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OBJECTIVES: To determine the effects of music intervention on quality of life, anxiety, and fatigue among patients with breast cancer. SAMPLE & SETTING: 170 individuals from the general surgery unit of Kaohsiung Chang Gung Memorial Hospital in Taiwan. METHODS & VARIABLES: Individuals who had received a mastectomy were randomly assigned to a treatment group or control group. In the treatment group, participants received music intervention for an hour each week, totaling 12 hours during 12 consecutive weeks. The primary variable was quality of life, and secondary variables were anxiety and fatigue. RESULTS: Greater quality of life was seen in the treatment group at 12 weeks. In the treatment group, participants showed significant improvement in State-Trait Anxiety Inventory (trait), which was most significant at eight weeks. No statistically significant difference was observed in fatigue levels after 4, 8, and 12 weeks of music intervention. IMPLICATIONS FOR NURSING: Music intervention may improve anxiety and quality of life of patients with breast cancer. Music intervention could be established following mastectomy and continued throughout recovery. [ABSTRACT FROM AUTHOR]

BACKGROUND: The oncology care environment includes a wide range of traumatic physical and emotional experiences that can be challenging for patients and healthcare providers. OBJECTIVES: This article aims to establish a knowledge base about the trauma-informed care (TIC) approach in oncology care. METHODS: This article provides a literature-based overview of TIC as a model of care for patients with cancer, informed by definitions of trauma, post-traumatic stress disorder, and adverse childhood experiences. This review is based on clinical studies, expertise, and evidence-based guidelines. FINDINGS: Based on a foundation of care for patients with cancer, nurses can apply TIC to clinical oncology practice. To illustrate TIC in practice, this article includes a case study, nursing approaches, implications, the TIC model of care, and resources. When applied to care, TIC benefits patients, staff, and organizations. [ABSTRACT FROM AUTHOR]

OBJECTIVES: To evaluate associations among social determinants of health (SDOH), stress, interleukin-6 (IL-6), and quality of life among non-Hispanic Black and Hispanic cancer survivors. SAMPLE & SETTING: Individuals who had completed cancer treatment and did not identify as White (N = 46) were recruited through community partnerships in western Massachusetts and a state cancer registry. METHODS & VARIABLES: This descriptive crosssectional study used questionnaires and morning salivary samples to collect data between June 2022 and September 2023. RESULTS: Most participants were breast cancer survivors, were female, identified as African American or Black, and reported moderate levels of stress and low physical activity. Cortisol levels were higher among African American or Black participants, those with lower body mass index, and those with less consumption of fruit and vegetables. Higher symptom experience was associated with higher IL-6 levels. No associations were identified between IL-6 and cortisol or perceived stress and cortisol levels. IMPLICATIONS FOR NURSING: Incorporating SDOH in self-reported outcomes, including health behaviors and associated biologic indicators, can facilitate early identification and interventions to improve symptom experience and health outcomes of cancer survivors. [ABSTRACT FROM AUTHOR]

Artificial intelligence use is increasing exponentially, including by patients in medical decisionmaking. Because of the limitations of chatbots and the possibility of receiving erroneous or incomplete information, patient education is a necessity. Nurses can advocate for patients by emphasizing the importance of conferring with oncology professionals before making decisions based solely on self-investigation using artificial intelligence. [ABSTRACT FROM AUTHOR]

Moving Beyond Cancer to Wellness is a patientand caregiver-focused educational outreach event with an inspirational message and lectures that address common concerns among cancer survivors. This event is open to the community and offers a keynote speaker, breakout sessions on specific survivorship topics, and a patient panel. This typically in-person event was held virtually in 2020 and 2021 because of the COVID-19 pandemic, but returned to the in-person format in 2022. As demonstrated by consistently strong attendance and high satisfaction results, this communitybased educational event has been successful in communicating survivorship information to cancer survivors and their families. [ABSTRACT FROM AUTHOR]

OBJECTIVES: To evaluate for differences in global, cancer-specific, and cumulative life stress, as well as resilience and use of various coping strategies among five groups (no depression or sleep disturbance, no depression and moderate sleep disturbance, subsyndromal depression and very high sleep disturbance, moderate depression and moderate sleep disturbance [Both Moderate]; and high depression and very high sleep disturbance [Both High]). SAMPLE & SETTING: Patients (N = 1,331) receiving chemotherapy were recruited from outpatient oncology clinics. METHODS & VARIABLES: Measures of global, cancer-specific, and cumulative life stress, resilience, and coping were obtained. Differences were evaluated using parametric and nonparametric tests. RESULTS: Global and cancer-specific stress scores increased as joint profiles worsened. Both Moderate and Both High classes had cancer-specific stress scores suggestive of post-traumatic stress. Both Moderate and Both High classes reported higher occurrence rates for several stressful life events and higher use of disengagement coping. Both Moderate and Both High classes had resilience scores below the normative score for the United States. IMPLICATIONS FOR NURSING: Clinicians need to screen vulnerable patients for post-traumatic stress disorder and implement interventions to reduce stress. [ABSTRACT FROM AUTHOR]

OBJECTIVES: To explore and characterize predisposing, precipitating, and perpetuating factors of subthreshold, moderate, and severe insomnia in cancer survivors. SAMPLE & SETTING: 135 cancer survivors who selfreported symptom severity on the Insomnia Severity Index during the baseline phase of a randomized clinical trial on insomnia treatment. METHODS & VARIABLES: Participants completed measures assessing predisposing factors (age, sex, race and ethnicity, body mass index), precipitating factors (number of years since cancer diagnosis, depression and anxiety symptoms, health-related quality of life), and perpetuating factors (frequency of consuming alcoholic and caffeinated beverages, napping behavior, dysfunctional beliefs about sleep). RESULTS: In the multivariate model, being female was protective against insomnia, and being a person of color, having higher anxiety, having more depression symptoms, and having stronger dysfunctional beliefs about sleep were significantly associated with greater insomnia severity. IMPLICATIONS FOR NURSING: By fostering interprofessional collaboration and implementing evidence-based interventions, nurses can contribute to the well-being of cancer survivors and address their sleep-related challenges. This study underscores the importance of regular insomnia screenings for cancer survivors, with nurses as essential facilitators. [ABSTRACT FROM AUTHOR]

