Characteristics associated with inter-individual variability in financial distress in patients with breast cancer prior to and for 12 months following surgery.

PURPOSE: To evaluate for inter-individual differences in financial distress and identify demographic, clinical, and symptom characteristics associated with higher levels of financial distress. METHODS: Patients (n = 387) were enrolled prior to breast cancer surgery and followed for 12 months. Financial distress was measured using a 0 (no problem) to 10 (severe problem) numeric rating scale. Hierarchical linear modeling was used to evaluate for inter-individual differences in trajectories of financial distress and characteristics associated with financial distress at enrollment and over 12 months. RESULTS: Patients' mean age was 55.0 (± 11.7) years and the majority underwent breast conservation surgery (80.6%). Mean financial distress score prior to surgery was 3.3 (± 3.4; range 0 to 10). Unconditional model for financial distress demonstrated no significant changes over time (-0.006/month). Younger age, lower income, receipt of an axillary lymph node dissection and adjuvant chemotherapy, and lower attentional function were associated with higher preoperative levels of financial distress. CONCLUSION: Risk factors identified in this study can be used to inform clinicians regarding the need to initiate financial discussions and social work referrals for some patients. Additional clinical or system level interventions should be considered for vulnerable groups with these risk factors.

Evidence-informed implementation of nurse prescribing under supervision: An integrative review.

AIM: To explore evidence reporting facilitators and barriers to implementation of nurse prescribing and provide practical recommendations for evidence-informed implementation and adoption of nurse prescribing under a supervision model. BACKGROUND: As demand for access to quality health care services increases, health professional roles are expanding to meet population needs. Nurse prescribing has been effective in some countries and is being considered globally to address growing health care demand. Successful implementation of health service models requires careful planning and consideration. No existing reviews have examined implementation factors in the literature. DESIGN: Integrative review. DATA SOURCES: CINAHL, MEDLINE, PubMed and EMBASE databases were searched from inception to 15 April 2020. REVIEW METHODS: This integrative review is guided by Whittemore and Knafl and adheres to PRISMA reporting guidelines. The sustainability of innovation framework was used to synthesize data concerning implementation and sustainability factors (i.e. innovation, organizational, political, workforce and financial) for nurse prescribing. RESULTS: A total of 39 articles were reviewed with literature predominantly reporting findings related to non-medical and nurse prescribing under various models. Variable evidence was found to inform nurse prescribing across five implementation and sustainability factors identifying several areas that require in-depth consideration. Very little evidence is available on nurse prescribing under supervision. CONCLUSION: Introduction of service reform is often costly. This review highlights gaps in the literature and raises areas for consideration prior to implementation of this new service delivery model. The introduction of nurse prescribing must be planned and informed by available evidence to support effective adoption, practice and patient outcomes. IMPACT: There are significant gaps in evidence related to nurse prescribing under a supervision model. Based on the evidence synthesized in this review, this paper provides practical recommendations for health service providers, managers, clinicians, educators and researchers to support implementation and adoption of nurse prescribing.

Is the Australian nursing workforce ready to embrace prescribing under supervision? A cross-sectional survey.

