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Oncology Nursing Forum

ISSN: 0190-535X eISSN: 1538-0688
Subject: oncology
Published by Oncology Nursing Society

No Issue Number

Learning About a Twist in the Road: Perspectives of At-Risk Relatives Learning of Potential for Cancer
Purpose/Objectives: To describe the experiences of women who accessed the Facing Our Risk of Cancer Empowered (FORCE) Web site after learning of a family BRCA1 or BRCA2 mutation.Research Approach: Interpretive phenomenology based on Heideggerian hermeneutics.Setting: Telephone interviews of women living in the United States who accessed FORCE.Participants: A purposive sample of eight women aged 19-47 years.Methodologic Approach: Team interpretation using Diekelmann, Allen, and Tanner's seven-step process.Main Research Variables: Experience of family communication of BRCA results.Findings: Women described (a) finding out, (b) unexpected feelings, (c) mulling it over, (d) finding support, (e) seeking direction from healthcare professionals, (f) redefining future possibilities, and (g) navigating a twist in the road.Conclusions: Many healthcare professionals are not prepared to address genetic risk. Some women who learned of potential risk experienced turmoil as potential risk for cancer unfolded. They felt isolated and unsupported by healthcare providers. They desired assistance in navigating the healthcare system to protect their future health.Interpretation: Healthcare professionals have important roles in (a) assessing support networks of individuals seeking BRCA testing, (b) providing anticipatory guidance on risk communication, (c) remaining sensitive to the impact of seeing cancer as a future possibility, (d) allowing time for individuals to process such news, (e) assessing the psychosocial impact of news of a family BRCA mutation, and (f) providing referrals for support and health needs. Women desire decision support from healthcare providers. Future research should examine cancer risk communication in diverse groups of women.<ul> <li>Content Type Journal Article</li><li>Pages 723-733</li><li>DOI 10.1188/10.ONF.723-733</li><li>Authors<ul> <li>Cheryl B. Crotser, PhD, RN, Roberts Wesleyan College, Rochester, NY</li><li>Suzanne S. Dickerson, DNS, RN, University at Buffalo, New York</li> </ul></li> </ul><ul class="parents"> <ul class="details"> <li>Journal <a href="http://ons.metapress.com/content/120390/">Oncology Nursing Forum</a></li><li>Online ISSN 1538-0688</li><li>Print ISSN 0190-535X</li> </ul><ul class="details"> <li>Journal Volume Volume 37</li> </ul><ul class="details"> <li>Journal Issue <a href="http://ons.metapress.com/content/w3pq1r236884/">Volume 37, Number 6 / November 2010</a></li> </ul> </ul>
Decision Making for Cancer Clinical Trial Participation: A Systematic Review

Purpose/Objectives: To describe what is known about the factors that influence cancer clinical trial decision making.

Data Sources: PubMed database and reference lists of identified articles.

Data Synthesis: Variations in research design and methods, including sample characteristics, instrumentation, time between decision made and measurement of decision making, and response rates, have effects on what is known about decision making for cancer clinical trial participation. Communication, whether in the form of education about a cancer clinical trial or as a personal invitation to join, is an important factor influencing decision making. Personal and system factors influence the outcomes of decision making for cancer clinical trials.

Conclusions: The process of decision making for cancer clinical trials is understudied. Nevertheless, the currently available cancer clinical trial decision-making literature suggests a multitude of factors that influence the outcomes of the decision to accept or decline clinical trial participation, as well as the psychosocial consequences of decisional regret, pressures, and satisfaction.

Implications for Nursing: The decision-making process of cancer clinical trials is a fertile area for research and, subsequently, evidence-based interventions. Oncology nurses are in a position to facilitate the process and to relieve the pressures patients perceive regarding decision making for cancer clinical trials that will benefit individuals and, ultimately, society.
- Content Type Journal Article
- Pages E387-E399
- DOI 10.1188/10.ONF.E387-E399
- Authors
  - Barbara A. Biedrzycki, PhD, CRNP, AOCNP�, Sidney Kimmel Comprehensive Cancer Center, Johns Hopkins Medicine, Baltimore, MD
The Symptom Cluster Experience Profile Framework
Purpose/Objectives: To present the novel Symptom Cluster Experience Profile (SCEP) framework for guiding symptom research in adult survivors of childhood cancers and other subgroups at risk for high symptom burden.Data Sources: Empirically derived model of symptom cluster experience profiles, existing theoretical frameworks, and data-based literature on symptoms and quality of life in adult survivors of childhood cancers.Data Synthesis: In a previous study, the authors generated a preliminary model to characterize subgroups of adult survivors of childhood cancers with high-risk symptom cluster profiles. The authors developed the SCEP framework, which depicts symptom cluster experiences as subgroup-specific profiles that are driven by multiple sets of risk and protective factors. The risk and protective factors may directly and indirectly contribute to or alleviate symptoms through their effects on systemic stress. Systemic stress instigates and sustains the symptom experience that, in turn, is expressed through negative diffusion into other components of quality of life, such as functional status, general health perceptions, and overall quality of life.Conclusions: The SCEP framework is an initial approach to unbundle the complex heterogeneity that underlies the clustering of symptoms. By measuring a wide range of risk and protective factors in future studies of adult survivors of childhood cancers and other subgroups at risk for high symptom burden, further development and validation of the SCEP framework will occur.Implications for Nursing: The SCEP framework can be used to specify mechanisms underlying symptom cluster profiles and derive interventions targeted to high-risk symptom profiles. Findings from future studies can be translated to risk-based surveillance and symptom management clinical practice guidelines.<ul> <li>Content Type Journal Article</li><li>Pages E377-E386</li><li>DOI 10.1188/10.ONF.E377-E386</li><li>Authors<ul> <li>Lorna Finnegan, PhD, APN, CNP, College of Nursing, University of Illinois at Chicago</li><li>Joan L. Shaver, PhD, RN, FAAN, College of Nursing, University of Arizona, Tucson</li><li>Shannon N. Zenk, PhD, MPH, RN, Harriet H. Werley Endowed Chair for Nursing Research, Center for End-of-Life Transition Research</li><li>Diana J. Wilkie, PhD, RN, FAAN, Harriet H. Werley Endowed Chair for Nursing Research, Center for End-of-Life Transition Research</li><li>Carol Estwing Ferrans, PhD, RN, FAAN, College of Nursing, University of Illinois at Chicago</li> </ul></li> </ul><ul class="parents"> <ul class="details"> <li>Journal <a href="http://ons.metapress.com/content/120390/">Oncology Nursing Forum</a></li><li>Online ISSN 1538-0688</li><li>Print ISSN 0190-535X</li> </ul><ul class="details"> <li>Journal Volume Volume 37</li> </ul><ul class="details"> <li>Journal Issue <a href="http://ons.metapress.com/content/w3pq1r236884/">Volume 37, Number 6 / November 2010</a></li> </ul> </ul>
Knowledge Central

Knowledge Central
- Content Type Journal Article
- Pages 785-786
- DOI 10.1188/10.ONF.785-786
- Authors
  - Patricia Ringos Beach, MSN, RN, AOCN�
Oncology Update

Oncology Update
- Content Type Journal Article
- Pages 783-784
- DOI 10.1188/10.ONF.783-784
- Authors
  - Michael Smart, RN, BSN, OCN�
Knowledge, Attitudes, and Practice Behaviors of Oncology Advanced Practice Nurses Regarding Advanced Care Planning for Patients With Cancer

Purpose/Objectives: To establish initial reliability and validity of a Web-based survey focused on oncology advanced practice nurses' (APNs') knowledge, attitudes, and practice behaviors regarding advanced care planning, and to obtain preliminary understanding of APNs' knowledge, attitudes, and practice behaviors and perceived barriers to advanced care planning.

Design: Descriptive, cross-sectional, pilot survey study.

Setting: The eastern United States.

Sample: 300 oncology APNs.

Methods: Guided by the Theory of Planned Behavior, a knowledge, attitudes, and practice behaviors survey was developed and reviewed for content validity. The survey was distributed to 300 APNs via e-mail and sent again to the 89 APNs who responded to the initial survey. Exploratory factor analysis was used to examine the construct validity and test-retest reliability of the survey's attitudinal and practice behavior portions.

Main Research Variables: Respondents' demographics, knowledge, attitudes, practice behaviors, and perceived barriers to advanced care planning practice.

Findings: Exploratory factor analysis yielded a five-factor solution from the survey's attitudes and practice behavior portions with internal consistency using Cronbach alpha. Respondents achieved an average of 67% correct answers in the 12-item knowledge section and scored positively in attitudes toward advanced care planning. Their practice behavior scores were marginally positive. The most common reported barriers were from patients' and families' as well as physicians' reluctance to discuss advanced care planning.

Conclusions: The attitudinal and practice behaviors portions of the survey demonstrated preliminary construct validity and test-retest reliability. Regarding advanced care planning, respondents were moderately knowledgeable, but their advanced care planning practice was not routine.

Implications for Nursing: Validly assessing oncology APNs' knowledge, attitudes, and practice behaviors regarding advanced care planning will enable more tailored approaches to improve end-of-life care outcomes.
- Content Type Journal Article
- Pages E400-E410
- DOI 10.1188/10.ONF.E400-E410
- Authors
  - Guiyun Zhou, DNP, CRNP, AOCNS�, Vita Medical Associates, Bethlehem, PA
  - Jill C. Stoltzfus, PhD, Research Institute, St. Luke's Hospital and Health Network, Bethlehem
  - Arlene D. Houldin, PhD, PMHCNS-BC, School of Nursing, University of Pennsylvania, Philadelphia
  - Susan M. Parks, MD, Jefferson School of Nursing, Thomas Jefferson University, Philadelphia
  - Beth Ann Swan, PhD, CRNP, FAAN, Jefferson School of Nursing, Thomas Jefferson University, Philadelphia
The Relationship Between Symptom Severity and Symptom Interference, Education, Age, Marital Status, and Type of Chemotherapy Treatment in Israeli Women With Early-Stage Breast Cancer
Purpose/Objectives: To examine symptom severity's relationship to symptom interference, education, age, marital status, and type of chemotherapy treatment in Israeli women with stage I or II breast cancer.Design: Cross-sectional, descriptive, correlational design.Setting: Hadassah University Hospital's oncology daytime care unit in Israel.Sample: 51 women with stage I or II breast cancer who were receiving an adjuvant chemotherapy protocol that included doxorubicin.Methods: Women receiving adjuvant chemotherapy were given the M.D. Anderson Symptom Inventory (MDASI), a modified version of the Breast Cancer Prevention Trial Hot Flashes Subscale (BCPT-HFS), and a demographic and treatment questionnaire to assess their symptoms toward the end of their chemotherapy treatment.Main Research Variables: Symptom severity, symptom interference, education, age, marital status, and type of chemotherapy treatment.Findings: The most frequent and severe symptoms were fatigue, sleep disturbance, and drowsiness. The MDASI symptom severity total scores were positively correlated with total scores of interference with activities of daily life, with most individual symptoms being significantly related to the total interference scores. The strongest relationships were found with fatigue, distress, and sadness. Education was inversely related to the MDASI general symptom severity total scores; age was inversely related to the BCPT-HFS total scores. Patients who received treatment with doxorubicin plus cyclophosphamide or doxorubicin, cyclophosphamide, plus fluorouracil had greater symptom severity than those who received doxorubicin plus cyclophosphamide followed by paclitaxel and had their symptoms evaluated after receiving paclitaxel.Conclusions: Increased symptom severity disrupts daily function and life in women with breast cancer.Implications for Nursing: Evidence-based symptom profiles for different chemotherapy protocols are needed.<ul> <li>Content Type Journal Article</li><li>Pages E411-E418</li><li>DOI 10.1188/10.ONF.E411-E418</li><li>Authors<ul> <li>Ayelet Prigozin, RN, MSN, School of Nursing, Hadassah Hebrew University</li><li>Beatrice Uziely, MD, MPH, Hadassah Medical Center</li><li>Catherine F. Musgrave, RN, DNSc, School of Nursing, Hadassah Hebrew University</li> </ul></li> </ul><ul class="parents"> <ul class="details"> <li>Journal <a href="http://ons.metapress.com/content/120390/">Oncology Nursing Forum</a></li><li>Online ISSN 1538-0688</li><li>Print ISSN 0190-535X</li> </ul><ul class="details"> <li>Journal Volume Volume 37</li> </ul><ul class="details"> <li>Journal Issue <a href="http://ons.metapress.com/content/w3pq1r236884/">Volume 37, Number 6 / November 2010</a></li> </ul> </ul>
Oncology Nursing Society 2010 Advanced Practice Nursing Conference Poster Abstracts
Oncology Nursing Society 2010 Advanced Practice Nursing Conference Poster Abstracts<ul> <li>Content Type Journal Article</li><li>Pages E426-E437</li><li>DOI 10.1188/10.ONF.E426-E437</li> </ul><ul class="parents"> <ul class="details"> <li>Journal <a href="http://ons.metapress.com/content/120390/">Oncology Nursing Forum</a></li><li>Online ISSN 1538-0688</li><li>Print ISSN 0190-535X</li> </ul><ul class="details"> <li>Journal Volume Volume 37</li> </ul><ul class="details"> <li>Journal Issue <a href="http://ons.metapress.com/content/w3pq1r236884/">Volume 37, Number 6 / November 2010</a></li> </ul> </ul>
The Relationship of Chemotherapy-Induced Nausea to the Frequency of Pericardium 6 Digital Acupressure
Purpose/Objectives: To explain the relationship between the intensity of chemotherapy-induced nausea (CIN) and the frequency of pericardium 6 (P6) digital acupressure.Design: Secondary data analysis of a multicenter, longitudinal, randomized, clinical trial.Setting: Nine community clinical oncology programs and six independent sites in the United States.Sample: 53 patients with breast cancer who received moderate to highly emetogenic chemotherapy and applied P6 digital acupressure in addition to antiemetics to control CIN.Methods: A daily log measuring nausea intensity and the frequency of acupressure for 11 days after the administration of chemotherapy. Hierarchical generalized linear modeling procedure (multilevel negative binomial regression) was used for analyzing the data.Main Research Variables: Nausea intensity and acupressure frequency.Findings: Participants used acupressure an average of two times per day (SD = 1.84, range 0-10). Women who used acupressure more frequently after the peak of nausea (on day 4) were predicted to have a 0.97-point higher nausea intensity in the acute phase than women who used acupressure less frequently, controlling for the effects of other variables in the model (incidence rate ratio = 1.52, p < 0.01).Conclusions: Patients with breast cancer whose nausea intensity started higher from the acute phase continued to experience higher symptom intensity during the 11 days after chemotherapy administration and required more frequent acupressure even after the peak of nausea.Implications for Nursing: Careful assessment and management of acute CIN with continuous monitoring and care of CIN in the delayed phase are important nursing issues in caring for patients receiving chemotherapy.<ul> <li>Content Type Journal Article</li><li>Pages E419-E425</li><li>DOI 10.1188/10.ONF.E419-E425</li><li>Authors<ul> <li>Jiyeon Lee, RN, PhD, School of Nursing, University of California, San Francisco</li><li>Suzanne Dibble, RN, DNSc, School of Nursing, University of California, San Francisco</li><li>Marylin Dodd, RN, PhD, FAAN, School of Nursing, University of California, San Francisco</li><li>Donald Abrams, MD, School of Medicine, University of California, San Francisco</li><li>Beverly Burns, LAc, MS, Osher Center for Integrative Medicine, University of California, San Francisco</li> </ul></li> </ul><ul class="parents"> <ul class="details"> <li>Journal <a href="http://ons.metapress.com/content/120390/">Oncology Nursing Forum</a></li><li>Online ISSN 1538-0688</li><li>Print ISSN 0190-535X</li> </ul><ul class="details"> <li>Journal Volume Volume 37</li> </ul><ul class="details"> <li>Journal Issue <a href="http://ons.metapress.com/content/w3pq1r236884/">Volume 37, Number 6 / November 2010</a></li> </ul> </ul>
Letters to the Editor
Letters to the Editor<ul> <li>Content Type Journal Article</li><li>Pages 660-660</li><li>DOI 10.1188/10.ONF.660</li><li>Authors<ul> <li>Rose Mary Carroll-Johnson, MN, RN</li> </ul></li> </ul><ul class="parents"> <ul class="details"> <li>Journal <a href="http://ons.metapress.com/content/120390/">Oncology Nursing Forum</a></li><li>Online ISSN 1538-0688</li><li>Print ISSN 0190-535X</li> </ul><ul class="details"> <li>Journal Volume Volume 37</li> </ul><ul class="details"> <li>Journal Issue <a href="http://ons.metapress.com/content/w3pq1r236884/">Volume 37, Number 6 / November 2010</a></li> </ul> </ul>
With a Little Help From Our Friends
With a Little Help From Our Friends<ul> <li>Content Type Journal Article</li><li>Pages 657-657</li><li>DOI 10.1188/10.ONF.657</li><li>Authors<ul> <li>Rose Mary Carroll-Johnson, MN, RN</li> </ul></li> </ul><ul class="parents"> <ul class="details"> <li>Journal <a href="http://ons.metapress.com/content/120390/">Oncology Nursing Forum</a></li><li>Online ISSN 1538-0688</li><li>Print ISSN 0190-535X</li> </ul><ul class="details"> <li>Journal Volume Volume 37</li> </ul><ul class="details"> <li>Journal Issue <a href="http://ons.metapress.com/content/w3pq1r236884/">Volume 37, Number 6 / November 2010</a></li> </ul> </ul>
People & Events

People & Events
- Content Type Journal Article
- Pages 661-662
- DOI 10.1188/10.ONF.661-662
- Authors
  - Linda K. Morse, RN, MSN
Resilience: The Power Within

Purpose/Objectives: To advance understanding of resilience as an innate resource and its potential and relevance in the management of workplace stress for oncology nurses.

Data Sources: Journal articles and research results, particularly seminal literature from a variety of Australian and international journals and published texts, including government and nursing organizations.

Data Synthesis: Resilience is defined as an innate energy or motivating life force present to varying degrees in every individual, exemplified by the presence of particular traits or characteristics that, through application of dynamic processes, enable an individual to cope with, recover from, and grow as a result of stress or adversity. Literature from a wide variety of fields, including physics, medicine, theology, philosophy, psychology, and spirituality, was reviewed to build an overview of existing knowledge and evolving theories on the subject of resilience and further the understanding of resilience as an innate personal resource.

Conclusions: Innate resilience can be developed or enhanced through cognitive transformational practices, education, and environmental support. Such processes may have use in ameliorating the effects of workplace stress.

Implications for Nursing: The complex nature of oncology and other specialty nursing roles creates a certain amount of inevitable stress that depletes the self and may lead to compassion fatigue and burnout. A greater understanding of resilience as an innate stress response resource highlights the need for processes that support resilience development and organizational and personal stress-management strategies for nurses to be part of mainstream nursing education.
- Content Type Journal Article
- Pages 698-705
- DOI 10.1188/10.ONF.698-705
- Authors
  - Eileen Grafton, RN, BN, MADvPrac(Hons), GradCertClinEd, OCN�, MRCNA, Research Centre for Clinical and Practice Innovation and the School of Nursing and Midwifery, Griffith University, Gold Coast Campus, in Southport, Queensland, Australia
  - Brigid Gillespie, RN, RM, Cert Periop BHlthSc, PhD, Research Centre for Clinical and Practice Innovation and the School of Nursing and Midwifery, Griffith University, Gold Coast Campus, in Southport, Queensland, Australia
  - Saras Henderson, RN, RM, BAppSc (Nursing), MEd, PhD, Research Centre for Clinical and Practice Innovation and the School of Nursing and Midwifery, Griffith University, Gold Coast Campus, in Southport, Queensland, Australia
Race and Lung Cancer Surgery—A Qualitative Analysis of Relevant Beliefs and Management Preferences
Purpose/Objectives: To gain a better understanding of beliefs about the utility of lung cancer resection surgery and preferences for lung cancer management among African American and Caucasian adults.Research Approach: Qualitative.Setting: The Philadelphia Veterans Affairs Medical Center.Participants: 21 participants (9 African Americans and 12 Caucasians; 11 with chronic obstructive pulmonary disease and 10 with lung cancer).Methodologic Approach: Three focus groups were conducted. Transcripts and field notes were coded, grouped into thematic categories, and explored in later focus groups.Main Research Variables: Beliefs about lung cancer resection surgery and management preferences.Findings: African Americans doubted that surgery was needed, questioned its efficacy, and preferred complementary and alternative medicine (CAM). African Americans and Caucasians believed that exposure to air during surgery could cause tumor spread and were skeptical that smoking caused lung cancer. Therefore, they had a sense of treatment futility. Conversely, Caucasians were impatient with forced waiting for surgery. Both groups believed that surgery would be better accepted if current patients met past surgical patients, obtained second opinions, and had trusting patient-provider relationships.Conclusions: Suspicion about surgeons' motives and perceived ineffectiveness of surgery, as well as support for CAM among African Americans, may contribute to key racial disparities in lung cancer care.Interpretation: If providers understand more clearly the beliefs and preferences that impede acceptance of surgical resection, then they can formulate educational interventions directed at overcoming patient resistance. The clinical utility of such individualized interventions could be evaluated in future studies.<ul> <li>Content Type Journal Article</li><li>Pages 740-748</li><li>DOI 10.1188/10.ONF.740-748</li><li>Authors<ul> <li>Maureen George, PhD, RN, AE-C, Family and Community Health Division, Center for Health Disparities Research, School of Nursing at the University of Pennsylvania, Philadelphia</li><li>Mitchell L. Margolis, MD, Critical Care Division of the Philadelphia Veterans Affairs Medical Center, University of Pennsylvania Medical Center, Philadelphia</li> </ul></li> </ul><ul class="parents"> <ul class="details"> <li>Journal <a href="http://ons.metapress.com/content/120390/">Oncology Nursing Forum</a></li><li>Online ISSN 1538-0688</li><li>Print ISSN 0190-535X</li> </ul><ul class="details"> <li>Journal Volume Volume 37</li> </ul><ul class="details"> <li>Journal Issue <a href="http://ons.metapress.com/content/w3pq1r236884/">Volume 37, Number 6 / November 2010</a></li> </ul> </ul>
The Feasibility and Effectiveness of Expressive Writing for Rural and Urban Breast Cancer Survivors

Purpose/Objectives: To determine the feasibility and effectiveness of implementing an in-home expressive-writing intervention among breast cancer survivors living in urban and rural areas.