BACKGROUND: Patients with head and neck cancer are prone to malnutrition, which can lead to adverse health outcomes. A review of the literature revealed a lack of systematic reviews addressing risk factors for malnutrition in this population. OBJECTIVES: This study aimed to fill the knowledge gap by identifying risk factors for malnutrition in patients with head and neck cancer. METHODS: A comprehensive search was conducted in PubMed®, Web of Science, Embase®, and Cochrane Library databases, spanning from their inception until June 2023. Three researchers critically evaluated the inclusion and exclusion criteria. Two investigators independently screened the literature and extracted data, resolving any discrepancies through consensus. FINDINGS: This systematic review includes 18 studies. The results indicated that risk factors for malnutrition in patients with head and neck cancer encompass disease-related, genetic, lifestyle, nutritional health, physiologic, psychological, and treatment-related factors. [ABSTRACT FROM AUTHOR]

A team conducted semistructured interviews and developed case reports about financial toxicity (FT) and healthcare transitions (HCTs) with two adolescent and young adult (AYA) cancer survivors. These reports found poor HCTs from pediatric specialty care to adult primary care. Nurses can address FT and facilitate smooth HCTs by screening AYA survivors and caregivers for financial stressors, engaging in cost-of-care conversations and interprofessional care coordination, and supporting access to navigation services. AT A GLANCE * AYAs are vulnerable to FT and challenges with HCTs and access to care throughout the cancer care continuum. * Income loss, limited assets, restrictions on eligibility for financial aid, caregiver dependence, and limited support from providers contribute to FT in AYAs with cancer. * Nurses can support AYA cancer survivors by coordinating care among providers and facilitating access to financial, legal, and social services. [ABSTRACT FROM AUTHOR]

The article focuses on the importance of fertility preservation for individuals with cancer, emphasizing universal access to counseling and preservation options from diagnosis through survivorship. It highlights the critical role of oncology nurses and advanced practice providers in educating patients about infertility risks, offering referrals, and advocating for equitable access to fertility services, addressing psychosocial and cultural aspects of care.

PURPOSE: To explore the impact of disruptions in information processing (DIPs) on social roles, well-being, and quality of life (QOL) in breast cancer survivors after chemotherapy. PARTICIPANTS & SETTING: Experiences of DIPs were explored in eight breast cancer survivors aged 53-70 years, 12-60 months post-treatment, referred from a National Cancer Institute-designated cancer center and a nonprofit breast cancer support organization from January 6 to August 31, 2020. METHODOLOGIC APPROACH: This study used a mixed-methods approach. Participants journaled and answered questionnaires sent via mail that asked them about changes in their cognition, QOL, and social roles. Qualitative data were thematically analyzed using constant comparative analysis, and questionnaire scores were compared with qualitative data. FINDINGS: Journals revealed problems with functioning in occupational roles and increased stress, anxiety, and frustration. Women with more DIPs tended to have lower role satisfaction and QOL. Greater role satisfaction was associated with higher QOL and social role participation. IMPLICATIONS FOR NURSING: Mitigating the effects of DIPs on social function may allow women to continue in important roles, which has the potential to affect QOL. [ABSTRACT FROM AUTHOR]

OBJECTIVES: To examine associations of sociodemographic factors and social limitations with health-related quality of life (HRQOL) from pre- to postdiagnosis in older female cancer survivors. SAMPLE & SETTING: 9,807 women aged 65 years or older with breast or gynecologic cancer from the Surveillance, Epidemiology, and End Results-Medicare Health Outcomes Survey. METHODS & VARIABLES: Physical and mental HRQOL were assessed using the physical component summary (PCS) and mental component summary (MCS) of the Veterans RAND 12-Item Health Survey. Descriptive statistics and mixed-effects models for repeated measures were used. RESULTS: Social limitations were the only significant factor associated with changes in MCS scores. Race and ethnicity, rurality, and social interference were associated with significant decreases in PCS scores. IMPLICATIONS FOR NURSING: Nurses can assess mental and physical HRQOL after diagnosis and advocate for appropriate referrals. Oncology care should be tailored to cultural considerations, including race and ethnicity, rurality, and social support. [ABSTRACT FROM AUTHOR]

OBJECTIVES: To examine sleep quality and self-reported causes of sleep disturbance among patients with breast cancer at diagnosis and one year later. SAMPLE & SETTING: 486 of 606 patients with histologically confirmed breast cancer completed a Pittsburgh Quality Sleep Index (PSQI) survey at the time of diagnosis and again one year later. METHODS & VARIABLES: In this secondary data analysis, descriptive statistics were computed for seven PSQI components and its global score. Wilcoxon signed-rank tests and McNemar's tests were used. Self-reported reasons for sleep disturbances were summarized. RESULTS: PSQI scores significantly increased from baseline (... = 6.75) to one-year follow-up (... = 7.12), indicating worsened sleep. Sleep disturbance and onset latency scores increased, whereas sleep efficiency decreased. The two most frequently reported reasons for sleep disturbance were waking up late in the night or early in the morning (more than 50%) and needing to use the bathroom (49%). Feeling too hot and experiencing pain three or more times per week were reported by participants at baseline and one year later. IMPLICATIONS FOR NURSING: Results can aid in monitoring patient response to treatment methods and formulating benchmarks to manage sleep problems. [ABSTRACT FROM AUTHOR]