AIM: The aim was to explore nurses' preparedness to expand their practice to prescribe medicines under a supervision model. DESIGN: This was a cross-sectional study. METHODS: A convenience sample of Australian nurses recruited from memberships of State-based Nursing and Midwifery Unions and professional bodies from diverse care settings. Nurses undertook an online researcher-constructed survey between March and July 2021 to identify current prescribing practices, motivations for undertaking education in prescribing and perceived barriers to implementation of nurse prescribing under supervision. Data related to demographics, nursing experience and barriers to becoming a prescriber were analysed descriptively. Logistic regression was used to model nursing experience variables with desire to become a prescriber. RESULTS: A total of 4424 nurses participated with the majority (n = 3645, 82%) reporting they were highly likely to expand their practice to prescribe medicines under supervision. The main motivations to prescribe were to enhance patient care and job satisfaction. Nurses were more likely to want to prescribe if they had <10 years experience (95% CI = 0.3-0.5, p < 0.001), held a bachelor's degree (95% CI = 1.3-2.2, p < 0.001) or higher qualification (95% CI = 1.8-2.9, p < 0.001). Most reported lack of acknowledgement of increased responsibility and workloads (n = 4098, 93%), and insufficient organizational support (n = 4197, 95%) may prevent uptake of nurse prescribing. CONCLUSIONS: Most Australian nurses demonstrated their preparedness to embrace the role of prescribing under supervision. The perceived barriers identified in this study can inform future implementation of this expanded nursing role. IMPACT: The Nursing and Midwifery Board of Australia has proposed a standard of practice to enable nurses to prescribe under supervision. Models of nurse prescribing are being considered globally to address population needs. Successful adoption of this practice is dependent on aspects such as key personnel's acceptance of the initiative. The workforce readiness and barriers highlighted in this study can inform implementation at policy and organizational levels.

Bridging the research to practice gap: a systematic scoping review of implementation of interventions for cancer-related fatigue management.

BACKGROUND: Cancer-related fatigue (CRF) is one of the most common and distressing symptoms in people with cancer. Although efficacy of interventions for CRF have been extensively investigated, less has been done to ensure successful translation into routine clinical practice. The aim of this systematic scoping review was to synthesise knowledge surrounding the implementation of CRF interventions, summarise the processes and outcomes of implementation strategies used, and identify opportunities for further research. METHODS: PubMed, Cochrane CENTRAL, EMBASE and CINAHL databases were searched (up to December 2020). The Cochrane Effective Practice and Organisation of Care (EPOC) Group taxonomy and the RE-AIM Framework were used to guide the evaluation of implementation strategies and outcomes, respectively. RESULTS: Six studies were included. Three used an implementation framework (PARIHS, KTA, Cullens & Adams' Implementation Guide) to guide implementation. Overall, the implementation strategies used across all studies were reported to have directly resulted in immediate changes at the clinician level (e.g., increased clinician behaviours, self-efficacy, attitudes, knowledge of CRF management). No clear relationship was found between the use of implementation models and the number or type of implementation strategies used. For outcomes, Effectiveness and Implementation were the most highly reported RE-AIM measures followed by Reach then Maintenance. Adoption was the least reported. CONCLUSIONS: Despite the high prevalence of CRF and evidence-based interventions for managing CRF, there is limited evidence informing the sustainable implementation of these interventions. This systematic scoping review emphasises the lack of quality CRF implementation studies presently available in the literature leading to a disconnect between effective CRF interventions, routine clinical care, and cancer survivors at present. This review highlights the need for robust study designs guided by established frameworks to methodically design and evaluate the implementation of CRF management interventions in the future.

Distinct employment interference profiles in patients with breast cancer prior to and for 12 months following surgery.

PURPOSE: To identify subgroups of female breast cancer patients with distinct self-reported employment interference (EI) profiles and determine which demographic, clinical, and symptom characteristics, and quality of life outcomes were associated with subgroup membership. METHODS: Women with breast cancer (n = 385) were assessed for changes in EI over ten times, from prior to, through 12 months after breast cancer surgery. Latent profile analysis (LPA) was used to identify subgroups of patients with distinct EI profiles. RESULTS: Three distinct EI profiles (i.e., None - 26.2% (n = 101), Low - 42.6% (n = 164), High - 31.2% (n = 120)) were identified. Compared to the None and Low groups, patients in the High group were more likely to be younger. Higher proportions in the High group were non-White, pre-menopausal prior to surgery, had more advanced stage disease, had received an axillary lymph node dissection, had received neoadjuvant chemotherapy, had received adjuvant chemotherapy, and had a re-excision or mastectomy on the affected breast within 6 months after surgery. In addition, these patients had lower quality of life scores. Compared to the None group, the High group had higher levels of trait and state anxiety, depressive symptoms, fatigue and sleep disturbance and lower levels of cognitive function. CONCLUSIONS: This study provides new knowledge regarding EI profiles among women in the year following breast cancer surgery. The non-modifiable risk factors (e.g., younger age, being non-White, having more advanced stage disease) can inform current screening procedures. The potentially modifiable risk factors can be used to develop interventions to improve employment outcomes of breast cancer patients.

