Effect of comprehensive nursing care for the liver cancer patients undergoing interventional therapy in China: A systematic review and meta-analysis.

AIMS: This review aims to assess the effect of comprehensive nursing care on liver cancer patients undergoing interventional therapy in China. METHODS: In accordance with PRISMA guidelines, we reviewed randomized controlled trials and observational studies assessing the effect of comprehensive nursing care against standard care on liver cancer patients undergoing specific interventional therapies in China, including PubMed, Embase, CENTRAL and CINAHL till June 2023. Data synthesis was conducted using a random-effects model and reported as pooled odds ratio (OR) or mean difference (MD) or standardized mean differences (SMD). RESULTS: Ten Chinese studies with 1682 participants were evaluated. Comprehensive nursing care significantly enhanced patient outcomes in liver cancer treatment. Quality of life improved markedly (OR: 0.16, 95% CI: 0.06-0.41). Notable reductions were observed in anxiety (MD: -8.96, 95% CI: -11.52 to -6.40) and depression (MD: -9.47, 95% CI: -11.79 to -7.14). Patients also experienced increased physical (SMD: 1.70, 95% CI: 1.15-2.25), social (SMD: 1.65, 95% CI: 1.14-2.16) and activity scores (SMD: 1.94, 95% CI: 1.49-2.39), alongside a decrease in post-treatment complications (OR: 0.28, 95% CI: 0.21-0.37), demonstrating the multifaceted benefits of comprehensive care. CONCLUSION: Comprehensive nursing care may improve patient outcomes in liver cancer treatment, offering potential benefits in reducing the side effects of interventional therapy.

Moral Resilience: Managing and Preventing Moral Distress and Moral Residue.

Moral resilience is the ability to deal with an ethically adverse situation without lasting effects of moral distress and moral residue. This requires morally courageous action, activating needed supports and doing the right thing. Morally resilient people also have developed self-confidence by confronting such situations so they can maintain their self-esteem, no matter what life delivers. Finally, the ability to adapt to changing circumstances with a sense of humor is at the heart of their flexibility. Morally resilient nurses are not naïve about the price of moral integrity. They know it does not come without pain of dealing with adversity, but they believe the virtue of moral courage is necessary to meet the ethical obligations of their profession (ANA, 2015b).

Diseases of the Liver.

IMPAIRED LIVER function affects every aspect of the body's physiology. Diseases of the liver have more widespread and life-threatening impacts than malfunctioning of any of the body's other conditions. accessory organs. Non-alcoholic fatty Liver disease rates are soaring, concurrent with the obesity epidemic and increasing rates of type 2 diabetes. Alcoholic liver disease and viral hepatitis also contribute to high rates of liver damage in the population, making liver disease one of the commonest causes premature death. Liver transplants, hepatocellular carcinomas, and deaths from Liver disease are increasingly due to preventable or treatable liver conditions. Understanding normal liver function allows nurses to predict the impact of Liver disease on their patients' health and well-being. Knowledge of underlying causes of impaired liver function enhances our ability to support and counsel those who are at risk of, or have been diagnosed with liver disease.

Effect of hospice care on quality indicators of end-of-life care among patients with liver cancer: a national longitudinal population-based study in Taiwan 2000-2011.

