An evaluation of the Train the Trainer International Breast Health and Breast Cancer Education: lessons learned.

BACKGROUND: Train the Trainer (TTT) Breast Health and Breast Cancer Education program was a workshop for nurses to improve knowledge about breast health and breast cancer. METHODS: The TTT approach used several teaching-learning strategies. A total of 3 programs were held biannually since 2000; 32 nurses represented 20 international countries. RESULTS: In 2000, participants represented developed countries. In 2002 and 2004, participants represented limited resource nations in Africa, Asia, and South America. Formative and summative evaluations using e-mail survey showed that over 1400 patients and families and over 900 nurses and doctors were reached. CONCLUSIONS: Findings support viability of international breast health and/or breast cancer education programs.

The longitudinal effects of cancer treatment on sexuality in individuals with lung cancer.

PURPOSE/OBJECTIVES: To examine changes in sexual functioning during treatment for lung cancer and the extent to which age, gender, social support, and mood status affect sexual dysfunction. DESIGN: Prospective, exploratory. SETTING: Outpatient cancer clinic. SAMPLE: 59 of 84 eligible patients diagnosed with small cell or non-small cell lung cancer. METHODS: The Derogatis Interview for Sexual Function, Self-Report, to measure sexual functioning; the Social Provisions Scale to measure social support; and the Derogatis Affects Balance Scale to measure mood status were administered at diagnosis and at two and four months during treatment. MAIN RESEARCH VARIABLES: Level of sexual function, treatment, age, gender, social support, and mood status. FINDINGS: Results indicate a decrease in sexual function but no significant change in sexual function between the two treatment groups. Age was a significant factor affecting sexual function. Gender significantly affected sexual function at time 2 only. Between times 1 and 2, mood status had a significant relationship with sexual function. Social support did not affect sexual function directly; social support was found to significantly affect mood status. CONCLUSIONS: Most patients reported below-normal sexual function at baseline. Sexual function worsened over time. Further research is warranted to examine time, place, and type of intervention needed. IMPLICATIONS FOR NURSING: New data encourage assessment, intervention, and research related to the sexual function of patients with lung cancer.

Transition from treatment to survivorship: effects of a psychoeducational intervention on quality of life in breast cancer survivors.

PURPOSE/OBJECTIVES: To examine the effectiveness of a psychoeducational intervention on quality of life (QOL) in breast cancer survivors in post-treatment survivorship. DESIGN: A randomized controlled trial. SETTING: An academic center collaborating with a regional cancer center in the southeastern United States. SAMPLE: 256 breast cancer survivors. METHODS: Women were randomly assigned to the experimental or wait control group. The Breast Cancer Education Intervention (BCEI) study was delivered in three face-to-face sessions and five monthly follow-up sessions (three by telephone and two in person). The control group received four monthly attention control telephone calls and the BCEI at month 6. Data were collected at baseline, three and six months after the BCEI for the experimental group, and one month after the BCEI (at month 7) for the wait control group. MAIN RESEARCH VARIABLES: Primary endpoints were overall QOL and physical, psychological, social, and spiritual well-being. FINDINGS: No differences in QOL were reported at baseline between groups. The experimental group reported improved QOL at three months, whereas the wait control group reported a significant decline in QOL. The experimental group reported continued maintenance of QOL at six months. Although the wait control group reported improved QOL at six months, significant differences continued to exist between the groups. CONCLUSIONS: The BCEI was an effective intervention in improving QOL during the first year of breast cancer survivorship. Treatment effects were durable over time. IMPLICATIONS FOR NURSING: Post-treatment survivorship has not been empirically studied to a large degree. The BCEI is one of the few interventions demonstrating effectiveness among survivors after primary treatment, suggesting that oncology nurses may be uniquely positioned to provide safe passage using education and support.

Upper extremity lymphedema after treatment for breast cancer: a review of the literature.

Upper extremity lymphedema - a common, poorly understood, and relatively understudied complication of cancer therapy - is a progressive and debilitating condition for which no cure is available. While advances in cancer treatment have lowered the incidence of lymphedema, lymph node trauma is often inevitable and the number of cancer survivors and elderly are increasing. A review of the literature suggests that research is needed to better understand the incidence and magnitude of upper extremity lymphedema; develop reliable and valid lymphedema risk assessment instruments; improve collaborative research efforts among skin, wound, and cancer investigators; and develop evidence-based lymphedema prevention and treatment protocols. Currently available evidence also indicates that increased clinician and patient awareness and education may help reduce the risk of lymphedema-associated complications through early detection and prompt interventions.

Pressure ulcers and other chronic wounds in patients with and patients without cancer: a retrospective, comparative analysis of healing patterns.

Knowledge about wound healing patterns in patients with cancer is limited. To compare wound healing outcomes and patterns between persons with and persons without a diagnosis of cancer, a retrospective study was conducted using a convenience sample drawn from international chronic wound databases containing almost 36,000 standardized wound assessments (consisting of 13 anatomical wound characteristics). Based on the recorded chronic wound profiles, 18 patients who had cancer were matched with 18 who did not have cancer; their first assessment wound profiles were completely identical. It was hypothesized that, compared to patients without cancer, patients with cancer have 1) a greater percentage of non-healing wounds, 2) wounds that take longer to heal, and 3) more comorbidities that can delay healing. After a maximum treatment period of 24 weeks, 44% of wounds in patients with cancer compared to 78% of wounds in patients without cancer were healed (P = .018). Wounds that healed did so at the same pace regardless of cancer status (approximately 55 days [+/-41] for patients with cancer and 59 days [+/-48] for patients without cancer). Patients with cancer had more comorbidities and other factors that could impede wound healing [mean 4.72 (+/-1.09)] than patients without cancer [mean 1.50 (+/-0.39)]. Differential healing patterns between the two groups after 8 weeks suggest that alternative treatment and management practices may be warranted for cancer patients with non-healing wounds.