Multiple Myeloma: Validation of the Values and Preferences Elicitation Questionnaire- Cure and Survival Preference Scale (VPEQ-CSPS).

BACKGROUND: With the emergence of many novel therapies, the treatment decisions for multiple myeloma (MM) are increasingly guided by concerns of quality of life, achievement of cancer-free remission, living a longer overall survival, and a relentless search for a cure; however, the impact of various decision-making factors on patients' actual therapy choices and the patients' desire for cure and survival is mainly unknown. The lack of a valid and reliable measure for uncovering patients' preferences for cure and survival makes it more challenging to put this factor into the actual treatment decision equation. PURPOSE: This study examined the psychometric properties of the Values and Preferences Elicitation Questionnaire-Cure and Survival Preference Scale (VPEQ-CSPS) instrument. METHODS: The VPEQ-CSPS instrument was deployed using an anonymous Qualtrics online survey to patients diagnosed with MM within the network of International Myeloma Foundation online patient support groups across the United States. One hundred seventy-four (N = 174) valid responses were obtained and used to examine the validity and reliability of the VPEQ-CSPS. RESULTS: Exploratory factor analysis (EFA) revealed a Kaiser-Meyer-Olkin value of 0.72 indicating excellent sample adequacy. A statistically significant Bartlett's test of sphericity (P < .001) indicated significant correlations among the variables of the dataset to conduct the EFA. The internal consistency coefficients indicated adequate reliability of the instrument with Cronbach's alpha value at 0.80. The EFA and parallel analysis revealed the 5-item VPEQ-CSPS as a valid and reliable unidimensional scale that can be used by oncology clinicians to elicit their patient's preferences for cure and survival. This new instrument has the potential to contribute to the achievement of shared decision-making for myeloma treatment decisions.

Using the Caprini Risk Score to Increase Awareness of Venous Thrombus Embolism in the Community: Know Your Score II.

To assess individual participants' baseline thrombosis risk calculated by Caprini Risk Score (CRS) before injury, illness, or hospitalization occur, to increase the awareness of venous thromboembolism (VTE) by viewing 2 short videos. A cross-sectional study was conducted online between August 2022 and January 2023 in the USA, UK, and India to assess the risk of thrombosis of individuals as a baseline. One nursing practitioner and 4 high school students were on the research team. Descriptive statistical methods were used in data analysis. A total of 928 usable completed questionnaires from 945 participants were analyzed. The mean CRS was 4.93 ± 3.175; 0 to 4 (N = 460, 49.6%), 5 to 8 (N = 394, 42.5%), and 9 (N = 74: 8.0%). History of blood clots (N = 247, 26.6%), <40 years old (N = 133, 52.6%); women on oral contraceptives (N = 324, 34.9%), history of smoking (30%), diabetes (26%), and inflammatory bowel disease (IBD; 17.3%). Top-level findings: High incidence of family history of thrombosis (26.6%), smoking, diabetes, contraceptives, and IBD. The average CRS (7.9) in patients over 75 years indicates that even a minor surgical procedure may be associated with significant VTE risk. We achieved an important goal by increasing awareness of VTE using this unique method involving high school students and a nurse working with friends and families to complete the CRS assessment. Encouraging the respondents to share information with their personal physicians prior to the event and keep these data in their medical file is a potential valuable source of saving time. This study emphasizes the importance of individuals collecting baseline information prior to illness or hospitalization.

Stress and Coping: A Literature Review of Everyday Stressors and Strategies to Cope in Pediatric Patients With Cancer.

Although cancer survival rates are improving, pediatric patients with cancer still face numerous stressors. Using an integrative approach, a literature review was conducted to identify stressors and synthesize effective coping strategies among pediatric patients with cancer. The CINAHL® Complete, ProQuest, and PubMed® databases were searched for relevant studies using key terms. Eight studies were included in the final analysis. Three factors contributing to everyday stressors of pediatric patients with cancer and four major coping categories were identified.

Care Delivery and Treatment Decision Making: Bioethical and Nursing Considerations During and After the COVID-19 Pandemic.