BACKGROUND: Women with breast cancer (BC) experience symptoms related to fatigue, sleep quality, and quality of life (QOL) in the posttreatment period. Oncology nurses need to plan interventions such as physical activity (PA) aimed at reducing the symptoms experienced by patients. OBJECTIVES: The aim of this article is to determine the efficacy of a home-based, unsupervised PA program on fatigue, sleep quality, and QOL in survivors of BC. METHODS: This study was an experimental study with a prospective control group. Female survivors of BC were randomly assigned to either the homebased, unsupervised PA intervention group or the control group for 12 weeks. Fatigue, sleep quality, and QOL were assessed with questionnaires at baseline and the 12th week. FINDINGS: The home-based, unsupervised PA program yielded positive effects on fatigue and QOL among participants. The program did not affect sleep quality. [ABSTRACT FROM AUTHOR]

OBJECTIVES: To identify an empirical typology of social engagement and its association with depressive symptoms and life satisfaction among older cancer survivors. SAMPLE & SETTING: This was a cross-sectional study using data from the Korean Longitudinal Study of Aging. METHODS & VARIABLES: Latent class analysis was used to categorize social engagement types. Hierarchical regression analysis then investigated the impact of older cancer survivors' social engagement on depressive symptoms and life satisfaction. RESULTS: Three classes were identified as follows: a religiously centered group, a diverse social participation group, and a passive participation group. Hierarchical regression indicated that the depressive symptoms of the diverse social participation group were significantly lower than those of the passive participation group (β = -0.157, p = 0.002). There was no significant effect on life satisfaction. IMPLICATIONS FOR NURSING: This study enhances the understanding of engagement patterns and serves as a reference for older cancer survivors who need support. [ABSTRACT FROM AUTHOR]

OBJECTIVES: To evaluate nurses' views, experiences, and perceptions of the benefits and barriers to fertility preservation (FP) care for patients with cancer. SAMPLE & SETTING: The sample consisted of 236 nurses who provided care before gonadotoxic treatment for people with cancer in three university hospitals in Istanbul, Turkey, from January to June 2018. METHODS & VARIABLES: The data were collected using a participant information form and the Oncology FP Survey. The main research variables were nurses' views, experiences, and perceptions of benefits and barriers to FP care. Data were evaluated using means, SDs, frequencies, and the Mann-Whitney U test. RESULTS: Patients and their families were informed about FP most of the time. This information was given by physicians about half the time and by nurses less than one-fourth of the time. Mean scores on the Oncology FP Survey were moderate and indicated challenges among nurses in self-confidence, selfawareness of personal limitations, and perceived barriers when providing effective FP care. IMPLICATIONS FOR NURSING: Nurses face challenges in providing counseling about FP options for patients with cancer and their families. Increasing self-confidence, reducing personal limitations, and decreasing perceived barriers to FP care through appropriate training may improve nurses' ability to provide FP counseling. [ABSTRACT FROM AUTHOR]

Patients with cancer who are immunocompromised are at risk for catheter-associated urinary tract infections (CAUTIs). Many recommendations are available for healthcare organizations to use to reduce CAUTIs. Implementing various approaches to prevent CAUTIs requires teams to collaborate and communicate well. The oncology nurse can lead the team to achieve the best patient outcomes and assist in recommending the use of teamwork models. [ABSTRACT FROM AUTHOR]

Patients with cancer and multiple chronic conditions (complex cancer survivors) are vulnerable to the negative impacts of COVID-19. However, their experiences and coping strategies during the COVID-19 pandemic have not been extensively studied. A mixed-methods design was used to assess coping strategies and protective responses taken to minimize COVID-19 infection. Participants were drawn from a cohort of complex cancer survivors from a pragmatic clinical trial. Participants reported high adherence to recommended protective behaviors, and risk was assessed based on comorbidities, not cancer status. Most did not experience significant disruptions in cancer-related or primary health care but experienced pandemic-related emotional stressors. Participants managed the impact of the pandemic using spirituality, support from social networks, and coping lessons from their cancer experience. [ABSTRACT FROM AUTHOR]

PURPOSE: To understand the sources of social support and perceptions of cancer and the caregiving role for Korean American patients with cancer and their family caregivers. PARTICIPANTS & SETTING: Using convenience sampling, Korean American patients with cancer and their family caregivers were recruited from Korean American churches and community health agencies. METHODOLOGIC APPROACH: Semistructured interviews guided by the sociocultural stress and coping model were conducted with 12 dyads (N = 24) of Korean American patients with cancer and their family caregivers. Data were analyzed using thematic analysis. FINDINGS: Patients' social support sources included Korean cancer support programs, family or friends, and religion. Family caregivers' sources of social support were limited to religion and friends. IMPLICATIONS FOR NURSING: Nurses can encourage patients with cancer in racial and ethnic minority groups to attend cancer support programs offered in their primary language to enhance their quality of life during cancer survivorship. Culturally tailored interventions are needed to support the patients' family caregivers. [ABSTRACT FROM AUTHOR]

PURPOSE: To describe the self-advocacy experiences of women from underrepresented groups who have advanced breast or gynecologic cancer. PARTICIPANTS & SETTING: To be eligible for the study, participants had to self-identify as vulnerable, which was defined as a member of a group considered at risk for poor cancer outcomes and underrepresented in clinical research. METHODOLOGIC APPROACH: This descriptive, longitudinal, qualitative study consisted of one-on- one interviews of women within three months of an advanced breast or gynecologic cancer diagnosis. FINDINGS: 10 participants completed 25 interviews. The average age of participants was 60.2 years (range = 38-75 years). Three major themes emerged: (a) speaking up and speaking out, (b) interacting with the healthcare team, and (c) relying on support from others. IMPLICATIONS FOR NURSING: Women with advanced cancer who are from underrepresented groups self-advocated in unique ways, learning over time the importance of how to communicate their needs and manage their healthcare team. Future research should incorporate these findings into tailored self-advocacy interventions. [ABSTRACT FROM AUTHOR]