The effects of a family-centered psychosocial-based nutrition intervention in patients with advanced cancer: the PiCNIC2 pilot randomised controlled trial.

BACKGROUND: Malnutrition in advanced cancer patients is common but limited and inconclusive data exists on the effectiveness of nutrition interventions. Feasibility and acceptability of a novel family-based nutritional psychosocial intervention were established recently. The aims of this present study were to assess the feasibility of undertaking a randomised controlled trial of the latter intervention, to pilot test outcome measures and to explore preliminary outcomes. METHODS: Pilot randomised controlled trial recruiting advanced cancer patients and family caregivers in Australia and Hong Kong. Participants were randomised and assigned to one of two groups, either a family-centered nutritional intervention or the control group receiving usual care only. The intervention provided 2-3 h of direct dietitian contact time with patients and family members over a 4-6-week period. During the intervention, issues with nutrition impact symptoms and food or eating-related psychosocial concerns were addressed through nutrition counselling, with a focus on improving nutrition-related communication between the dyads and setting nutritional goals. Feasibility assessment included recruitment, consent rate, retention rate, and acceptability of assessment tools. Validated nutritional and quality of life self-reported measures were used to collect patient and caregiver outcome data, including the 3-day food diary, the Patient-Generated Subjective Global Assessment Short Form, the Functional Assessment Anorexia/Cachexia scale, Eating-related Distress or Enjoyment, and measures of self-efficacy, carers' distress, anxiety and depression. RESULTS: Seventy-four patients and 54 family caregivers participated in the study. Recruitment was challenging, and for every patient agreeing to participate, 14-31 patients had to be screened. The consent rate was 44% in patients and 55% in caregivers. Only half the participants completed the trial's final assessment. The data showed promise for some patient outcomes in the intervention group, particularly with improvements in eating-related distress (p = 0.046 in the Australian data; p = 0.07 in the Hong Kong data), eating-related enjoyment (p = 0.024, Hong Kong data) and quality of life (p = 0.045, Australian data). Energy and protein intake also increased in a clinically meaningful way. Caregiver data on eating-related distress, anxiety, depression and caregiving burden, however, showed little or no change. CONCLUSIONS: Despite challenges with participant recruitment, the intervention demonstrates good potential to have positive effects on patients' nutritional status and eating-related distress. The results of this trial warrant a larger and fully-powered trial to ascertain the effectiveness of this intervention. TRIAL REGISTRATION: The trial was registered with the Australian & New Zealand Clinical Trials Registry, registration number ACTRN12618001352291 .

Unmet Supportive Care Needs and Associated Factors: a Cross-sectional Survey of Chinese Cancer Survivors.

To assess cancer survivors' unmet supportive care needs and associated factors. Limited evidence is available about the supportive care needs of Chinese cancer survivors to inform future service planning. A cross-sectional survey was conducted (STROBE cross-sectional checklist used for report). Standardized questionnaires were administered to 364 cancer survivors. Using the Supportive Care Framework as conceptual framework, factors concerning individuals' cognitive appraisals of their situation and social resources were examined to explore their association with unmet supportive care needs. The most common unmet supportive care needs included concern about the cancer coming back (51.5%), the need for up-to-date information (49.3%), collaborative management with the medical team (48.8%), and financial support (48.8%). Factors associated with greater strength of unmet supportive care needs included being female, having higher personal support, and higher self-efficacy pertaining to social relationship. Having lower support from family and friends was a contributing factor associated with greater strength of unmet needs in comprehensive cancer care and relationship, as was lower self-efficacy pertaining to uncertainty management associated with greater strength of unmet needs in quality of life, and lower self-efficacy pertaining to health professional interaction associated with greater strength of unmet needs in information. Chinese cancer survivors experience a number of unmet supportive needs. Female and rural cancer survivors, and those with lower social support level and self-efficacy are susceptible to having higher levels of unmet supportive care needs. Consistent information provision and peer support system establishment are two potentially beneficial approaches to meet cancer patients' long-term supportive care needs. Females and rural cancer survivors, those with less support from family and friends, and those with lower self-efficacy in interactions with health professionals and in managing uncertainty are especially at risk for unmet supportive care needs.