Design: Women who had completed radiation therapy were selected to participate in either expressive writing or a usual-care control condition.

Setting: All materials were completed in the privacy of participants' homes.

Sample: Of the 57 breast cancer survivors recruited, 40 participated in the writing intervention. An additional 40 women were assigned to the control group.

Methods: Participants completed measures of physical and psychological health at two time points prior to writing and at two follow-up time points three and nine months after writing.

Main Research Variables: Participation rates and physical and psychological health.

Findings: Results showed that engaging in a single in-home writing session for women with breast cancer was feasible and showed significant improvements in physical and psychological health compared to control three months (but not nine months) after writing. Although no difference was found in effectiveness of the intervention between women living in urban versus rural areas, rural women showed slightly higher participation rates.

Conclusions: The results illustrate the utility of employing remotely administered expressive-writing interventions for breast cancer survivors.

Implications for Nursing: Healthcare professionals who wish to use writing to facilitate improvements in their patients may suggest that patients write at multiple time points, offer for the intervention to be completed at home, and target rural populations in particular.
- Content Type Journal Article
- Pages 749-757
- DOI 10.1188/10.ONF.749-757
- Authors
  - Erika A. Henry, MA, Department of Psychological Sciences, University of Missouri in Columbia
  - Rebecca J. Schlegel, PhD, Department of Psychology, Texas A&M University in College Station
  - Amelia E. Talley, PhD, Department of Psychological Sciences, University of Missouri
  - Lisa A. Molix, PhD, Department of Psychology, Tulane University, New Orleans, LA
  - B. Ann Bettencourt, PhD, Department of Psychological Sciences, University of Missouri
Fatigue and Other Variables During Adjuvant Chemotherapy for Colon and Rectal Cancer

Purpose/Objectives: To examine patterns of fatigue and other variables (sleep quality, sleep-wake variables, activity and rest, circadian rhythms, quality of life [QOL], blood counts, and demographic and medical variables) during colon and rectal cancer adjuvant chemotherapy, as well as feasibility of the study.

Design: Longitudinal, descriptive feasibility study.

Setting: Two oncology clinics in the midwestern region of the United States.

Sample: From April 2006-December 2008, 27% of screened subjects (n = 21) enrolled and 14 completed the study. Participants were middle aged, partnered, and employed and had postsecondary education.

Methods: Measurements completed during the first week of three two-week cycles (chemotherapy 1-3) and at six weeks (before chemotherapy 4) were the Piper Fatigue Scale, Pittsburgh Sleep Quality Index, wrist actigraphy, Functional Assessment of Cancer Therapy-Colon, blood counts, and demographic and medical data form. Analysis included descriptive statistics and repeated-measures analysis of variance.

Main Research Variables: Fatigue, sleep quality, sleep-wake variables, activity-rest, circadian activity rhythms, and QOL.

Findings: Fatigue was mild at baseline and rose to moderate levels during chemotherapy 1-3. Sleep quality was poor the months prior to chemotherapy 1 and chemotherapy 4. Actigraphy data revealed disturbed sleep, low daytime activity, and impaired circadian activity rhythms during the first week after chemotherapy 1-3. QOL ratings were similar to those in other cancer populations. Fatigue increased, and white blood cell counts decreased significantly over time.

Conclusions: During adjuvant chemotherapy, patients reported moderate fatigue and poor sleep quality; actigraphs confirmed problems with sleep maintenance as well as low daytime activity and disturbed circadian rhythms. Multiple barriers were encountered during the study.

Implications for Nursing: Clinicians should screen for fatigue and sleep-wake variables and use guidelines to select interventions.
- Content Type Journal Article
- Pages E359-E369
- DOI 10.1188/10.ONF.E359-E369
- Authors
  - Ann M. Berger, PhD, RN, AOCNS�, FAAN, PhD program, Dorothy Hodges Olson Endowed Chair
  - Jean L. Grem, MD, University of Nebraska Medical Center, Omaha
  - Constance Visovsky, PhD, APRN-NP, University of Nebraska Medical Center, Omaha
  - Heather A. Marunda, MSN, RN, University of Nebraska Medical Center, Omaha
  - Justin M. Yurkovich, MA, UNMC, CON, University of Nebraska Medical Center, Omaha
Technical Evaluation of a New Sterile Medical Device to Improve Anticancer Chemotherapy Administration

Purpose/Objectives: To assess the PCHIMX-1� (Doran International), a new sterile medical device intended by its manufacturer to improve the quality and safety of cytotoxic drug infusions, as well as its influence on manipulation times required for pharmacy technicians and nurses and its effect on infusion line outflow parameters.

Design: PCHIMX-1 assemblies were compared to standard infusion sets.

Setting: Pharmacy and oncology units of a French general hospital.

Methods: Reference assemblies (an infusion bag connected to an infusion set) were compared to PCHIMX-1 assemblies (PCHIMX-1 connected to two bags and to an infusion set). Two assessments were performed: (a) comparison of the times of manipulation during both preparation and administration of 5-fluorouracil infusion bags (n = 40) and (b) effect of PCHIMX-1 on infusion quality.

Main Research Variables: Manipulation times in the pharmacy (TP) and in the ward (TW) were measured, as well as flow rate and infusion efficiency.

Findings: The results showed that TW was significantly increased, whereas TP was significantly decreased; total time was unchanged. Results also showed that PCHIMX-1 significantly changed infusion efficiency; flow rate was not affected.

Conclusions: PCHIMX-1 obliges pharmacy technicians and nurses to change their handling procedures. The device does not have any influence on infusion flow rate but considerably improves infusion quality by ensuring that the full quantity of medication prescribed is administered.

Implications for Nursing: PCHIMX-1 guarantees that the complete prescribed dose of chemotherapy is administered without any change in infusion quality and adheres to the latest recommendations concerning occupational exposure protection.
- Content Type Journal Article
- Pages E370-E376
- DOI 10.1188/10.ONF.E370-E376
- Authors
  - Nicolas Simon, MSc, PharmD, Department of Biopharmacy, Galenic and Hospital Pharmacy, Lille Nord de France University
  - Bertrand D�caudin, PharmD, PhD, Department of Biopharmacy, Galenic and Hospital Pharmacy, Lille Nord de France University, Lille University hospital center
  - Damien Lannoy, MSc, PharmD, Department of Biopharmacy, Galenic and Hospital Pharmacy, Lille Nord de France University, Lille University hospital center
  - Fr�d�rique Danicourt, PharmD, Dunkerque general hospital, France
  - Christine Barth�l�my, PharmD, PhD, Department of Biopharmacy, Galenic and Hospital Pharmacy, Lille Nord de France University
  - Pascal Odou, PharmD, PhD, Department of Biopharmacy, Galenic and Hospital Pharmacy, Lille Nord de France University
Using a Patient Portal for Electronic Communication With Patients With Cancer: Implications for Nurses

Using a Patient Portal for Electronic Communication With Patients With Cancer: Implications for Nurses
- Content Type Journal Article
- Pages 667-671
- DOI 10.1188/10.ONF.667-671
- Authors
  - Elizabeth S. Rodriguez, DNP, RN, OCN�, Memorial Sloan-Kettering Cancer Center, New York, NY
Carcinoid Tumor
Carcinoid Tumor<ul> <li>Content Type Journal Article</li><li>Pages 677-679</li><li>DOI 10.1188/10.ONF.677-679</li><li>Authors<ul> <li>Joyce Chowsanitphon, RN, MSN, NP, School of Nursing, University of California, Los Angeles</li> </ul></li> </ul><ul class="parents"> <ul class="details"> <li>Journal <a href="http://ons.metapress.com/content/120390/">Oncology Nursing Forum</a></li><li>Online ISSN 1538-0688</li><li>Print ISSN 0190-535X</li> </ul><ul class="details"> <li>Journal Volume Volume 37</li> </ul><ul class="details"> <li>Journal Issue <a href="http://ons.metapress.com/content/w3pq1r236884/">Volume 37, Number 6 / November 2010</a></li> </ul> </ul>
The Influence of Easy-to-Read Pamphlets About Self-Care Management of Radiation Side Effects on Patients' Knowledge
Purpose/Objectives: To test patients' knowledge of side effects after they review six easy-to-read pamphlets on radiation side effects.Design: Nonexperimental.Setting: Urban radiation oncology clinic.Sample: 47 patients receiving radiation treatment.Methods: The Knowledge of Radiation Side Effects Test was administered.Main Research Variables: Patient literacy and knowledge level.Findings: The self-report of highest grade completed in school was 10th grade; however, the actual reading level was 4th-6th grade. Scores for each knowledge test increased with literacy level, with statistically significant correlations for pamphlets on fatigue, skin problems for women, and skin problems for men. Participants who read at the 4th-6th-grade level scored higher than expected.Conclusions: Although the pamphlets were deemed easy to read, patients who had the lowest reading levels still had difficulty understanding them.Implications for Nursing: In addition to written patient information, oncology nurses should use innovative teaching strategies to improve patient understanding and self-care behaviors. A need exists for continued nursing inquiry that will focus on self-care behaviors to manage radiation side effects, particularly for patients with low literacy.<ul> <li>Content Type Journal Article</li><li>Pages 774-781</li><li>DOI 10.1188/10.ONF.774-781</li><li>Authors<ul> <li>Feleta L. Wilson, PhD, RN, College of Nursing, Wayne State University, Detroit, MI</li><li>Darlene Mood, PhD, College of Nursing, Wayne State University, Detroit, MI</li><li>Cheryl K. Nordstrom, PhD, College of Nursing, Wayne State University, Detroit, MI</li> </ul></li> </ul><ul class="parents"> <ul class="details"> <li>Journal <a href="http://ons.metapress.com/content/120390/">Oncology Nursing Forum</a></li><li>Online ISSN 1538-0688</li><li>Print ISSN 0190-535X</li> </ul><ul class="details"> <li>Journal Volume Volume 37</li> </ul><ul class="details"> <li>Journal Issue <a href="http://ons.metapress.com/content/w3pq1r236884/">Volume 37, Number 6 / November 2010</a></li> </ul> </ul>
Depressive Symptoms, Grief, and Complicated Grief Among Family Caregivers of Patients With Advanced Cancer Three Months Into Bereavement
Purpose/Objectives: To describe depressive symptoms, grief, and complicated grief for bereaved family caregivers of patients who died from cancer-related causes and to explore relationships among these variables.Design: A nonexperimental, secondary analysis of cross-sectional descriptive data from a longitudinal intervention study evaluating the effect of providing feedback from standardized assessment tools.Setting: Two large, private, not-for-profit hospices in Florida.Sample: Convenience sample of 280 family caregivers, bereaved three months.Methods: Secondary analysis of self-report, survey data three months following death.Main Research Variables: Depressive symptoms, grief, and complicated grief.Findings: Three months after the loss of a loved one, 34% of the caregivers had clinically meaningful scores for depressive symptoms. A significant number of bereaved caregivers were experiencing grief and depression.Conclusions: Bereaved caregivers were experiencing significant levels of depressive symptoms and complicated grief. Caregivers with higher levels of grief had more depressive symptoms.Implications for Nursing: Tools are available to identify bereaved caregivers most in need of intervention.<ul> <li>Content Type Journal Article</li><li>Category Article</li><li>Pages 60-65</li><li>DOI 10.1188/11.ONF.60-65</li><li>Authors<ul> <li>Lorraine F. Holtslander, RN, PhD, CHPCN(c), College of Nursing, University of Saskatchewan in Saskatoon, Canada</li><li>Susan C. McMillan, PhD, ARNP, FAAN, College of Nursing, University of South Florida in Tampa</li> </ul></li> </ul><ul class="parents"> <ul class="details"> <li>Journal <a href="http://ons.metapress.com/content/120390/">Oncology Nursing Forum</a></li><li>Online ISSN 1538-0688</li><li>Print ISSN 0190-535X</li> </ul><ul class="details"> <li>Journal Volume Volume 38</li> </ul><ul class="details"> <li>Journal Issue <a href="http://ons.metapress.com/content/v55457034214/">Volume 38, Number 1 / January 2011</a></li> </ul> </ul>
A Breast Navigator Program: Barriers, Enhancers, and Nursing Interventions

Purpose/Objectives: To identify barriers to and enhancers of completion of breast cancer treatment from the perspective of participants in a breast health navigator program.

Research Approach: Qualitative, using focus group methodology and telephone interview.

Setting: Two teaching hospital ambulatory cancer centers.

Participants: Women enrolled in the breast navigator program, including patients who completed (n = 13) and did not complete (n = 1) breast cancer treatment.

Methodologic Approach: Researchers used semistructured, open-ended questioning to guide the interviews and elicit identification of barriers to and enhancers of treatment. A flexible approach was used and the interviews were recorded. Content analysis was used to identify themes.

Main Research Variables: Perceived barriers and enhancers of breast cancer treatment.

Findings: The most common theme was the value of the education and information received from the navigator. Several participants saw this as the essence of the role. Assistance with managing symptoms, access to financial and community resources, and the team approach were completion enhancers.

Conclusions: Completion of breast cancer therapy and care can be improved by recognizing the value the nurse navigator role brings to the patient experience and enhancing that role.

Interpretation: The intentional presence of the oncology nurse and the nursing emphasis on culturally appropriate education and care can be seen as key competencies of the navigator. As the concept of the navigation process is expanded to other cancers, oncology nurses are particularly well positioned to advocate for the navigator role as a nursing domain.
- Content Type Journal Article
- Category Article
- Pages 44-50
- DOI 10.1188/11.ONF.44-50
- Authors
  - Susan F. Korber, MS, RN, OCN�, NE-BC, Miriam Hospital, Providence, RI
  - Cynthia Padula, PhD, RN, CS, Miriam Hospital, Providence, RI
  - Julie Gray, RN, BS, Miriam Hospital, Providence, RI
  - Margot Powell, RN, Rhode Island Hospital in Providence
Evaluation of Tobacco Cessation Classes Aimed at Hospital Staff Nurses

Purpose/Objectives: To evaluate a three-hour smoking cessation program and its effect on nurse knowledge, counseling behaviors, and confidence in counseling behaviors.

Design: Program evaluation.

Setting: A Magnet�-designated, 500-bed community hospital in Southern California.

Sample: 107 nurses.

Methods: Program content included behavior counseling and pharmacotherapy along with role playing. Investigator-developed self-report surveys were completed on the day of the class and at 3, 6, and 12 months.

Main Research Variables: Short- and long-term changes in nurse knowledge, attitudes, and behaviors about tobacco cessation efforts.

Findings: Knowledge significantly increased from baseline to post-test. Counseling skills improved. Nurses who completed all surveys exhibited no significant changes about asking patients to quit smoking but did demonstrate significant changes at three months regarding advising patients, assessing quit readiness, and providing assistance. Changes were maintained over the year. Nurses' average ability to counsel patients was rated "good or very good" after one year. At 3, 6, and 12 months, most respondents reported providing cessation counseling or referrals to at least one patient.

Conclusions: These findings support tobacco cessation programs for bedside nurses as useful in enhancing nurse confidence in patient-counseling skills.

Implications for Nursing: Study findings demonstrated benefits to using the developed curriculum. Additional research is needed on tobacco cessation programs for hospital nurses, particularly with longitudinal outcomes and actual nurse behaviors.
- Content Type Journal Article
- Category Article
- Pages 67-73
- DOI 10.1188/11.ONF.67-73
- Authors
  - Pamela Matten, RN, BNS, OCN�, Center for Cancer Prevention and Treatment, St. Joseph Hospital in Orange, CA
  - Victoria Morrison, RN, MSN, FNP, Office of Nursing Research, St. Joseph Hospital
  - Dana N. Rutledge, RN, PhD, Office of Nursing Research, St. Joseph Hospital
  - Timothy Chen, PharmD, Veterans Administration San Diego Healthcare System, California
  - Eunice Chung, PharmD, College of Pharmacy, Western University, Pomona, CA
  - Siu-Fun Wong, PharmD, FASHP, FCSHP, College of Pharmacy, Western University, Pomona, CA
Healthcare Team Members' Perception of Staffing Adequacy in a Comprehensive Cancer Center

Purpose/Objectives: To describe the perceptions of staffing adequacy of healthcare team members working together on units in a comprehensive cancer center.

Research Approach: A descriptive, phenomenologic design was used. Semistructured interviews were conducted with participants.

Setting: An urban, Magnet�-designated comprehensive cancer center in the southwestern United States.

Participants: A purposive sample of 10 RNs, 5 nursing assistants, and 5 associate directors.

Methodologic Approach: Data analysis was guided by Streubert's procedural interpretation of the phenomenologic method.

Findings: Themes emerged, including alterations to care; challenges to an already challenging shift; the right mix; effects on patients, safety, and quality; mitigating factors; and the aftermath.

Conclusions: Perceived inadequate staffing affects healthcare staff both personally and professionally, triggering responses that influence approaches to patient care, unit operations, and relationships.

Interpretation: The unique and sometimes varied perspectives and experiences of frontline staff are critical to understanding factors that influence and affect willingness to work and remain in hospital settings, and may serve as a basis for shaping interventions and strategies to ensure adequate numbers of caregivers at the bedside.
- Content Type Journal Article
- Category Journal Club and Open Access Article
- Pages 52-59
- DOI 10.1188/11.ONF.52-59
- Authors
  - Beverly A. Nelson, PhD, RN, NEA-BC, University of Texas M. D. Anderson Cancer Center, Houston
Oncology Nursing Society 11th National Conference on Cancer Nursing Research Abstracts
Oncology Nursing Society 11th National Conference on Cancer Nursing Research Abstracts<ul> <li>Content Type Journal Article</li><li>Category Conference Abstracts</li><li>Pages A1-A90</li><li>DOI 10.1188/11.ONF.E60</li> </ul><ul class="parents"> <ul class="details"> <li>Journal <a href="http://ons.metapress.com/content/120390/">Oncology Nursing Forum</a></li><li>Online ISSN 1538-0688</li><li>Print ISSN 0190-535X</li> </ul><ul class="details"> <li>Journal Volume Volume 38</li> </ul><ul class="details"> <li>Journal Issue <a href="http://ons.metapress.com/content/v55457034214/">Volume 38, Number 1 / January 2011</a></li> </ul> </ul>
Healthcare Team Members' Perception of Staffing Adequacy in a Comprehensive Cancer Center

Purpose/Objectives: To describe the perceptions of staffing adequacy of healthcare team members working together on units in a comprehensive cancer center.

Research Approach: A descriptive, phenomenologic design was used. Semistructured interviews were conducted with participants.

Setting: An urban, Magnet�-designated comprehensive cancer center in the southwestern United States.

Participants: A purposive sample of 10 RNs, 5 nursing assistants, and 5 associate directors.

Methodologic Approach: Data analysis was guided by Streubert's procedural interpretation of the phenomenologic method.

Findings: Themes emerged, including alterations to care; challenges to an already challenging shift; the right mix; effects on patients, safety, and quality; mitigating factors; and the aftermath.

Conclusions: Perceived inadequate staffing affects healthcare staff both personally and professionally, triggering responses that influence approaches to patient care, unit operations, and relationships.

Interpretation: The unique and sometimes varied perspectives and experiences of frontline staff are critical to understanding factors that influence and affect willingness to work and remain in hospital settings, and may serve as a basis for shaping interventions and strategies to ensure adequate numbers of caregivers at the bedside.
- Content Type Journal Article
- Category Journal Club and Open Access Article
- Pages 52-59
- DOI 10.1188/11.ONF.52-59
- Authors
  - Beverly A. Nelson, PhD, RN, NEA-BC, University of Texas M. D. Anderson Cancer Center, Houston
Oncology Nursing Society 11th National Conference on Cancer Nursing Research Abstracts
Oncology Nursing Society 11th National Conference on Cancer Nursing Research Abstracts<ul> <li>Content Type Journal Article</li><li>Category Conference Abstracts</li><li>Pages A1-A90</li><li>DOI 10.1188/11.ONF.E60</li> </ul><ul class="parents"> <ul class="details"> <li>Journal <a href="http://ons.metapress.com/content/120390/">Oncology Nursing Forum</a></li><li>Online ISSN 1538-0688</li><li>Print ISSN 0190-535X</li> </ul><ul class="details"> <li>Journal Volume Volume 38</li> </ul><ul class="details"> <li>Journal Issue <a href="http://ons.metapress.com/content/v55457034214/">Volume 38, Number 1 / January 2011</a></li> </ul> </ul>
Depressive Symptoms, Grief, and Complicated Grief Among Family Caregivers of Patients With Advanced Cancer Three Months Into Bereavement
Purpose/Objectives: To describe depressive symptoms, grief, and complicated grief for bereaved family caregivers of patients who died from cancer-related causes and to explore relationships among these variables.Design: A nonexperimental, secondary analysis of cross-sectional descriptive data from a longitudinal intervention study evaluating the effect of providing feedback from standardized assessment tools.Setting: Two large, private, not-for-profit hospices in Florida.Sample: Convenience sample of 280 family caregivers, bereaved three months.Methods: Secondary analysis of self-report, survey data three months following death.Main Research Variables: Depressive symptoms, grief, and complicated grief.Findings: Three months after the loss of a loved one, 34% of the caregivers had clinically meaningful scores for depressive symptoms. A significant number of bereaved caregivers were experiencing grief and depression.Conclusions: Bereaved caregivers were experiencing significant levels of depressive symptoms and complicated grief. Caregivers with higher levels of grief had more depressive symptoms.Implications for Nursing: Tools are available to identify bereaved caregivers most in need of intervention.<ul> <li>Content Type Journal Article</li><li>Category Article</li><li>Pages 60-65</li><li>DOI 10.1188/11.ONF.60-65</li><li>Authors<ul> <li>Lorraine F. Holtslander, RN, PhD, CHPCN(c), College of Nursing, University of Saskatchewan in Saskatoon, Canada</li><li>Susan C. McMillan, PhD, ARNP, FAAN, College of Nursing, University of South Florida in Tampa</li> </ul></li> </ul><ul class="parents"> <ul class="details"> <li>Journal <a href="http://ons.metapress.com/content/120390/">Oncology Nursing Forum</a></li><li>Online ISSN 1538-0688</li><li>Print ISSN 0190-535X</li> </ul><ul class="details"> <li>Journal Volume Volume 38</li> </ul><ul class="details"> <li>Journal Issue <a href="http://ons.metapress.com/content/v55457034214/">Volume 38, Number 1 / January 2011</a></li> </ul> </ul>
Healthcare Team Members' Perception of Staffing Adequacy in a Comprehensive Cancer Center

Purpose/Objectives: To describe the perceptions of staffing adequacy of healthcare team members working together on units in a comprehensive cancer center.