OBJECTIVES: To evaluate for subgroups of patients with distinct symptom profiles and differences in demographic and clinical characteristics and stress and resilience among these subgroups. SAMPLE & SETTING: 1,145 patients with cancer aged 18 years or older completed a survey online. Data were collected between May 2020 and February 2021. METHODS & VARIABLES: Patients completed measures for depression, state anxiety, cognitive function, morning fatigue, evening fatigue, morning energy, evening energy, sleep disturbance, pain, stress, and resilience. Latent class profile analysis was used to identify subgroups of patients with distinct symptom profiles. Differences among the subgroups on study measures were evaluated using parametric and nonparametric tests. RESULTS: Four distinct profiles were identified (none, low, high, and very high). Patients in the high and very high classes reported clinically meaningful levels of all nine symptoms. Differences among the four profiles for stress and resilience exhibited a dose--response effect. IMPLICATIONS FOR NURSING: Findings can serve as benchmark data of the symptom burden of patients with cancer following the COVID-19 pandemic. [ABSTRACT FROM AUTHOR]

OBJECTIVES: To explore the correlation between health--illness transition (HIT) experiences and distress among patients with pancreatic cancer. SAMPLE & SETTING: 55 patients with a diagnosis of pancreatic cancer receiving chemotherapy at a tertiary cancer center in New York. METHODS & VARIABLES: A prospective correlational study was performed to explore the frequency, extent, and management of HITs. HITs were evaluated using the Measurement of Transitions in Cancer Scale, and distress was measured with the National Comprehensive Cancer Network Distress Thermometer. RESULTS: All patients experienced at least one HIT. The extent of HITs decreased over time. Patients reported that they managed HITs moderately well. There was a significant correlation between unmanaged HITs and distress. As distress increased, the extent of the physical and emotional HITs increased and management worsened. IMPLICATIONS FOR NURSING: HITs are ubiquitous among patients diagnosed with pancreatic cancer. Associated distress inhibits management. Nurses are well suited to assess for potential HITs and to support self-management of HITs. [ABSTRACT FROM AUTHOR]

OBJECTIVES: To determine whether there are differences in the health-related quality of life (HRQOL) of older adult survivors of breast cancer (BC) diagnosed in different time periods and to gain insight into whether advances in BC treatment have improved HRQOL. SAMPLE & SETTING: Three cohorts of older adult survivors of BC diagnosed before 1995, from 1996 to 2005, and from 2006 to 2015 were examined using the Surveillance, Epidemiology, and End Results--Medicare Health Outcomes Survey linked databases. METHODS & VARIABLES: HRQOL was measured using the Veterans RAND 12-Item Health Survey. Mean cohort HRQOL scores were compared using analysis of variance, then multivariate regression models were used to examine the effects of cohort membership and covariates on mental and physical HRQOL. RESULTS: Adjusted mean HRQOL scores trended significantly lower with each successive cohort. Higher comorbidity count and increased functional limitations were negatively associated with HRQOL, and income, education level, and better general health perceptions were positively associated with HRQOL. IMPLICATIONS FOR NURSING: Regardless of time since diagnosis, older survivors of BC are at risk for poor HRQOL and should be regularly assessed. Maximizing HRQOL requires consideration of the survivor's resources, comorbidities, and functional limitations when planning care. [ABSTRACT FROM AUTHOR]

BACKGROUND: Sleep disturbances have been shown to have negative health effects leading to inferior well-being, increased fatigue, and impaired performance. For hospitalized patients receiving oncology care, improving nighttime comfort may positively affect well-being and health outcomes, leading to decreased length of stay. Aromatherapy can improve sleep quantity and quality. OBJECTIVES: This pilot study aimed to determine whether aromatherapy improves nighttime comfort, in particular well-being and sleep quality, for hospitalized patients with cancer. METHODS: This quasi-experimental pilot study with a single-arm pre-/post-test design evaluated the effects of nighttime aromatherapy for hospitalized patients with cancer. Measures were the World Health Organization–Five Well-Being Index and Pittsburgh Sleep Quality Index. FINDINGS: A total of 34 hospitalized patients with cancer participated. After aromatherapy, mean well-being scores improved significantly. Mean sleep quality scores also improved but did not reach significance. Of participants who submitted openended responses, 20 of 22 described a positive experience with aromatherapy, including better sleep, relaxation, soothing effects, and nausea relief. [ABSTRACT FROM AUTHOR]

Symptoms of distress are common in people living with cancer. Evidence-based interventions for distress management in patients with cancer include mind–body approaches. Deep breathing, progressive muscle relaxation, and mindfulness are three interventions patients can use for self management of distress [ABSTRACT FROM AUTHOR]

Individuals with cancer experience high levels of anxiety. The purpose of this quality improvement project was to improve staff knowledge of topical aromatherapy and evaluate its impact on the level of anxiety experienced by patients with cancer. The efficacy of an education curriculum intervention to increase staff knowledge of topical aromatherapy was evaluated, and patients shared their experiences receiving a hand massage using essential oils prediluted with massage oil. Staff knowledge about topical aromatherapy increased postintervention. All patients who received a topical aromatherapy hand massage (N = 9) had a decrease of five or more points on the State-Trait Anxiety Inventory for Adults™ Short Form Y-1 from pre- to postintervention. Patient responses also showed reduced pain and enhanced sleep [ABSTRACT FROM AUTHOR]

