Multicultural approaches of cancer pain.

PURPOSE OF REVIEW: Pain continues to be a prevalent symptom in cancer patients. Patient's ethnicity may influence the experience of pain with variations in pain outcomes among different ethnic groups. The objective of this thematic review is to investigate the relationship between ethnicity and cancer pain experience, assessment and management. RECENT FINDINGS: Cancer pain is not only a biophysiological construct but is rather a multidimensional concept of physiological and psychosocial responses, including the biocultural dimension. Culture can significantly affect patients' cancer pain-related beliefs and behaviors and patient's ethnicity may influence the experience of pain.We found a scarcity of data and an inconsistent literature that highlights gaps in knowledge, research and clinical practice concerning effective cancer pain management in a multicultural context. SUMMARY: To face disparities among ethnic minorities in cancer pain management, well-designed randomized controlled trials and robust qualitative research on cancer pain-related issues should inform good clinical practice. A close worldwide collaboration between researchers and clinicians and professional organizations is warranted.

Are we ready for intercultural cancer care?

PURPOSE OF REVIEW: Migration is increasing worldwide, with accumulating evidence of health disparities. At the same time, oncology faces new challenges within a fast-changing care landscape. These two developments raise the question of integration of migrants and ethnic minorities (MEMs) and cultural influences in oncology. RECENT FINDINGS: Perceptions of health and disease differ substantially across and within societies and cultures. However, health needs of MEMs and cultural influences seem often out of the scope of cancer care. The purpose of this thematic review is to consider three major challenges of current and future oncology through the prism of culture and ethnicity: enrollment in cancer clinical trials, therapeutic adherence, and new models and paradigms of care. We found inconsistent literature highlighting gaps in knowledge, research, and clinical practice. This confirms unequal situations for MEMs in cancer and asserts interactions between culture influences and therapeutic transactions. SUMMARY: To eliminate the burden of health disparities and ensure the best outcomes in MEM's cancer patients, a collaborative approach from research and clinical practice is necessary. Only robust research from all countries exploring unmet needs of MEMs and striving for functional understanding can inform and innovate clinical practice.

Temper the Specialist Nurses Heterogeneity in the Interest of Quality Practice and Mobility-18 EU Countries Study.

BACKGROUND: The position of the specialist nurse profession varies across the European Union. Action is required to address the challenges to promote mobility and the contribution of specialist nurses to quality of care. The purpose of the study is to identify the interfaces of the specialist nurse profession across the European Union. METHODS: A mixed method study was conducted in October 2019 and total of 40 answers from 18 different European Union countries were selected using a purposive sampling method. RESULTS: The participants had completed various Bologna degree cycles and 57.2% had followed a specific educational programme to become a specialist nurse. More professional autonomy was acquired by 81.9% participants. CONCLUSION: A striving for homogeneity in the interpretation of the specialist nurses role and competencies is needed to achieve better quality of care provision and facilitate their mobility around the European Union. The lack of recognition identified in this study should encourage nurse managers to consider specialist nurse roles with the aim of capitalizing on the advanced care and expertise that specialist nurses provide. These results are an opportunity to improve the specialist nurses profession with an ultimate impact on management practices of streamlined, cost-effective clinical services.

Neutropenia management with granulocyte colony-stimulating factors: from guidelines to nursing practice protocols.

Neutropenia, a problem that oncology nurses face in daily practice, is the major dose-limiting toxicity in patients with cancer who are treated with myelosuppressive chemotherapy. The incidence of chemotherapy dose reductions or treatment delays, which can impact overall dose intensity and compromise treatment outcomes, may be reduced by the proactive use of granulocyte colony-stimulating factor (G-CSF). National and international guidelines have been developed to promote the cost-effective use of G-CSF. Nursing care protocols for the management of chemotherapy-induced neutropenia (CIN) can be developed based on the national guidelines and modified for use by individual clinical practices. Risk assessment for CIN, which considers the prescribed chemotherapy regimen, patient risk factors, and treatment intent, should be a key component of the practice guidelines. Because most neutropenic events occur in the first cycle of chemotherapy, risk assessments should be conducted before the initiation of chemotherapy. Patients identified as at high risk for neutropenic complications should be given G-CSF in the first and subsequent cycles to allow the delivery of chemotherapy at full dose and on schedule. Nurses are instrumental in the development and implementation of neutropenia management protocols, which have the potential to markedly improve the quality of care and outcomes for patients with cancer.