patients and family members. Design Classic grounded theory methodology was used for this study. Method Using classic grounded theory methodology, family members ( n = 35) of patients undergoing chemotherapy treatment for cancer were interviewed (June 2010-July 2011). Data were analysed using the concurrent processes of constant comparative analysis, data collection, theoretical sampling and memo writing. Findings The main concern that emerged for participants was fear of emotional collapse. This fear was dealt with through a process conceptualized as 'Emotional Resistance Building'. This is a basic social process with three phases: 'Figuring out', 'Getting on with it' and 'Uncertainty adjustment'. The phases are not linear, but interrelated as participants can be in any one or more of the phases at any one time. Conclusion This theory has the potential to be used by healthcare professionals working in oncology to support family members of patients undergoing chemotherapy. New ways of supporting family members through this most difficult and challenging period are articulated within this theory. [ABSTRACT FROM AUTHOR]