PURPOSE: To clarify the experiences of spirituality among adolescents and young adults (AYAs) with cancer following diagnosis. PARTICIPANTS & SETTING: Participants were recruited at a clinic and on an oncology unit in Turkey. A combination of purposive sampling and theoretical sampling strategy was used to identify 14 participants. METHODOLOGIC APPROACH: A grounded theory design was used for this study. Semistructured interviews were conducted with each participant between October 2021 and January 2022. The data were analyzed using open, axial, and selective coding. FINDINGS: All the participants were Muslim, were aged 15-39 years, spoke Turkish, and had undergone treatment for any type of cancer. The core category was identified as rebuilding and guiding the self with spirituality. AYAs connected more closely with their sense of spirituality after being diagnosed with cancer. IMPLICATIONS FOR NURSING: This study demonstrated the importance of providing a supportive healing environment to address the spiritual dimension of the cancer experience for AYAs. Individualized interventions ensuring an appropriate level of spiritual care based on clinical standards are essential to meet the needs of patients and ensure positive long-term health outcomes. [ABSTRACT FROM AUTHOR]

Individuals diagnosed with hematologic cancers experience a variety of psychological and physiologic hardships. The purpose of this evidence-based practice pilot project was to determine whether patients who listened to music had improved symptom management. Individuals admitted to an inpatient hematology-oncology unit participated in music sessions. These sessions consisted of patient-preferred music being played for 30-45 minutes. Surveys were administered before and immediately after the intervention. Overall, 58 patients participated. Symptoms that were most improved were tiredness (52%), well-being (48%), drowsiness (45%), and anxiety (41%). [ABSTRACT FROM AUTHOR]

The care of older adults differs from the care of younger patients, and specialized knowledge about aging and caring for older adults can help guide their care. Nurses can use geriatric assessment tools, many of which can be completed within a few minutes and can be easily incorporated into encounters with older adults in oncology practice settings. The results of the assessments can be used to develop care plans that identify vulnerabilities or patient concerns. [ABSTRACT FROM AUTHOR]

BACKGROUND: Central venous catheter (CVC) maintenance is critical in administering chemotherapy, transfusions, and high-frequency laboratory draws. Although normal saline (NS) flushes have been associated with similar incidences of irreversible port occlusions as heparin among adult patients with cancer and ports, additional research is needed regarding NS efficacy in other central line maintenance within large populations with cancer. OBJECTIVES: The aim of this study was to analyze changes in reported CVC line patency via tissue plasminogen activator (tPA) administration rates in ports and other central lines because of an institutional switch from heparin to NS as preferred flushes in adult ambulatory patients with cancer. METHODS: Retrospective data were collected from patients with ports (3,706 prepolicy, 3,402 postpolicy) and nonport CVCs (816 prepolicy, 694 postpolicy). FINDINGS: Patients with nonport CVCs experienced similar tPA usage pre-versus postpolicy, versus an increased rate of tPA usage for ports. This policy resulted in institutional savings of $28,695.92. NS flushes are as effective as heparin for maintaining patency in ports and other CVCs for adult outpatients with cancer and address safety concerns with heparin-associated complications. [ABSTRACT FROM AUTHOR]

PURPOSE: To explore the perspectives on patient and family needs during cancer treatment and survivorship of American Indian (AI) cancer survivors, caregivers, Tribal leaders, and healers. PARTICIPANTS & SETTING: 36 AI cancer survivors from three reservations in the Great Plains region. METHODOLOGIC APPROACH: A community-based participatory research design was employed. Postcolonial Indigenous research techniques of talking circles and semistructured interviews were used to gather qualitative data. Data were analyzed using content analysis to identify themes. FINDINGS: The overarching theme of accompaniment was identified. The following themes were intertwined with this theme: (a) the need for home health care, with the subthemes of family support and symptom management; and (b) patient and family education. IMPLICATIONS FOR NURSING: To provide highquality cancer care to AI patients in their home communities, oncology clinicians should collaborate with local care providers, relevant organizations, and the Indian Health Service to identify and develop essential services. Future efforts must emphasize culturally responsive interventions in which Tribal community health workers serve as navigators to accompany patients and families during treatment and in survivorship. [ABSTRACT FROM AUTHOR]

OBJECTIVES: To conduct an integrative review of studies to identify disparities in quality of life (QOL), symptoms, and symptom burden between men and women diagnosed with hematologic malignancies. SAMPLE & SETTING: 11 studies comprising 13,546 participants aged 18 years or older were included in the analysis. Studies were original peer-reviewed research published in English between January 2005 and December 2020. METHODS & VARIABLES: A literature search was performed using keywords associated with healthrelated QOL, hematologic malignancy, and sex/ gender differences. PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines were followed to identify relevant studies. Data were extracted for sex differences in QOL, symptoms, and symptom burden. All studies were appraised for quality and level of evidence. RESULTS: Women have worse physical health and function, more pain, and higher symptom burden compared with men. IMPLICATIONS FOR NURSING: Healthcare providers need to understand the impact of sex-based differences on QOL, symptoms, and symptom burden to provide optimal, personalized care. [ABSTRACT FROM AUTHOR]

OBJECTIVE: TO determine distinct profile based on symptom severity in patients undergoing surgery for oral cancer and examine whether these profiles differ by participant characteristics. SAMPLE & SETTING: 300 patients who underwent surgery for oral cancer at two outpatient clinics between June and December 2021. METHODS & VARIABLES: Symptoms were assessed using the MD Anderson Symptom Inventory-Head and Neck Cancer Module. Sociodemographic and clinical characteristics were collected. Latent profile analysis was performed. RESULTS: Five distinct dysphagia profiles were identified, which qualitatively differed regarding co-occurrence patterns of dysphagia, mucusrelated symptoms, speech disturbances, and psychoneurologic symptoms. Significant differences were reported in interference to function, number of co-occurring symptoms, time since diagnosis and treatment completion, use of symptom management medications, oral cancer stage and site, and treatment completed. IMPLICATIONS FOR NURSING: Identifying distinct dysphagia profiles can improve patient outcomes and help in planning specific nursing interventions to influence nutritional and functional status in oral cancer survivors. Dysphagia and dry mouth can persist beyond one year post-treatment, so follow-up dysphagia assessments are needed. [ABSTRACT FROM AUTHOR]