Supportive care and unmet needs in patients with melanoma: a mixed-methods systematic review.

PURPOSE: Understanding the supportive care and unmet care needs of patients with melanoma is essential for informing the development or evaluation of supportive care services and interventions for patients with melanoma. METHODS: Three electronic databases (CINAHL, Medline and PsycINFO) were searched from 2000 to November 2019 to identify eligible quantitative and qualitative studies. The quality of evidence was assessed using the Mixed Methods Appraisal Tool. RESULTS: Fourteen studies (10 quantitative, three qualitative and one mixed-methods) were included. Informational care and unmet needs were the most commonly reported in patients with melanoma, followed by psychological, then social and physical. Findings were consistent between quantitative and qualitative studies; however, findings from qualitative data complimented those from quantitative data by providing more depth and insight into the prevalence, effects and associations of the different care needs. Patients' care and unmet needs were found to also be present all throughout their cancer journey and vary according to the stage throughout. CONCLUSION: Melanoma-specific care and unmet care needs were identified most commonly in the informational domain, followed by psychological, social and physical domains. Oncology practitioners should consider enhancing their supportive care interventions throughout the journey of patient with melanoma to reduce or address their unmet needs. The results of this mixed-methods systematic review warrant further research using robust study designs, melanoma-specific validated outcome measures and complete reporting of data in terms of disease stage.

A longitudinal analysis of phenotypic and symptom characteristics associated with inter-individual variability in employment interference in patients with breast cancer.

PURPOSE: A breast cancer diagnosis has a substantial economic impact. Study aims were to evaluate for inter-individual differences in cancer's level of interference with employment and identify phenotypic and symptom characteristics associated with higher levels of interference. METHODS: Patients (n = 387) were enrolled prior to breast cancer surgery and followed for 12 months. Interference with employment was measured using a 0 (no problem) to 10 (severe problem) numeric rating scale. Hierarchical linear modeling (HLM) was used to evaluate for inter-individual differences in trajectories of employment interference and characteristics associated with employment interference at enrollment and over 12 months. RESULTS: Patients' mean age was 55.0 (±11.7) years and the majority underwent breast conservation surgery (80.6%). Mean employment interference score was 3.2 (±3.7). Unconditional model for employment interference demonstrated a decreasing linear trend (-.076/month). Younger age, lower income, higher pain intensity, and having an axillary lymph node dissection were associated with higher pre-surgical interference scores. Having a sentinel lymph node biopsy was associated with ongoing employment interference scores. Higher sleep disturbance scores were associated with both initial and ongoing employment interference scores. Receipt of chemotherapy, use of complementary or alternative therapies, and re-excision or mastectomy following surgery were significant time varying covariates. CONCLUSION: This study is the first to use HLM to describe inter-individual differences in the trajectories of cancer's interference with employment and associated factors prior to and for 12 months following breast cancer surgery. Patients with the identified risk factors warrant ongoing assessments of employment interference and appropriate referrals.

End-of-life care preferences for people with advanced cancer and their families in intensive care units: a systematic review.

