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OBJECTIVE: To provide an overview of sexuality and sexual expression in older adult cancer survivors and to outline implications for nursing and interdisciplinary practice. DATA SOURCES: Research articles, abstracts, reviews, and clinical expertise. CONCLUSION: Unique features of sexuality in late life provide evidence to support clinical exploration of sexuality for older adult cancer survivors. Approaches to intervention with older adult cancer survivors are predicated on adaptation of best practices in sexuality and sexual health to create care that is sensitive to age and generation. Targeted research in sexuality for older adult cancer survivors includes intimacy, relationship, sexual experience, and imbedded sexual behavior. IMPLICATIONS FOR NURSING PRACTICE: Nurses can improve the care of older adults with cancer by careful consideration of intimacy and sexuality using standards of practice with younger adults integrated with understanding of issues unique to later life. Copyright © 2008 by Elsevier Inc. [ABSTRACT FROM AUTHOR]

Background: Little is known about the impact of extrinsic factors on pressure ulcer risk. The objective of this study was to determine whether risk of pressure ulcers early in the hospital stay is associated with extrinsic factors such as longer emergency department (ED) stays, night or weekend admission, potentially immobilizing procedures and medications, and admission to an intensive care unit (ICU).Methods: A nested case-control study was performed in two teaching hospitals in Philadelphia, Pennsylvania. Participants were medical patients age > or =65 years admitted through the ED. Cases (n = 195) had > or =1 possibly or definitely hospital-acquired pressure ulcers. Three controls per case were sampled randomly from among noncases at the same hospital in the same month (n = 597). Pressure ulcer status was determined by a research nurse on the third day of hospitalization. Pressure ulcers were classified as preexisting, possibly hospital-acquired, or definitely hospital-acquired. Information on extrinsic factors was obtained by chart review.Results: The odds of pressure ulcers were twice as high for those with an ICU stay as for those without (adjusted odds ratio [aOR] 2.0, 95% confidence interval [CI], 1.2-3.5). The aOR was 0.6 (95% CI, 0.3-0.9) for use of any potentially immobilizing medications during the early inpatient period.Conclusions: Many of the procedures experienced by patients in the ED and early in the inpatient stay do not confer excess pressure ulcer risk. Having an ICU stay is associated with a doubling of risk. This finding emphasizes the importance of developing and evaluating interventions to prevent pressure ulcers among patients in the ICU. [ABSTRACT FROM AUTHOR]

Delirium is a healthcare issue that continues to challenge critical care nurses. Providing doula services under the supervision of critical care nurses to critically ill older adults with delirium may be an innovative model for addressing these care needs. [ABSTRACT FROM AUTHOR]

The purpose of this study was to estimate the incidence of hospital-acquired pressure ulcers among elderly patients hospitalized for hip fracture surgery and to identify extrinsic factors that are associated with increased risk. We conducted a secondary analysis of data abstracted from medical records at 20 hospitals in Pennsylvania, Texas, New Jersey, and Virginia. Participants were patients aged 60 years and older admitted with hip fracture to the study hospitals between 1983 and 1993. The incidence of hospital-acquired pressure ulcers was 8.8% (95% confidence interval 8.2%-9.4%). After adjusting for confounding variables, longer wait before surgery, intensive care unit stay, longer surgical procedure, and general anesthesia were significantly associated with higher pressure ulcer risk. Extrinsic factors may be important markers for high pressure ulcer risk in hospitalized hip fracture patients. Although it is not possible to eliminate factors such as requiring an intensive care unit stay or having a long surgical procedure, it may be possible to develop interventions that minimize pressure ulcer risk in patients who experience these factors. [ABSTRACT FROM AUTHOR]