BACKGROUND: Quality of near end-of-life (EOL) care is typically evaluated using six accepted quality indicators (QIs). Research has yet to evaluate the quality of EOL care for liver cancer patients in Taiwan. We evaluated the effect of hospice care on the quality of EOL care for patients with advanced liver cancer. METHODS: Using claims data obtained from the Taiwan National Health Insurance Research Database, we analyzed the QIs of EOL care for patients who died between 2000 and 2011. Logistic regression was performed to identify predictors for QIs of EOL care. RESULTS: A total of 3092 adult patients died of liver cancer during the study period. The patients were divided into those who received hospice care for a period longer than 1 month (long-H group), shorter than 1 month (short-H group), and not at all (non-H group). There was no significant difference in survival probability among the three groups (p = 0.212). Compared with the non-H group, the long- and short-H groups exhibited a significantly lower risk of being admitted to an intensive care unit (ICU) (odds ratios [ORs] = 0.25 and 0.26, respectively, p < 0.001) and requiring cardiopulmonary resuscitation (CPR) during the final month of life (ORs = 0.21 and 0.09, respectively, p < 0.001). Compared with the non-H group, the short-H group had a higher risk of more than one emergency room (ER) visit, and more than one hospital admission (OR = 1.97, p = 0.003; and OR = 1.56, p = 0.001, respectively), but the long-H group did not differed significantly from the non-H group on these measures. CONCLUSIONS: Patients with liver cancer who received hospice care were less likely to be admitted to ICUs or require CPR compared with those who received no hospice care. A longer duration of hospice care was associated with reduced risks of more than one ER visit and more than one hospital admission. We conclude that EOL cancer care in Taiwan might be improved by implementing policies encouraging early hospice referral programs.

HBV-related health behaviors in a socio-cultural context: perspectives from Khmers and Koreans.

PURPOSE: The aim of this study is to explore factors influencing health and health care within the sociocultural context of Cambodian Americans (CAs or Khmers) and Korean Americans (KA) and to examine intergroup similarities and differences between CAs and KAs, focusing on hepatitis B virus (HBV) and liver cancer prevention behaviors. METHODS: The study used a qualitative design guided by the revised Network Episode Model (NEM) and informed by ethnographic analysis. Focus group interviews with key informants among CA community health leaders (CHLs, n=14) and individual interviews with key informants of KA CHLs (n=9) were audiotaped and transcribed. RESULTS: Three categories that influenced HBV and liver cancer prevention emerged from both CAs and KAs: the socio-cultural, individual, and behavioral. Four additional subcategories (sub-themes) of sociocultural were identified as socio-history, socio-medicine, socio-linguistic, and socio-health resources. Both CAs and KAs, however, have low levels of knowledge and significant misunderstandings about HBV infection. CONCLUSIONS: The study identifies and compares the social-cultural determinant for HBV and liver cancer and highlights the factors of education, intercultural communication, and interactions within socio-cultural contexts of CA and KA subgroups. In general, conceptual overlaps are apparent between Khmers (from now on, the terms, CA and Khmer, will be used interchangeably) and Koreans except for the sub-theme of socio-history. However, differences in concept-specific attributes point to the need to account for differing conceptualizations and implications of specific ethnic groups' sociocultural contexts, and to design contextually-relevant outreach and educational interventions for targeted AAPI subgroups.

Fast-track recovery after major liver and pancreatic resection from the nursing point of view.

Postoperative fast-track recovery protocols combine various methods to support immediate care of patients who undergo major surgery. These protocols include control of postoperative pain and early beginning of oral diet and mobilization. The combination of these approaches may reduce the rate of postoperative complications and facilitate hospital discharge. The aim of this study was to evaluate progress and parameters of fast-track recovery after major liver and pancreatic resection. A descriptive bibliographical review from 2001 to 2012 via electronic databases such as MEDLINE, PubMed, and Google Scholar was undertaken. Articles that focused on a fast-track protocol were studied. Reports focusing on the implementation of a fast-track protocol in the postoperative recovery of patients after major hepatectomy or pancreatectomy were selected. Fast-track protocols may be applicable to patients recovering after major liver or pancreatic resection. Future research should be focused on particular parameters of the fast-track protocol separately.

Investigation and Correlation Analysis of Self-Care Ability and Fatigue Among Primary Caregivers of Postoperative Patients With Liver Cancer in China.