Research Approach: A descriptive, phenomenologic design was used. Semistructured interviews were conducted with participants.

Setting: An urban, Magnet�-designated comprehensive cancer center in the southwestern United States.

Participants: A purposive sample of 10 RNs, 5 nursing assistants, and 5 associate directors.

Methodologic Approach: Data analysis was guided by Streubert's procedural interpretation of the phenomenologic method.

Findings: Themes emerged, including alterations to care; challenges to an already challenging shift; the right mix; effects on patients, safety, and quality; mitigating factors; and the aftermath.

Conclusions: Perceived inadequate staffing affects healthcare staff both personally and professionally, triggering responses that influence approaches to patient care, unit operations, and relationships.

Interpretation: The unique and sometimes varied perspectives and experiences of frontline staff are critical to understanding factors that influence and affect willingness to work and remain in hospital settings, and may serve as a basis for shaping interventions and strategies to ensure adequate numbers of caregivers at the bedside.
- Content Type Journal Article
- Category Journal Club and Open Access Article
- Pages 52-59
- DOI 10.1188/11.ONF.52-59
- Authors
  - Beverly A. Nelson, PhD, RN, NEA-BC, University of Texas M. D. Anderson Cancer Center, Houston
Oncology Update

Oncology Update
- Content Type Journal Article
- Category Feature
- Pages 93-94
- DOI 10.1188/11.ONF.93-94
- Authors
  - Michael Smart, RN, BSN, OCN�
A Breast Navigator Program: Barriers, Enhancers, and Nursing Interventions

Purpose/Objectives: To identify barriers to and enhancers of completion of breast cancer treatment from the perspective of participants in a breast health navigator program.

Research Approach: Qualitative, using focus group methodology and telephone interview.

Setting: Two teaching hospital ambulatory cancer centers.

Participants: Women enrolled in the breast navigator program, including patients who completed (n = 13) and did not complete (n = 1) breast cancer treatment.

Methodologic Approach: Researchers used semistructured, open-ended questioning to guide the interviews and elicit identification of barriers to and enhancers of treatment. A flexible approach was used and the interviews were recorded. Content analysis was used to identify themes.

Main Research Variables: Perceived barriers and enhancers of breast cancer treatment.

Findings: The most common theme was the value of the education and information received from the navigator. Several participants saw this as the essence of the role. Assistance with managing symptoms, access to financial and community resources, and the team approach were completion enhancers.

Conclusions: Completion of breast cancer therapy and care can be improved by recognizing the value the nurse navigator role brings to the patient experience and enhancing that role.

Interpretation: The intentional presence of the oncology nurse and the nursing emphasis on culturally appropriate education and care can be seen as key competencies of the navigator. As the concept of the navigation process is expanded to other cancers, oncology nurses are particularly well positioned to advocate for the navigator role as a nursing domain.
- Content Type Journal Article
- Category Article
- Pages 44-50
- DOI 10.1188/11.ONF.44-50
- Authors
  - Susan F. Korber, MS, RN, OCN�, NE-BC, Miriam Hospital, Providence, RI
  - Cynthia Padula, PhD, RN, CS, Miriam Hospital, Providence, RI
  - Julie Gray, RN, BS, Miriam Hospital, Providence, RI
  - Margot Powell, RN, Rhode Island Hospital in Providence
Knowledge Central

Knowledge Central
- Content Type Journal Article
- Category Feature
- Pages 95-96
- DOI 10.1188/11.ONF.95-96
- Authors
  - Patricia Ringos Beach, MSN, RN, AOCN�, ACHPN
People and Events
People and Events<ul> <li>Content Type Journal Article</li><li>Category People and Events</li><li>Pages 9-10</li><li>DOI 10.1188/11.ONF.9-10</li><li>Authors<ul> <li>Linda K. Morse, RN, MSN</li> </ul></li> </ul><ul class="parents"> <ul class="details"> <li>Journal <a href="http://ons.metapress.com/content/120390/">Oncology Nursing Forum</a></li><li>Online ISSN 1538-0688</li><li>Print ISSN 0190-535X</li> </ul><ul class="details"> <li>Journal Volume Volume 38</li> </ul><ul class="details"> <li>Journal Issue <a href="http://ons.metapress.com/content/v55457034214/">Volume 38, Number 1 / January 2011</a></li> </ul> </ul>
Top 10 From the Top Two
Top 10 From the Top Two<ul> <li>Content Type Journal Article</li><li>Category Editorial</li><li>Pages 7-8</li><li>DOI 10.1188/11.ONF.7-8</li><li>Authors<ul> <li>Rose Mary Carroll-Johnson, MN, RN</li> </ul></li> </ul><ul class="parents"> <ul class="details"> <li>Journal <a href="http://ons.metapress.com/content/120390/">Oncology Nursing Forum</a></li><li>Online ISSN 1538-0688</li><li>Print ISSN 0190-535X</li> </ul><ul class="details"> <li>Journal Volume Volume 38</li> </ul><ul class="details"> <li>Journal Issue <a href="http://ons.metapress.com/content/v55457034214/">Volume 38, Number 1 / January 2011</a></li> </ul> </ul>
A Young Woman Looks Back: Losing Her Mother to Breast Cancer
A Young Woman Looks Back: Losing Her Mother to Breast Cancer<ul> <li>Content Type Journal Article</li><li>Category Clinical Challenges</li><li>Pages 15-18</li><li>DOI 10.1188/11.ONF.15-18</li><li>Authors<ul> <li>Jessica Redin, RN, BSN, PCCN, School of Nursing, University of California, Los Angeles</li> </ul></li> </ul><ul class="parents"> <ul class="details"> <li>Journal <a href="http://ons.metapress.com/content/120390/">Oncology Nursing Forum</a></li><li>Online ISSN 1538-0688</li><li>Print ISSN 0190-535X</li> </ul><ul class="details"> <li>Journal Volume Volume 38</li> </ul><ul class="details"> <li>Journal Issue <a href="http://ons.metapress.com/content/v55457034214/">Volume 38, Number 1 / January 2011</a></li> </ul> </ul>
The Power of Videotaped Personal Statements of Patients With Lung Cancer: A Recruitment Strategy for Smoking Prevention and Cessation Programs

The Power of Videotaped Personal Statements of Patients With Lung Cancer: A Recruitment Strategy for Smoking Prevention and Cessation Programs
- Content Type Journal Article
- Category Leadership & Professional Development
- Pages 11-14
- DOI 10.1188/11.ONF.11-14
- Authors
  - Virginia Luftman, RN, PhD, LCSW, Department of Psychiatry, College of Medicine
  - Catherine A. Martin, MD, Department of Psychiatry, College of Medicine
  - Greg Guenthner, MLIS, Department of Psychiatry, College of Medicine
  - Susanne M. Arnold, MD, Department of Hematology and Oncology, College of Medicine
  - Timothy W. Mullett, MD, Department of Surgery, College of Medicine
  - Malhar Jhaveri, MBBS, MPH, College of Public Health, University of Kentucky, Lexington
Measuring Stigma in People With Lung Cancer: Psychometric Testing of the Cataldo Lung Cancer Stigma Scale
Purpose/Objectives: To develop an instrument to measure the stigma perceived by people with lung cancer based on the HIV Stigma Scale.Design: Psychometric analysis.Setting: Online survey.Sample: 186 patients with lung cancer.Methods: An exploratory factor analysis with a common factor model using alpha factor extraction.Main Research Variables: Lung cancer stigma, depression, and quality of life.Findings: Four factors emerged: stigma and shame, social isolation, discrimination, and smoking. Inspection of unrotated first-factor loadings showed support for a general stigma factor. Construct validity was supported by relationships with related constructs: self-esteem, depression, social support, and social conflict. Coefficient alphas ranging from 0.75-0.97 for the subscales (0.96 for stigma and shame, 0.97 for social isolation, 0.9 for discrimination, and 0.75 for smoking) and 0.98 for the 43-item Cataldo Lung Cancer Stigma Scale (CLCSS) provided evidence of reliability. The final version of the CLCSS was 31 items. Coefficient alpha was recalculated for the total stigma scale (0.96) and the four subscales (0.97 for stigma and shame, 0.96 for social isolation, 0.92 for discrimination, and 0.75 for smoking).Conclusions: The CLCSS is a reliable and valid measure of health-related stigma in this sample of people with lung cancer.Implications for Nursing: The CLCSS can be used to identify the presence and impact of lung cancer stigma and allow for the development of effective stigma interventions for patients with lung cancer.<ul> <li>Content Type Journal Article</li><li>Category Online Exclusive Article</li><li>Pages E46-E54</li><li>DOI 10.1188/11.ONF.E46-E54</li><li>Authors<ul> <li>Janine K. Cataldo, RN, PhD, Department of Physiological Nursing-Gerontology, University of California, San Francisco</li><li>Robert Slaughter, PhD, Office of Research and Information Technology, School of Nursing</li><li>Thierry M. Jahan, MD, Helen Diller Family Comprehensive Cancer Center, University of California, San Francisco</li><li>Voranan L. Pongquan, RN, MPH, School of Nursing, University of California, San Francisco</li><li>Won Ju Hwang, RN, MPH, School of Nursing, University of California, San Francisco</li> </ul></li> </ul><ul class="parents"> <ul class="details"> <li>Journal <a href="http://ons.metapress.com/content/120390/">Oncology Nursing Forum</a></li><li>Online ISSN 1538-0688</li><li>Print ISSN 0190-535X</li> </ul><ul class="details"> <li>Journal Volume Volume 38</li> </ul><ul class="details"> <li>Journal Issue <a href="http://ons.metapress.com/content/v55457034214/">Volume 38, Number 1 / January 2011</a></li> </ul> </ul>
Tailoring Cancer Education and Support Programs for Low-Income, Primarily African American Cancer Survivors
Purpose/Objectives: To identify the information and stress-management topics of most interest to low-income, predominantly African American cancer survivors.Research Approach: Descriptive, cross sectional.Setting: Outpatient oncology clinic in a public hospital in Birmingham, Alabama.Participants: 25 patients with cancer; 12 were men, 22 were African Americans, and 16 had a 12th-grade education or less.Methodologic Approach: Patients ranked potential topics to be included in an educational curriculum.Main Research Variables: Quantitative rankings of information and stress-management priorities.Findings: Learning about cancer, understanding cancer treatments, relieving cancer pain, and keeping well in mind and body were the most highly ranked topics among those offered within the American Cancer Society's I Can Cope curriculum, which also included supportive topics such as mobilizing social support. The preferred stress-management topics were humor therapy, music therapy, meditation, and relaxation; lower-ranked topics included pet therapy and art as therapy.Conclusions: Cancer survivors appear most interested in topics specific to their illness and treatment versus supportive topics. Stress management also received high rankings.Interpretation: Nurses have a key role in providing patient education and support. Tailoring education programs may better target specific needs and improve the quality of cancer care of underserved patients.<ul> <li>Content Type Journal Article</li><li>Category Online Exclusive Article</li><li>Pages E55-E59</li><li>DOI 10.1188/11.ONF.E55-E59</li><li>Authors<ul> <li>Michelle Y. Martin, PhD, Department of Medicine, University of Alabama at Birmingham</li><li>Lori A. Pollack, MD, MPH, Division of Cancer Prevention and Control, Centers for Disease Control and Prevention, Atlanta, GA</li><li>Mary B. Evans, MA, Center for the Study of Community Health, University of Alabama at Birmingham</li><li>Judith Lee Smith, PhD, Division of Cancer Prevention and Control, Centers for Disease Control and Prevention</li><li>Polly Kratt, PhD, Department of Medicine, University of Alabama at Birmingham</li><li>Heather Prayor-Patterson, PhD, Department of Psychiatry and Psychology, Cleveland Clinic, Ohio</li><li>Christopher D. Watson, MPH, Southside Medical Center and Institute of Public Health, Georgia State University, Atlanta</li><li>Mark Dignan, PhD, MPH, Prevention Research Center in the Department of Internal Medicine, University of Kentucky, Lexington</li><li>Lydia C. Cheney, MEd, CHES, Birmingham Comprehensive Cancer Center, University of Alabama</li><li>Maria Pisu, PhD, Department of Medicine, University of Alabama at Birmingham</li><li>Amandiy Liwo, MD, Department of Medicine, University of Alabama at Birmingham</li><li>Sandral Hullett, MD, MPH, Cooper Green Mercy Hospital, Birmingham</li> </ul></li> </ul><ul class="parents"> <ul class="details"> <li>Journal <a href="http://ons.metapress.com/content/120390/">Oncology Nursing Forum</a></li><li>Online ISSN 1538-0688</li><li>Print ISSN 0190-535X</li> </ul><ul class="details"> <li>Journal Volume Volume 38</li> </ul><ul class="details"> <li>Journal Issue <a href="http://ons.metapress.com/content/v55457034214/">Volume 38, Number 1 / January 2011</a></li> </ul> </ul>
Striving to Respond to Palliative Care Patients' Pain at Home: A Puzzle for Family Caregivers

Purpose/Objectives: To describe the types of pain patients in palliative care at home experience and how family caregivers assess them and intervene.

Research Approach: Qualitative using grounded theory.

Setting: Family caregivers' homes.

Participants: 24 family caregivers of patients with advanced cancer receiving palliative care at home.

Methodologic Approach: Semistructured interviews and field notes. Data analysis used Strauss and Corbin's recommendations for open, axial, and selective coding.

Main Research Variables: Pain, pain management, family caregivers, palliative care, and home care.

Findings: Caregivers assessed different types of pain and, therefore, were experimenting with different types of interventions. Not all family caregivers were able to distinguish between the different pains afflicting patients, and, consequently, were not selecting the most appropriate interventions. This often led to poorly managed pain and frustrated family caregivers.

Conclusions: The accurate assessment of the types of pain the patient is experiencing, coupled with the most appropriate intervention for pain control, is critical for optimal pain relief as well as supporting the confidence and feelings of family caregivers who are undertaking the complex process of cancer pain management.

Interpretation: Nurses involved with patients receiving palliative care and their family caregivers should be aware of all types of pain experienced by the patient and how caregivers are managing the pain. Nurses should be knowledgeable about different pain relief interventions to help family caregivers obtain accurate information, understand their options, and administer these interventions safely and effectively.
- Content Type Journal Article
- Category Online Exclusive Article
- Pages E37-E45
- DOI 10.1188/11.ONF.E37-E45
- Authors
  - Anita Mehta, RN, PhD, Psychosocial Oncology Program, McGill University Health Centre at Montreal General Hospital
  - S. Robin Cohen, PhD, Lady Davis Institute, S. M. B. D. Jewish General Hospital, Quebec, Canada
  - Helene Ezer, RN, PhD, School of Nursing, McGill University, Quebec, Canada
  - Franco A. Carnevale, RN, PhD, Centre de Recherche at the Institut Universitaire de G�riatrie de Montr�al, Universit� de Montr�al, Quebec, Canada
  - Francine Ducharme, PhD, Centre de Recherche at the Institut Universitaire de G�riatrie de Montr�al, Universit� de Montr�al, Quebec, Canada
The Role of Information Sources and Objective Risk Status on Lymphedema Risk-Minimization Behaviors in Women Recently Diagnosed With Breast Cancer
Purpose/Objectives: To assess the role of education sources and objective risk status on knowledge and practice of lymphedema risk-minimization behaviors among women recently diagnosed with breast cancer.Research Approach: Prospective survey.Setting: A hospital in Sydney, Australia.Participants: 106 women recently diagnosed with breast cancer at increased risk for developing lymphedema following lymph node dissection.Methodologic Approach: A questionnaire administered at the time of surgery and three months after surgery measured demographics, lymphedema knowledge, lymphedema information sources used, and adherence to risk-minimization recommendations.Main Research Variables: Lymphedema knowledge, source of information used, objective lymphedema risk, and adherence to risk-minimization behaviors.Findings: Knowledge was high and increased over time. Lymphedema information from the clinic (e.g., brochures, nursing staff) was the most cited source. Adherence to recommendations was moderate; nonadherence was mostly for behaviors requiring regular enactment. Regression analysis revealed that only receipt of information from nursing staff and lymphedema knowledge three months after surgery were significant predictors of risk-minimization behaviors.Conclusions: Exposing women to lymphedema risk information at the time of breast cancer diagnosis facilitates increased awareness and enactment of risk-minimization behaviors. Nursing staff play a key role in disseminating this information and in convincing women to perform the recommendations.Interpretation: Provision of lymphedema education by breast clinic staff is critical to ensure that women realize the importance of early detection and treatment. Reminder booster sessions by nursing staff may be beneficial particularly for longer-term knowledge retention and adherence to recommended behaviors.<ul> <li>Content Type Journal Article</li><li>Category Online Exclusive Article</li><li>Pages E27-E36</li><li>DOI 10.1188/11.ONF.E27-E36</li><li>Authors<ul> <li>Kerry A. Sherman, PhD, Department of Psychology, Macquarie University, Sydney, Australia</li><li>Louise Koelmeyer, BAppSc(OT), Westmead Breast Cancer Institute, Westmead Hospital, Sydney, Australia</li> </ul></li> </ul><ul class="parents"> <ul class="details"> <li>Journal <a href="http://ons.metapress.com/content/120390/">Oncology Nursing Forum</a></li><li>Online ISSN 1538-0688</li><li>Print ISSN 0190-535X</li> </ul><ul class="details"> <li>Journal Volume Volume 38</li> </ul><ul class="details"> <li>Journal Issue <a href="http://ons.metapress.com/content/v55457034214/">Volume 38, Number 1 / January 2011</a></li> </ul> </ul>
Sensory Perceptions of Patients With Cancer Undergoing Surgical Insertion of a Totally Implantable Venous Access Device: A Qualitative, Exploratory Study

Purpose/Objectives: To investigate sensory perceptions of patients who underwent insertion of a totally implantable venous access device (TIVAD) under local anesthesia.

Research Approach: Qualitative, exploratory study.

Setting: Tertiary care center in Belgium.

Participants: 20 adult patients with cancer or hematologic disease undergoing a first-time TIVAD insertion.

Methodologic Approach: Immediately after insertion, patients were asked to describe their sensory perceptions during each of four phases. Descriptions were documented in a sensory information grid (SIG) that was composed of a row and column matrix of entries for the four phases of the procedure and the five sensory modalities. Verbatim descriptions of patients were assigned labels using a descriptive coding process.

Main Research Variables: Sensory perceptions in the modalities of hearing, sight, touch, smell, and taste.

Findings: Patients experienced many sensory perceptions that mainly occurred during preparation of the patients and surgical equipment (phase 2) and during the actual TIVAD insertion (phase 3). Patients perceived fewer olfactory sensations. No taste perceptions were mentioned.

Conclusions: Patients reported numerous sensory perceptions during TIVAD insertion. The SIG method proved suitable for assessing and documenting patients' sensory perceptions.

Interpretation: The reported descriptions can be used (a) to develop a structured questionnaire to quantitatively assess sensory perceptions and (b) to prepare patients for what to expect with regard to sensory information experienced before, during, and after TIVAD insertion. This method for exploring and documenting sensory perceptions might be applicable to other diagnostic or therapeutic interventions.
- Content Type Journal Article
- Category Online Exclusive Article
- Pages E20-E26
- DOI 10.1188/11.ONF.E20-E26
- Authors
  - Eva Goossens, MSc, RN, Center for Health Services and Nursing Research, Katholieke Universiteit, Leuven, Belgium
  - Godelieve A. Goossens, MSc, RN, Department of Surgical Oncology, University Hospitals Leuven
  - Marguerite Stas, MD, PhD, Department of Surgical Oncology, University Hospitals Leuven
  - Christel Janssens, MSc, RN, Department of Surgical Oncology, University Hospitals Leuven
  - Martine J�r�me, MSc, RN, Department of Surgical Oncology, University Hospitals Leuven
  - Philip Moons, PhD, RN, Center for Health Services and Nursing Research, Katholieke Universiteit
Oncology Nurses' Perspectives on the State of Cancer Survivorship Care: Current Practice and Barriers to Implementation

Purpose/Objectives: To describe current survivorship care from the perspectives of oncology nurses.

Design: Descriptive.

Setting: E-mail invitation to Web-based survey.

Sample: 399 Oncology Nursing Society members providing care for patients initially treated more than one year previously.

Methods: An online survey was used to evaluate current aspects of survivorship care.

Main Research Variables: Practice settings, services provided, and barriers to delivering survivorship care.

Findings: Few nurses (27%) worked in settings with a formal survivorship program. Several program components were provided significantly more often in outpatient settings, pediatric facilities, and workplaces with a formal survivorship program. At the transition from acute to follow-up care, the survivorship nursing care provided most often was scheduling for ongoing monitoring (71%) and the least likely was assistance for employment or legal issues (16%). The greatest barriers to providing survivorship care were lack of time and funding (46%). Among nurses new to oncology (fewer than five years), 49% indicated they lacked sufficient knowledge compared to 36% of nurses with more than five years of oncology experience.

Conclusions: Findings describe current aspects of survivorship care across practice settings. Nurses reported that the greatest barriers are lack of time, funding, and lack of knowledge about survivorship issues.

Implications for Nursing: A need exists for education to enhance knowledge and skills of nurses who will provide survivorship care. Research is warranted to develop empirically supported guidelines and care-delivery models that address the barriers to providing survivorship services.
- Content Type Journal Article
- Category Online Exclusive Article
- Pages E11-E19
- DOI 10.1188/11.ONF.E11-E19
- Authors
  - Margaret Irwin, RN, MN, PhD, Research Department, Oncology Nursing Society (ONS), Pittsburgh, PA
  - Jennifer R. Klemp, MA, PhD, MPH, Breast Cancer Survivorship Center, University of Kansas Cancer Center
  - Catherine Glennon, RN, MHS, BC, CAN, OCN�, University of Kansas Cancer Center
  - Linda M. Frazier, MD, MPH, Department of Obstetrics and Gynecology in the School of Medicine, University of Kansas
Lymphedema in Patients With Head and Neck Cancer

Purpose/Objectives: To describe the current state of the science on secondary lymphedema in patients with head and neck cancer.

Data Sources: Published journal articles and books and data from the National Cancer Institute, the American Cancer Society, and other healthcare-related professional association Web sites.