The purpose of this study was to understand the phenomenon of hand holding as a coping strategy used by adolescents to deal with treatment-related pain. The convenience sample consisted of 20 adolescents whose ages were 11 to 19 years: 10 had cancer and 10 had renal disease (this served as the comparison group). Using a descriptive design, a semistructured interview was conducted with each adolescent. To supplement and support interview data, structured observations were conducted as adolescents underwent painful treatments (eg, blood draws, shunt placement, peripheral chemotherapy, lumbar punctures, and bone marrow aspirations). Data were analyzed using descriptive statistics and qualitative analytic techniques similar to those delineated by Strauss and Corbin. The results of this study indicated that subjects in both the cancer and the renal disease group perceived hand holding to be a very effective coping strategy in ameliorating treatment-related pain. Overwhelmingly the patients preferred to hold their mother's hand. When the mother was unavailable, they preferred to hold a specific nurse's hand. Hand holding functioned to reduce tension associated with impending treatments, as a source of distraction, and as a source of security. Accordingly, adolescents' subjective experience of treatment-related pain was reduced when they felt more secure, less tense, and were distracted. [ABSTRACT FROM AUTHOR]

PURPOSE/OBJECTIVES: To examine reciprocity (i.e., a mutual exchange of benefit) in study participation via a thematic analysis of field notes on study participation from a parent psychometric study. DESIGN: Qualitative. SETTING: Head and neck surgery clinic in an urban tertiary hospital. SAMPLE: Seven patients with head and neck cancer recruited to participate in an instrument development project. METHODS: Symbolic interactionism was employed to frame the examination of field notes from observations and interactions with patients, as well as participant notes accompanying returned retest questionnaires. Analysis relied on the constant comparative technique at the levels of open and axial coding. MAIN RESEARCH VARIABLES: Participation in an instrument development project. FINDINGS: Four content themes emerged in the analysis: Willingness to Help, Reassurance That the Deficits Patients Experience Are Common, Participation Provides Social Contact, and Confirmation of Clinically Significant Findings. A process theme, Unveiling the Experience, integrated the content themes in relation to participation itself. The role of the study nurse appears to be pivotal in this process. CONCLUSIONS: A notion of reciprocity in research participation is apparent. The role of the study nurse is an important element in the process of reciprocity. This role should be explored to enhance study participation. IMPLICATIONS FOR NURSING: Implications, particularly for clinical trial nurses, include recasting the benefits of participating in research, better addressing preparation for patients scheduled to receive treatment for head and neck cancer, and exploring and enhancing the role of the study nurse. [Abstract for this article also available on page 1410 of printed version. Full article available at www.ons.org/xp6/ONS/Library.xml/ONS_Publications.xml /ONF.xml] [ABSTRACT FROM AUTHOR]

Competing Interests: The author has no funding or conflicts of interest to disclose.

Competing Interests: The author has no funding or conflicts of interest to disclose.

Competing Interests: The authors have no funding or conflicts of interest to disclose.

Competing Interests: The author has no funding or conflicts of interest to disclose.

Competing Interests: The authors have no funding or conflicts of interest to disclose.

Objectives: Cancer care attuned to meeting the needs of older adults is imperative to ensure that they receive appropriate levels of treatment in accordance with their goals of care. Achieving age-friendly systems and geriatric-competent workforces require rethinking current models of cancer care delivery. This article reports on a descriptive study on the readiness of U.S. cancer programs to provide age-friendly cancer care., Sample & Setting: A survey was sent to 567 ambulatory oncology leaders in the United States. Of the 81 respondents, 61 answered all questions., Methods & Variables: The authors developed and administered an online survey assessing cancer programs' age-friendly cancer care practices and readiness. Survey questions were based on the elements of the 4Ms framework. Results were analyzed using frequencies and percentages for categorically measured survey items and measures of central tendency for continuously scaled survey items., Results: 67% of respondents reported that their program could deliver age-friendly cancer care within five years. Respondents less frequently indicated that they employed specific 4Ms elements., Implications for Nursing: The results of this study suggest gaps in readiness to implement age-friendly cancer care. Recommendations to improve readiness include increasing awareness, expanding workforce preparation, and improving cancer program leadership engagement.