BACKGROUND: The disruption in the supply chain of resources and interruptions in cancer treatments caused by the pandemic presented tremendous challenges to the healthcare system. OBJECTIVES: This article describes the National Academy of Medicine-defined states of medical and nursing care delivery for which local plans should be drawn and the shifting and evolving systems framework that can guide decisions to optimize the crisis standards of care. METHODS: A case study is presented to describe the process of shifting the state of medical and nursing care delivery and bioethical nursing considerations during the pandemic and beyond. FINDINGS: An evolving and shifting systems framework for crises rooted in deontology, principlism, and the ethics of care model provide meaningful guidance for establishing priorities for patient care.

Shared Decision-Making Competency: Provider-Specific Factors in Hematology-Oncology Clinical Practice.

A computerized database search was performed using PubMed®, CINAHL®, and EBSCOhost to identify provider-specific factors associated with shared decision-making (SDM) competency among direct patient care providers in hematology-oncology practice. Personal factors included being female or older in age and having higher education. Years of clinical experience, nonclinical experiences, institutional support for SDM, administrative support for SDM training and education, and cultural competence were also reported as having a positive correlation with SDM competence among care providers. Future research is needed to identify core SDM competencies in the interprofessional hematology-oncology care setting.

Art Therapy: A Literature Review of Efficacy in Improving Psychosomatic Symptoms in Patients With Cancer.

A high percentage of patients with cancer receive a comorbid diagnosis of anxiety, depression, or another psychological disorder. However, research evaluating the efficacy of art therapy as an intervention to alleviate these symptoms is limited. Art therapy can offer psychosomatic symptom relief among patients with cancer, but more rigorous and randomized controlled clinical trials are warranted to strengthen evidence-based research supporting its clinical utility.

Liquid Biopsy: A Tool for the Diagnostic and Prognostic Evaluation of Cancers.

Liquid biopsy is defined as the process of obtaining material for pathologic examination and analysis from body fluids. Liquid biopsy has been intensively researched for its clinical application in patients with solid malignancies, including melanoma and colon, breast, and lung cancers. This will become a standard and routine tool for the diagnostic and prognostic evaluation of all cancer types. This article provides an overview of liquid biopsy, its uses in cancer management, and its implications for nursing practice.

Pediatric Palliative Care: A Literature Review of Best Practices in Oncology Nursing Education Programs.

Palliative care as a foundation for patient-centered care is not adequately covered in nursing curricula. This gap in education means that pediatric oncology nurses may lack necessary palliative care competencies to provide comprehensive care to patients. A literature review was performed to determine if nurses believe that they are prepared to provide clinical palliative care to pediatric patients and how pediatric palliative care best practices can be better integrated into nursing education programs. According to the literature review, studies suggest that providing pediatric palliative care education in nursing programs can build nurses' confidence and better prepare them to competently care for patients and families.

Shared Decision Making: Effects of an Online Education Session on Knowledge, Attitudes, Adaptability, and Communication Skills Among Nurses.

BACKGROUND: Shared decision making (SDM) is beneficial for interprofessional teams but also challenging to implement correctly. Oncology nurses are at the forefront of patients' treatment and, therefore, one of the most essential components of the SDM process. OBJECTIVES: The aim of this pilot study was to examine the effects of a one-hour web-based SDM education session on self-reported knowledge, attitudes, adaptability, and communication skills related to SDM among oncology nurses. METHODS: Using the ADDIE (analysis, design, development, implementation, and evaluation) theoretical framework, this study used a post-test-only, single-group, nonexperimental design. FINDINGS: This study provides preliminary evidence that a one-hour web-based SDM education session is acceptable and has positive effects on oncology nurses' self-reported knowledge, attitudes, adaptability, and communication skills. More research is warranted to validate these findings.

Shared Decision Making: Improving Patient Outcomes by Understanding the Benefits of and Barriers to Effective Communication.