Data Synthesis: Survivors of head and neck cancer may develop secondary lymphedema as a result of the cancer or its treatment. Secondary lymphedema may involve external (e.g., submental area) and internal (e.g., laryngeal, pharyngeal, oral cavity) structures. Although lymphedema affects highly visible anatomic sites (e.g., face, neck), and profoundly influences critical physical functions (e.g., speech, breathing, swallowing, cervical range of motion), research regarding this issue is lacking. Studies are needed to address a variety of vital questions, including incidence and prevalence, optimal measurement techniques, associated symptom burden, functional loss, and psychosocial impact.

Conclusions: Secondary lymphedema in patients with head and neck cancer is a significant but understudied issue.

Implications for Nursing: A need exists to systematically examine secondary lymphedema related to treatment for head and neck cancer and address gaps in the current literature, such as symptom burden, effects on body functions, and influences on quality of life. Oncology nurses and other healthcare professionals should have empirical evidence to help them manage lymphedema after head and neck cancer treatment.
- Content Type Journal Article
- Category Online Exclusive and Continuing Education Article
- Pages E1-E10
- DOI 10.1188/11.ONF.E1-E10
- Authors
  - Jie Deng, PhD, RN, OCN�, School of Nursing, Vanderbilt University, Nashville, TN
  - Sheila H. Ridner, PhD, RN, FAAN, School of Nursing, Vanderbilt University, Nashville, TN
  - Barbara A. Murphy, MD, Vanderbilt-Ingram Cancer Center, Nashville, TN
The Attitudes, Communication, Treatment, and Support Intervention to Reduce Breast Cancer Treatment Disparity

Purpose/Objectives: To test the effect of a supportive, one-time psychoeducational intervention on treatment adherence among African American women receiving first adjuvant therapy for breast cancer.

Design: A pilot, randomized, controlled clinical trial, two-group design, with one-time intervention and four data collection points.

Setting: Two University of Pittsburgh Cancer Institute clinics.

Sample: 24 African American women.

Methods: The Attitudes, Communication, Treatment, and Support (ACTS) intervention is a 45-minute one-on-one session with an African American woman recommended to have chemotherapy for breast cancer. The interventionist is an African American breast cancer survivor. The intervention consists of a discussion about chemotherapy and the importance of communicating knowledge needs and distress, an explanation of the specific treatment plan according to pathology, and support through the survivor testimonial and video clips from the African American community.

Main Research Variables: Dose of chemotherapy received and dose of chemotherapy prescribed.

Findings: Twenty patients completed chemotherapy, and four chose not to begin or discontinued recommended chemotherapy. The groups were equal in key sociodemographic variables. Compared to usual care, the ACTS intervention participants demonstrated trends toward initiation of chemotherapy (100% versus 82%), overall adherence to chemotherapy (92% versus 73%), and percentage of total dose of chemotherapy received or prescribed (94% versus 74%). Compared to usual care, the ACTS intervention participants demonstrated more rapid initiation of chemotherapy and better overall adherence to chemotherapy.

Conclusions: The pilot ACTS intervention shows promise as a psychoeducational intervention to assist with chemotherapy decision making among African American women.

Implications for Nursing: African American women are at high risk of not receiving the full dose of prescribed chemotherapy for breast cancer for multiple reasons. Nurses must be sensitive to the unique fears and concerns of this population regarding chemotherapy decisions. An intervention addressing these fears and concerns may help to increase adherence.
- Content Type Journal Article
- Category Research Brief Article
- Pages 85-89
- DOI 10.1188/11.ONF.85-89
- Authors
  - Margaret Rosenzweig, PhD, FNP-BC, AOCNP�, University of Pittsburgh School of Nursing, Pennsylvania
  - Adam Brufsky, MD, PhD, Magee-Womens Breast Cancer Program of UPMC Cancer Centers, University of Pittsburgh School of Medicine and medical, Pittsburgh
  - Priya Rastogi, MD, Magee-Womens Breast Cancer Program of UPMC Cancer Centers, University of Pittsburgh School of Medicine and physicians
  - Shannon Puhalla, MD, Magee-Womens Breast Cancer Program of UPMC Cancer Centers, University of Pittsburgh School of Medicine and physicians
  - Jacqueline Simon, University of Pittsburgh School of Nursing
  - Sandra Underwood, PhD, RN, FAAN, University of Wisconsin-Milwaukee
Determinants of Quality of Life in Patients Near the End of Life: A Longitudinal Perspective
Purpose/Objectives: To describe the quality of life (QOL) of patients near the end of life and to identify determinants of their QOL.Design: Descriptive, longitudinal.Setting: University-affiliated cancer center, two private oncologists' offices, and patients' homes.Sample: 80 patients with either stage IIIb or IV lung cancer newly diagnosed in the previous month or recurrent lung cancer with distant disease.Methods: Patients were interviewed for responses to instruments to assess demographic, physical, psychosocial, and spiritual characteristics. Baseline data were collected at the patients' places of oncology care. Home visits were made for the two-month and four-month data collection points.Main Research Variables: QOL; symptom frequency, severity, and distress; functional status; anxiety; depression.Findings: Fifty percent of patients died within five months of their lung cancer diagnosis. Patients reported a relatively high QOL that did not change significantly as they approached the end of life. Symptom distress was the strongest determinant of QOL, followed by symptom severity, symptom frequency, and depression.Conclusions: QOL was most affected by symptoms experienced in patients with advanced lung cancer, particularly distress associated with symptoms. Interventions for symptom management must be implemented at diagnosis because patients in this population may approach the end of life quickly.Implications for Nursing: A routine and thorough symptom assessment is imperative for patients with advanced lung cancer. Attention to symptom distress is important because of its effect on QOL.<ul> <li>Content Type Journal Article</li><li>Category Podcast Article</li><li>Pages 23-31</li><li>DOI 10.1188/11.ONF.23-31</li><li>Authors<ul> <li>Carla P. Hermann, PhD, RN, School of Nursing, University of Louisville, Kentucky</li><li>Stephen W. Looney, PhD, Department of Biostatistics, Medical College of Georgia in Augusta</li> </ul></li> </ul><ul class="parents"> <ul class="details"> <li>Journal <a href="http://ons.metapress.com/content/120390/">Oncology Nursing Forum</a></li><li>Online ISSN 1538-0688</li><li>Print ISSN 0190-535X</li> </ul><ul class="details"> <li>Journal Volume Volume 38</li> </ul><ul class="details"> <li>Journal Issue <a href="http://ons.metapress.com/content/v55457034214/">Volume 38, Number 1 / January 2011</a></li> </ul> </ul>
Identification of Latent Classes in Patients Who Are Receiving Biotherapy Based on Symptom Experience and Its Effect on Functional Status and Quality of Life

Purpose/Objectives: To identify subgroups of patients receiving biotherapy with pain, fatigue, sleep disturbance, and depression and to determine functional status and quality of life differences between subgroups.

Design: A descriptive, prospective, cohort study design.

Setting: Internet-based survey.

Sample: 187 patients with cancer receiving biotherapy.

Methods: Pain intensity, Piper Fatigue Scale, General Sleep Disturbance Scale, Center for Epidemiological Studies-Depression, Karnofsky Performance Scale, and the Multidimensional Quality of Life Scale-Cancer were used at two time points one month apart (T1 and T2). Latent profile analysis identified subgroups.

Main Research Variables: Biotherapy, symptoms, functional status, and quality of life.

Findings: At T1 (N = 187), five patient subgroups were identified, ranging from subgroup 1 (mild fatigue and sleep disturbance) to subgroup 5 (severe on all four symptoms). At T2 (N = 114), three patient subgroups were identified, ranging from subgroup 1 (mild pain, fatigue, and sleep disturbance without depression) to subgroup 3 (mild pain, moderate fatigue, and sleep disturbance with severe depression). At each time point, the patient subgroup with the most severe symptoms showed significantly lower functional status and quality of life.

Conclusions: As with other cancer treatments, biotherapy can be divided into similar patient subgroups with four prevalent symptoms. Subgroups of patients differ in functional status and quality of life as a result of symptom severity.

Implications for Nursing: Clinicians should assess and identify patients with severe levels of the four prevalent symptoms and offer appropriate interventions. Future study is needed to investigate the factors that contribute to symptom severity and to examine the occurrence of symptom clusters that may place patients at increased risk for poorer outcomes.
- Content Type Journal Article
- Category Article
- Pages 33-42
- DOI 10.1188/11.ONF.33-42
- Authors
  - Marylin J. Dodd, RN, PhD, FAAN, Department of Physiological Nursing in the School of Nursing, University of California, San Francisco
  - Maria H. Cho, RN, PhD, AOCNS�, Department of Physiological Nursing in the School of Nursing, University of California, San Francisco
  - Bruce A. Cooper, PhD, Department of Community Health Care Systems, School of Nursing at UCSF
  - Judy Petersen, RN, MS, NexCura, Seattle, WA
  - Kayee Alice Bank, RN, MS, OCN�, Kaiser Permanente, Irvine, CA
  - Kathryn A. Lee, RN, PhD, FAAN, Department of Family Health Care Nursing, School of Nursing at UCSF
  - Christine Miaskowski, RN, PhD, FAAN, Department of Physiological Nursing, School of Nursing at UCSF
A Pilot Study of Activity Engagement in the First Six Months After Stem Cell Transplantation
Prpose/Objectives: To describe the natural pace and pattern of activity resumption in the first six months after stem cell transplantation (SCT).Design: Longitudinal, descriptive survey.Setting: Bone marrow transplantation program of a National Cancer Institute-designated comprehensive cancer center in the northeastern United States.Sample: 18 men and 18 women who underwent either autologous (83%) or allogeneic (17%) transplantation.Methods: Participants were surveyed 30 days, 100 days, and six months after SCT. Descriptive statistics were followed by exploratory linear mixed modeling with factors of time, gender, and the interaction between time and gender.Main Research Variables: A modified checklist version of the Activity Card Sort was used to measure activity retention.Findings: Participants generally were performing 49% of their usual activities 30 days after transplantation, 70% of their premorbid activities 100 days after transplantation, and 77% of their premorbid activities six months after transplantation. Level of activity engagement increased over time, with the greatest changes observed from 30-100 days after SCT. Men retained more of their activities than women in the domains of low physical-demand leisure and social activities.Conclusions: Rehabilitation screening may be most helpful in the period from 100 days to six months, when activity levels begin to plateau. Activity recovery may differ for men and women; future research should explore how this could affect rehabilitation needs.Implications for Nursing: Nurses can use structured surveys to explore and promote patients' satisfaction with and ability to engage in daily activities and ensure appropriate referrals to rehabilitation during recovery from SCT.<ul> <li>Content Type Journal Article</li><li>Category Article</li><li>Pages 75-83</li><li>DOI 10.1188/11.ONF.75-83</li><li>Authors<ul> <li>Kathleen Doyle Lyons, ScD, OTR/L, Dartmouth Medical School, Norris Cotton Cancer Center, Lebanon, NH</li><li>Jay G. Hull, PhD, Department of Brain and Psychological Sciences, Dartmouth College, Hanover, NH</li><li>Lynn D. Root, RN, Section of Hematology Oncology, Dartmouth-Hitchcock Medical Center, Lebanon</li><li>Elizabeth Kimtis, ARNP, Section of Hematology Oncology, Dartmouth-Hitchcock Medical Center, Lebanon</li><li>Anna D. Schaal, RN, MS, ARNP, Section of Hematology Oncology, Dartmouth-Hitchcock Medical Center, Lebanon</li><li>Diane M. Stearns, MSN, ARNP, Section of Hematology Oncology, Dartmouth-Hitchcock Medical Center, Lebanon</li><li>Idalina C. Williams, RN, ADN, BSW, Section of Hematology Oncology, Dartmouth-Hitchcock Medical Center, Lebanon</li><li>Kenneth R. Meehan, MD, Department of Medicine at Dartmouth Medical School, Norris Cotton Cancer Center</li><li>Tim A. Ahles, PhD, Department of Psychiatry and Behavioral Sciences, Memorial Sloan-Kettering Cancer Center, New York, NY</li> </ul></li> </ul><ul class="parents"> <ul class="details"> <li>Journal <a href="http://ons.metapress.com/content/120390/">Oncology Nursing Forum</a></li><li>Online ISSN 1538-0688</li><li>Print ISSN 0190-535X</li> </ul><ul class="details"> <li>Journal Volume Volume 38</li> </ul><ul class="details"> <li>Journal Issue <a href="http://ons.metapress.com/content/v55457034214/">Volume 38, Number 1 / January 2011</a></li> </ul> </ul>
No Issue Number
Statistics. Get It'

Statistics. Get It?
- Content Type Journal Article
- Category Editorial
- Pages 105-106
- DOI 10.1188/11.ONF.105-106
- Authors
  - Susan Moore, RN, MSN, ANP, AOCN�, Consultant, Chicago, IL
Changes in Caregiver Perceptions Over Time in Response to Providing Care for a Loved One With a Primary Malignant Brain Tumor
Purpose/Objectives: To examine how family members of patients with a primary malignant brain tumor transition into the caregiver role and how their perceptions of this transition change over time.Research Approach: Descriptive, qualitative.Setting: Neurosurgery and neuro-oncology clinics of a regional medical center.Participants: 10 family caregivers of patients with a primary malignant brain tumor.Methodologic Approach: A series of 11 open-ended questions addressing various aspects of the care situation were administered to each caregiver. The same questions were asked at baseline (within one month of the patient's diagnosis) and four months later. Content analysis was performed to identify themes among interviews.Main Research Variables: Patient changes, caregiver adjustments, and accessing support.Findings: Caregivers described difficulties stemming from the patient's tumor-related dysfunction and changes in their familial, occupational, and social roles. Support from family and friends was vital to caregivers' emotional health, but shock and fear were evident in all interviews. Becoming subsumed in the care situation was described as enmeshment. Caregivers reported difficulty in communicating with healthcare providers. When looking at change over time, three major themes emerged: Patient Changes: The New Normal; Caregiver Adjustments; and Accessing Support.Conclusions: Caregivers require support in handling neurologic and physical sequelae, transitioning into new roles, and avoiding becoming enmeshed in the care situation.Interpretation: This study underlines the importance of continuing research in this area to provide the necessary interventions that will assist caregivers and provide support throughout their loved one's disease trajectory.<ul> <li>Content Type Journal Article</li><li>Category Article</li><li>Pages 149-155</li><li>DOI 10.1188/11.ONF.149-155</li><li>Authors<ul> <li>Paula Sherwood, RN, PhD, CNRN, School of Nursing, University of Pittsburgh in Pennsylvania</li><li>Allison Hricik, MS, School of Nursing, University of Pittsburgh in Pennsylvania</li><li>Heidi Donovan, RN, PhD, School of Nursing, University of Pittsburgh in Pennsylvania</li><li>Sarah E. Bradley, MS, Maimonides Cancer Center in Brooklyn, NY</li><li>Barbara A. Given, PhD, RN, FAAN, College of Nursing, Michigan State University in East Lansing</li><li>Catherine M. Bender, RN, PhD, School of Nursing, University of Pittsburgh</li><li>Alyssa Newberry, MS-c, School of Nursing, University of Pittsburgh</li><li>Rebekah Hamilton, RN, PhD, College of Nursing, University of Illinois at Chicago</li><li>Charles W. Given, PhD, School of Medicine, Michigan State University</li> </ul></li> </ul><ul class="parents"> <ul class="details"> <li>Journal <a href="http://ons.metapress.com/content/120390/">Oncology Nursing Forum</a></li><li>Online ISSN 1538-0688</li><li>Print ISSN 0190-535X</li> </ul><ul class="details"> <li>Journal Volume Volume 38</li> </ul><ul class="details"> <li>Journal Issue <a href="http://ons.metapress.com/content/k281r0712201/">Volume 38, Number 2 / March 2011</a></li> </ul> </ul>
Experience of Newly Diagnosed Patients With Sarcoma Receiving Chemotherapy

Purpose/Objectives: To examine symptom distress and quality of life (QOL) in newly diagnosed patients with sarcoma receiving chemotherapy.

Design: Pilot study; descriptive, quantitative.

Setting: Urban community cancer center in the northeastern United States.

Sample: 11 newly diagnosed patients with sarcoma.

Methods: Participants completed the Edmonton Symptom Assessment Scale and the Functional Assessment of Cancer Therapy-General at baseline and on days 1, 15, and 21 of their chemotherapy treatment.

Main Research Variables: Symptom distress and QOL.

Findings: Fatigue was the most prevalent and pervasive symptom. Anxiety, well-being, lack of appetite, drowsiness, and depression were the most commonly reported symptoms during chemotherapy. QOL was negatively affected. The lowest mean score reported was for functional well-being. Outcome profiles for symptom distress increased over time, whereas QOL profiles decreased over time. Exploratory analyses of age, race, sex, and diagnosis group suggested differences that warrant further study.

Conclusions: Overall, increasing symptom distress and reduced QOL over time were reported by patients with sarcoma during chemotherapy. Exploratory analysis by demographic variables and treatment group suggested the need for further research of predictors for symptom distress and QOL.

Implications for Nursing: Clinical and research implications included the need for better understanding about symptom distress and QOL predictors in patients with sarcoma, as well as the evaluation of interventions directed to address this population's specific needs.
- Content Type Journal Article
- Category Article
- Pages 160-169
- DOI 10.1188/11.ONF.160-169
- Authors
  - Clara Granda-Cameron, CRNP, MSN, Pain and Supportive Care Program, Joan Karnell Cancer Center at Pennsylvania Hospital, Philadelphia
  - Alexandra L. Hanlon, PhD, School of Nursing, University of Pennsylvania, Philadelphia
  - Mary Pat Lynch, CRNP, MSN, AOCN�, Joan Karnell Cancer Center, Philadelphia
  - Arlene Houldin, PhD, PMHCNS-BC, School of Nursing, University of Pennsylvania, Philadelphia
Oncology Nursing Society 36th Annual Congress Podium and Poster Abstracts
Oncology Nursing Society 36th Annual Congress Podium and Poster Abstracts<ul> <li>Content Type Journal Article</li><li>Category Online Exclusive Article</li><li>Pages E118-E180</li><li>DOI 10.1188/11.ONF.E118-E180</li> </ul><ul class="parents"> <ul class="details"> <li>Journal <a href="http://ons.metapress.com/content/120390/">Oncology Nursing Forum</a></li><li>Online ISSN 1538-0688</li><li>Print ISSN 0190-535X</li> </ul><ul class="details"> <li>Journal Volume Volume 38</li> </ul><ul class="details"> <li>Journal Issue <a href="http://ons.metapress.com/content/k281r0712201/">Volume 38, Number 2 / March 2011</a></li> </ul> </ul>
Late-Breaking Abstracts From the Oncology Nursing Society 11th National Conference on Cancer Nursing Research
Late-Breaking Abstracts From the Oncology Nursing Society 11th National Conference on Cancer Nursing Research<ul> <li>Content Type Journal Article</li><li>Category Online Exclusive Article</li><li>Pages E181-E190</li><li>DOI 10.1188/11.ONF.E181-E190</li> </ul><ul class="parents"> <ul class="details"> <li>Journal <a href="http://ons.metapress.com/content/120390/">Oncology Nursing Forum</a></li><li>Online ISSN 1538-0688</li><li>Print ISSN 0190-535X</li> </ul><ul class="details"> <li>Journal Volume Volume 38</li> </ul><ul class="details"> <li>Journal Issue <a href="http://ons.metapress.com/content/k281r0712201/">Volume 38, Number 2 / March 2011</a></li> </ul> </ul>
No Issue Number
Oncology Update

A comprehensive clinical review by Russi et al. (2012) focused on dysphagia as a prevalent and debilitating symptom associated with head and neck cancer (HNC). At diagnosis, as many as two-thirds of patients with HNC present with dysphagia, and about one-third of those may develop aspiration pneumonia with associated mortality rates of 20%-65%. Prior studies have shown pretreatment deficits common in patients with advanced-stage HNC and indicated a poor correlation between measurable deficits and patient deficit perception. The article provides a detailed overview of anatomic and physiologic swallowing mechanisms, along with recommendations for pretreatment swallowing assessments by speech and language therapists to identify the potential syndrome of silent dysphagia, as well as the risk of concomitant aspiration.
- Content Type Journal Article
- Category Oncology Update
- Pages 95-96
- DOI 10.1188/13.ONF.95-96
- Authors
  - Susan Weiss Behrend, RN, MSN, AOCN�, Department of Nursing, Fox Chase Cancer Center, Philadelphia, PA
40 Years in the Making

Believe it or not, the Oncology Nursing Forum (ONF) celebrates its 40th anniversary in 2013, and the first question that many of you may have is, "How can ONF be entering its 40th year when the Oncology Nursing Society (ONS) is only 38 years old?" In short, those wise leaders who determined the need for an organization of nurses specializing in the care of patients with cancer began their efforts in 1973 with a newsletter called the Cancer Nursing Newsletter. That first newsletter changed names rather rapidly, becoming the Oncology Nursing Newsletter in 1974, the Newsletter of the Oncology Nursing Society in 1975, and the Oncology Nursing Society Newsletter in 1976. Finally, in 1977, it was renamed Oncology Nursing Forum.
- Content Type Journal Article
- Category Guest Editorial
- Pages 9-9
- DOI 10.1188/13.ONF.9
- Authors
  - Barbara A. Sigler, RN, MNEd, Oncology Nursing Society, Pittsburgh, PA
Meet the Editorial Board
The following thought leaders, educators, and researchers comprise the Editorial Board of the Oncology Nursing Forum (ONF) for 2013. Each brings a unique skill set based on years of oncology experience to the work of the journal. The associate editors support the mission of ONF: To convey research information related to practice, technology, education, and leadership, to disseminate oncology nursing research and evidence-based practice to enhance transdisciplinary high-quality cancer care, and to stimulate discussion of critical issues relevant to oncology nursing. Each associate editor shepherds a column in the journal; their contributions can be seen in every issue. Contact information for the editors can be found at the end of each description.<ul> <li>Content Type Journal Article</li><li>Category Online Exclusive Feature</li><li>Pages E1-E3</li><li>DOI 10.1188/13.ONF.E1-E3</li> </ul><ul class="parents"> <ul class="details"> <li>Journal <a href="http://ons.metapress.com/content/120390/">Oncology Nursing Forum</a></li><li>
Online ISSN 0190-535X</li> </ul><ul class="details"> <li>Journal Volume Volume 40</li> </ul><ul class="details"> <li>Journal Issue <a href="http://ons.metapress.com/content/u63333wh2g2g/">Volume 40, Number 1 / January 2013</a></li> </ul> </ul>
No Issue Number
Understanding the Functional Late Effects and Informational Needs of Adult Survivors of Childhood Cancer

Purpose/Objectives: To report functional (physical and cognitive) late effects, experiences, and information needs of adult survivors of childhood cancer.

