RESUMO
Insomnia disorder, defined by nocturnal and daytime symptoms, is highly prevalent worldwide and is associated with the onset of mental illness. Although daytime symptoms are often the reason insomnia patients seek help, it is not clear whether recommended treatment is effective on daytime symptoms. We aimed to investigate the efficacy of cognitive and behavior therapies for insomnia (CBT-I) on all daytime symptoms explored in the literature using both direct and indirect data. 86 studies (15,578 participants) met inclusion criteria. Results showed significant effects of CBT-I administered face-to-face individually, in group and different self-help settings on depressive symptoms, anxiety, daytime sleepiness, fatigue, quality of life, daytime and social functioning and mental state, with Cohen's d's ranging from -0.52 and 0.81. Our results suggest that CBT-I is effective in the treatment of daytime symptoms, albeit with predominantly small to moderate effects compared to far stronger effects on the core symptoms of insomnia. Effects may be biased for depressive and anxiety symptoms, since many included studies excluded patients with severe levels of these complaints. Further, small to moderate effects may reflect that CBT-I, by improving nighttime symptoms, has a positive effect on daytime symptoms, but it does not target the daytime symptoms directly. Future studies may benefit from adding therapeutic techniques that address daytime symptoms more directly.
Assuntos
Terapia Cognitivo-Comportamental/métodos , Distúrbios do Início e da Manutenção do Sono/terapia , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Ansiedade/terapia , Cognição , Depressão/terapia , Fadiga/terapia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Metanálise em Rede , Qualidade de Vida , Resultado do Tratamento , Adulto JovemRESUMO
In this work, we present a conceptual framework to support clinical trial optimization and enrollment workflows and review the current state, limitations, and future trends in this space. This framework includes knowledge representation of clinical trials, clinical trial optimization, clinical trial design, enrollment workflows for prospective clinical trial matching, waitlist management, and, finally, evaluation strategies for assessing improvement.
Assuntos
Ensaios Clínicos como Assunto , Sistemas de Apoio a Decisões Clínicas , Informática Médica/métodos , Algoritmos , Ensaios Clínicos como Assunto/métodos , Ensaios Clínicos como Assunto/normas , Bases de Dados Factuais , Humanos , Processamento de Linguagem Natural , Projetos de Pesquisa , Software , Fluxo de TrabalhoRESUMO
PROBLEM STATEMENT: To define the Oncology Nursing Society Research Agenda for 2019-2022. DESIGN: Multimethod, consensus-building approach by members of the Research Agenda Project Team. DATA SOURCES: Expert opinion, literature review, surveys, interviews, focus groups, town hall, and review of research priorities from other cancer care organizations and funding agencies. ANALYSIS: Content analysis and descriptive statistics were used to synthesize research priority themes that emerged. FINDINGS: Three priority areas for scientific development were identified. IMPLICATIONS FOR NURSING: The Research Agenda can be used to focus oncology nurses' research, scholarship, leadership, and health policy efforts to advance quality cancer care, inform research funding priorities, and align initiatives and resources across the ONS enterprise.
Assuntos
Pesquisa em Enfermagem/organização & administração , Enfermagem Oncológica/organização & administração , Objetivos Organizacionais , Projetos de Pesquisa/tendências , Sociedades de Enfermagem/organização & administração , Humanos , Inquéritos e Questionários , Estados UnidosRESUMO
Cancer patients treated with parenteral chimeric or humanized monoclonal antibody agents or chemotherapy are at risk of experiencing an infusion reaction. The impact of infusion reactions can be substantial. Infusion reactions, even when mild, can be disruptive and stressful. In-person interviews with 202 nurses were conducted at the 2005 Annual Oncology Nursing Society Congress to evaluate the impact of infusion reactions on patients and nurses in the inpatient and outpatient practice settings. Results from this survey study suggest that infusion reactions have a significant negative impact on both patients and nurses.
Assuntos
Antineoplásicos/efeitos adversos , Atitude do Pessoal de Saúde , Hipersensibilidade a Drogas/etiologia , Infusões Intravenosas/efeitos adversos , Recursos Humanos de Enfermagem/psicologia , Enfermagem Oncológica , Adaptação Psicológica , Anticorpos Monoclonais/efeitos adversos , Atitude Frente a Saúde , Congressos como Assunto , Efeitos Psicossociais da Doença , Hipersensibilidade a Drogas/epidemiologia , Hipersensibilidade a Drogas/prevenção & controle , Monitoramento de Medicamentos/enfermagem , Feminino , Humanos , Infusões Intravenosas/enfermagem , Infusões Intravenosas/estatística & dados numéricos , Pacientes Internados/psicologia , Masculino , Avaliação em Enfermagem , Pesquisa Metodológica em Enfermagem , Recursos Humanos de Enfermagem/educação , Enfermagem Oncológica/educação , Enfermagem Oncológica/organização & administração , Pacientes Ambulatoriais/psicologia , Pesquisa Qualitativa , Gestão da Segurança , Índice de Gravidade de Doença , Estresse Psicológico/etiologia , Estresse Psicológico/psicologia , Inquéritos e QuestionáriosRESUMO
OBJECTIVES: To present emerging models for oncology health professionals to consider when coordinating cancer care among professionals, beginning as early as initial professional education and training and continuing along the cancer continuum to include cancer treatment and psychosocial support. DATA SOURCES: Journal articles indexed on the National Library of Medicine database and personal communications with oncology colleagues. CONCLUSION: Interprofessional collaboration is becoming increasingly important in the specialty of oncology. The complexity of new therapies and their associated side-effect profiles benefit from a collaborative, interprofessional approach to the care of the patient with cancer. Additionally, oncology patients can benefit from interprofessional collaboration across the complexities of the care continuum. IMPLICATIONS FOR NURSING PRACTICE: Oncology nurses are often in roles that can facilitate interprofessional collaboration, optimizing the care of patients with cancer.