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BACKGROUND: The study aim was to elucidate the effect of the 2024 Noto Peninsula earthquake on outpatient chemotherapy treatment of cancer survivors at Kanazawa Medical University Hospital (KMUH), Japan. METHODS: Medical and nursing records for January 4-31, 2024, from KMUH were retrospectively collected, and data for 286 participants were analyzed. RESULTS: Of the 286 participants, 95.1% were able to attend their first scheduled appointment. Of the 12 (4.2%) who could not attend because of the earthquake, 7 (58.3%) rescheduled their appointments. A total of 8 participants (2.8%) were unable to attend their second scheduled appointment in January, despite being able to attend their first appointment; 3 (37.5%) of these participants reported that they were unable to attend their appointments because of the effect of the earthquake. Chemotherapy was not administered to 53 (18.5%) participants who did attend, mainly owing to neutropenia, progressive disease, rash, and anemia. Evacuation information was available for 25 participants (8.7%); of these, 8 (28.6%) evacuated to their homes, 7 (25.0%) to public shelters, and 4 (14.3%) to apartments near the hospital. Disaster status information was obtained from 62 participants (21.7%), and indicated experiences such as home damage, water outages, and relying on transportation assistance from family to attend appointments. CONCLUSIONS: Most cancer survivors receiving chemotherapy at KMUH were able to maintain outpatient visits. However, a few could not attend because of the earthquake. Further studies are needed to provide more detailed information on the effect of disasters on cancer survivors and the potential factors underlying non-attendance at medical appointments.
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Supervivientes de Cáncer , Terremotos , Neoplasias , Pacientes Ambulatorios , Humanos , Masculino , Femenino , Japón/epidemiología , Estudios Retrospectivos , Persona de Mediana Edad , Anciano , Supervivientes de Cáncer/estadística & datos numéricos , Pacientes Ambulatorios/estadística & datos numéricos , Adulto , Neoplasias/tratamiento farmacológico , Atención Ambulatoria/estadística & datos numéricos , Anciano de 80 o más AñosRESUMEN
Objective: Immunotherapeutic approaches to cancer, such as dendritic cell vaccine therapy, promise to improve survival rate but may present unique challenges to patients. However, there is no research on the lived experiences of cancer patients receiving dendritic cell vaccine therapy. The aim of this study was to explore the attitudes, expectations, and experiences of cancer patients receiving dendritic cell vaccine therapy in Japan. Methods: This was an exploratory qualitative study. A descriptive phenomenological approach was used to investigate the experiences of eight advanced-stage cancer patients (median age: 59.5 years). Data were collected between July 2018 and March 2020 using in-depth semi-structured interviews. Data were analyzed according to Colaizzi's seven-step phenomenological strategy, and EQUATOR's Consolidated Criteria for Reporting Qualitative Research (COREQ) guidelines for qualitative studies were followed. Results: Four themes emerged from the data analysis: strong concerns about chemotherapy, faith in dendritic cell vaccine therapy, motivation to succeed, and physical and mental changes. The first two themes related to pretreatment attitudes and expectations. The latter two themes expressed participants' experiences during and after therapy. Conclusions: Dendritic cell vaccine therapy patients expressed fears about the effects of standard treatment, and hope and uncertainty regarding immunotherapy treatment decisions and efficacy. The findings suggest that such patients require nursing care that includes prevention and reduction of chemotherapy side effects, careful observation of patients' well-being, management of patients' expectations and uncertainty, formation of patient-health care practitioner partnerships, and team medicine.
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Disasters caused by natural phenomena are increasing in frequency and devastation. The growing number of cancer survivors constitute a vulnerable population in their need for continuous and high-level care, a vulnerability that is exacerbated in the event of disasters. Although the evidence base on the needs of cancer survivors is growing, little is known about cancer care in disaster settings. Therefore, we prepared a narrative literature review that outlines existing evidence, identifies knowledge gaps, and clarifies key concepts that are central to the burgeoning area of research into the quality of care for cancer survivors through disasters. As the preponderance of available evidence stresses the importance of careful disaster planning for maintaining care services, this review also provides guidance in developing plans for how to proceed during, and in the aftermath of, disasters.
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Supervivientes de Cáncer , Planificación en Desastres , Desastres , Neoplasias , Humanos , Calidad de Vida , Neoplasias/epidemiología , Neoplasias/terapiaRESUMEN
Three years after the outbreak of the coronavirus disease (COVID-19) pandemic, turnover among frontline nurses has increased. The participants of this study were nurses at two general hospitals in Ishikawa, Japan, receiving COVID-19 patients. An original self-report questionnaire was created based on previous research. The questionnaire was distributed to 400 nurses, and responses were received from 227 nurses (response rate: 56.8%). The factors influencing turnover intention at the facilities were having less time to relax (odds ratio [OR]: 2.88, 95% confidence interval [CI]: 1.12-7.41) and wanting to receive counseling (OR: 5.21, 95% CI: 1.30-20.91). As a strategy to prevent turnover, nurse managers should provide opportunities for nurses to receive counseling during normal working hours and pay particular attention to changes in nurses' daily lives, such as changes in the time available for relaxation.
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The purpose of this study was to assess the burden of caregiving among family caregivers of cancer survivors aged 75 years or older in Japan. We included family caregivers of cancer survivors aged 75 years or older who were attending two hospitals in Ishikawa Prefecture, Japan, or receiving treatment during home visits. A self-administered questionnaire was developed based on previous studies. We obtained 37 responses from 37 respondents. Excluding those with incomplete responses, we had data from 35 respondents for analysis. The factor that significantly influenced the burden of caregiving for cancer survivors aged 75 years or older and family caregivers living together was the provision of full-time care (p = 0.041). Helping cancer survivors manage money (p = 0.055) was also associated with a higher burden. For family caregivers living separately, a more detailed examination of the association between the sense of caregiving burden and distance of travel to provide home-visit care is necessary, along with more support to attend hospitals with cancer survivors.