Design: Descriptive, mixed methods survey.

Setting: Two pediatric oncology programs in the Midwest.

Sample: Convenience sample of 272 young adult survivors.

Methods: Voluntary survey completion by young adult survivors regarding late effects, experiences, and educational needs to develop appropriate comprehensive care programs for care provision before, during, and after transition to adult care. Survey domains were identified from existing survivorship literature and focused on all aspects of survivorship; however, this article focuses on results specific to the functional domain.

Main Research Variables: Functional late effects, experiences, information needs, age, gender, and treatment intensity of young adult survivors of childhood cancer.

Findings: Response rate was 48%. Functional late effects, perceptions, and information needs all correlated with intensity of treatment (those survivors most heavily treated experienced the most symptoms). Survivors wanted more information about late effects and how to deal with them. Women wanted more information about fertility-related topics, and participants who received more intense treatment generally wanted more information. Brain tumor survivors perceived greater cognitive difficulties, cognitive late effects, fatigue, and financial difficulties.

Conclusions: Survivors experience myriad physical late effects and require ongoing access to information as needs change over time.

Implications for Nursing: Identifying new and innovative ways to reach survivors and better meet needs is important for care, research, and program development.

Knowledge Translation: The findings of the research underscore the importance of continuous learning opportunities for adult survivors of childhood cancer. The findings also highlight the need for healthcare teams to better understand the current and long-term needs of this population. In addition to traditional communication approaches, technologies such as social media and telemedicine can provide innovative ways to deliver patient-centered care.
- Content Type Journal Article
- Category Journal Club/Open Access/Podcast
- Pages 254-262
- DOI 10.1188/13.ONF.254-262
- Authors
  - Wendy McClellan, RN, BSN, Survive and Thrive Survivorship Program, Children's Mercy Hospitals and Clinics, Kansas City, MO
  - Jennifer R. Klemp, PhD, MPH, Division of Clinical Oncology, University of Kansas Cancer Center, Westwood
  - Hope Krebill, RN, BSN, MSW, Division of Clinical Oncology, University of Kansas Cancer Center, Westwood
  - Robin Ryan, MPH, CCRP, Midwest Cancer Alliance, University of Kansas Cancer Center, Westwood
  - Eve-Lynn Nelson, PhD, Division of Hematology/Oncology, Children's Mercy Hospitals and Clinics
  - Jyoti Panicker, MD, Institute for Community Engagement, University of Kansas Medical Center, Kansas City, KS
  - Mukta Sharma, MD, MPH, University of Kansas Cancer Center
  - Kristin Stegenga, PhD, RN, CPON�, Division of Hematology/Oncology, Children's Mercy Hospitals and Clinics
A New Reality: Long-Term Survivorship With a Malignant Brain Tumor
Purpose/Objectives: To explore the survivor experience of adults who have been diagnosed three years or longer with a primary malignant brain tumor (PMBT).Research Approach: Qualitative using a biographical narrative approach.Setting: Six sites across the United States.Participants: Survivors of PMBTs (N = 35) and their family caregivers (N = 35).Methodologic Approach: Using a semistructured interview guide, survivors and caregivers were interviewed individually about their lives before and since the PMBT diagnosis. Thematic analysis was performed to identify themes.Findings: Stability in survivor lives disintegrated as a result of the changes experienced related to the tumor and its treatment. Those changes were profound and ultimately contributed to multiple losses in key areas of their lives. Over time, living with the diagnosis and its consequences required survivors and their caregivers to adapt to the new reality of their lives. Through the process of becoming a survivor, individuals were able to take back control of their lives. Adaptation required survivors to use internal and external resources as ways of coping with their new reality.Conclusions: People with PMBTs require support as they adapt to losses and changes that impact their lives. Assessment of specific changes that impact survivors' lives may be useful in guiding type of support given. Symptom management and mobilization of internal and external resources may lessen the life-changing impact.Interpretation: Nurses should capture symptom meaning during assessments and expand assessments to include social support systems. Instituting measures that facilitate survivor independence may lessen the impact of disability. The significance of symptom worsening over time requires additional research.Knowledge Translation: Restoring self-worth and taking control of their lives are critical concerns for survivors of PMBTs.<ul> <li>Content Type Journal Article</li><li>Category Article</li><li>Pages 267-274</li><li>DOI 10.1188/13.ONF.267-274</li><li>Authors<ul> <li>Mary Pat Lovely, PhD, RN, College of Nursing, University of California, San Francisco</li><li>Christina Stewart-Amidei, RN, PhD, APN-CNS, CNRN, CCRN, FAAN, Department of Neuro-Oncology, University of Chicago in Illinois</li><li>Margaretta Page, RN, MS, University of California, San Francisco</li><li>Kathleen Mogensen, RN, MSN, APN-C, Ros-well Park Cancer Institute, Buffalo, NY</li><li>Jean Arzbaecher, RN, MS, APN-CNS, CNRN, University of Chicago</li><li>Kathleen Lupica, RN, MSN, CNP, Cleveland Clinic, Ohio</li><li>Mary Ellen Maher, RN, MSN, CNP, Northwestern University, Chicago</li> </ul></li> </ul><ul class="parents"> <ul class="details"> <li>Journal <a href="http://ons.metapress.com/content/120390/">Oncology Nursing Forum</a></li><li>Online ISSN 1538-0688</li><li>Print ISSN 0190-535X</li> </ul><ul class="details"> <li>Journal Volume Volume 40</li> </ul><ul class="details"> <li>Journal Issue <a href="http://ons.metapress.com/content/np5882q4019k/">Volume 40, Number 3 / May 2013</a></li> </ul> </ul>
Prevention of Dimethylsulfoxide-Related Nausea and Vomiting by Prophylactic Administration of Ondansetron for Patients Receiving Autologous Cryopreserved Peripheral Blood Stem Cells

Purpose/Objectives: To evaluate the effectiveness of ondansetron for the prevention of nausea and vomiting from dimethylsulfoxide (DMSO) during autologous stem cell transplantation (ASCT) infusion.

Design: Nonrandomized cohort using historical control.

Setting: Comprehensive cancer center outpatient infusion department.

Sample: 50 patients receiving ASCT in the outpatient setting.

Methods: Patients were assessed for nausea and vomiting on their infusion day using the Multinational Association of Supportive Care in Cancer Antiemesis Tool (MAT) at arrival, pre-ASCT infusion, pre-ondansetron administration, prior to the first bag, and after each bag of stem cells. A standard script was used to ensure consistency. Ondansetron, 16 mg IV, was administered 30-90 minutes prior to each ASCT infusion. Number and volume of stem cells bags, as well as infusion rate and emesis episodes, were recorded. Nausea scores and vomiting episodes were compared to historical data.

Main Research Variables: Subjectivity of nausea, potential Hawthorne Effect.

Findings: Forty-five percent of patients had an MAT score greater than 2 on arrival, decreasing to 18% after receiving ondansetron before the first bag. Twenty-four percent had MAT increases of more than two points by infusion end compared to 58% in the historic control group. Eighteen percent of patients vomited compared to 28% of historic controls.

Conclusions: The administration of 16 mg of IV ondansetron significantly reduced DMSO-related nausea and episodes of vomiting in patients receiving ASCT.

Implications for Nursing: Prophylactic administration of ondansetron had a positive effect on reducing nausea symptoms and episodes of vomiting during ASCT infusions. These results prompted a change in clinical practice. More research is required to determine whether the inclusion of other antiemetic agents would provide even greater benefit.

Knowledge Translation: To date, no other published studies have explored the benefits of premedicating patients with ondansetron prior to ASCT infusions. This study is the first to establish efficacy of ondansetron for an unlabeled indication. These results may pave the way for future research in decreasing nausea and vomiting in this setting.
- Content Type Journal Article
- Category Article
- Pages 285-292
- DOI 10.1188/13.ONF.285-292
- Authors
  - Seth Eisenberg, RN, OCN�, Seattle Cancer Care Alliance
  - Mihkaila Wickline, RN, MSN, AOCN�, School of Nursing, University of Washington Medical Center
  - Michael Linenberger, MD, Hematology and Medicine in the School of Medicine, University of Washington
  - Ted Gooley, PhD, Fred Hutchinson Cancer Research Center
  - Leona Holmberg, MD, PhD, School of Medicine, University of Washington, Seattle, WA
Patterns of Symptoms Following Surgery for Esophageal Cancer

Design: Longitudinal, descriptive study.

Setting: An urban comprehensive cancer center in the northeastern United States.

Sample: 218 patients with cancer of the esophagus undergoing esophagectomy.

Methods: Symptoms were assessed by self-report before surgery, at the first postoperative visit, and at 6 and 12 months postsurgery.

Main Research Variables: Symptoms and demographic and clinical variables, including stage, treatment, gender, and comorbidities.

Findings: Patients with esophageal cancer reported numerous symptoms before and after esophagectomy. Several patterns of symptoms were identified. General cancer symptoms (e.g., pain, cough, shortness of breath, weight loss) were reported as worse after surgery but recovered to baseline by one year. A second pattern of esophageal-specific symptoms (feeling full too quickly, feeling bloated, nausea, and diarrhea) worsened after surgery and did not recover to baseline by one year. Reflux was the only symptom that did not worsen after surgery but did worsen significantly during the first year of recovery.

Conclusions: Patients with esophageal cancer experienced multiple prolonged symptoms following surgical treatment for their disease. General cancer symptoms resolved by one year post-treatment, whereas esophageal-specific symptoms worsened after surgery and did not recover to baseline.

Implications for Nursing: Identification of symptom patterns preoperatively and during recovery can assist nurses in developing intervention protocols to minimize long-term complications for patients with esophageal cancer.

Knowledge Translation: Patients with esophageal cancer are at risk for multiple prolonged symptoms following surgery. Symptom assessment should occur often after surgery and include a broad range of symptoms.
- Content Type Journal Article
- Category Online Exclusive Article
- Pages E101-E107
- DOI 10.1188/13.ONF.E101-E107
- Authors
  - Pamela Ginex, EdD, RN, OCN�, Department of Nursing at Lehman College, City University of New York, New York, NY
  - Bridgette Thom, MS, Department of Nursing, Memorial Sloan-Kettering Cancer Center
  - Maureen Jingeleski, BSN, OCN�, Department of Nursing, Memorial Sloan-Kettering Cancer Center
  - Alain Vincent, BS, Department of Surgery, Memorial Sloan-Kettering Cancer Center
  - Gabriel Plourde, BS, Department of Surgery, Memorial Sloan-Kettering Cancer Center
  - Nabil Rizk, MD, FACS, Department of Surgery, Memorial Sloan-Kettering Cancer Center
  - Valerie W. Rusch, MD, FACS, Department of Surgery, Memorial Sloan-Kettering Cancer Center
  - Manjit Bains, MBBS, FACS, Department of Surgery, Memorial Sloan-Kettering Cancer Center
Exploring Spirituality in Family Caregivers of Patients With Primary Malignant Brain Tumors Across the Disease Trajectory
Purpose/Objectives: To determine whether the perceived level of spirituality in family caregivers of patients with primary malignant brain tumors (PMBTs) changes across the disease trajectory.Design: Ongoing descriptive, longitudinal study.Setting: Southwestern Pennsylvania.Sample: 50 family caregivers of patients with PMBT.Methods: Caregivers and care recipients were recruited at time of diagnosis. Participants were interviewed at two subsequent time points, four and eight months following diagnosis.Main Research Variables: Care recipients' symptoms, neuropsychologic status, and physical function, as well as caregiver social support.Findings: Results showed no significant difference in spirituality scores reported at baseline and eight months (p = 0.8), suggesting that spirituality may be a stable trait across the disease trajectory.Conclusions: Spirituality remains relatively stable along the course of the disease trajectory. Reports of caregiver depressive symptoms and anxiety were lower when paired with higher reports of spirituality.Implications for Nursing: Clinicians can better identify caregivers at risk for negative outcomes by identifying those who report lower levels of spirituality. Future interventions should focus on the development and implementation of interventions that provide protective buffers such as increased social support.Knowledge Translation: Spirituality is a relatively stable trait. High levels of spirituality can serve as a protective buffer from negative mental health outcomes. Caregivers with low levels of spirituality may be at risk for greater levels of burden, anxiety, and stress.<ul> <li>Content Type Journal Article</li><li>Category Online Exclusive Article</li><li>Pages E119-E125</li><li>DOI 10.1188/13.ONF.E119-E125</li><li>Authors<ul> <li>Alyssa G. Newberry, MEd, School of Nursing, University of Pittsburgh, Pennsylvania</li><li>Chien-Wen Jean Choi, MS, School of Nursing, University of Pittsburgh, Pennsylvania</li><li>Heidi S. Donovan, PhD, RN, School of Nursing, University of Pittsburgh, Pennsylvania</li><li>Richard Schulz, PhD, Department of Psychology, University of Pittsburgh, Pennsylvania</li><li>Catherine Bender, PhD, School of Nursing, University of Pittsburgh, Pennsylvania</li><li>Barbara Given, PhD, RN, FAAN, School of Nursing, Michigan State University in East Lansing</li><li>Paula Sherwood, PhD, RN, CNRN, FAAN, School of Nursing, University of Pittsburgh</li> </ul></li> </ul><ul class="parents"> <ul class="details"> <li>Journal <a href="http://ons.metapress.com/content/120390/">Oncology Nursing Forum</a></li><li>Online ISSN 1538-0688</li><li>Print ISSN 0190-535X</li> </ul><ul class="details"> <li>Journal Volume Volume 40</li> </ul><ul class="details"> <li>Journal Issue <a href="http://ons.metapress.com/content/np5882q4019k/">Volume 40, Number 3 / May 2013</a></li> </ul> </ul>
Relationships Between Three Beliefs as Barriers to Symptom Management and Quality of Life in Older Breast Cancer Survivors
Purpose/Objectives: To describe relationships among perceived barriers to symptom management and quality of life and to test the mediating role of perceived communication difficulties on the relationships between other perceived barriers to symptom management and quality of life in older adult breast cancer survivors.Design: Cross-sectional descriptive-correlational design using baseline data from a randomized, controlled trial that tested the efficacy and durability of the individualized representational intervention in reducing symptom distress and improving quality of life in older adult breast cancer survivors.Setting: The community, an oncology clinic, and a state tumor registry.Sample: 190 older adult breast cancer survivors (X age = 70.4 years) who were an average of 3.3 years after breast cancer diagnosis.Methods: Path analysis using Mplus, version 5.1.Main Research Variables: Negative beliefs about symptom management (Symptom Management Beliefs Questionnaire [SMBQ]), perceived negative attitudes from healthcare providers (Communication Attitudes [CommA]), perceived communication difficulties (CommD), and quality of life.Findings: Significant direct effects of SMBQ and CommA on CommD were found after controlling for age, number of health problems, and number of symptoms. CommD was a significant mediator of the effects of CommA on quality of life after controlling for the covariates. SMBQ had significant total effects on quality of life after adjusting for the covariates but was not mediated by CommD.Conclusions: Patient-provider communication is an important factor in the quality of life of older adult breast cancer survivors.Implications for Nursing: Developing and testing nursing interventions focusing on enhancing both positive beliefs about symptom management and effective communication in old age is suggested.Knowledge Translation: Older adults and healthcare providers must overcome stereotyped beliefs about aging that may affect self-care and health outcomes for this population. Older adults must be allowed to express their views and emotions about aging.<ul> <li>Content Type Journal Article</li><li>Category Online Exclusive Article</li><li>Pages E108-E118</li><li>DOI 10.1188/13.ONF.E108-E118</li><li>Authors<ul> <li>Hyun-E Yeom, PhD, RN, Department of Nursing in the College of Medicine, Dongguk University, Gyeongbuk, South Korea</li><li>Susan M. Heidrich, PhD, RN, School of Nursing, University of Wisconsin-Madison</li> </ul></li> </ul><ul class="parents"> <ul class="details"> <li>Journal <a href="http://ons.metapress.com/content/120390/">Oncology Nursing Forum</a></li><li>Online ISSN 1538-0688</li><li>Print ISSN 0190-535X</li> </ul><ul class="details"> <li>Journal Volume Volume 40</li> </ul><ul class="details"> <li>Journal Issue <a href="http://ons.metapress.com/content/np5882q4019k/">Volume 40, Number 3 / May 2013</a></li> </ul> </ul>
Frailty in Older Breast Cancer Survivors: Age, Prevalence, and Associated Factors
Purpose/Objectives: To describe frailty and associated factors in breast cancer survivors (BCSs) and evaluate whether BCSs are frail at an earlier age than female participants from in two large epidemiological studies.Design: Descriptive, cross-sectional.Setting: School of Nursing at Oregon Health and Science University.Sample: 216 BCSs aged 53-87 years who were a mean 5-7 years post-treatment and not currently participating in exercise.Methods: Performance tests, clinical measures, and self-reported questionnaires provided baseline data on five criteria for frailty.Main Research Variables: Frailty was defined as meeting three of the five criteria of the frailty phenotype: shrinking, exhaustion, low activity, slowness, and weakness. Data were compared to published data from women in the Cardiovascular Health Study (CHS) and Women's Health and Aging Study (WHAS).Findings: Eighteen percent of BCSs aged 70-79 years were frail compared to 11% of women of the same age in the CHS and WHAS. Frailty was more common at a younger age in BCSs, and more BCSs were frail in all age groups compared to women in the CHS study until about age 80 years, when prevalence of frailty was similar in the two groups. Fifty percent of BCSs were classified as prefrail because they met one or two of the five frailty criteria. Higher body mass index increased the odds of frailty, and higher physical activity decreased the odds of frailty (odds ratio [OR] = 1.12, p = 0.003, and OR = 0.99, p = 0.000, respectively).Conclusions: Frailty and prefrailty may be common in BCSs and may occur at an earlier age than in adults without a history of breast cancer.Implications for Nursing: Nurses should be alert to prefrailty or frailty at a younger age in BCSs. Awareness and early intervention may delay or prevent frailty.Knowledge Translation: BCSs may be frail even when they are not yet considered older adults. Prefrailty in BCSs is important to recognize because it suggests impending frailty that could lead to reduced physical functioning or poor health. Prefrailty and frailty could be assessed in BCSs aged 50 years and older in a clinical setting using a few questions about weight, fatigue, and activity levels, in addition to simple tests of walking speed and grip strength, if warranted.<ul> <li>Content Type Journal Article</li><li>Category Online Exclusive Article</li><li>Pages E126-E134</li><li>DOI 10.1188/13.ONF.E126-E134</li><li>Authors<ul> <li>Jill A. Bennett, PhD, RN, School of Nursing, Oregon Health and Science University, Portland</li><li>Kerri M. Winters-Stone, PhD, School of Nursing, Oregon Health and Science University, Portland</li><li>Jessica Dobek, MS, School of Nursing, Oregon Health and Science University, Portland</li><li>Lillian M. Nail, PhD, RN, FAAN, School of Nursing, Oregon Health and Science University, Portland</li> </ul></li> </ul><ul class="parents"> <ul class="details"> <li>Journal <a href="http://ons.metapress.com/content/120390/">Oncology Nursing Forum</a></li><li>Online ISSN 1538-0688</li><li>Print ISSN 0190-535X</li> </ul><ul class="details"> <li>Journal Volume Volume 40</li> </ul><ul class="details"> <li>Journal Issue <a href="http://ons.metapress.com/content/np5882q4019k/">Volume 40, Number 3 / May 2013</a></li> </ul> </ul>
Pre- and Postoperative Self-Reported Cognitive Effectiveness and Worry in Patients With Suspected Lung Malignancy

Purpose/Objectives: To examine perceived cognitive effectiveness and worry in individuals with suspected lung cancer before and after surgical resection and to determine any differences between individuals with and without a postoperative diagnosis of lung cancer.

Design: A repeated measures longitudinal design.

Setting: A comprehensive cancer center and a Veterans Administration medical center in the midwestern United States.

Sample: 15 men and 8 women aged 37-82 years (X = 61.4, SD = 10.7) with suspected lung cancer.

Methods: Descriptive statistics were used to characterize data. Paired t tests and nonparametric correlation analysis were used to determine relationships among the main study variables.

Main Research Variables: Perceived effectiveness in cognitive function as well as general and cancer-specific worry.

Findings: Patients diagnosed with lung cancer were significantly older. Patients self-reported lowered perceived effectiveness in daily activities that require directed attention both pre- and postoperatively. Patients with nonmalignant postoperative reports had higher general worry at each time point, which was significant following surgery.

Conclusions: A diagnosis of suspected lung cancer may contribute to compromised perceived effectiveness in cognitive function. Nonmalignant pathology following a diagnosis of suspected lung cancer may be associated with continued worry.

Implications for Nursing: Nursing assessment and interventions aimed at supporting effective cognitive function and modifying worry for patients with suspected lung cancer are essential to optimize adjustment.