BACKGROUND: Advanced cancer patients' end-of-life care preferences in oncology units, medical-surgical units, nursing homes and palliative care services have been established. However, less is known about end-of-life care preferences of patients with advanced cancer in intensive care units and their families. AIM: To explore end-of-life care preferences of patients with advanced cancer and their families in intensive care units and if these align with essential elements for end-of-life care. DESIGN: Electronic databases were searched up to February 2018. Reference lists of retrieved articles were screened for potential studies. RESULTS: A total of 112 full text articles were retrieved. Of these, 12 articles reporting outcomes from 10 studies were eligible for inclusion. The majority were retrospective chart reviews (n = 7) and conducted in developed countries (n = 9). Care preferences change over time with deteriorating physical condition. Ongoing patient-centred communication and shared decision-making are critical as is teamwork and involvement of a palliative care team. Marital status, gender and ethnicity appear to influence care preferences. Of those studies examining patient preferences and/or the receiving of their preferences, these could be aligned with approximately half of the Australian essential elements for end-of-life care. CONCLUSIONS: Providing end-of-life care for patients with advanced cancer in intensive care units is challenging. No studies have investigated prospectively the end-of-life care preferences of patients and their families in this acute setting. Further research is required to determine the elements of care preferences for patients with advanced cancer and their families in intensive care units in developing countries.

The effects of Tai Chi on quality of life of cancer survivors: a systematic review and meta-analysis.

PURPOSES: To assess the effects of Tai Chi on quality of life (QOL) of cancer survivors. METHODS: The following databases were searched: PubMed, Cochrane CENTRAL, EBSCO (including MEDLINE, CINAHL, and other databases), ScienceDirect, CNKI, Wangfang Data, and CQVIP until April 25, 2018. Randomized controlled trials (RCTs) published in English or Chinese examining the effects of Tai Chi intervention for cancer survivors were included. The primary outcome was QOL; the secondary outcomes were limb function/muscular strength, immune function indicators, cancer-related fatigue (CRF), and sleep disturbance. Methodological quality was assessed using the Cochrane Risk of Bias tool. Results of RCTs were pooled with mean difference (MD) or standardized mean difference (SMD) with 95% confidence intervals (CI). Quality of evidence for each outcome was assessed with the GRADE system. RESULTS: Twenty-two RCTs were included in this review. Tai Chi improved the physical (SMD 0.34, 95%CI 0.09, 0.59) and mental health (SMD 0.60, 95%CI 0.12, 1.08) domains of quality of life. The intervention improved the limb/muscular function of breast cancer survivors (SMD 1.19, 95%CI 0.63, 1.75) and in mixed samples of cancer survivors reduced the levels of cortisol (MD - 0.09, 95%CI - 0.16, - 0.02), alleviated CRF (SMD - 0.37, 95%CI - 0.70, - 0.04), and promoted sleep (SMD - 0.37, 95%CI - 0.72, - 0.02). CONCLUSION: There is low-level evidence suggesting that Tai Chi improves physical and mental dimensions of QOL and sleep. There is moderate-level evidence suggesting Tai Chi reduces levels of cortisol and CRF and improves limb function. Additional studies with larger sample sizes and with higher-quality RCT designs comparing different regimens of Tai Chi are warranted.

Correction to: Oncology practitioners' perspectives and practice patterns of post-treatment cancer survivorship care in the Asia-Pacific region: results from the STEP study.

It has been highlighted that the original manuscript [1] contains a typesetting error in the surname of Jesson Butcon. This was incorrectly captured as Jessica Butcon in the original manuscript which has since been updated.

Nurses attitudes and practices towards provision of survivorship care for people with a haematological cancer on completion of treatment.

