Reported Signs, Symptoms, and Diagnostic Tests Before Cardiotoxicity Among Women With Breast Cancer: A Pilot Study.

BACKGROUND: Cardiotoxicity after cancer treatment is a potentially preventable life-threatening complication among women with breast cancer. There is no algorithm to identify women with breast cancer at risk of cardiotoxicity. OBJECTIVES: We quantified signs and symptoms as well as selected laboratory values among women with breast cancer who developed cardiotoxicity. METHODS: The clinical characteristics (n = 15) were collected from electronic health records. Spearman correlation coefficients and a nonparametric statistical test were used to analyze data. RESULTS: Significant statistical differences were detected in the laboratory values comparing the first and second half of 6 months before cardiotoxicity including alanine aminotransferase (U/L) (30.67 ± 26.27 and 42.31 ± 35.65, respectively; P = .03, Cohen's d = 0.37). A negative correlation was found between estimated glomerular filtration rate and new onset of more than 1 sign or symptom (Spearman's ρ = -0.5, P = .06). CONCLUSIONS: Investigating clinical characteristics before cardiotoxicity may determine the mechanism(s) and identify high-risk patients.

The Patient-Provider Relationship: Predictors of black/African American Cancer Patients' Perceived Quality of Care and Health Outcomes.

We examined whether the patient-provider relationship (PPR) is associated with Black survivors' health outcomes and whether this association was mediated by the quality of care. The outcome variables were survivors' quality of care and health outcome, and the predictor variable was PPR (communication, emotional support, time spent, and survivors' shared-decision making). A sample of 223 Black cancer survivors (age 63.0 ± 14.0 years) provided evaluable data. The most common cancer types reported by the participants were: gynecologic (32.7%), genitourinary (21.5%), and gastrointestinal cancers (11.2%). After controlling for covariates. A Structural Equation Model (SEM) showed that PPR was significantly associated with both health outcome (p = .015) and quality of care (p = .002). When PPR and quality of care were tested in the mediation model, the direct association between PPR and health outcome was attenuated, and it was no longer significant (b = -0.05, SE = 0.11, p = .65). However, indirectly, there was a strong association between PPR and health outcome through the quality of care (b = 0.22, SE = 0.08, p = .003), indicating full mediation. Providers' interpersonal relationships had a significant influence on the health of Black survivors, and this influence may be due to the increased positive perception of the quality of care. The implications of these findings for further research are discussed.

Supporting an Inclusive Environment Through Correct Name Pronunciation.

BACKGROUND: The Future of Nursing 2020-2030 Report recommends eliminating practices within nursing education that contribute to racism and discrimination. PROBLEM: Name mispronunciation has been identified as a microaggression that can interfere with an inclusive learning environment and a sense of belonging. APPROACH: The faculty development approach used a TEDx talk of a story about personal naming, followed by a discussion on appropriate and inappropriate responses to name mispronunciation. Tools and strategies to promote correct name pronunciation were shared. OUTCOMES: Participants reported (1) the training and video were meaningful and impactful; (2) increased understanding that name mispronunciation may be considered a microaggression; and (3) increased awareness of their response to correct name pronunciation. CONCLUSIONS: A just and equitable learning environment free of discrimination is integral to achieving inclusion and belonging in nursing education. Correct name pronunciation tools and techniques can engender a sense of inclusion.

Creating a Nursing Student Center for Academic and Professional Success.

BACKGROUND: The purpose of this article is to describe the development of an innovative broad-based initiative supportive of academic and professional success, the Center for Academic and Professional Success (CAPS) at the University of Rochester School of Nursing. While CAPS was founded to support all nursing students, it was also carefully developed to meet the special needs of students in the accelerated program for non-nurses (APNN) due to their diversity and the intensity and rapidity of the APNN program. METHOD: Faculty discussion, literature review, and student needs assessment findings informed program development. Outcome data obtained during the past 4 years are presented. RESULTS: Data revealed a correspondence between identified student needs and use of program services, as well as high satisfaction ratings. CONCLUSION: Findings supported the provision of both traditional academic support, as well as other critical supports to address the academic and social stressors associated with the transitions experienced by nontraditional, working, and graduate nursing students. [J Nurs Educ. 2017;56(4):235-239.].

Care-seeking behaviors of African American women with breast cancer symptoms.

In this descriptive correlational study, 48 African American women were assessed for delay in care-seeking for breast cancer symptoms by examining: (a) relationships between selected psychosocial variables (fear, denial, utility, and social norm) and delay, (b) relationships between delay and having an identified health provider, affordable health care services, and accessible health-care services, (c) whether denial would mediate the effect of fear on delay, (d) whether utility would moderate the effects of social norm and facilitating conditions on delay, and (e) whether denial was related to escape-avoidance coping. Participants completed mailed questionnaires. Pearson correlation and separate regression analyses showed that denial was associated with increased delay. Confrontive coping, social support, and problem-solving strategies had no relationship with delay. Interventions focusing on denial could help enhance early care seeking.