Knowledge Translation: Suspected lung cancer imposes high demands on cognitive and emotional function. Oncology nurses are in key positions to support patients during and following the diagnostic workup for lung cancer. Younger patients with nonmalignant postoperative reports may need continued follow-up.
- Content Type Journal Article
- Category Online Exclusive Article
- Pages E135-E141
- DOI 10.1188/13.ONF.E135-E141
- Authors
  - Rebecca H. Lehto, PhD, RN, OCN�, College of Nursing, Michigan State University in East Lansing
Breast Cancer Education for the Deaf Community in American Sign Language
Purpose/Objectives: To create and evaluate an educational video designed to increase breast cancer-related knowledge and screening behaviors among women who are deaf and use American Sign Language (ASL) as their preferred communication method.Design: A test-retest survey was used to determine retained knowledge following an intervention with an ASL breast cancer education video.Setting: Deaf-friendly community settings in southern California.Sample: 122 women who were deaf with a preference for communicating via ASL.Methods: Participants completed a knowledge survey to determine their breast cancer screening practices and baseline breast cancer awareness. Participants then viewed a 30-minute video in ASL. Immediately after viewing the video, participants completed an identical knowledge survey. The survey was administered again two months after the initial intervention to determine long-term breast cancer knowledge retention.Main Research Variables: Age, breast cancer knowledge and screening practices, education, and health insurance.Findings: At baseline, breast cancer knowledge varied widely and respondents' answered an average of 3 out of 10 questions correctly. Postintervention, respondents answered an average of 8 out of 10 questions correctly, a significant increase from the baseline scores. At the two-month follow-up, respondents answered an average of 6 out of 10 questions correctly, still a significant increase from the baseline scores.Conclusions: Breast cancer knowledge of women who are deaf increased significantly by viewing an educational video in ASL and most of the new knowledge remained at the two-month follow-up.Implications for Nursing: Nurses can help improve the Deaf community's (DC's) access to breast cancer-related information by disseminating awareness of this online program.Knowledge Translation: With this online resource, nurses can more easily initiate discussions to help improve knowledge and screening behaviors in a linguistically and culturally appropriate manner. Improving the DC's access to breast cancer information is of paramount importance to reducing breast cancer morbidity and mortality in the DC.<ul> <li>Content Type Journal Article</li><li>Category Online Exclusive Article</li><li>Pages E86-E91</li><li>DOI 10.1188/13.ONF.E86-E91</li><li>Authors<ul> <li>Sean Hickey, MD, Department of Surgery in the School of Medicine, University of California, San Diego</li><li>Erin L. Merz, MA, Joint Doctoral Program of Clinical Psychology in the Department of Psychology, San Diego State University</li><li>Vanessa L. Malcarne, PhD, Department of Psychology, SDSU</li><li>Darlene Clark Gunsauls, MS, Department Chair of Deaf Culture and American Sign Language, American River College, Sacramento, CA</li><li>Jessica Huang, PharmD, Ally Pharmacy Solutions, San Francisco, CA</li><li>Georgia Robins Sadler, BSN, MBA, PhD, Moores Cancer Center at UCSD</li> </ul></li> </ul><ul class="parents"> <ul class="details"> <li>Journal <a href="http://ons.metapress.com/content/120390/">Oncology Nursing Forum</a></li><li>Online ISSN 1538-0688</li><li>Print ISSN 0190-535X</li> </ul><ul class="details"> <li>Journal Volume Volume 40</li> </ul><ul class="details"> <li>Journal Issue <a href="http://ons.metapress.com/content/np5882q4019k/">Volume 40, Number 3 / May 2013</a></li> </ul> </ul>
Telling the Tales of Young Adult Survivors

Have you ever noticed how sometimes things just work out perfectly? I love it when that happens… I am hard at work on another book for Hygeia Media, the consumer imprint of the Oncology Nursing Society, and the book focuses on young adults with cancer. Although many memoirs are available that describe personal experiences with cancer, few take an evidence-based approach to the advice provided for the reader.
- Content Type Journal Article
- Category Editorial
- Pages 203-203
- DOI 10.1188/13.ONF.203
- Authors
  - Anne Katz, RN, PhD, Department of Psychosocial Oncology, CancerCare Manitoba, Winnipeg, Manitoba, Canada
Trajectory of Medication-Induced Constipation in Patients With Cancer
Purpose/Objectives: To determine the severity and trajectory of constipation among patients with cancer from opioids and/or vinca alkaloids.Design: Exploratory, descriptive.Setting: Moffitt Cancer Center, a National Cancer Institute-designated comprehensive cancer center in Tampa, FL.Sample: 400 patients at risk for developing medication-induced constipation from opioids, vinca alkaloids, or both.Methods: Patients' baseline data included the Constipation Assessment Scale (CAS), the constipation item from the Memorial Symptom Assessment Scale (MSAS) for intensity and distress, and the laxative interview. Following the interview, the medical chart was reviewed for clinical and demographic data. Patients were asked about constipation (CAS) and laxatives consumed (laxative interview) during eight weekly telephone calls.Main Research Variables: Constipation presence, intensity, and distress.Findings: At baseline, 63% of patients reported some level of constipation. During the eight weeks, constipation fluctuated with scores ranging from 0-16, with the opioid-only group showing a small but statistically significant decrease in intensity. Constipation intensity and distress on the MSAS were significantly correlated (r = 0.76; p = 0.000).Conclusions: The majority of the sample reported constipation that ranged from mild to severe, persisted over time, and caused symptom distress. Therefore, healthcare providers in the cancer center likely were neither adequately managing the medication-induced constipation nor apparently teaching patients to manage it themselves.Implications for Nursing: National Comprehensive Cancer Network guidelines support the importance of managing medication-induced constipation. However, guidelines are not being followed in many cases; therefore, more focus is needed on constipation in clinical and educational settings as well as more research.Knowledge Translation: Patients receiving opioids and vinca alkaloids are at risk of constipation. Currently, medication-induced constipation is poorly managed. Managing constipation may lessen symptom distress, thereby improving quality of life in these patients.<ul> <li>Content Type Journal Article</li><li>Category Online Exclusive Article</li><li>Pages E92-E100</li><li>DOI 10.1188/13.ONF.E92-E100</li><li>Authors<ul> <li>Susan C. McMillan, PhD, ARNP, FAAN, Oncology Nursing, College of Nursing, University of South Florida in Tampa</li><li>Cindy Tofthagen, PhD, ARNP, College of Nursing, University of South Florida in Tampa</li><li>Brent Small, PhD, School of Aging Studies, University of South Florida in Tampa</li><li>Sloan Karver, MD, Palliative Care Consultant, Tampa, FL</li><li>David Craig, PharmD, Moffitt Cancer Center and Research Institute, Tampa, FL</li> </ul></li> </ul><ul class="parents"> <ul class="details"> <li>Journal <a href="http://ons.metapress.com/content/120390/">Oncology Nursing Forum</a></li><li>Online ISSN 1538-0688</li><li>Print ISSN 0190-535X</li> </ul><ul class="details"> <li>Journal Volume Volume 40</li> </ul><ul class="details"> <li>Journal Issue <a href="http://ons.metapress.com/content/np5882q4019k/">Volume 40, Number 3 / May 2013</a></li> </ul> </ul>
2013 Oncology Nursing Society Annual Congress: Research Abstracts
Abstracts appear as they were submitted and have not undergone editing or the Oncology Nursing Forum's review process. If any errors or omissions have been made, please accept our apologies. Abstracts that are not being presented do not appear.Abstracts are marked as poster (ps) or podium (pd) sessions throughout.<ul> <li>Content Type Journal Article</li><li>Category Online Exclusive Article</li><li>Pages E279-E302</li><li>DOI 10.1188/13.ONF.E279-E302</li> </ul><ul class="parents"> <ul class="details"> <li>Journal <a href="http://ons.metapress.com/content/120390/">Oncology Nursing Forum</a></li><li>Online ISSN 1538-0688</li><li>Print ISSN 0190-535X</li> </ul><ul class="details"> <li>Journal Volume Volume 40</li> </ul><ul class="details"> <li>Journal Issue <a href="http://ons.metapress.com/content/np5882q4019k/">Volume 40, Number 3 / May 2013</a></li> </ul> </ul>
2013 Oncology Nursing Society Annual Congress: Administration/Leadership Development Abstracts
Abstracts appear as they were submitted and have not undergone editing or the Oncology Nursing Forum's review process. If any errors or omissions have been made, please accept our apologies. Abstracts that are not being presented do not appear.<ul> <li>Content Type Journal Article</li><li>Category Online Exclusive Article</li><li>Pages E142-E172</li><li>DOI 10.1188/13.ONF.E142-E172</li> </ul><ul class="parents"> <ul class="details"> <li>Journal <a href="http://ons.metapress.com/content/120390/">Oncology Nursing Forum</a></li><li>Online ISSN 1538-0688</li><li>Print ISSN 0190-535X</li> </ul><ul class="details"> <li>Journal Volume Volume 40</li> </ul><ul class="details"> <li>Journal Issue <a href="http://ons.metapress.com/content/np5882q4019k/">Volume 40, Number 3 / May 2013</a></li> </ul> </ul>
Historical Perspective on the Progress of Chemotherapy-Induced Nausea and Vomiting Treatment in Oncology Nursing Forum
Oncology Nursing Forum (ONF) published an article in its early newsletter format in 1977 entitled "Variables Affecting Nausea and Vomiting" (Mayer Scogna, 1977). That literature review provided an excellent analysis of the state of the art in the management of chemotherapy-induced nausea and vomiting (CINV) at that time. Healthcare providers knew that the vomiting center, chemoreceptor trigger zone (CTZ), and vagal afferents in the gastrointestinal (GI) tract were intimately involved in CINV and that multiple and varied chemoreceptors existed in the CTZ. Unfortunately, interventions lagged compared to the knowledge of the pathophysiology of the CINV process. Only 13 studies on the effectiveness of available antiemetics were published from 1964 to 1977, and no new agents had been developed since the 1950s (Mayer Scogna, 1977). That study investigated whether extrinsic factors, subjective attitude about effectiveness of chemotherapy, hours of sleep prior to treatment, activity level, or food intake affected CINV and found that they did not. Mayer Scogna (1977) recognized anticipatory nausea and vomiting, referring to this as a conditioned psychological component, and noted the lack of reliable tools to objectively measure nausea and vomiting.<ul> <li>Content Type Journal Article</li><li>Category In the Stacks</li><li>Pages 205-207</li><li>DOI 10.1188/13.ONF.205-207</li><li>Authors<ul> <li>Anne Marie C. Flaherty, MSN, RN, APNc, John Theurer Cancer Center, Hackensack University Medical Center, New Jersey</li> </ul></li> </ul><ul class="parents"> <ul class="details"> <li>Journal <a href="http://ons.metapress.com/content/120390/">Oncology Nursing Forum</a></li><li>Online ISSN 1538-0688</li><li>Print ISSN 0190-535X</li> </ul><ul class="details"> <li>Journal Volume Volume 40</li> </ul><ul class="details"> <li>Journal Issue <a href="http://ons.metapress.com/content/np5882q4019k/">Volume 40, Number 3 / May 2013</a></li> </ul> </ul>
Beyond Evidence-Based Practice—Achieving Fundamental Changes in Research and Practice

Since the early 2000s, significant discussion about evidence-based practice (EBP) has occurred in the healthcare arena and early steps have been taken toward it; however, searching the EBP literature can be overwhelming. A MEDLINE� (EBSCO) search for evidence-based practice yielded interesting results. When limited to 1999 or prior, 635 articles were identified starting at 1987, and when limited to 2000-2013, 11,511 articles were identified, an 18-fold increase. The concept of EBP has been readily adopted in the healthcare community. However, the questions that remain are: So what? Who cares? Has this avalanche of new information truly changed practice or just added more layers to practice and workloads? Where do we go next? The focus of the current article is to present current initiatives directed toward integrating research and clinical knowledge through interdisciplinary and transdisciplinary processes.
- Content Type Journal Article
- Category Leadership & Professional Development
- Pages 208-210
- DOI 10.1188/13.ONF.208-210
- Authors
  - Judith A. Schreiber, RN, PhD, School of Nursing, University of Louisville in Kentucky
Nursing Management of Patients With Metastatic Melanoma Receiving Ipilimumab

A 46-year-old Caucasian male named N.M. was diagnosed in March 2002 with melanoma of the trunk. The melanoma was resected and a left axillary sentinel lymph node biopsy was negative for malignant cells. Three years later, melanoma recurred to the left axillary lymph nodes, which were subsequently dissected. No adjuvant therapy was administered. In November 2007, a computed tomography (CT) scan showed multiple lesions (2-6 cm) in the abdomen wall, peritoneum, and small bowel, and a mass of 10 cm in the left axillary region. N.M. was enrolled into a phase III trial and received 850 mg/m2 dacarbazine plus 10 mg/kg ipilimumab at weeks 1, 4, 7, and 10, followed by dacarbazine alone every three weeks through week 22.
- Content Type Journal Article
- Category Clinical Challenges
- Pages 215-218
- DOI 10.1188/13.ONF.215-218
- Authors
  - Jane Bryce, MSN, AOCNS�, Clinical Trials Unit, National Cancer Institute, Naples, Italy
  - Claudia Passoni, RN, Melanoma and Muscle-Cutaneous Sarcoma Division, European Institute of Oncology, Milan, Italy
Large Genomic Rearrangements in BRCA1 and BRCA2: Implications for Patient Care

Hereditary breast cancer is responsible for about 5%-10% of all breast cancer cases and is frequently associated with the inheritance of a germline mutation in one of two genes, BRCA1 (chromosome 17) or BRCA2 (chromosome 13). Inheritance of a mutation in one of these genes confers a high cumulative risk of breast (90% lifetime risk) or ovarian (44% lifetime risk) cancer (Daly et al., 2013). To date, BRCA1 and BRCA2 genetic testing only is available through one company, Myriad Genetics Laboratories (MGL), as a result of patent issues surrounding these two genes. In 1996, MGL introduced Comprehensive BRACAnalysis�, which included the sequencing of BRCA1 and BRCA2 . Because of technological advancement, MGL added a five-site rearrangement panel to Comprehensive BRACAnalysis in 2002 to detect five recurring large genomic rearrangements (LGR) in BRCA1 . Additional technological advances led to the addition in 2006 of the BRACAnalysis Large Rearrangement Test (BART) as a separate but full LGR test for BRCA1 and BRCA2 . The Comprehensive BRACAnalysis and BART tests were ordered as two distinct tests. In October 2012, Medicare approved BART as a reimbursable test, provided specific guidelines were met, based on the 2013 National Comprehensive Cancer Network guideline (Daly et al., 2013) recommending LGR testing for all patients undergoing testing for BRCA1 and BRCA2 . Beginning in January 2013, MGL began incorporating BART testing into routine BRCA1 and BRCA2 testing, now termed Integrated BRACAnalysis (MGL, 2012).
- Content Type Journal Article
- Category Genetics & Genomics
- Pages 220-222
- DOI 10.1188/13.ONF.220-222
- Authors
  - Suzanne M. Mahon, RN, DNSc, AOCN�, APNG, School of Nursing, Saint Louis University, Missouri
Update on … Environmental Carcinogens

An observational study was conducted in response to public concern regarding the release of both known and suspected environmental carcinogens following the terrorist attacks of September 11, 2001, at the World Trade Center (WTC) in New York, NY, and the potential increase of cancer incidence among exposed individuals. The study subjects were New York state residents enrolled in the WTC Health Registry from 2003-2004 (N = 55,778). The cohort was divided as rescue and recovery workers (n = 21,850) and those not involved in rescue and recovery (n = 33,928). All were followed through December 31, 2008. Standardized incidence ratios (SIRs) made adjustments for age, race and ethnicity, and gender; were computed with 2003-2008 New York state rates as reference; and focused on diagnosed cancers in 2007-2008 as most likely related to exposure during September 11, 2001, and the aftermath. The total and site-specific incidence rate differences per 100,000 person-years between the study population and the New York state population in 2007-2008 also were calculated.
- Content Type Journal Article
- Category Oncology Update
- Pages 295-296
- DOI 10.1188/13.ONF.295-296
- Authors
  - Susan Weiss Behrend, RN, MSN, AOCN�, Department of Nursing, Fox Chase Cancer Center, Philadelphia, PA
Knowledge Central

At first read, the purpose of this book seemed to be a timeline from diagnosis to death of David Hallman's partner, Bill Conklin. From August 7-23 of 2009, the reader is led thro-ugh the daily ups and downs of Bill and David's journey with cancer. The grief experienced by David is palpable, and the acceptance and peaceful attitude of Bill is comforting. Although this book would appeal to all audiences, the general medical population would benefit, including hospice and palliative care professionals as well as any oncology specialty.
- Content Type Journal Article
- Category Knowledge Central
- Pages 293-294
- DOI 10.1188/13.ONF.293-294
- Authors
  - Patricia Ringos Beach, MSN, RN, AOCN�, ACHPN, Mercy Cancer Center, Toledo, OH
An Integrative Review of Nursing Research on Active Surveillance in an Older Adult Prostate Cancer Population

Problem Identification: To summarize the current state of nursing knowledge regarding the management of older adult men with prostate cancer with active surveillance as the treatment strategy.

Literature Search: Publications of nursing research from January 2003 to March 2012 addressing patients with prostate cancer undergoing an active surveillance treatment management strategy.

Data Evaluation and Analysis: A paradigm shift in the recommendation to consider active surveillance is apparent in the literature. Since 2003, active surveillance has become a more frequent recommendation as the management approach for low-risk, small-volume prostate cancers. Current nursing literature provides data on decision making and the uncertainty associated with active surveillance; however, minimal information is available that specifically addresses the needs of the aging adult population with prostate cancer. In addition, the trajectory of adaptation has only been preliminarily identified within the body of nursing knowledge; the actions that promote or obstruct successful adaptation to active surveillance as a treatment approach require in-depth study.

Presentation of Findings: Active surveillance has relevance for the aging population while providing a potential means to judiciously allocate medical resources and expenses within the healthcare delivery system. The nurse researcher, in partnership with the advanced practice nurse, should proactively address the multifaceted needs of this patient population.

Implications for Nursing Practice: Active surveillance, as a program of cooperative, intentional, and prescribed monitoring of prostate cancer with a clearly defined strategy for management, is ideally suited for nursing research into the adaptation, educational needs, and management of chronic disease processes of older adult men while advancing the educator and provider roles of the advanced practice nurse.

Knowledge Translation: Active surveillance is an appropriate treatment option in older men with low-risk, low-volume prostate cancer. However, this treatment also is a source of uncertainty. Targeted, ongoing nursing education about active surveillance as treatment must address this uncertainty in this patient population so patients are comfortable with planned monitoring.
- Content Type Journal Article
- Category Advanced Print Exclusive Article
- Pages A1-A9
- DOI 10.1188/13.ONF.40-04AP
- Authors
  - Lydia Madsen, MSN, RN, AOCNS�, Department of Genitourinary Medical Oncology, University of Texas MD Anderson Cancer Center, Houston
  - Lene Symes, PhD, RN, College of Nursing, Texas Woman's University, Houston
Do Older Adults With Cancer Fall More Often' A Comparative Analysis of Falls in Those With and Without Cancer
Purpose/Objectives: To examine whether a history of cancer increased the likelihood of a fall in community-dwelling older adults, and if cancer type, stage, or time since diagnosis increased falls.Design: A longitudinal, retrospective, cohort study.Setting: A home- and community-based waiver program in Michigan.Sample: 862 older adults aged 65 years or older with cancer compared to 8,617 older adults without cancer using data from the Minimum Data Set-Home Care and Michigan cancer registry.Methods: Reports of falls were examined for 90-180 days. Generalized estimating equations were used to compare differences between the groups.Main Research Variables: Cancer, falls, patient characteristics, comorbidities, medications, pain, weight loss, vision, memory recall, and activities, as well as cancer type, stage, and time since diagnosis.Findings: A fall occurred at a rate of 33% in older adults with cancer compared to 29% without cancer (p < 0.00). Those with a history of cancer were more likely to fall than those without cancer (adjusted odds ratio 1.16; 95% confidence interval [1.02, 1.33]; p = 0.03). No differences in fall rates were determined by cancer type or stage, and the odds of a fall did not increase when adding time since cancer diagnosis.Conclusions: The fall rate was higher in older adults with cancer than in older adults without cancer.Implications for Nursing: Nurses need to assess fall risk and initiate fall prevention measures for older adults at the time of cancer diagnosis.Knowledge Translation: When caring for older adults with cancer, nurses should be aware of an increased risk for falls. Healthcare staff also should be aware of an increased risk for falls in that population during cancer treatment. Evidence-based fall prevention measures should be included in care plans for older adult cancer survivors.<ul> <li>Content Type Journal Article</li><li>Category Online Exclusive Article</li><li>Pages E69-E78</li><li>DOI 10.1188/13.ONF.E69-E78</li><li>Authors<ul> <li>Sandra L. Spoelstra, PhD, RN, College of Nursing, Michigan State University in East Lansing</li><li>Barbara A. Given, PhD, RN, FAAN, College of Nursing, Michigan State University in East Lansing</li><li>Debra L. Schutte, PhD, RN, College of Nursing, Michigan State University in East Lansing</li><li>Alla Sikorskii, PhD, Department of Statistics and Probability, Michigan State University in East Lansing</li><li>Mei You, MS, College of Nursing, Michigan State University in East Lansing</li><li>Charles W. Given, PhD, Department of Family Medicine, Michigan State University in East Lansing</li> </ul></li> </ul><ul class="parents"> <ul class="details"> <li>Journal <a href="http://ons.metapress.com/content/120390/">Oncology Nursing Forum</a></li><li>Online ISSN 1538-0688</li><li>Print ISSN 0190-535X</li> </ul><ul class="details"> <li>Journal Volume Volume 40</li> </ul><ul class="details"> <li>Journal Issue <a href="http://ons.metapress.com/content/w02114u0427x/">Volume 40, Number 2 / March 2013</a></li> </ul> </ul>
Evaluation of a Compassion Fatigue Resiliency Program for Oncology Nurses
Purpose/Objectives: To evaluate a resiliency program designed to educate oncology nurses about compassion fatigue.Design: Descriptive pilot study.Setting: A National Cancer Institute-designated comprehensive cancer center in the midwestern United States.Sample: 13 oncology nurses employed in an outpatient infusion center.Methods: Nurses attended a five-week program involving five 90-minute sessions on compassion fatigue resiliency. A pre- and post-test design, using repeated measures, was conducted over six months.Main Research Variables: Scores on the Professional Quality of Life (ProQOL) IV, Maslach Burnout Inventory-Human Services Survey, Impact of Event Scale-Revised (IES-R), and the Nursing Job Satisfaction Scale.Findings: Long-term benefits were realized from the program. Secondary traumatization scores on the ProQOL IV declined immediately after the program, remained down at three months, and then dropped again at six months, with a statistically significant mean difference compared with baseline. The average IES-R total scores improved significantly overall and for each of the three postintervention time points. Participants evaluated the program positively with respect to their ability to apply and benefit from resiliency techniques.Conclusions: This is the first reported study to show benefits gained from a compassion fatigue intervention program. Participants received useful strategies for managing stress at work and home.Implications for Nursing: Compassion fatigue is a prevalent condition among healthcare providers. Development of resiliency to compassion fatigue may improve decision making, clarity of communication, and patient and nurse satisfaction.Knowledge Translation: Self-regulation offers an approach to reduce stress during a perceived threat. Working by intention reduces reactivity in the workplace and makes communication more intentional and, therefore, effective.<ul> <li>Content Type Journal Article</li><li>Category Article</li><li>Pages 180-187</li><li>DOI 10.1188/13.ONF.180-187</li><li>Authors<ul> <li>Patricia Potter, RN, PhD, FAAN, Patient Care Services, Barnes-Jewish Hospital</li><li>Teresa Deshields, PhD, Siteman Counseling Service, Barnes-Jewish Hospital</li><li>Julia Allen Berger, DMin, BCC, Palliative Care Team, Oncology Services, and Spiritual Care Services, Barnes-Jewish Hospital</li><li>Marty Clarke, PA-C, PhD, Department of Psychiatry in the School of Medicine, Washington University</li><li>Sarah Olsen, RN, BS, Barnes-Jewish Hospital</li><li>Ling Chen, MSPH, PhD, Department of Biostatistics in the School of Medicine, Washington University, St. Louis, MO</li> </ul></li> </ul><ul class="parents"> <ul class="details"> <li>Journal <a href="http://ons.metapress.com/content/120390/">Oncology Nursing Forum</a></li><li>Online ISSN 1538-0688</li><li>Print ISSN 0190-535X</li> </ul><ul class="details"> <li>Journal Volume Volume 40</li> </ul><ul class="details"> <li>Journal Issue <a href="http://ons.metapress.com/content/w02114u0427x/">Volume 40, Number 2 / March 2013</a></li> </ul> </ul>
Stress Reactivity, Health Behaviors, and Compliance to Medical Care in Breast Cancer Survivors
Purpose/Objectives: To explore relationships among quality of life (QOL), stress reactivity, health behaviors, and compliance to medical care in breast cancer survivors.Design: One-time descriptive laboratory study.Setting: A visual motor laboratory at a rural university in the southeastern United States.Sample: 25 breast cancer survivors.Methods: Participants were subjected to the Trier Social Stress Test (TSST) in a laboratory setting and completed questionnaires at home prior to and after the laboratory session.Main Research Variables: Changes in heart rate variability (HRV), salivary cortisol, and state anxiety from the State-Trait Anxiety Inventory (STAI) estimated stress reactivity. Health behaviors, QOL, and trait anxiety were determined by questionnaires. Compliance to medical care was determined from medical records.Findings: Analyses of variance (ANOVAs) indicated that QOL scores were higher for participants with lower compared to higher stress reactivity (p < 0.05). In addition, ANOVAs revealed that participants high in compliance to medical care indicated a lower stress response as determined by HRV (p < 0.01) and the STAI (p < 0.05) compared to those low in compliance. No significant differences were noted in any of the health behaviors based on stress reactivity.Conclusions: The data suggest that breast cancer survivors who indicate the greatest stress reactivity tend to have the poorest compliance to medical care and lowest QOL.Implications for Nursing: Nurses may wish to provide additional support to breast cancer survivors who indicate high stress reactivity in the hopes of improving compliance to medical care and QOL.Knowledge Translation: The data suggest that supportive care strategies that reduce stress could potentially improve compliance to medical care in breast cancer survivors. In addition, strategies for managing stress may result in improvements in QOL. Health behaviors, according to the data, do not seem to be influenced by stress reactivity.<ul> <li>Content Type Journal Article</li><li>Category Article</li><li>Pages 149-156</li><li>DOI 10.1188/13.ONF.149-156</li><li>Authors<ul> <li>Kristina H. Karvinen, PhD, School of Physical and Health Education, Nipissing University in North Bay, Ontario, Canada</li><li>Nicholas P. Murray, PhD, Department of Kinesiology, East Carolina University, Greenville, NC</li><li>Hyder Arastu, MD, Department of Radiation Oncology, Brody School of Medicine, East Carolina University, Greenville, NC</li><li>Ron R. Allison, MD, 21st Century Oncology, Greenville, NC</li> </ul></li> </ul><ul class="parents"> <ul class="details"> <li>Journal <a href="http://ons.metapress.com/content/120390/">Oncology Nursing Forum</a></li><li>Online ISSN 1538-0688</li><li>Print ISSN 0190-535X</li> </ul><ul class="details"> <li>Journal Volume Volume 40</li> </ul><ul class="details"> <li>Journal Issue <a href="http://ons.metapress.com/content/w02114u0427x/">Volume 40, Number 2 / March 2013</a></li> </ul> </ul>
Demographic and Disease Characteristics Associated With Non-Hodgkin Lymphoma Survivors' Quality of Life: Does Age Matter'