PURPOSE: The purpose of this study is to assess cancer nurses' perceptions of responsibility, confidence levels and practice in relation to survivorship care for people with a haematological malignancy on completion of treatment. METHODS: A prospective cross-sectional survey was conducted. An online survey was distributed to members of two Australian professional bodies. RESULTS: A total of 310 cancer nurses participated in the study, representing a response rate of 28%. The participants generally agreed that all survivorship care items were part of their role. Of the 17 survivorship care items, the three items receiving the lowest confidence scores were discussing fertility issues, discussing employment and financial issues and discussing how to identify signs of cancer recurrence. The least performed survivorship care items were discussing fertility issues, communicating survivorship care with primary healthcare team (i.e. general practitioners) and discussing sexuality issues. Older age, more years of experience, having a post-graduate qualification and working in non-metropolitan area were associated with higher levels of perception of responsibilities and confidence (p < 0.05). The top ranked barriers to survivorship care were reported to be lack of end-of-treatment consultation dedicated to survivorship care, time and an appropriate physical space for delivering care. CONCLUSIONS: Cancer nurses perceive key aspects of survivorship care to be part of their role, however there remains variations in practice and confidence with respect to implementation of survivorship care practices. IMPLICATIONS FOR CANCER SURVIVORS: Interventions that focus on enhancing the capability of cancer nurses and eliminating barriers identified in this study have the potential to improve quality survivorship care provision.

A step forward in addressing cancer survivorship in the Asia-Pacific region.

Cancer survivorship is being increasingly recognized as an important component of cancer care. This commentary reviews the key findings reported in the recent BMC Medicine publication of the ACTION study, which focuses on the health-related quality of life and psychological distress in 5249 cancer survivors in eight low- and middle-income countries in Southeast Asia. The study identified that more than one-third of survivors experience at least mild levels of anxiety and depressive symptoms and that poorer outcomes in quality of life, anxiety, and depressive symptoms are linked to a number of clinical and demographic factors. Such data provides an important foundation to inform cancer policy and service planning in Asia. Future research efforts are required to further understand the needs of cancer survivors in this region and determine interventions to improve outcomes for this population.Please see related article: http://bmcmedicine.biomedcentral.com/articles/10.1186/s12916-016-0768-2 .

A systematic review of prognostic factors at the end of life for people with a hematological malignancy.

BACKGROUND: Accurate prognosticating is needed when patients are nearing the end of life to ensure appropriate treatment decisions, and facilitate palliative care provision and transitioning to terminal care. People with a hematological malignancy characteristically experience a fluctuating illness trajectory leading to difficulties with prognosticating. The aim of this review was to identify current knowledge regarding 'bedside' prognostic factors in the final 3 months of life for people with a hematological malignancy associated with increased risk of mortality. METHODS: A systematic review of the literature was performed across: PubMed; CINAHL; PsycINFO; and Cochrane with set inclusion criteria: 1) prognostic cohort studies; 2) published 2004-2014; 3) sample ≥ 18 years; 4) >50% sample had a hematological malignancy; 5) reported 'bedside' prognostic factors; 6) median survival of <3 months; and 7) English language. Quality appraisal was performed using the Quality In Prognostic Studies (QUIPS) tool. Results are reported in line with PRISMA guidelines. RESULTS: The search returned 4860 studies of which 28 met inclusion criteria. Twenty-four studies were rated moderate quality, three were high quality and one study was deemed to be of low quality. Most studies were set in the ICU (n = 24/28) and were retrospective (n = 25/28). Forty 'bedside' prognostic factors were identified as associated with increased risk of mortality encompassing the following broad categories: 1) demographics; 2) physiological complications or conditions; 3) disease characteristics; 4) laboratory blood values; and 5) interventions. CONCLUSIONS: The literature on prognosticating in the final months of life was predominantly focused on people who had experienced acute physiological deterioration and were being treated aggressively in the in-patient setting. A significant gap in the literature exists for people who are treated less aggressively or are on a palliative trajectory. Findings did not report on, or confirm the significance of, many of the key prognostic factors associated with increased risk of mortality at the end of life in the solid tumour population, demonstrating key differences in the two populations. TRIAL REGISTRATION: This systematic review was not registered.

Oncology practitioners' perspectives and practice patterns of post-treatment cancer survivorship care in the Asia-Pacific region: results from the STEP study.