Shared decision making (SDM) is a healthcare delivery model that mandates patient-centered care for clinical practice. Practicing SDM ensures that patients and family caregivers are engaged in making decisions about their care and treatment with healthcare providers. This article reviews the evidence on how nurses can influence the outcomes of cancer treatment decisions by using the SDM model.

Enteral and Parenteral Nutrition: An Integrative Literature Review on Nutrition in Pediatric Recipients of Hematopoietic Stem Cell Transplantation.

This article provides a summary of an integrative review on the efficacy of enteral nutrition (EN) and parenteral nutrition (PN) for meeting the nutrition and energy needs of pediatric patients following hematopoietic stem cell transplantation (HSCT). In addition, recommendations for clinical practice and research on nutrition supplementation for pediatric patients post-HSCT are included.

Role competency scale on shared decision-making nurses: Development and psychometric properties.

OBJECTIVES: This study aimed to develop a scale that can measure the role competency of oncology nurses during shared decision-making process. METHODS: A total of 226 oncology nurses who actively provide direct care to patients from inpatient and outpatient oncology units in the Midwest and Pacific Northwest completed the online or mail survey. Exploratory factor analysis and parallel analysis showed the multidimensionality of the role competency scale on shared decision-making nurses. RESULTS: The role competency scale on shared decision-making nurses revealed four dimensions: knowledge, attitudes, communication, and adaptability. The 22 items have excellent internal consistency with a Cronbach's alpha of 0.91. The four subscales also have adequate reliability with Cronbach's alpha >0.70 as well as greater than 0.70 Spearman-Brown's correlation coefficients in split-half reliability testing for each subscale. CONCLUSION: The new scale has the potential to be used as a clinical tool to assess the need for shared decision-making education and training in oncology nurses.

Biosimilars: Exploring the History, Science, and Progress.

BACKGROUND: Biosimilars provide opportunities for improving healthcare access and outcomes and reducing overall healthcare costs for patients with cancer. OBJECTIVES: The purpose of this article is to explore the history of biosimilars, regulatory pathways, and barriers to biosimilar approval. This article also aims to describe the patient and clinician barriers to biosimilars use and the progress that has been achieved since the first biosimilar approval in Europe in 2006 and in the United States in 2015. METHODS: A literature search was conducted to retrieve articles that are highly relevant to the history of biosimilars development and regulatory pathways in the United States, Europe, Asia, and Canada. Patient and clinician perspectives on safety issues and concerns regarding immunogenicity and bioequivalence that limit use of biosimilars are also included. FINDINGS: Patient and provider concerns regarding immunologic patient safety issues, such as immunogenicity, lack of comparability, and low biosimilarity, still exist. The clinical safety, efficacy, and tolerability of biosimilars are among the top concerns in patients, prescribers, and clinicians.

Bibliotherapy: Appraisal of Evidence for Patients Diagnosed With Cancer

An appraisal of the evidence on the efficacy of bibliotherapy on anxiety, distress, and coping in patients with cancer is lacking in the literature. Bibliotherapy is a self-help intervention using a variety of tools, such as self-help workbooks, pamphlets, novels, and audiobooks, to improve mental health. This review identified nine original research articles that examined bibliotherapy as an intervention to alleviate the psychological issues associated with a cancer diagnosis. Data synthesis from these studies provides preliminary evidence that bibliotherapy is an acceptable and beneficial adjunct therapy for patients with cancer experiencing anxiety, depression, and ineffective coping.

Decision Aids: Assisting Patients With Multiple Myeloma and Caregivers With Treatment Decision Making

A consolidated evaluation of resources on treatment decision aids (DAs) for multiple myeloma (MM) is lacking in the literature. This review identified 29 published DAs. Further analysis of these DAs revealed that the personal values and preferences of patients with MM are not well integrated into the development of these DAs, indicating the need for a more explicit shared decision-making model of MM care delivery. The development and testing of a web-based and individualized treatment DA will likely promote a shared decision-making process in clinical practice, improve patient satisfaction with treatment decisions, and decrease decisional regrets in patients newly diagnosed with MM.
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Bone Health, Pain, and Mobility: Evidence-Based Recommendations for Patients With Multiple Myeloma