BACKGROUND: In the postoperative period, patients mainly rely on caregivers, who experience their own physical and mental fatigue. Caregiver fatigue may affect patient outcomes. OBJECTIVES: This study explored the fatigue status and influencing factors of primary caregivers of patients after liver cancer surgery. METHODS: A baseline information questionnaire, the Fatigue Scale-14, and the Barthel Index were used to investigate the self-care ability and fatigue status of 191 primary caregivers of patients with hepatic carcinoma who had had surgery. FINDINGS: The postoperative hospitalization time and self-care level of patients, whether the primary caregiver had health insurance, subjective feelings of fatigue, the perception that health was affected, and the patients' desired level of postoperative care were correlated with the occurrence of primary caregiver fatigue.

Improving outcomes for patients receiving transarterial chemoembolization for hepatocellular carcinoma.

Hepatocellular carcinoma is a cancer with increasing incidence in the veteran population. This type of cancer can be treated with transarterial chemoembolization, an invasive procedure performed by specially trained interventional radiologists. The most common serious complications are liver failure, sepsis secondary to ischemic cholecystitis or liver abscess, gastrointestinal bleeding, and death. However, nursing staff and physicians often have little or no experience in caring for patients in the hospital who have had this procedure. Patient safety can be threatened by this lack of knowledge. Sources of threat to patient safety are described by the Institute of Medicine as falling into 4 categories: management, workforce, work processes, and organizational culture. To promote patient safety, defenses need to be deployed to address each category. In this article, the author provides a case example, describes threats to the patient's safety, and describes a plan to improve the care of all patients undergoing this procedure.

Analysis of the Curative Effect of Continuous Nursing Based on Data Mining on Patients with Liver Tumors.

Studies have shown that the physical, psychological, and social problems of liver cancer patients are more serious than those of other cancer patients and their quality of life is significantly reduced. This may be related to the poor treatment effect of patients with advanced liver cancer. Patients often have adverse symptoms such as cancer pain, pleural effusion, and ascites, etc., which have a great impact on patients' psychology and recovery from illness. With the change of the medical model, it has become history to rely solely on drugs to care for patients with advanced liver cancer and comprehensive nursing intervention has become very important. Continuous nursing intervention focuses on individualized and full-hearted care, effectively alleviating patients' anxiety and fear and improving patients' environmental adaptability and psychological defense mechanisms. However, in the field of liver cancer, there is no detailed comparison between the efficacy of continuous nursing and traditional conventional nursing. This article applies the hidden Markov model, starts with medical data mining, and describes the process achieved by the application of this article and the analysis of the results obtained by the two nursing methods, which reflect the difference in curative effect evaluation, and it proves that continuous nursing has more advantages in the curative effect of patients with liver tumors.

Metastatic colorectal cancer: management challenges and opportunities.

Median survival of patients with metastatic colorectal cancer (mCRC) has increased significantly, owing to individualized treatment plans developed from the available multidisciplinary options for disease management. These plans include early evaluation for possible resection of hepatic metastases, and metastasectomy, as well as coordinated chemobiotherapy for unresectable patients. This article focuses on current management of mCRC, including resection of liver metastases, which offers the possibility of cure to selected patients; sequential chemobiotherapy, which has been used effectively to increase median survival of patients with unresectable mCRC; the roles of neoadjuvant, conversion, and adjuvant chemobiotherapy in patients who undergo hepatic resection; and the emerging use of biomarkers to guide therapy. Implications for nurses are summarized, underscoring the important role that the nurse plays in the increasingly complex treatment of mCRC.

Periprocedural pain of radiofrequency ablation for hepatocellular carcinoma.

Although radiofrequency ablation has been accepted as a safe and effective treatment for small hepatocellular carcinoma, there are few studies addressing periprocedural pain. Our study aims were to investigate periprocedural pain and evaluate its related factors. Ninety-nine patients diagnosed as having hepatocellular carcinoma and who underwent radiofrequency ablation were consecutively enrolled. The pain intensity, mental preparation status for radiofrequency ablation, and demographic and clinical characteristics were investigated. We used an 11-point numerical rating scale to assess for pain. Forty-three percent of subjects reported the intensity of periprocedural pain as more than a level of six (severe pain). The longer duration of ablation (r(s) = .29, p = .004), the number of ablations (r(s) = .27, p = .008), higher pain anxiety (r(s) = .42, p < .001), and difficulty sleeping on the previous day (r(s) = .24, p = .019) were factors related to experiencing more severe pain. The major related factors to severe periprocedural pain were the longer duration of ablation and the more anxiety about pain. Clinicians should offer better information to radiofrequency ablation patients regarding pain expectations and carefully consider periprocedural analgesia requirements.