BACKGROUND: Most efforts to advance cancer survivorship care have occurred in Western countries. There has been limited research towards gaining a comprehensive understanding of survivorship care provision in the Asia-Pacific region. This study aimed to establish the perceptions of responsibility, confidence, and frequency of survivorship care practices of oncology practitioners and examine their perspectives on factors that impede quality survivorship care. METHODS: A cross-sectional survey of hospital-based oncology practitioners in 10 Asia-Pacific countries was undertaken between May 2015-October 2016. The participating countries included Australia, Hong Kong, China, Japan, South Korea, Thailand, Singapore, India, Myanmar, and The Philippines. The survey was administered using paper-based or online questionnaires via specialist cancer care settings, educational meetings, and professional organisations. RESULTS: In total, 1501 oncology practitioners participated in the study. When comparing the subscales of responsibility perception, frequency and confidence, Australian practitioners had significantly higher ratings than practitioners in Hong Kong, Japan, Thailand, and Singapore (all p < 0.05). Surprisingly, practitioners working in Low- and Mid- Income Countries (LMICs) had higher levels of responsibility perception, confidence and frequencies of delivering survivorship care than those working in High-Income Countries (HICs) (p < 0.001), except for the responsibility perception of care coordination where no difference in scores was observed (p = 0.83). Physicians were more confident in delivering most of the survivorship care interventions compared to nurses and allied-health professionals. Perceived barriers to survivorship care were similar across the HICs and LMICs, with the most highly rated items for all practitioners being lack of time, dedicated educational resources for patients and family members, and evidence-based practice guidelines informing survivorship care. CONCLUSIONS: Different survivorship practices have been observed between HICs and LMICs, Australia and other countries and between the professional disciplines. Future service planning and research efforts should take these findings into account and overcome barriers identified in this study.

Topical interventions to prevent acute radiation dermatitis in head and neck cancer patients: a systematic review.

PURPOSE: The purpose of the study is to evaluate the effects of pharmacological and non-pharmacological topical controls in the prevention of radiation dermatitis. METHODS: Relevant clinical trials were identified through electronic searching databases CINAHL, CENTRAL, LILACS, PubMed, Scopus, and Web of Science. Handsearching and gray literature searches were also performed to find additional references. Primary outcomes of interest were the development of radiation dermatitis and the time of occurrence of radiation dermatitis. RESULTS: Thirteen randomized clinical trials were included in this review. The trials were published in Chinese, English, or French, from 1980 to 2015. Pharmacological interventions used in the trials were trolamine, aloe vera, allantoin, Lianbai liquid, sucralfate, Na-sucrose octasulfate, olive oil, hialuronic acid, and dexpanthenol. Non-pharmacological topical controls were usual care/institution routine, aqueous cream, mild soap, water thermal gel, placebo, and no intervention. CONCLUSIONS: There was no strong evidence that indicates differences between topical pharmacological interventions or non-pharmacological topical controls in the prevention of acute radiation dermatitis among patients with head and neck cancer undergoing radiotherapy.

Models of survivorship care provision in adult patients with haematological cancer: an integrative literature review.

PURPOSE: Increasing numbers of haematology cancer survivors warrants identification of the most effective model of survivorship care to survivors from a diverse range of haematological cancers with aggressive treatment regimens. This review aimed to identify models of survivorship care to support the needs of haematology cancer survivors. METHOD: An integrative literature review method utilised a search of electronic databases (CINAHL, Medline, PsycInfo, PubMed, EMBASE, PsycArticles, and Cochrane Library) for eligible articles (up to July 2014). Articles were included if they proposed or reported the use of a model of care for haematology cancer survivors. RESULTS: Fourteen articles were included in this review. Eight articles proposed and described models of care, and six reported the use of a range of survivorship models of care in haematology cancer survivors. No randomised controlled trials or literature reviews were found to have been undertaken specifically with this cohort of cancer survivors. There was variation in the models described and who provided the survivorship care. CONCLUSION: Due to the lack of studies evaluating the effectiveness of models of care, it is difficult to determine the best model of care for haematology cancer survivors. Many different models of care are being put into practice before robust research is conducted. Therefore, well-designed high-quality pragmatic randomised controlled trials are required to inform clinical practice.