PURPOSE: To describe and assess physical and psychosocial concerns and care processes related to cancer and treatment in gynecologic cancer survivors. PARTICIPANTS & SETTING: 44 survivors of gynecologic cancer at City of Hope National Medical Center in southern California were enrolled. METHODOLOGIC APPROACH: A descriptive mixedmethods approach was used. Data were collected on survivorship care plan implementation, supportive care referrals, and barriers to receiving care. Participants completed questionnaires assessing quality of life, unmet needs, and other outcomes at three, six, and nine months after enrollment. Changes over time were analyzed, and quantitative and qualitative results were compared. FINDINGS: The most common unmet needs were stress reduction, side effect management, fear of cancer recurrence (FCR), and perception of adequate communication among the care team. Qualitative themes centered around communication, care coordination, FCR, financial distress, and need for information about peer support and healthy lifestyles. IMPLICATIONS FOR NURSING: Nurses play a key role in coordinating care, assessing symptoms, and addressing psychosocial concerns. Providing education and coaching can reduce stress and facilitate survivors' self-management and self-efficacy. [ABSTRACT FROM AUTHOR]

OBJECTIVES: To determine if subgroups of individuals with prostate cancer and their partners could be identified based on their distinct symptom profiles and to identify and characterize subgroups based on sociodemographic and cancer characteristics. SAMPLE & SETTING: 263 individuals with prostate cancer and 263 partners recruited from three academic cancer centers in the Midwest. METHODS & VARIABLES: Latent class analysis was applied to divide individuals into subgroups based on symptom prevalence. Multinomial logistic regression models were used to estimate the prevalence of each symptom, predict subgroup membership, and adjust for direct or indirect effects of covariates on the symptoms. RESULTS: Three distinct subgroups (low, moderate, and high symptoms) were identified among individuals with prostate cancer and partners, respectively. Education and household income of individuals with prostate cancer were associated with different symptom burdens. Partners' household income differentiated among the subgroups. IMPLICATIONS FOR NURSING: Understanding the influence of sociodemographic and cancer characteristics can inform risk stratification and tailored symptom management interventions. [ABSTRACT FROM AUTHOR]

BACKGROUND: Rural post-treatment head and neck cancer (HNC) survivors experience high rates of cancer-related distress and may experience unique symptom clusters. Oncology nurses can benefit from a better understanding of the symptom clusters that HNC survivors experience. OBJECTIVES: The purpose of this secondary data analysis was to identify symptom clusters of cancer-related distress in rural HNC survivors. METHODS: Secondary data analysis was conducted with survey data collected from rural HNC survivors (N = 20). Distress symptoms were measured using the National Comprehensive Cancer Network Distress Thermometer and Problem List, amended for a population with HNC. Symptom clusters were defined as two or more co-occurring symptoms and evaluated based on participantreported severity using exploratory factor analysis. Resultant clusters were assessed for theoretical and clinical appropriateness. FINDINGS: Preliminary analysis suggests rural HNC survivors experience eight symptom clusters. As a first step, the results of this study can help nurses to identify symptom clusters in rural HNC survivors. [ABSTRACT FROM AUTHOR]

OBJECTIVES: To examine the effects of perceived body image and perceived control over life on physical and mental health of young and midlife adults with cancer. SAMPLE & SETTING: A total of 49 young and midlife adults with cancer were recruited through a state cancer registry. METHODS & VARIABLES: This study was a secondary analysis of data from a small study of young and midlife couples surviving cancer. Physical and mental health were measured with the SF-36®. Negative effect of cancer on body image and perceived control were measured with single items from the Life Impact Checklist. RESULTS: Most individuals reported a very negative to neutral effect of cancer on body image and a very negative to somewhat positive effect on perceived control. There were no significant differences by age or sex. Negative effect on body image was significantly associated with worse physical health. Negative effect on body image and perceived control over life were significantly associated with worse mental health. IMPLICATIONS FOR NURSING: Nurses are uniquely placed to provide holistic care to individuals with cancer and facilitate support for those experiencing negative body image and perceived lack of control years after diagnosis. [ABSTRACT FROM AUTHOR]

OBJECTIVES: To examine colorectal cancer survivors’ positive psychology and symptom characteristics, and to assess for potential impact of prior trauma on these relationships during acute cancer survivorship. SAMPLE & SETTING: A cross-sectional study of 117 colorectal cancer survivors was conducted at a National Cancer Institute–designated cancer center. METHODS & VARIABLES: Participants completed a demographic questionnaire, and the Carver Benefit Finding Scale and Posttraumatic Growth Inventory assessed positive psychology. Descriptive statistics and multiple linear regression analyses were performed. RESULTS: 49 symptoms were reported and varied based on prior trauma. Significance was found between positive psychology and symptom frequency (p < 0.001); symptoms reported almost daily and daily were inversely related to positive psychology. IMPLICATIONS FOR NURSING: Nurses should prioritize symptoms; less frequent symptoms improve positive psychology. Early identification of positive changes may promote survivors’ self-awareness and management skills to mitigate adverse symptoms. [ABSTRACT FROM AUTHOR]

PURPOSE: To explore women’s perceptions of and preferred peer characteristics for peer mentoring to support physical activity promotion. Understanding how women living beyond a cancer diagnosis perceive peers for physical activity may help guide further health behavior mentoring and support practices. PARTICIPANTS & SETTING: 16 English-speaking adult women living beyond a cancer diagnosis. METHODOLOGIC APPROACH: Following a qualitative descriptive approach, four in-person focus groups were conducted and discussions were analyzed using inductive content analysis. FINDINGS: Participants described four considerations for peer matching: (a) personal characteristics, (b) physical activity characteristics, (c) cancer characteristics, and (d) finding a peer. Similarities in age, life phase, location, history of physical activity, type of cancer, severity of cancer, and personality were integral. An online or mobile application and the ability to create multiple partnerships were preferred. IMPLICATIONS FOR NURSING: Understanding methods to promote physical activity is imperative for long-term survivorship outcomes. Nurses in oncology care settings may promote physical activity and social support for women living beyond cancer diagnoses by facilitating optimal peer matches. [ABSTRACT FROM AUTHOR]