Managing patients receiving sorafenib for advanced hepatocellular carcinoma: a case study.

Despite improvements in cytotoxic chemotherapy agents over the last 50 years, the outlook for patients with many of the most common solid tumours has remained poor. However, in recent years a number of targeted therapies have been licensed in the European Union for use in these cancer types. One such therapy, a tyrosine kinase inhibitor (sorafenib) is now used to treat patients with advanced hepatocellular carcinoma (HCC) and metastatic renal cell carcinoma. This article will explore the role of the oncology nurse in managing patients receiving sorafenib for advanced HCC. A brief overview of sorafenib as a current treatment approved for advanced HCC in the palliative setting is presented. This is followed by a case study-based discussion with particular reference to some of the key care coordination challenges facing the oncology nurse. The management of treatment-related adverse events and the importance of using a multidisciplinary team approach is also reviewed.

[Spiritual care of a terminal liver cancer patient: a nursing experience].

Death, an unavoidable event in the human experience, causes physical as well as mental and spiritual suffering. This paper reports on a nursing experience giving spiritual care to a terminal liver cancer patient between January 17 and February 9, 2009. Eleven nursing logs were used as the source of data for daily information. During the care period, patient religious needs featured prominently, including his desire to become a Christian and his eagerness to know about and help in the arrangement of his funeral. Taking the initiative, the nurse helped link him with religious resources, arranged a minister for his baptism ceremony, had the priest explain funeral proceedings, and assisted with the completion of his entrusted plans. The function of this nursing care intervention was to provide a personal touch to a patient who was in desperate need of warm spiritual care. It is hoped that this report can help caregivers increase their sensitivity toward patient spiritual needs and enhance routine nursing care quality.

[Case report: the practical use of the self-care deficit nursing theory for a patient with a neuroendocrine cancer of the duodenum]. / Fallstudie: Praktische Anwendung der Selbstpflegedefizit-Theorie bei einem Patienten mit neuroendokrinem Karzinom des Duodenums.

This case describes the nursing care of a 66-year-old electively admitted patient who came to hospital for the treatment of a hepatic secondary neuroendocrine duodenum cancer. A typical liver resection with duodeno-pancreatectomy and sigmaresection was performed. Complications led to more than ten re-laparatomies with resection of the stomach and oesophagus. It was necessary to perform blind occlusion of the jejunum and the disposition of an oesophagus stoma. A diabetes mellitus was caused by the total resection of the pancreas. Mister B. got a percutaneous endoscope jejunostomy but it could not be used because of a new small intestine fistula into the abdominal cavity wherefore a port was implanted. The following different conceptions of the self-care deficit theory have been used to describe and analyse the patient situation as follows: Basic conditioning factors, self-care requisites, therapeutic self-care demands, self-care competence. The future self-management capabilities consist of the following: Care of the oesophagus stoma, care of the percutaneous endoscope jejunostomy, management of the diabetes mellitus, coping with the changed self-image, coping with the restriction of movement and with the needed prophylaxis. Support was given by the transfer of knowledge to the patient. Instructions were given during realisations of new activities and development of skills. It was evaluated if the patient is capable to reflect his actions and to assess if he is able to react on deviations from the normal standards in a correct and appropriate way. After dismissal it was secured by phone call that the patient successfully manages the new self-care demands independently.

Effects of high-quality nursing care on psychological outcomes and quality of life in patients with hepatocellular carcinoma: A protocol of systematic review and meta-analysis.

