Emerging From the Haze™: Pilot Feasibility Study Comparing Two Virtual Formats of a Cognitive Rehabilitation Intervention.

OBJECTIVES: To gather feasibility and preliminary data comparing two virtual delivery methods for providing Emerging From the Haze™ (Haze) to cancer survivors compared to waitlist control (WLC). SAMPLE & SETTING: Eligible participants (N = 93) reported cancer-related cognitive impairment following chemotherapy for stage I-III solid tumors, Hodgkin lymphoma, or non-Hodgkin lymphoma. METHODS & VARIABLES: A three-arm randomized design was used to compare virtual live group presentation of Haze sessions, virtual prerecorded Haze group sessions, and WLC. Data were collected at baseline, week 10, and week 14. RESULTS: Feasibility was demonstrated. Significant cognitive function improvement at week 10 versus WLC was reported for the live group, and clinical improvement was reported for the prerecorded group. The prerecorded group reported significant improvement at week 14 versus WLC in physical activity, sleep, and health-related quality of life. IMPLICATIONS FOR NURSING: Additional pilot and feasibility evidence for cognitive rehabilitation interventions was demonstrated. Prerecorded Haze delivery shows potential for clinical effectiveness and scalability. Future multisite research is warranted.

Post-traumatic stress symptoms, post-traumatic stress disorder, and post-traumatic growth among cancer survivors: a systematic scoping review of interventions.

The detrimental effects of Post-Traumatic Stress Symptoms (PTSS) and Post-Traumatic Stress Disorder (PTSD) and the benefits of Post-Traumatic Growth (PTG) are well established for cancer survivors. Increased cancer survival rates necessitate an understanding of how these two paradoxical outcomes, PTSS/PTSD and PTG, are targeted through interventions. This systematic scoping review aims to (a) examine existing evidence on interventions targeting PTSS/PTSD and/or PTG among cancer survivors and (b) identify knowledge gaps to inform future research. Following the six steps of a scoping review, 76 articles met the inclusion criteria. Quantitative articles were examined using descriptive analysis. Frequency counts of the collated data were tabulated into summary tables. Qualitative articles were reviewed using meta-synthesis. Most articles were quantitative (n = 52) and targeted PTG (n = 68) through promising intervention approaches such as psychotherapy, mindfulness, physical activity, and psilocybin-assisted therapy. Three key implications for future research and practice were synthesized: (1) mechanistic considerations for intervention design that provide a roadmap for rigorous and theoretically-grounded research; (2) the need for improved representation of cancer survivors in trials; and (3) potential facilitators of intervention efficacy. Together, these findings can direct future research to optimize interventions to reduce PTSS/PTSD and promote PTG achievement among cancer survivors.

Feasibility Pilot Study of a Virtual Intervention for Survivors With Decreased Perceived Cognitive Function After Cancer Treatment.

OBJECTIVES: Many cancer survivors report issues with cognitive function following diagnosis and treatment. The purpose of this single-arm pilot study was to test the feasibility and acceptability of virtual delivery of a cognitive rehabilitation intervention for participants in virtual groups. SAMPLE & SETTING: 37 adult cancer survivors reporting impaired cognitive function following primary treatment were enrolled from Cedars-Sinai Medical Center and affiliates, the University of Kansas Cancer Center, and the Masonic Cancer Alliance. METHODS & VARIABLES: Two cohorts attended six weekly virtual sessions and completed pre- and postintervention patient-reported outcome questionnaires designed to measure perceived cognitive function, loneliness, and determinants of behavior change for exercise, sleep, and mindfulness. RESULTS: Postintervention scores for perceived cognitive function, determinants of behavior change, and loneliness ratings significantly improved. IMPLICATIONS FOR NURSING: Evidence continues to build in support of cognitive rehabilitation interventions for cancer survivors. Nurses play an important role in terms of patient identification, participation, and facilitation.

Behavior management on an acute brain injury unit: evaluating the effectiveness of an interdisciplinary training program.

OBJECTIVE: To measure the effect of behavior management training on restraint use and prn medication delivery on an acute inpatient brain injury unit. SETTING/PARTICIPANTS: Interdisciplinary staff and hospitalized brain injury patients on a 20-bed unit within a freestanding rehabilitation hospital. INTERVENTION: Staff participated in the Nonviolent Crisis Intervention (NCI) program from the Crisis Prevention Institute. MAIN OUTCOME MEASURES: Applied physical restraints and delivered prn medications. RESULTS: Despite comparable patient levels of agitation severity across the duration of the study, the use of physical restraints initially declined and then increased after training. Data collected on prn medication delivery also indicated a trend for an increase in the delivery of select medication categories across time. CONCLUSION: NCI training resulted in a temporary, short-lived reduction in physical restraint use, but had an inverse effect on prn medication delivery for select categories of medication. Medication delivery significantly increased over time and restraint use eventually exceeded baseline level. Ramifications of these results are discussed.

An effort index for the Repeatable Battery For The Assessment Of Neuropsychological Status (RBANS).

The present study aimed to develop an internal validity indicator for a brief general purpose screening battery, the Repeatable Battery for the Assessment of Neuropsychological Status (RBANS). Two subtests of the RBANS were predicted to be relatively resilient to cognitive dysfunction on the basis of previous research. An Effort Index (EI) was created by combining them via a scaling system. The frequency of EI scores was first examined in a heterogenous clinical sample. A subsequent validation study showed good discriminability. In conclusion, the EI appears to be useful for detecting insufficient effort on a screening battery.