PURPOSE: To explore cancer survivors’ access to and use and disposal of opioids in the context of the opioid epidemic. PARTICIPANTS & SETTING: Community-based recruitment strategies were employed for individuals aged 18 years or older who were previously diagnosed with cancer, completed cancer treatment within the past five years, or were cancer free, and who were prescribed opioids for cancer-related pain. METHODOLOGIC APPROACH: This qualitative study used semistructured interviews. Data were analyzed using applied thematic analysis techniques. FINDINGS: Themes included the following: (a) restrictive policies affecting opioid access and supply, (b) decreased opioid use because of concerns of addiction and other opioid-related side effects, and (c) lack of clarity on safeguarding and disposal of opioids. IMPLICATIONS FOR NURSING: Cancer survivors may encounter barriers to opioid access, alter medicationtaking behavior over fear of addiction and side effects, and face inadequate education regarding proper disposal of opioids. Nurses can advocate for appropriate access to prescribed opioids, assess opioid-taking behavior, provide education regarding storage and disposal, and implement educational interventions accordingly [ABSTRACT FROM AUTHOR]

OBJECTIVES: To gather preliminary data on correlations among psycholinguistic measures, self-report of cognitive function, and performance on neurocognitive tests in breast cancer survivors. SAMPLE & SETTING: Participants were breast cancer survivors who reported issues with cognitive function after completion of chemotherapy. This secondary analysis used data from participants in parent studies at two National Cancer Institute-designated cancer centers. METHODS & VARIABLES: Qualitative interview transcripts (N = 52) underwent psycholinguistic analyses for grammatical and semantic complexity. Relationships among six psycholinguistic variables, self-report of cognitive function, and performance on neurocognitive tests were examined. RESULTS: Three grammatical complexity variables had a significant positive correlation to self-report of cognitive function. One semantic complexity variable had a significant positive correlation to delayed recall neurocognitive tests. IMPLICATIONS FOR NURSING: Results suggest that psycholinguistic analysis may be used to assess cognitive function among breast cancer survivors. Confirmatory studies are needed to establish the correlation between psycholinguistic measures, self-report of cognitive function, and domain-specific tests of neurocognitive performance, as well as to evaluate longitudinal sensitivity to change. [ABSTRACT FROM AUTHOR]

PROBLEM IDENTIFICATION: Significant cancer disparities exist between Black and White patients. One important contributor to patient outcomes disparities is patient-clinician communication. Conversations between clinicians and Black patients are often shorter and less detailed compared to White patients. LITERATURE SEARCH: A systematic literature search was conducted. Databases were searched to identify studies that included (a) participants with a cancer diagnosis, (b) information specific to Black or African American participants, and (c) information on patient-clinician communication. A total of 67 articles underwent full review; 24 studies met inclusion criteria. DATA EVALUATION: Each included study was scored for level of evidence, and common themes were identified across studies using the Matrix Method. SYNTHESIS: The following themes were identified: relationship building, building trust, empowering patients for shared decision-making, addressing topics of patient concern, and consideration of community and family. IMPLICATIONS FOR RESEARCH: Results identify several ways that nurses can improve communication with Black patients. Research aimed at identifying interpersonal strategies to mitigate cancer disparities is needed. [ABSTRACT FROM AUTHOR]

The COVID-19 pandemic has intensified the social isolation of individuals with cancer. Studies about how to address social isolation among patients with cancer are limited, yet data from other high-risk populations can inform oncology nursing practice. This literature review of evidence-based clinical interventions provides a foundation for clinical oncology nursing practice. With the use of technology, institutional resources, and community resources, oncology nurses can tailor physical activity, psychotherapy, and socialization interventions to reduce the negative psychosocial outcomes of isolation. [ABSTRACT FROM AUTHOR]

OBJECTIVES: Hematologic malignancies (HMs) are life-threatening cancers that frequently entail aggressive, long, inpatient treatment protocols. This can result in numerous concurrent symptoms and decreased quality of life for patients and can affect family caregivers (FCs). This study examined the impact of an HM diagnosis on patients and on their FCs. SAMPLE & SETTING: A descriptive design was used to explore the experiences of 28 newly diagnosed patients and their FCs. All patients were receiving treatment on an inpatient acute oncology unit at a National Cancer Institute-designated cancer center. METHODS & VARIABLES: Semistructured, separate interviews with patients and FCs were recorded and transcribed verbatim. Textual and content analyses were conducted to generate common themes. RESULTS: Patients and FCs reported how diagnosis and treatment affected them physically, emotionally, logistically, and financially. They described the effects of their experiences with the health system and providers in areas such as diagnostic process, trust in the medical team, support needs, and hospitalization. IMPLICATIONS FOR NURSING: Understanding the parallel experiences of patients with HMs and their designated FCs allows researchers to develop targeted interventions and enables clinicians to provide personalized patient- and family-centered care. [ABSTRACT FROM AUTHOR]

OBJECTIVES: To examine the relationship between levels of anxiety about COVID-19 and attitudes toward colorectal cancer screening in adult men in Turkey. SAMPLE & SETTING: The participants in this study were 188 adult men, aged 50-70 years, who were not diagnosed with cancer, and who could use social media. The researchers shared the link to the study forms through social media, and data were collected between February 2021 and May 2021. METHODS & VARIABLES: A personal information form, the Coronavirus Anxiety Scale, and the Attitude Scale for Cancer Screening were used to collect descriptive research data. RESULTS: Participants had mean scores of 1.04 (SD = 2.12) for the Coronavirus Anxiety Scale and 95.28 (SD = 16.91) for the Attitude Scale for Cancer Screening. There was no significant correlation between the scores (p > 0.05). Family structure and the reasons for applying for colorectal cancer screening were significantly related to participation in colorectal cancer screening programs (p < 0.05). IMPLICATIONS FOR NURSING: Individualized screening models can be used to prevent the deferral of cancer screenings. To ensure early diagnosis of colorectal cancer, nurses should be encouraged to use telehealth applications and help individuals perform immunochemical tests at home. [ABSTRACT FROM AUTHOR]

