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BACKGROUND: This report investigates the applicability of nursing support for patients with cancer with a prognosis of months and weeks, and their families. OBJECTIVES: To evaluate the applicability of nursing support for five symptoms (dyspnea, pain, nausea/vomiting, constipation, and delirium) in patients with cancer during the last weeks of life, and the caregiver burden on their families. DESIGN SETTING: A Delphi study was used to determine the applicability of nursing support for patients with terminal cancer and their families. Eight experts in symptom palliation in Japan who have direct care or research experience with these populations were included. The Delphi method was used to assess nursing support types for prognoses of months and weeks. Consensus was defined as ≥70% agreement for either "high applicability" or "low applicability" of each support type. RESULTS: A total of 50 nursing support types for 5 symptoms were evaluated as highly applicable for 92% (n = 46) of patients with cancer with a prognosis of months. For patients with cancer with a prognosis of weeks, 78% (n = 39) of the nursing support was rated as highly applicable. For both prognosis groups, all nursing support (n = 6) for caregiver burden was highly applicable. CONCLUSION: Applicability ratings of nursing support may be influenced by a high degree of invasiveness, accessibility of knowledge and information, and high expectations of effectiveness. Future studies are needed to verify the effectiveness of nursing support evaluated as highly applicable to patients with cancer during the last few months and weeks of life.
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Background: Constipation is an uncomfortable symptom experienced by many patients with advanced cancer, and it decreases the quality of life. Several studies have advised pharmacological therapies for constipation management, whereas others have promoted nonpharmacological approaches that promote changes in the patient's lifestyle. However, constipation management by nurses has not yet been systematically reviewed in patients with cancer. Therefore, this study conducted a scoping review of nursing support focused on nonpharmacological therapies offered to relieve constipation in patients with cancer. Methods: The review was guided by Arksey and O'Malley's five-stage scoping review framework. We searched the databases of PubMed, Cumulative Index to Nursing and Allied Health Literature, CENTRAL in the Cochrane Library, and Ichushi-Web of the Japan Medical Abstract Society from the databases' inceptions to August 31, 2023, using various search terms such as "cancer," "constipation," and "nursing care." Results: A total of 1501 articles that met the eligibility criteria were identified; of these, 5 articles were selected, and 1 additional article was found via handsearching. The final sample included six articles. We categorized the articles into three major nursing support types: acupressure, aroma massage to the abdomen, and self-management education. Five studies used a randomized controlled trial (RCT) design, including one with a randomized, waiting-list controlled trial, and one used a non-RCT design. All included studies showed the effectiveness of nonpharmacological interventions to improve constipation. Conclusion: This study also identified three types of nursing support for patients with cancer to relieve constipation. However, because of the small sample size, further evidence is required.
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Pain is subjective, warranting tailored responses in pharmacotherapy and nursing support. Despite this, the evidence for suitable nursing support for pain is not well established in terminally ill patients such as those with cancer; therefore, it is necessary to provide support in consideration of changes in physical symptoms and quality of life. However, interventional studies for such patients are often difficult. There have been no comprehensive studies to date on non-pharmacological support that can be implemented by nurses. Therefore, with the aim of examining nursing support applicable at the end of life, this scoping review comprehensively mapped nursing support for pain in cancer patients at all stages of the disease. This study complies with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement and the Arksey and O'Malley framework. All available published articles from the time of database establishment to January 31, 2022, were systematically searched for in PubMed, Cumulative Index to Nursing and Allied Health Literature (CINAHL), CENTRAL, and the Ichushi Web database of the Japanese Society of Medical Abstracts. Overall, 10,385 articles were screened, and 72 were finally included. Both randomized controlled trials (RCTs) (n = 62) and non-RCTs (n = 10) were included. Twenty-two types of nursing support were identified. Eighteen of them showed positive results; five of them were provided only to terminally ill patients, three of which were effective, namely, comfort care, foot bath, and combined therapy. It is important to examine the applicability of types of nursing support in clinical practice in the future.