Reclaiming Self-Balancing on a Tightrope Across Time a grounded theory of transition to survivorship in older adult blood cancer survivors.

AIM: To develop a theoretical understanding of the transition to survivorship in older adult blood cancer survivors. DESIGN: Qualitative research employing Classic Glaserian Grounded Theory methods. METHODS: Purposive and theoretical sampling recruited 17 participants via Leukaemia & Lymphoma Society© Community webpages (65-83 years) from across the US and Canada. Data from individual semi-structured interviews using HIPPA-compliant Zoom© were analysed from September 2020 to March 2021. RESULTS: Participants' main concern was losing their sense of self and reclaiming self was the core category. The substantive theory of Reclaiming Self-Balancing on a Tightrope Across Time is a six-phase transition process to survivorship: receiving a blood cancer diagnosis, finding bearings, reclaiming self, persevering through, realizing a transition and living in a new reality. CONCLUSIONS: The transition to survivorship in older adult blood cancer survivors is a complex process because of age and disease type. IMPLICATIONS: Age-related aspects of one's sense of self and its relation to health, well-being and quality of life, as older adult blood cancer survivors advance into older age need further research. Ageism and its impact on cancer survivorship care in older adults should also be explored. IMPACT: What problem did the study address?: Existing theoretical frameworks do not explain the complex process of transition to survivorship for older adult blood cancer survivors. What were the main findings?: A substantive theory Reclaiming Self-Balancing on a Tightrope Across Time is a six-phase transition process from cancer diagnosis to survivorship characterized by an uncertain and liminal nature. Where and on whom will the research have an impact?: Understanding how older adults experience the transition to survivorship can inform age-appropriate person-centered nursing practices and healthcare policies specific to their needs. REPORTING METHOD: COREQ. PATIENT OR PUBLIC CONTRIBUTION: No patient or public contribution.

Physical activity interventions for cancer-related fatigue: A scoping review of randomized controlled trials from a Nursing Science Precision Health Model perspective.

BACKGROUND: The Nursing Science Precision Health (NSPH) Model has the potential to guide research on the development, testing, and targeting of interventions. PURPOSE: This scoping review examines the relationship between physical activity (PA) and cancer-related fatigue (CRF) within the context of the NSPH Model. METHODS: The Joanna Briggs Institute scoping review methodology and Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews guided this review. We included randomized controlled trials in people with cancer that investigated PA interventions and measured change in CRF as an outcome. DISCUSSION: A total of 181 studies met the eligibility criteria. Over 20 different instruments were used to measure CRF. The most common PA interventions were strength training (48%), walking (36%), cycling (26%), and yoga (15%). A limited number of studies reported phenotypic characteristics (32/181, 17%) or biomarkers (31/181, 17%) associated with CRF. CONCLUSION: This scoping review identified the body of existing research exploring CRF and PA from a precision health perspective.

Keeping the Nurse in the Nurse Practitioner: Returning to Our Disciplinary Roots of Knowing in Nursing.

Nurse practitioners are a vital and growing body of primary healthcare providers. The ever-changing advancements in science and technology and the increasing complexities in health care delivery are significant factors culminating in the expanding role of nurse practitioner-led care. Nurse educators are striving to develop nurse practitioner curricula to keep pace with the increasingly sophisticated knowledge and competencies nurse practitioners must possess to render safe quality care as independent primary health care providers. However, nursing theory is losing its place as a formative foundation in nurse practitioner curricula. Multiple factors such as content-laden, competency-based, medically focused education have caused a diminishing presence of nursing theory, shrinking the philosophical basis for nursing in nurse practitioner education. The loss of the central unifying focus of the discipline and discipline-specific knowledge (nursology) risks losing the very identity that forms the basis and relevance for nurse practitioner practice. Moreover, the loss of the nurse in the nurse practitioner unmoors nurse practitioner practice from its theoretical and scientific basis, losing discipline-specific attributes that lead to higher levels of patient satisfaction and improved patient outcomes. Keeping the nurse in the nurse practitioner is a moral imperative in nurses' ethical and social contract with society. This article discusses relevant literature and offers recommendations to keep the nurse in the nurse practitioner.

Prevention of Infection: A Systematic Review of Evidence-Based Practice Interventions for Management in Patients With Cancer

BACKGROUND: Cancer-related infections lead to increases in mortality, antibiotic use, and hospital stays. Other adverse outcomes include dose delays and reductions, which can result in suboptimal treatment outcomes. OBJECTIVES: Effective implementation of risk assessment and evidence-based interventions for the prevention and treatment of infection are essential to improve care and reduce costs related to infections in patients with cancer receiving immunosuppressive therapy. METHODS: The Oncology Nursing Society (ONS) Putting Evidence Into Practice (PEP) prevention of infection resource have been developed and updated to identify and disseminate the best available scientific evidence. FINDINGS: Pharmacologic and nonpharmacologic interventions were evaluated, resulting in recommended for practice rating for catheter care bundles, antimicrobial prophylaxis, vaccination for specific populations, and implementation of contact precautions for resistant organisms.

Transition to Cancer Survivorship: A Concept Analysis.

Transition to cancer survivorship is frequent lexicon denoting the posttreatment phase of cancer treatment. The concept of being in transition to survivorship is not well defined. To critically analyze this concept, data sources (n = 63) (from 1985 to 2016) from nursing, sociology, medicine, and psychology were evaluated employing Rodgers evolutionary method. Transition to cancer survivorship is a turning point with a variable time period one passes through after treatment. It is an individualized experience with degrees of liminality, changes, and challenging consequences. Understanding this concept helps identify patient needs for targeted nursing interventions that can bridge safe passage to cancer survivorship.

Implementation of national comprehensive cancer network evidence-based guidelines to prevent and treat cancer-related infections.

Clinical practice guidelines are an important result of evidence-based research. However, current clinical practice remains out of step with the rapid pace of research advancements. Often, decades pass before research is translated into clinical practice. The National Comprehensive Cancer Network (NCCN) has created evidence-based clinical guidelines to promote effective clinical practice. Formerly, the NCCN established guidelines to reduce cancer-related infections only for neutropenic patients; however, they have expanded their guidelines beyond neutropenia to prevent and treat cancer-related infections. Implementing scientific evidence into clinical practice is challenging and complex, and healthcare professionals should understand barriers to implementing clinical practice guidelines to ensure successful translation into practice. This article provides a brief review of NCCN guidelines and describes common barriers encountered during implementation. In addition, a conceptual framework is offered to help identify and address potential concerns before and after adoption of guidelines.