OBJECTIVES: Patients with advanced cancer and minor children experience high rates of depression and anxiety. However, associations between parental status and other aspects of the patient experience are not well understood. This study compared patient-reported outcomes of patients with and without minor children. SAMPLE & SETTING: This was a retrospective analysis of 448 adults with stage III or IV solid tumors from a public research registry. METHODS & VARIABLES: Multiple linear regression models or modified Poisson regression models were fitted to evaluate differences in health-related quality of life, global health, and patient satisfaction scores between patients living with and without minors. RESULTS: One in five patients lived with minor children. They reported significantly worse healthrelated quality of life, global physical health, and global mental health. They also expressed lower satisfaction with time spent with their provider, communication, and financial aspects. IMPLICATIONS FOR NURSING: Patients with minor children may benefit from earlier identification and support for their psychosocial needs and concerns. [ABSTRACT FROM AUTHOR]

OBJECTIVES: To evaluate the effect of a symptom management mobile application on quality of life and symptom severity in women with breast cancer undergoing chemotherapy. SAMPLE & SETTING: This parallel randomized pilot study consisted of women with breast cancer admitted to oncology outpatient clinics between November 2019 and January 2021 in Turkey. METHODS & VARIABLES: Participants (N = 40) were randomly assigned to the intervention (n = 20) or control group (n = 20). The intervention group used the mobile application in conjunction with usual care. The control group received usual care. Participants were assessed during the first, third, and last chemotherapy cycles. Data were collected using the European Organisation for Research and Treatment of Cancer Quality-of-Life Questionnaire-Core 30 and the Edmonton Symptom Assessment System. RESULTS: During the study, the decrease in general health and physical functioning and the increase in the severity of depression/sadness in the intervention group were statistically lower than in the control group. IMPLICATIONS FOR NURSING: The use of a mobile application for symptom management may promote general well-being and physical function and may alleviate symptoms of depression/sadness in women with breast cancer undergoing chemotherapy. Further studies are needed to evaluate the application in clinical settings with larger groups. [ABSTRACT FROM AUTHOR]

ROBLEM IDENTIFICATION: Growing numbers of African Caribbean immigrants with cancer reside in the United States and frequently encounter different challenges than survivors born in the United States. LITERATURE SEARCH: More than a decade of research was searched in the PubMed®, Embase®, CINAHL®, and Scopus® databases using terms reflective of African Caribbean immigrant survivors in the United States. DATA EVALUATION: The initial search in this scoping review revealed 912 articles, with seven meeting inclusion criteria. Data extracted from articles included purpose/aims, design, sample/setting, methods, and results. SYNTHESIS: Five retrospective analyses, one case report, and one qualitative study comprised the final sample. Thematic analysis used to synthesize results revealed two themes: survival patterns and barriers. IMPLICATIONS FOR RESEARCH: The results indicated a need to identify and address root causes of disparity, and track the effectiveness of available treatments and outcomes by country of birth. Research capturing the experiences of African Caribbean immigrants would benefit from collaboration with community leaders and survivors. Oncology nurses play critical roles in leading research and developing culturally informed practices in clinical settings. [ABSTRACT FROM AUTHOR]

OBJECTIVES: To determine the relative predictive validity of personality and spirituality for mental health and salivary alpha-amylase (sAA) in breast cancer (BC) survivors. SAMPLE & SETTING: 23 BC survivors participated in a single-group, cross-sectional study. METHODS & VARIABLES: Predictor variables included personality and spiritual variables. Outcome variables included subjective physical and mental health outcomes and sAA, a neuroimmune biomarker. RESULTS: Hierarchical regressions indicated that (a) conscientiousness and forgiveness independently predict 38% and 11% of variance in mental health scores, respectively; and (b) conscientiousness and forgiveness independently predict 15% and 24% of the variance in sAA, respectively. Consistent with psychoneuroimmunology theory, personality and spiritual variables independently influence subjective mental health and neuroimmune activity in BC survivors. IMPLICATIONS FOR NURSING: Nurses should be aware of BC survivors’ personality characteristics and spiritual dispositions so that distinct interventions can be offered to promote mental health and reduce stress-related neuroimmune inflammation. [ABSTRACT FROM AUTHOR]

OBJECTIVES: To examine the physical, mental, and general health among young adult childhood cancer survivors (CCS). SAMPLE & SETTING: This secondary analysis study used data from the Behavioral Risk Factor Surveillance System. The analytic sample included 697 young adult CCS (537 women; 160 men). METHODS & VARIABLES: Chi-square tests of independence were done to compare the rates across cancer survivorship groups on categorical variables. Logistic regression was performed to determine correlates with physical, mental, and general health. RESULTS: Female CCS had a significantly (p < 0.0001) greater number of “no days” in which they reported good physical, mental, and general health compared to male CCS. Female CCS were more likely to experience 30 days of poor physical health compared to male CCS (odds ratio [OR] = 1.8, p < 0.05) when controlling for education, race, and age. Depressed female CCS had higher odds of being in poor physical, mental, and general health (OR = 2.9, 7.6, and 2.6, respectively). IMPLICATIONS FOR NURSING: Findings support the need for continued screening, following published practice guidelines, among young adult female CCS for emotional distress with the use of well-established distress and psychosocial assessment measures. [ABSTRACT FROM AUTHOR]