Purpose/Objectives: To examine demographic and disease characteristics by age and the moderating effect of age on quality of life (QOL) among non-Hodgkin lymphoma (NHL) survivors.

Design: A cross-sectional, secondary analysis study of NHL survivors.

Setting: Two North Carolina cancer registries.

Sample: 741 NHL survivors with a mean age of 62 years and a mean time since diagnosis of 10 years.

Methods: Mailed surveys were sent to individuals treated for NHL. All analyses were conducted using SPSS�, version 18.0. Multiple regression was used to analyze relationships among demographic and disease characteristics, age, and QOL.

Main Research Variables: Demographic, disease, and clinical characteristics on QOL.

Findings: In relation to QOL, income and gender were moderated by age; for example, younger survivors who earned less than $30,000 annually had a poorer QOL. Women reported a higher QOL than men.

Conclusions: Age was a moderator for income and an indicator for how income could affect care of younger survivors. Men reported a lower QOL than women and gender-specific resources may be helpful to them.

Implications for Nursing: Nursing research should focus on age-sensitive resources targeted for younger NHL survivors.

Knowledge Translation: Age is an important characteristic that impacts overall health-related QOL. Oncology nurses are instrumental in identifying patients at all ages who could benefit from age-specific resources.
- Content Type Journal Article
- Category Article
- Pages 157-162
- DOI 10.1188/13.ONF.157-162
- Authors
  - Ashley Leak, PhD, RN-BC, OCN�, Department of Health Policy and Management, School of Nursing, University of North Carolina at Chapel Hill
  - Sophia K. Smith, PhD, MSW, Duke Cancer Institute, Duke University, Durham, NC
  - Jamie Crandell, PhD, School of Nursing and Department of Biostatistics, University of North Carolina
  - Coretta Jenerette, PhD, RN, AOCN�, School of Nursing, University of North Carolina
  - Donald E. Bailey, PhD, RN, FAAN, School of Nursing at Duke University
  - Sheryl Zimmerman, PhD, School of Social Work, University of North Carolina
  - Deborah K. Mayer, PhD, RN, AOCN�, FAAN, School of Nursing, University of North Carolina
Sleep Characteristics of Family Caregivers of Individuals With a Primary Malignant Brain Tumor

Purpose/Objectives: To describe the sleep characteristics of family caregivers of individuals with a primary malignant brain tumor (PMBT).

Design: Cross-sectional, correlational design using baseline data from a longitudinal study.

Setting: Neuro-oncology and neurosurgery clinics at an urban tertiary medical center in the United States.

Sample: 133 family caregivers recruited one to two months following diagnosis of family member's PMBT.

Methods: Subjective and objective measures of sleep were obtained via self-report and the use of accelerometers (three nights).

Main Research Variables: Sleep characteristics including sleep latency, total sleep time, wake after sleep onset, number of naps, number of arousals, sleep-wake cycle, and sleep quality.

Findings: Sleep latency in caregivers was, on average, 35 minutes (SD = 34.5)—more than twice as long as the norm of 15 minutes (t[113]) = 6.18, p < 0.01). Caregivers averaged a total sleep time of 5 hours and 57 minutes (SD = 84.6), significantly less than the recommended 7 hours (t[113] = -8, p < 0.01), and were awake in the night 15% of the time, significantly more than the norm of 10% (t[111] = 5.84, p < 0.01). Caregivers aroused an average of 8.3 times during nocturnal sleep (SD = 3.5, range = 2-21), with about 32% reporting poor or very poor sleep quality.

Conclusions: Caregivers experienced sleep impairments that placed them at risk for poor mental and physical health, and may compromise their ability to continue in the caregiving role.

Implications for Nursing: Nurses need to assess sleep in caregivers of individuals with PMBT and implement interventions to improve sleep.

Knowledge Translation: Sleep deprivation is common in family caregivers during the early stages of care for individuals with a PMBT. A single-item sleep quality question could be an easy but valuable tool in assessing sleep disturbances in family caregivers of individuals with a PMBT. The health trajectory of family caregivers warrants further longitudinal study, in addition to the examination of the bidirectional relationship of health status of care recipients and their family caregiver.
- Content Type Journal Article
- Category Journal Club/Open Access
- Pages 171-179
- DOI 10.1188/13.ONF.171-179
- Authors
 - Jean D. Pawl, PhD, RN, OCN�, School of Nursing, Georgia Regents University in Augusta
 - Shih-Yu Lee, RNC, PhD, School of Nursing, Georgia State University in Atlanta
 - Patricia C. Clark, PhD, RN, FAHA, FAAN, School of Nursing, Georgia State University in Atlanta
 - Paula R. Sherwood, RN, PhD, CNRN, FAAN, School of Nursing, University of Pittsburgh in Pennsylvania
2013 Updated American Society of Clinical Oncology/Oncology Nursing Society Chemotherapy Administration Safety Standards Including Standards for the Safe Administration and Management of Oral Chemotherapy

In 2009, the American Society of Clinical Oncology (ASCO) and the Oncology Nursing Society (ONS) published standards for the safe use of parenteral chemotherapy in the outpatient setting, including issues of practitioner orders, preparation, and administration of medication. In 2011, these were updated to include inpatient facilities. In December 2011, a multistakeholder workgroup met to address the issues associated with orally administered antineoplastics, under the leadership of ASCO and ONS. The workgroup participants developed recommended standards, which were presented for public comment. Public comments informed final edits, and the final standards were reviewed and approved by the ASCO and ONS Boards of Directors. Significant newly identified recommendations include those associated with drug prescription and the necessity of ascertaining that prescriptions are filled. In addition, the importance of patient and family education regarding administration schedules, exception procedures, disposal of unused oral medication, and aspects of continuity of care across settings were identified. This article presents the newly developed standards.
- Content Type Journal Article
- Category Advanced Print Exclusive Article
- Pages 1-9
- DOI 10.1188/13.ONF.40-03AP2
- Authors
  - Michael N. Neuss, MD, Vanderbilt Ingram Cancer Center, Nashville TN
  - Martha Polovich, PhD, RN, AOCN�, Duke Oncology Network, Durham, NC
  - Kristen McNiff, MPH, University of Michigan Comprehensive Cancer Center, Ann Arbor MI
  - Peg Esper, MSN, RN, ANP-BC, AOCN�, American Society of Clinical Oncology, Alexandria, VA
  - Terry R. Gilmore, RN, American Society of Clinical Oncology, Alexandria, VA
  - Kristine B. LeFebvre, MSN, RN, AOCN�, Oncology Nursing Society, Pittsburgh, PA
  - Lisa Schulmeister, MN, APRN-BC, OCN�, FAAN, Oncology Nursing Consultant, New Orleans, LA
  - Joseph O. Jacobson, MD, MSc, Dana-Farber Cancer Institute, Boston, MA
The Relationship Between Learned Resourcefulness and Cancer-Related Fatigue in Patients With Non-Hodgkin Lymphoma
Purpose/Objectives: To investigate the effect of learned resourcefulness on fatigue symptoms in patients with non-Hodgkin lymphoma (NHL) receiving chemotherapy.Design: Quasi-experimental with repeated measures.Setting: Two large hospitals in Israel.Sample: 46 patients with NHL.Methods: On the first day of a cycle of chemotherapy treatment, participants completed questionnaires assessing fatigue and learned resourcefulness. Fatigue was assessed again after 10 and 21 days.Main Research Variables: Cancer-related fatigue, learned resourcefulness.Findings: Fatigue increased 10 days following chemotherapy treatment and returned to pretreatment levels at day 21. Learned resourcefulness correlated negatively with each of the three measurements of fatigue. In addition, a calculated partial correlation showed the specific effect of learned resourcefulness on chemotherapy-related fatigue.Conclusions: The findings showed a negative correlation between a physiologic variable (fatigue) and a psychological variable (learned resourcefulness), which is related to individual coping ability.Implications for Nursing: Nurses should receive education about learned resourcefulness to potentially help patients with cancer cope with chemotherapy-related fatigue.Knowledge Translation: As learned resourcefulness was negatively correlated with chemotherapy-related fatigue in patients with NHL, having this personality trait may help those patients manage fatigue.<ul> <li>Content Type Journal Article</li><li>Category Article</li><li>Pages 133-138</li><li>DOI 10.1188/13.ONF.133-138</li><li>Authors<ul> <li>Neveen Menshadi, RN, MA, Dina Academic School of Nursing, Rabin Medical Center, Clalit HMO, Petach Tikva</li><li>Yoram Bar-Tal, PhD, Nursing Department, Tel-Aviv University, Israel</li><li>Sivia Barnoy, RN, PhD, Nursing Department, Tel-Aviv University, Israel</li> </ul></li> </ul><ul class="parents"> <ul class="details"> <li>Journal <a href="http://ons.metapress.com/content/120390/">Oncology Nursing Forum</a></li><li>Online ISSN 1538-0688</li><li>Print ISSN 0190-535X</li> </ul><ul class="details"> <li>Journal Volume Volume 40</li> </ul><ul class="details"> <li>Journal Issue <a href="http://ons.metapress.com/content/w02114u0427x/">Volume 40, Number 2 / March 2013</a></li> </ul> </ul>
Development and Validation of a Chemotherapy-Induced Taste Alteration Scale
Purpose/Objectives: To develop an instrument to assess the specific symptoms of chemotherapy-induced taste alterations.Design: Cross-sectional study.Setting: Two outpatient chemotherapy centers in Kanto, Japan.Sample: Convenience sample of 214 adult patients with chemotherapy-induced taste alterations.Methods: Items on the chemotherapy-induced taste alteration scale (CiTAS) were developed by a qualitative study of patients with taste alterations, and the content validity of each item was assessed by a panel of specialized oncology nurses. Data were analyzed for item consistency using Cronbach alpha and construct validity using factor analysis.Main Research Variables: Taste alterations, symptoms of discomfort, and impact of taste alterations on daily life.Findings: An 18-item scale was developed with four dimensions identified through factor analysis: decline in basic taste, discomfort, phantogeusia and parageusia, and general taste alterations. The scale demonstrated excellent reliability (Cronbach alpha = 0.9) and test-retest reliability (r = 0.94, p < 0.001, n = 28), as well as good validity, which was indicated by its strong correlation with a visual analog scale of the impact of taste alterations on daily life (r = 0.62, p < 0.001) and by negative correlations with Short Form-8 quality-of-life measures (physical component summary, r = -0.33; mental component summary, r = -0.47).Conclusions: The CiTAS enabled valid, reliable measurement of specific symptoms of chemotherapy-induced taste alterations.Implications for Nursing: The CiTAS has potential as a clinical tool and also could be used as a measure of chemotherapy-induced taste alterations in future studies.Knowledge Translation: The CiTAS may help evaluate the effectiveness of interventions to reduce the symptoms of taste alterations, such as administering zinc and self-care strategies.<ul> <li>Content Type Journal Article</li><li>Category Online Exclusive Article</li><li>Pages E79-E85</li><li>DOI 10.1188/13.ONF.E79-E85</li><li>Authors<ul> <li>Taro Kano, RN, MSN, Department of Nursing, Gunma Prefectural College of Health Sciences, Japan</li><li>Kiyoko Kanda, RN, PhD, Department of Nursing in the Graduate School of Health Sciences, Gunma University, Japan</li> </ul></li> </ul><ul class="parents"> <ul class="details"> <li>Journal <a href="http://ons.metapress.com/content/120390/">Oncology Nursing Forum</a></li><li>Online ISSN 1538-0688</li><li>Print ISSN 0190-535X</li> </ul><ul class="details"> <li>Journal Volume Volume 40</li> </ul><ul class="details"> <li>Journal Issue <a href="http://ons.metapress.com/content/w02114u0427x/">Volume 40, Number 2 / March 2013</a></li> </ul> </ul>
Couples and Cancer
During the past decade, as a sexuality counselor at a large regional cancer center, I have heard many emotions expressed during counseling sessions. I have witnessed the vulnerability of men as those whose physical size suggests strength and power crumble in the face of the fallout from cancer. I have seen physically fragile women draw from a well of strength and overcome functional impairment that would bring many of us to our knees. I have observed, with no small degree of amazement, couples young and old overcome significant odds to grow closer and stronger despite the toll that cancer and its treatment take on them. I have learned what intimacy truly means-not as a euphemism for sexual activity, but the heart-to-heart connection between two people who have seen the worst of themselves and yet, in the eyes of the other, only kindness and love reflected back.<ul> <li>Content Type Journal Article</li><li>Category Editorial</li><li>Pages 105-105</li><li>DOI 10.1188/13.ONF.105</li><li>Authors<ul> <li>Anne Katz, RN, PhD, Faculty of Nursing, University of Manitoba</li> </ul></li> </ul><ul class="parents"> <ul class="details"> <li>Journal <a href="http://ons.metapress.com/content/120390/">Oncology Nursing Forum</a></li><li>Online ISSN 1538-0688</li><li>Print ISSN 0190-535X</li> </ul><ul class="details"> <li>Journal Volume Volume 40</li> </ul><ul class="details"> <li>Journal Issue <a href="http://ons.metapress.com/content/w02114u0427x/">Volume 40, Number 2 / March 2013</a></li> </ul> </ul>
The Relationships Among Coping Strategies, Religious Coping, and Spirituality in African American Women With Breast Cancer Receiving Chemotherapy

Purpose/Objectives: To (a) examine coping capacity, psychological distress, spiritual well-being, positive and negative religious coping, and coping strategies among African American (AA) women with breast cancer, and (b) explore relationships among these variables to enhance an already tested comprehensive coping strategy program (CCSP) intervention for AA women with breast cancer (CCSP-AA).

Design: Descriptive-correlational.

Setting: Comprehensive cancer center in Maryland.

Sample: 17 AA women with breast cancer.

Methods: Women completed the Hospital Anxiety and Depression Scale, Sense of Coherence scale, Functional Assessment of Chronic Illness Therapy-Spiritual Well-Being, Brief Religious Coping Inventory, and Coping Strategies Questionnaire.

Main Research Variables: Psychological distress, coping capacity, coping strategies, religious coping, and spiritual well-being.

Findings: A higher coping capacity was beneficial, as it was related to less psychological distress, negative religious coping, and catastrophizing. Women using less negative religious coping had greater spiritual well-being and less distress. Using more coping self-statements was associated with higher spiritual well-being and less negative religious coping. Catastrophizing had a negative effect on psychological distress and spiritual well-being.

Conclusions: The development of a CCSP-AA that incorporates aspects of spirituality and components in a coping intervention needs to be tested in a clinical trial. The intervention will teach patients to recognize and restructure their thinking to avoid catastrophizing and negative religious coping.

Implications for Nursing: Nurses need to work collaboratively with AA women to reinforce beneficial coping patterns and approaches. A tailored CCSP-AA for women with breast cancer administered by a nurse can be taught to assist AA patients in coping more effectively.

