Human Caring Perspectives of Care Meanings and Expressions in a Nigerian Cancer Care Setting.

BACKGROUND: Caring in Africa is often viewed from sociopolitical and humanity perspectives. OBJECTIVE: The aim of this study was to investigate the meanings and expressions of caring from the narratives of persons living with cancer and their nurses. METHODS: This study adopted a qualitative ethnonursing methodology. A purposive sampling technique was used to select the key participants, who were grouped into 7 nurses and 6 patients. General participants included 4 physicians, 3 ward assistants, and 6 patients' relatives. Interviews of participants were digitally audio-taped and then transcribed verbatim. Data analysis in this study followed the phases of ethnonursing data analysis enabler and was conducted using NVivo 14 software. Data categories were reviewed and sorted to discover recurrent patterns within the data. RESULTS: Caring was seen as a social practice that is both transactional and transformational. Six thematic patterns emerged: restoring hope, reaching out to the inner lifeworlds of the patients, mutual empathy, going the extra mile, compassionate presence, and being human/having a sense of human connection. The study revealed that there are discernible patterns in care needs and expectations, even though each cancer patient is unique in his or her specific care needs and expectations. CONCLUSION: Caring in this study constituted a variety of meanings, and human caring was demonstrated and practiced interpersonally. Hence, there is evidence of living caring in everyday life, in observable ways. IMPLICATIONS FOR PRACTICE: Nurses should enhance both their own and the patient's sense of personal meaning in the caring partnership to enable them to be present in concrete unique nursing situations with the suffering human being.

Prelicensure Nursing Students' Attitudes Toward Patients With Cancer Revisited.

Recruiting graduate nurses into oncology practice postgraduation continues to be challenging. Graduate nurses tend to prefer clinical settings that they consider high-tech or challenging, with oncology ranking low. In additio.

Palliative care needs and preferences of older adults with advanced or serious chronic illnesses and their families in rural communities of Indiana, USA.

PURPOSE: To explore the palliative care needs and preferences of older adults with advanced or serious chronic illnesses and their families. Also, to propose strategies to promote supportive palliative care in the rural communities of Indiana, USA. METHOD: We conducted qualitative interviews to gather rural caregivers' experiences of palliative care. Recruitment was done in collaboration with community partners using social media, flyers, emails, invitations, and word-of-mouth. A purposive sample of family caregivers was obtained. All the interviews were conducted online. The average interview was 30-45 minutes. Data were analyzed using a thematic analysis approach. FINDINGS: Our findings showed 6 major themes that indicated several palliative care needs and preferences of older patients and their families in rural communities that include: (1) difficulties in pain and symptom burden; (2) perceived discrimination and lack of trust; (3) longer distances to care facilities; (4) difficult conversations; (5) caregiving burden; and (6) use of telehealth in a rural palliative care context. CONCLUSION: Rural family caregivers experience several social inequities and disparities causing a lack of access to and low utilization of palliative care. All these disparities cause several challenges for patients and their families trying to manage serious illnesses and die in place with peace and comfort. Inadequate access and lack of resources cause pain and distress for both patients and their families. Provider education and trainings, initiating early palliative care models, integrating behavioral health in palliative care, and using culturally congruent care delivery approaches in support of community partners can improve palliative care services in rural communities.

Comprehensive Clinical Literature Review of Managing Bone Metastases in Breast Cancer: Focus on Pain and Skeletal-Related Events.

BACKGROUND: Bone metastases are the most common site of metastatic disease in breast cancer and can result in significant pain and an increased risk of skeletal-related events (SREs). Uncontrolled pain can further lead to negative outcomes. OBJECTIVES: The aim is to provide oncology nurses with the latest evidence on the management of bone metastases in metastatic breast cancer (MBC) with a focus on pain and SREs. METHODS: A literature search was conducted using the Embase®, PubMed®/MEDLINE®, CINAHL®, and Cochrane Library databases. Clinical trials, retrospective studies, systematic reviews, meta-analyses, and practice guidelines, as well as one high-level conference abstract, were reviewed. FINDINGS: Options for managing bone metastases in MBC include surgical and interventional strategies, radiation, and bone-modifying agents. Management plans frequently include a combination of these modalities. More information is needed to better define the role of bone-directed therapies in MBC, particularly as they relate to nursing care.

The experience of family support among patients newly diagnosed with cancer in Jordan.

PURPOSE: To describe the experiences of family support from the perspectives of patients newly diagnosed with cancer. METHODS: Descriptive qualitative phenomenological design was undertaken, including in-depth individual interviews with 13 newly diagnosed cancer patients from two hospitals in Jordan. RESULTS: Three themes emerged: 'being there,' 'family reunion and connectedness,' and 'gratified with family support.' Being there includes the compassion of family together, support by encouragement, and using religious rituals and traditional remedies. A cancer diagnosis brings family reunions and connectedness and strengthens relationships between spouses. The patients expressed gratitude that their families were compassionate, active listeners, and willing to help, which helped them make decisions related to cancer treatment and overcome their fears. CONCLUSIONS: Findings show the strength and priority of family support in Jordanian Arabic culture during an initial cancer diagnosis. In cultures where family members take the burden of care, religion and cultural practices play a vital role in directing patient care. Understanding the experiences of family support from the patients' view could help nurses provide comprehensive and culturally sensitive care and requires adopting a family-centered approach in preparing care plans for patients.

The Effect of the Pain Symptom Cluster on Performance in Women Diagnosed with Advanced Breast Cancer: The Mediating Role of the Psychoneurological Symptom Cluster.

BACKGROUND: Pain, depression, anxiety, sleep disturbances, and constipation were reported in different symptom clusters at different stages of breast cancer. Managing symptom clusters rather than individual symptoms can improve performance status. AIM: The study examined the effect of pain symptom cluster (pain and constipation) on performance when mediated by the psychoneurological symptom cluster (depression, anxiety, and sleep disturbances) using age as a moderator. DESIGN: A secondary analysis. SETTINGS: Palliative care center at a tertiary medical center in northeast Ohio. PARTICIPANTS: Eighty-six women diagnosed with advanced breast cancer. METHOD: A quantitative cross-sectional approach. RESULTS: Ordinal logistic regression showed that pain symptom cluster did not have a significant mediation effect on performance. Odds ratio indicated that subjects with pain symptom cluster were 63% more likely to be bedridden (odds ratio = 1.63, confidence interval = .69-3.84). Women who reported pain symptom cluster were 5% more likely to have psychoneurological symptom cluster (odds ratio = 1.05, confidence interval = .400-2.774). Stratified analysis of age showed no differences in performance. Post-hoc analysis showed that the components of pain symptom cluster had a significant effect on psychoneurological symptom cluster (odds ratio: 3 [1.18-7.62]). CONCLUSIONS: Pain, constipation, depression, anxiety, and sleep disturbances were highly prevalent in women with advanced breast cancer. However, they tended to cluster in different symptom clusters. Although some findings were not significant, they all supported the direction of the tested hypotheses. Variations in symptom clusters research, including methodology, instruments, statistical tests, and chosen symptom cluster correlation coefficient, should be addressed.