BACKGROUND: About 85% of patients with multiple myeloma develop bone disease. In these patients, lytic bone lesions can cause fractures, poor circulation, blood clots, pain, poor mobility, and decreased quality of life.
. OBJECTIVES: This article presents consensus statements to guide nurses in the assessment and management of bone disease, pain, and mobility in patients with multiple myeloma at varying points in their disease trajectory.
. METHODS: Members of the International Myeloma Foundation Nurse Leadership Board reviewed previously provided recommendations, current recommendations based on literature review, and evidence-based grading.
. FINDINGS: Oncology nurses play a key role in maximizing bone health, minimizing skeletal injury, maximizing pain control, and improving quality of life in patients by enhancing patient mobility and safety. Clinician assessment accompanied by effective interventions reduces patient injury and optimizes functioning in patients with multiple myeloma.

Myelosuppression, Bone Disease, and Acute Renal Failure: Evidence-Based Recommendations for Oncologic Emergencies

BACKGROUND: Oncologic emergencies associated with multiple myeloma include myelosuppression (anemia, neutropenia, and thrombocytopenia), bone-related emergencies, and acute renal failure. 
. OBJECTIVES: This article reviews the pathophysiology of these multiple myeloma-associated oncology emergencies and provides a framework for assessment and effective intervention.
. METHODS: A comprehensive review of the levels of evidence, focusing on assessment, diagnosis, comorbidities, treatment, ongoing monitoring, and patient education, are presented to support the plan of care for at-risk patients.
. FINDINGS: Attention to signs and symptoms is the foundation for preventing these emergencies or managing additional escalation of symptoms.

Renal, GI, and Peripheral Nerves: Evidence-Based Recommendations for the Management of Symptoms and Care for Patients With Multiple Myeloma

BACKGROUND: A majority of patients with multiple myeloma experience damage to the kidneys and peripheral nerves either at diagnosis or throughout the disease. Symptoms of diarrhea, nausea, vomiting, or constipation can also occur. Prevention and management of disease- and treatment-related side effects are essential to treatment adherence.
. OBJECTIVES: This article aims to provide insight into prevention and management of organ health-related toxicities and give best practice recommendations for optimal nursing care.
. METHODS: The authors performed a literature search, and articles were reviewed for relevance to each organ-related topic. FINDINGS: Prevention and management strategies include close monitoring and prompt intervention when organ damage develops to reverse impairment and maintain adherence to therapy when indicated.

Multiple Myeloma Genomics: A Systematic Review.

OBJECTIVES: This integrative review describes the genomic variants that have been found to be associated with poor prognosis in patients diagnosed with multiple myeloma (MM). Second, it identifies MM genetic and genomic changes using next-generation sequencing, specifically whole-genome sequencing or exome sequencing. DATA SOURCE: A search for peer-reviewed articles through PubMed, EBSCOhost, and DePaul WorldCat Libraries Worldwide yielded 33 articles that were included in the final analysis. CONCLUSION: The most commonly reported genetic changes were KRAS, NRAS, TP53, FAM46C, BRAF, DIS3, ATM, and CCND1. These genetic changes play a role in the pathogenesis of MM, prognostication, and therapeutic targets for novel therapies. IMPLICATIONS FOR NURSING PRACTICE: MM genetics and genomics are expanding rapidly; oncology nurse clinicians must have basic competencies in genetics and genomics to help patients understand the complexities of genetic and genomic alterations and be able to refer patients to appropriate genomic professionals if needed.

Changes in Cancer Treatment: Mabs, Mibs, Mids, Nabs, and Nibs.

Cancer therapeutics has been growing in an unprecedented fashion and has evolved rapidly in the past two decades. Specific gene mutation, protein dysfunction and dysregulation, intracellular signaling pathways, and immune modulation have been targeted. These therapeutic advances came largely because of improved understanding of the pathobiology of cancer at the genetic and molecular levels. This article addresses the need of novice nurses for cancer treatment-related information and evidence-based nursing care of patients diagnosed with cancer while undergoing novel and breakthrough therapeutics.