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Life satisfaction is increasingly important for older cancer survivors as the global population ages and the life expectancy 29 of cancer survivors increases. This study sought to identify factors associated with physical symptoms, quality of life under treatment, and current life satisfaction in cancer survivors aged 75 years and older receiving outpatient chemotherapy. Information about treatment for cancer survivors was collected from electronic medical records, and interviews were conducted to assess life satisfaction under treatment. Participants were older cancer survivors in Ishikawa, Japan. Of the participants, 80% lived on the Noto Peninsula. The average linear distance traveled for treatment was 40.7 km. The factors associated with patients' dissatisfaction with their current lives included general malaise (odds ratio: 9.61; 95% confidence interval: 1.28-72.22) and being less happy now than when they were younger (odds ratio: 10.559; 95% confidence interval: 1.50-74.24). In outpatient cancer treatment for survivors aged 75 years and older, support should consider the distance to the hospital. As in past studies, general malaise was shown to have a negative impact on the lives of cancer survivors aged 75 years or older. Support providers should pay attention to patients' general malaise when providing support.
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The purpose of this study was to investigate the factors related to Japanese nurses' desire to quit their jobs during the Omicron wave of the coronavirus disease 2019 pandemic. We distributed an original, self-administered questionnaire to nurses at 3 facilities that accepted patients with coronavirus disease 2019 in Ishikawa Prefecture, Japan. Of the 625 nurses, 152 responded (24.3%); after excluding 3 men to rule out the effects of sex, responses for 81 (53.3%) nurses were analyzed. In total, 49 (60.5%) nurses expressed a desire to quit their current job. After controlling for the effects of age and years of experience, factors related to the desire to quit the current job included having fewer than 2 years of experience (odds ratio [OR] 9.08, 95% confidence interval [CI] 1.69-48.87), feeling anxiety at work (OR 4.59, 95% CI 1.01-20.81), being afraid to go to work (OR 4.10, 95% CI 1.20-21.69), and experiencing difficulty talking to people (OR 10.26, 95% CI 1.48-70.99). Nurse managers should regularly screen nurses who have fewer than 2 years of experience, feel anxiety at work, are afraid to go to work, and find it difficult to talk to people. Early action may prevent the turnover of nurses during a public health emergency.
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COVID-19 , Enfermeras y Enfermeros , Personal de Enfermería en Hospital , Estudios Transversales , Humanos , Japón/epidemiología , Satisfacción en el Trabajo , Masculino , Pandemias , Encuestas y CuestionariosRESUMEN
Hospitals have established visiting restrictions to block coronavirus disease 2019 (COVID-19) external transmission routes. This study investigated factors associated with nurses' internal transfer intentions and changes in their workloads, burdens, and daily lives owing to pandemic-related family visiting restrictions. Participants were nurses from three medical institutions designated for infectious diseases in Ishikawa Prefecture, Japan. An original self-report questionnaire was developed based on previous studies and a web-based survey conducted. Responses were received from 152 nurses and 84 were included in the analysis. Factors influencing internal transfer intentions were age ≥30 years [odds ratio (OR): 6.54, 95% confidence interval (CI): 1.19-35.83]; ≥11 years of experience (OR: 12.57, 95% CI: 2.32-68.02); and longer working hours (OR: 4.51, 95% CI: 1.48-13.72). The effect of visitation restrictions on daily life and internal transfer intentions was greater in nurses with ≥11 years of experience (OR: 4.31, 95% CI: 1.09-17.04), those with increased night awakening (OR: 3.68, 95% CI: 1.33-10.18), and those who desired to receive counseling (OR: 4.38, 95% CI: 1.07-17.91). In conclusion, excessive working hours may affect nurses' internal transfer intentions during the COVID-19 pandemic. Nocturnal awakening and desire to receive counseling may predict nurses' internal transfer intentions.
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The purpose of this study was to compare the effectiveness of dental checkups incorporating tooth-brushing instruction (TBI) with that of conventional dental checkups. A team consisting of one dentist and three dental hygienists saw an average of 60 employees per day on-site at an airline company. The patient's teeth were stained with a disclosing tablet and the results recorded on a Plaque Control Record (PCR) chart. The patient was then given TBI. After recording the relevant data, including TBI given and PCR scores, the charts were stored. Checkups were performed in a total of 3,854 patients between 2001 and 2005 and changes in annual scores investigated. In addition, annual shifts in mean score in patients receiving checkups over all five years were compared with those in patients receiving checkups for the first time in each of the five years. The mean score in patients receiving a checkup in 2001 was 35.1%, declining by 2.6 points to 32.5% in 2005. Among patients receiving checkups over all five years, the mean score in 2001 was 34.0%, declining by 11.2 points to 22.8% in 2005. Over the five-year period, the mean score in patients receiving checkups was 34.1%. In patients receiving checkups over all five years, the proportion with PCR scores <30% increased each year. This was because the number of patients with PCR scores ≥60% decreased each year. These findings suggest that TBI is effective in reducing poor plaque control. When compared with in patients who had not received TBI, five consecutive years of checkups was clearly effective. These results indicate that checkups incorporating TBI are more effective than conventional dental checkups that simply check for caries. In future, this type of checkup should contribute to improved preventative dentistry with minimal intervention.