Knowledge Translation: AA women with breast cancer use more positive religious coping and experience less distress and greater spiritual well-being, but catastrophizing has a negative effect on spiritual well-being. Nurses need to reinforce positive coping patterns for AA women with cancer.
- Content Type Journal Article
- Category Article
- Pages 120-131
- DOI 10.1188/13.ONF.120-131
- Authors
  - Fannie Gaston-Johansson, PhD, RN, FAAN, School of Nursing, Johns Hopkins University, Baltimore, MD
  - Mary Ellen Haisfield-Wolfe, PhD, RN, OCN�, School of Nursing, University of Maryland, Baltimore
  - Bobbie Reddick, PhD, RN, School of Nursing, Winston-Salem State University, North Carolina
  - Nancy Goldstein, RN, DNP, School of Nursing, Johns Hopkins University
  - Tokunbor A. Lawal, RN, MS, School of Nursing, Johns Hopkins University
The Beneficial Effect of ST-36 (Zusanli) Acupressure on Postoperative Gastrointestinal Function in Patients With Colorectal Cancer
Purpose/Objectives: To evaluate the effectiveness of ST-36 (Zusanli) acupressure on recovery of postoperative gastrointestinal function in patients with colorectal cancer.Design: A longitudinal, randomized, controlled trial design.Setting: An urban medical center in Taiwan.Sample: 60 patients with colorectal cancer who had undergone abdominal surgery.Methods: Patients were randomly assigned to two groups, the ST-36 acupressure group (n = 30) and a sham acupressure group (n = 30). Patients in the ST-36 group received an acupressure procedure in a three-minute cycle performed three times per day during the five days after surgery. Patients in the control group received routine postoperative care and sham acupressure. Generalized estimating equations (GEEs) were used to gauge longitudinal effects of the two groups of patients.Main Research Variables: Frequency of bowel sounds, the time to first flatus passage, first liquid intake, solid intake, and defecation.Findings: Patients who received acupressure had significantly earlier flatus passage and time to liquid intake as compared to patients in the control group. Other main variables, including the first time to solid intake and defecation, did not show significant difference between the two groups. The GEE method revealed that all patients had increasing bowel sounds over time, and the experimental group had greater improvement of bowel motility than the control group within the period of 2-3 days postoperatively.Conclusions: ST-36 acupressure was able to shorten the time to first flatus passage, oral liquid intake, and improve gastrointestinal function in patients after abdominal surgery.Implications for Nursing: ST-36 acupressure can be integrated into postoperative adjunct nursing care to assist patients' postoperative gastrointestinal function.Knowledge Translation: Few studies have explored the effectiveness of acupressure techniques on promoting bowel sounds. Evidence from this study suggests stimulation of the ST-36 acupressure point can increase bowel sound frequency for patients with colorectal cancer in the first three days after surgery. Application of this technique may improve a patient's comfort after surgery.<ul> <li>Content Type Journal Article</li><li>Category Online Exclusive Article</li><li>Pages E61-E68</li><li>DOI 10.1188/13.ONF.E61-E68</li><li>Authors<ul> <li>Hui-Lin Chao, RN, MSN, Department of Nursing, Cathay General Hospital, Taipei, Taiwan</li><li>Shang-Jun Miao, RN, Department of Nursing, Cathay General Hospital, Taipei, Taiwan</li><li>Pei-Fen Liu, MS, Department of Nursing, Cathay General Hospital, Taipei, Taiwan</li><li>Henry Hsin-Chung Lee, MD, Department of Surgery, Cathay General Hospital, Taipei, Taiwan</li><li>Ying-Miao Chen, RN, Department of Nursing, Cathay General Hospital, Taipei, Taiwan</li><li>Chung-Tay Yao, MD, Department of Surgery, Cathay General Hospital, Taipei, Taiwan</li><li>Hsiu-Ling Chou, RN, PhD, Department of Nursing, Far Eastern Memorial Hospital and Oriental Institute of Technology, New Taipei City, Taiwan</li> </ul></li> </ul><ul class="parents"> <ul class="details"> <li>Journal <a href="http://ons.metapress.com/content/120390/">Oncology Nursing Forum</a></li><li>Online ISSN 1538-0688</li><li>Print ISSN 0190-535X</li> </ul><ul class="details"> <li>Journal Volume Volume 40</li> </ul><ul class="details"> <li>Journal Issue <a href="http://ons.metapress.com/content/w02114u0427x/">Volume 40, Number 2 / March 2013</a></li> </ul> </ul>
We've Come a Long Way: A Review of Cancer Pain Management
Some readers will be transported back to when they were new oncology nurses and practice standards now considered outdated were cutting edge. Others will be amazed that our current understanding is vastly different than what was then known. Current knowledge and research trajectories exist because of the dedication and hard work of colleagues who pioneered the specialty of oncology nursing 40 years ago.<ul> <li>Content Type Journal Article</li><li>Category In the Stacks</li><li>Pages 106-108</li><li>DOI 10.1188/13.ONF.106-108</li><li>Authors<ul> <li>Judy A. Schreiber, RN, PhD, School of Nursing, University of Louisville in Kentucky</li> </ul></li> </ul><ul class="parents"> <ul class="details"> <li>Journal <a href="http://ons.metapress.com/content/120390/">Oncology Nursing Forum</a></li><li>Online ISSN 1538-0688</li><li>Print ISSN 0190-535X</li> </ul><ul class="details"> <li>Journal Volume Volume 40</li> </ul><ul class="details"> <li>Journal Issue <a href="http://ons.metapress.com/content/w02114u0427x/">Volume 40, Number 2 / March 2013</a></li> </ul> </ul>
Succession Planning in Oncology Nursing: A Professional Must-Have

The average age of the active nursing force in the United States is approaching 50 years (U.S. Department of Health and Human Services, 2010). Nurses are retiring at a rapid rate; 55% of respondents to one survey indicated a plan to retire in the next seven years (Sverdlik, 2012). Of the survey participants, 13% held an administrative or management position and 44% were aged 55 years or older (Sverdlik, 2012). The age demographic of active oncology nurses mirrors that of the national nursing force. Of the 33,323 active members of the Oncology Nursing Society who indicated an age range on their membership application, 15,735 (47%) self-identified as aged 50 years or older (see Figure 1). At a time when many are planning for retirement, their respective employers are scrambling to fill open positions. With no clear vision or plan in place, many healthcare organizations will struggle to meet the ongoing needs of communities they serve. The challenge is to develop programs that identify, develop, motivate, and transition younger nurses to available positions.
- Content Type Journal Article
- Category Leadership & Professional Development
- Pages 114-115
- DOI 10.1188/13.ONF.114-115
- Authors
  - Cindy J. Rishel, PhD, RN, OCN�, Medical Center, University of Arizona in Tucson
Ginger as an Antiemetic Modality for Chemotherapy-Induced Nausea and Vomiting: A Systematic Review and Meta-Analysis

Purpose/Objectives: To evaluate the effect of ginger as an antiemetic modality for the control of chemotherapy-induced nausea and vomiting (CINV).

Data Sources: Databases searched included MEDLINE� (PubMed), Embase, CINAHL�, Cochrane Central Register of Controlled Trials, Korean Studies Information Service System, Research Information Sharing Service by the Korean Education and Research Information Service, and Dissertation Central.

Data Synthesis: A systematic review was conducted of five randomized, controlled trials involving 872 patients with cancer. Ginger was compared with placebo or metoclopramide. The participant characteristics, chemotherapy regimen and antiemetic control, ginger preparation and protocol, measurements, results of the studies, adherence to the treatment protocol, and side effects were reviewed systematically. The incidence and severity of acute and delayed CINV were subject to meta-analysis. The incidence of acute nausea (p = 0.67), incidence of acute vomiting (p = 0.37), and severity of acute nausea (p = 0.12) did not differ significantly between the ginger and control groups.

Conclusions: Current evidence does not support the use of ginger for the control of CINV. Ginger did not contribute to control of the incidence of acute nausea and vomiting or of the severity of acute nausea.

Implications for Nursing: Ginger has long been regarded as a traditional antiemetic modality, but its effectiveness remains to be established. The findings of this study could be incorporated into clinical guidelines, such as the Oncology Nursing Society's Putting Evidence Into Practice resources. Current evidence supports the need for more methodologically rigorous studies in this area.

Knowledge Translation: Although ginger is known as a traditional antiemetic, current evidence does not support the effect of ginger in CINV control. The findings of this study inform healthcare providers that its effectiveness remains to be established from methodologically rigorous future trials.
- Content Type Journal Article
- Category Article
- Pages 163-170
- DOI 10.1188/13.ONF.163-170
- Authors
  - Jiyeon Lee, RN, PhD, ACNP-BC, College of Nursing, Eulji University, Daejeon, Korea
  - Heeyoung Oh, RN, PhD, College of Nursing, Eulji University, Daejeon, Korea
Communication and Information Needs of Women Diagnosed With Ovarian Cancer Regarding Treatment-Focused Genetic Testing
Purpose/Objectives: To identify women's information and communication preferences about treatment-focused genetic testing (TFGT) in the ovarian cancer context.Research Approach: A qualitative interview study.Setting: Two familial cancer services and a gynecologic oncology clinic at a major teaching hospital in Australia.Participants: 22 women diagnosed with ovarian cancer who had either advanced disease and had previously undergone TFGT (n = 12) or had been diagnosed in the previous 6-20 weeks with ovarian cancer and had not undergone TFGT (n = 10).Methodologic Approach: Participants were interviewed individually about actual and hypothetical views of TFGT. The interviews were transcribed and organized into themes using qualitative analysis software.Findings: Most women wanted to be informed about TFGT prior to their surgery for ovarian cancer. The majority preferred to receive the information verbally; slightly more women preferred their medical oncologist to deliver the information compared to a genetic specialist or oncology nurse. Women preferred the focus of pretest information to be on them and their treatment.Conclusions: Women diagnosed with ovarian cancer want information about genetic testing early with focus placed on the potential benefits of genetic testing on treatment.Interpretation: The findings of this study provide much-needed guidance to oncology nurses and other oncology healthcare professionals about when, what, and how information about TFGT should be delivered to patients diagnosed with ovarian cancer. Supportive patient education materials now need to be developed to assist these women to make informed decisions about genetic testing.Knowledge Translation: Knowing that women do want TFGT, how they want it presented and by whom, and the content and level of detail that women want means that TFGT can now be presented as an option to women newly diagnosed with ovarian cancer, which may influence firstline treatment. The findings also provide the knowledge required to prepare education tools to assist oncology nurses involved in frontline care.<ul> <li>Content Type Journal Article</li><li>Category Advanced Print Exclusive Article</li><li>Pages A1-A9</li><li>DOI 10.1188/13.ONF.40-03AP</li><li>Authors<ul> <li>Margaret Gleeson, BNurs, PDipGenCoun, Department of Medical Oncology, Prince of Wales Hospital in Sydney</li><li>Bettina Meiser, PhD, Department of Medical Oncology at Prince of Wales Hospital, University of New South Wales in Sydney</li><li>Kristine Barlow-Stewart, PhD, Genetic Counselling Program, University of Sydney</li><li>Alison H. Trainer, PhD, Peter MacCallum Cancer Centre, Melbourne, Victoria</li><li>Kathy Tucker, MBBS, FRACP, Hereditary Cancer Clinic, Prince of Wales Hospital</li><li>Kaaren J. Watts, PhD, Psychosocial Research Group, University of New South Wales</li><li>Michael Friedlander, PhD, Department of Medical Oncology and at the Prince of Wales Clinical School, Faculty of Medicine, University of New South Wales</li><li>Nadine Kasparian, PhD, School of Women's and Children's Health, University of New South Wales, Australia</li> </ul></li> </ul><ul class="parents"> <ul class="details"> <li>Journal <a href="http://ons.metapress.com/content/120390/">Oncology Nursing Forum</a></li><li>Online ISSN 1538-0688</li><li>Print ISSN 0190-535X</li> </ul> </ul>
Cannabinoids May Be Therapeutic in Breast Cancer

Cannabinoids are a group of compounds synthesized exclusively by the Cannabis sativa plant, commonly known as marijuana. In 1990, the first cannabinoid-specific membrane (CB1) was characterized and cloned (Matsuda, Lolait, Brownstein, Young, & Bonner, 1990), which catapulted biomedical research on these unique compounds. Cannabinoids refer to both marijuana-derived compounds with the active ingredient of 9-tetrahydrocannabinol (THC) and also the synthetic molecules that activate the same primary targets as THC. Therapeutic properties of marijuana have been well established; however, the clinical use of either plant-sourced or pure cannabinoids remains limited. The anticachexia properties of cannabinoids are found in tetrahydrocannabinol (oral capsules of synthetically generated THC) and are used to manage weight loss, wasting syndrome, and nausea and vomiting associated with cancer treatment.
- Content Type Journal Article
- Category Oncology Update
- Pages 191-192
- DOI 10.1188/13.ONF.191-192
- Authors
  - Susan Weiss Behrend, RN, MSN, AOCN�, Department of Nursing, Fox Chase Cancer Center, Philadelphia, PA
Knowledge Central

Every healthcare provider caring for men with prostate cancer should share this comprehensive resource with their patients and families. This book is the first about prostate cancer written specifically for the partner. As described in the book, prostate cancer is a couple's disease; therefore, partners should understand the disease to lessen their own level of distress and best support the man with cancer. The book is easy to read and discusses prostate cancer in plain language.
- Content Type Journal Article
- Category Knowledge Central
- Pages 189-190
- DOI 10.1188/13.ONF.189-190
- Authors
  - Patricia Ringos Beach, MSN, RN, AOCN�, ACHPN, Oncology Nursing Forum
Management of Pancreatic Exocrine Insufficiency
A 56-year-old obese Caucasian woman named M.B. reported experiencing anorexia and early satiety in the prior two months. She has lost 10 pounds in two weeks. No changes had been made to her type 2 diabetes medications, she took no other medications, and her exercise habits were unchanged. M.B. made an appointment with her primary care physician (PCP) and her physical examination was inconclusive. The complete blood count and chemistry panel were normal; however, a computed tomography scan of the abdomen showed a 3 cm abnormality in her pancreas with a question of involvement of her superior mesenteric artery. Her PCP suggested that she see a gastroenterologist for an endoscopy.<ul> <li>Content Type Journal Article</li><li>Category Clinical Challenges</li><li>Pages 116-119</li><li>DOI 10.1188/13.ONF.116-119</li><li>Authors<ul> <li>Jeanne Ann Braddick, MS, RD, CSO, John Theurer Cancer Center, Hackensack University Medical Center in New Jersey</li><li>Anne Marie C. Flaherty, MSN, RN, APNc, John Theurer Cancer Center, Hackensack University Medical Center in New Jersey</li> </ul></li> </ul><ul class="parents"> <ul class="details"> <li>Journal <a href="http://ons.metapress.com/content/120390/">Oncology Nursing Forum</a></li><li>Online ISSN 1538-0688</li><li>Print ISSN 0190-535X</li> </ul><ul class="details"> <li>Journal Volume Volume 40</li> </ul><ul class="details"> <li>Journal Issue <a href="http://ons.metapress.com/content/w02114u0427x/">Volume 40, Number 2 / March 2013</a></li> </ul> </ul>
2013 Oncology Nursing Society Annual Congress: Administration/Leadership Development Abstracts
Abstracts appear as they were submitted and have not undergone editing or the Oncology Nursing Forum's review process. If any errors or omissions have been made, please accept our apologies. Abstracts that are not being presented do not appear.<ul> <li>Content Type Journal Article</li><li>Category Online Exclusive Article</li><li>Pages E142-E172</li><li>DOI 10.1188/13.ONF.E142-E172</li> </ul><ul class="parents"> <ul class="details"> <li>Journal <a href="http://ons.metapress.com/content/120390/">Oncology Nursing Forum</a></li><li>Online ISSN 1538-0688</li><li>Print ISSN 0190-535X</li> </ul><ul class="details"> <li>Journal Volume Volume 40</li> </ul><ul class="details"> <li>Journal Issue <a href="http://ons.metapress.com/content/np5882q4019k/">Volume 40, Number 3 / May 2013</a></li> </ul> </ul>
Contributing Factors to Colorectal Cancer and Hepatitis B Screening Among Vietnamese Americans

Purpose/Objectives: To identify factors associated with screening for colorectal cancer (CRC) and hepatitis B, because hepatitis B can increase the risk of liver cancer.

Data Sources: MEDLINE�, CINAHL�, and PsycINFO databases from January 1998 to April 2012.

Data Synthesis: The 23 reviewed studies included 15 descriptive, 2 intervention, 3 qualitative, 2 chart or medical record review, and 1 mixed method. Most studies used an investigator-developed instrument with no reported reliability. Inconsistent operational definitions for contributing factors to screening made it challenging to make comparisons.

Conclusions: CRC and hepatitis B screening are consistently low among Vietnamese Americans. Contributing factors included sociodemographics, knowledge, cultural beliefs, and external factors. External factors such as having a regular place of care and a healthcare provider were crucial because they influenced adherence to screening recommendations. Use of a public media education plus healthcare provider model and a culturally tailored intervention using Vietnamese lay advisors appeared to be promising for improving CRC screening. Additional intervention studies are needed to increase screening.

Implications for Nursing: Vietnamese is a fast-growing subgroup within the Asian American Pacific Islander (AAPI) group that may require targeted approaches to screening for disease. Future studies should focus on immigrants or those who were born in the United States (men and women) as disaggregated subgroups. Such research can inform culturally sensitive and appropriate interventions that may improve cancer screening rates.

Knowledge Translation: Although Vietnamese is the fourth largest racial-ethnic subgroup within the AAPI group, the literature about contributing factors to CRC and hepatitis B screening is limited among this subgroup. CRC and hepatitis B screening are consistently low among Vietnamese Americans. Use of public media education plus a healthcare provider model and a culturally tailored intervention using Vietnamese lay advisors appears promising for improving CRC screening.
- Content Type Journal Article
- Category Article
- Pages 238-251
- DOI 10.1188/13.ONF.238-251
- Authors
  - Connie K. Y. Nguyen-Truong, PhD, RN, PCCN, School of Nursing, Oregon Health and Science University, Portland
  - Frances Lee-Lin, PhD, RN, OCN�, CNS, School of Nursing, Oregon Health and Science University, Portland
  - Vivian Gedaly-Duff, DNSc, RN, School of Nursing, Oregon Health and Science University, Portland
2013 Oncology Nursing Society Annual Congress: Research Abstracts
Abstracts appear as they were submitted and have not undergone editing or the Oncology Nursing Forum's review process. If any errors or omissions have been made, please accept our apologies. Abstracts that are not being presented do not appear.Abstracts are marked as poster (ps) or podium (pd) sessions throughout.<ul> <li>Content Type Journal Article</li><li>Category Online Exclusive Article</li><li>Pages E279-E302</li><li>DOI 10.1188/13.ONF.E279-E302</li> </ul><ul class="parents"> <ul class="details"> <li>Journal <a href="http://ons.metapress.com/content/120390/">Oncology Nursing Forum</a></li><li>Online ISSN 1538-0688</li><li>Print ISSN 0190-535X</li> </ul><ul class="details"> <li>Journal Volume Volume 40</li> </ul><ul class="details"> <li>Journal Issue <a href="http://ons.metapress.com/content/np5882q4019k/">Volume 40, Number 3 / May 2013</a></li> </ul> </ul>
Contributing Factors to Colorectal Cancer and Hepatitis B Screening Among Vietnamese Americans

Purpose/Objectives: To identify factors associated with screening for colorectal cancer (CRC) and hepatitis B, because hepatitis B can increase the risk of liver cancer.

Data Sources: MEDLINE�, CINAHL�, and PsycINFO databases from January 1998 to April 2012.

Data Synthesis: The 23 reviewed studies included 15 descriptive, 2 intervention, 3 qualitative, 2 chart or medical record review, and 1 mixed method. Most studies used an investigator-developed instrument with no reported reliability. Inconsistent operational definitions for contributing factors to screening made it challenging to make comparisons.

Conclusions: CRC and hepatitis B screening are consistently low among Vietnamese Americans. Contributing factors included sociodemographics, knowledge, cultural beliefs, and external factors. External factors such as having a regular place of care and a healthcare provider were crucial because they influenced adherence to screening recommendations. Use of a public media education plus healthcare provider model and a culturally tailored intervention using Vietnamese lay advisors appeared to be promising for improving CRC screening. Additional intervention studies are needed to increase screening.

Implications for Nursing: Vietnamese is a fast-growing subgroup within the Asian American Pacific Islander (AAPI) group that may require targeted approaches to screening for disease. Future studies should focus on immigrants or those who were born in the United States (men and women) as disaggregated subgroups. Such research can inform culturally sensitive and appropriate interventions that may improve cancer screening rates.

Knowledge Translation: Although Vietnamese is the fourth largest racial-ethnic subgroup within the AAPI group, the literature about contributing factors to CRC and hepatitis B screening is limited among this subgroup. CRC and hepatitis B screening are consistently low among Vietnamese Americans. Use of public media education plus a healthcare provider model and a culturally tailored intervention using Vietnamese lay advisors appears promising for improving CRC screening.
- Content Type Journal Article
- Category Article
- Pages 238-251
- DOI 10.1188/13.ONF.238-251
- Authors
  - Connie K. Y. Nguyen-Truong, PhD, RN, PCCN, School of Nursing, Oregon Health and Science University, Portland
  - Frances Lee-Lin, PhD, RN, OCN�, CNS, School of Nursing, Oregon Health and Science University, Portland
  - Vivian Gedaly-Duff, DNSc, RN, School of Nursing, Oregon Health and Science University, Portland
2013 Oncology Nursing Society Annual Congress: Clinical/Evidence-Based Practice Abstracts
Abstracts appear as they were submitted and have not undergone editing or the Oncology Nursing Forum's review process. If any errors or omissions have been made, please accept our apologies. Abstracts that are not being presented do not appear.<ul> <li>Content Type Journal Article</li><li>Category Online Exclusive Article</li><li>Pages E173-E234</li><li>DOI 10.1188/13.ONF.E173-E234</li> </ul><ul class="parents"> <ul class="details"> <li>Journal <a href="http://ons.metapress.com/content/120390/">Oncology Nursing Forum</a></li><li>Online ISSN 1538-0688</li><li>Print ISSN 0190-535X</li> </ul><ul class="details"> <li>Journal Volume Volume 40</li> </ul><ul class="details"> <li>Journal Issue <a href="http://ons.metapress.com/content/np5882q4019k/">Volume 40, Number 3 / May 2013</a></li> </ul> </ul>
2013 Oncology Nursing Society Annual Congress: Education Abstracts
Abstracts appear as they were submitted and have not undergone editing or the Oncology Nursing Forum's review process. If any errors or omissions have been made, please accept our apologies. Abstracts that are not being presented do not appear.<ul> <li>Content Type Journal Article</li><li>Category Online Exclusive Article</li><li>Pages E235-E278</li><li>DOI 10.1188/13.ONF.E235-E278</li> </ul><ul class="parents"> <ul class="details"> <li>Journal <a href="http://ons.metapress.com/content/120390/">Oncology Nursing Forum</a></li><li>Online ISSN 1538-0688</li><li>Print ISSN 0190-535X</li> </ul><ul class="details"> <li>Journal Volume Volume 40</li> </ul><ul class="details"> <li>Journal Issue <a href="http://ons.metapress.com/content/np5882q4019k/">Volume 40, Number 3 / May 2013</a></li> </ul> </ul>
Contributing Factors to Colorectal Cancer and Hepatitis B Screening Among Vietnamese Americans

Purpose/Objectives: To identify factors associated with screening for colorectal cancer (CRC) and hepatitis B, because hepatitis B can increase the risk of liver cancer.

Data Sources: MEDLINE�, CINAHL�, and PsycINFO databases from January 1998 to April 2012.

Data Synthesis: The 23 reviewed studies included 15 descriptive, 2 intervention, 3 qualitative, 2 chart or medical record review, and 1 mixed method. Most studies used an investigator-developed instrument with no reported reliability. Inconsistent operational definitions for contributing factors to screening made it challenging to make comparisons.

Conclusions: CRC and hepatitis B screening are consistently low among Vietnamese Americans. Contributing factors included sociodemographics, knowledge, cultural beliefs, and external factors. External factors such as having a regular place of care and a healthcare provider were crucial because they influenced adherence to screening recommendations. Use of a public media education plus healthcare provider model and a culturally tailored intervention using Vietnamese lay advisors appeared to be promising for improving CRC screening. Additional intervention studies are needed to increase screening.

Implications for Nursing: Vietnamese is a fast-growing subgroup within the Asian American Pacific Islander (AAPI) group that may require targeted approaches to screening for disease. Future studies should focus on immigrants or those who were born in the United States (men and women) as disaggregated subgroups. Such research can inform culturally sensitive and appropriate interventions that may improve cancer screening rates.

Knowledge Translation: Although Vietnamese is the fourth largest racial-ethnic subgroup within the AAPI group, the literature about contributing factors to CRC and hepatitis B screening is limited among this subgroup. CRC and hepatitis B screening are consistently low among Vietnamese Americans. Use of public media education plus a healthcare provider model and a culturally tailored intervention using Vietnamese lay advisors appears promising for improving CRC screening.
- Content Type Journal Article
- Category Article
- Pages 238-251
- DOI 10.1188/13.ONF.238-251
- Authors
  - Connie K. Y. Nguyen-Truong, PhD, RN, PCCN, School of Nursing, Oregon Health and Science University, Portland
  - Frances Lee-Lin, PhD, RN, OCN�, CNS, School of Nursing, Oregon Health and Science University, Portland
  - Vivian Gedaly-Duff, DNSc, RN, School of Nursing, Oregon Health and Science University, Portland