BACKGROUND: High quality nursing care (HQNC) has been reported to effectively prevent psychological disorders and improve the quality of life (QoL) in patients with hepatocellular carcinoma (HCC) during the treatment. However, the exact effect of HQNC remains controversial. This systematic review will be aimed to assess the effectiveness of HQNC on psychological disorders and QoL in patients with HCC. METHODS: Eligible prospective controlled clinical trials were searched from Google Scholar, Medline, Excerpt Medica Database (Embase), PubMed, Web of Science (WOS), Cochrane Library, China Scientific Journal Database (CSJD), China National Knowledge Infrastructure (CNKI), Chinese BioMedical Database (CBM) and Wanfang Database. Papers in English or Chinese published from January 2000 to July 2020 will be included without any restrictions. The clinical outcomes including psychological outcomes, QoL, and adverse events of HQNC in patients with HCC were systematically evaluated.Study selection and data extraction will be performed independently by two reviewers. Stata 14.0 and Review Manager 5.3 were used for data analysis. Methodological quality for each eligible study will be assessed by using Cochrane risk of bias tool. Subgroup and meta-regression analysis will be carried out depending on the availability of sufficient data. RESULTS: The results of this systematic review will be published in a peer-reviewed journal. CONCLUSION: The results of this study may provide helpful evidence of HQNC on psychological effects and QoL in patients with HCC. INPLASY REGISTRATION NUMBER: INPLASY202070096.

Cancers of the pancreas and hepatobiliary system.

OBJECTIVES: To review the incidence, risk factors, staging, and diagnosis of hepatobiliary malignancies and pancreas cancer as well as nursing challenges associated with managing patients with these tumors. DATA SOURCES: Published research reports, epidemiologic data, patient management guidelines, and institution-based clinical tools. CONCLUSION: While survival is slowly increasing, morbidity and mortality associated with hepatobiliary and pancreas cancers remains high. Further scientific study is needed to identify methods of detecting these malignancies earlier and to develop therapeutic approaches that will effectively decrease tumor burden while simultaneously palliating disease and treatment-induced consequences including both physical and emotional effects. IMPLICATIONS FOR NURSING PRACTICE: Nurses need to be familiar with the natural history of these diseases and current and future therapies to facilitate treatment decision-making when options are limited, anticipate and intervene in managing disease and treatment-induced effects, and support clinical research efforts.

[Hospice care nursing experience related to a patient with terminal stage liver cancer].

This case report describes hospice care provided to a patient suffering from terminal stage liver cancer. Care was analyzed based on the Neuman System Model. In the nursing process, the author first established a good relationship with the patient and then collected information related to patient physical, mental and spiritual needs through discussions, observations and anamnesis. Results revealed that sources of pressure affecting patient functional system harmony came from two intrinsic factors; namely, intrapersonal and interpersonal stressors. Intrapersonal stressors included changes in nutritional status, aches, and struggles with fear of death. Interpersonal stressors addressed the guilt of being unable to meet the expectations of family members. Based on the Neuman System Model, patient pressures were analyzed at three levels of prevention in order to strengthen their ability to cope. The scope of intervention included (1) alleviate problems of aches and malnutrition resulting from abdominal dropsy in the terminal stage of cancer; (2) provide psychological and spiritual care in order to ease patient fears of death and encourage positive reflection on life; (3) position the family to perform a positive role to help the patient and his family obtain the best quality of life. The patient finally passed away in the company of his family in a dignified, peaceful and painless manner.

Overview of stereotactic body radiotherapy and the nursing role.

Stereotactic body radiotherapy (SBRT) is a rapidly emerging technology that enhances radiation therapy delivery. It allows for tightly conformed treatment fields and accurate delivery even with moving targets in the body. SBRT currently is used most commonly in treatment of medically inoperable stage I non-small cell lung cancers, as well as lung, liver, and spinal metastases. Studies to date are encouraging for increased local control with acceptable patient tolerance. This article familiarizes nurses with the use of this new technology and proposes the potential nursing role in maximizing patient preparation and follow-up care.