Evaluation of the Nurse-Led Symptom Management Program for Patients With Gynecologic Cancer Undergoing Chemotherapy.

BACKGROUND: Patients with cancer experience symptoms concurrently. Nurses need to make multisymptom management and educate patients about self-management strategies. OBJECTIVE: The aim of this study was to evaluate the effect of a nurse-led symptom management program (NL-SMP), developed based on the Symptom Management Model, quality of life (QoL), and symptom severity of women with gynecological cancer undergoing chemotherapy. METHODS: This randomized controlled study sample consisted of 41 women receiving chemotherapy at an outpatient clinic in Istanbul, Turkey, between November 2018 and December 2019. European Organisation for Research and Treatment of Cancer Quality-of-Life Scale, Edmonton Symptom Assessment Scale, and Modified Brief Sexual Symptom Checklist-Women were used to collect data. Women were randomly assigned to 2 groups: intervention (n = 21) and control (n = 20). The intervention group attended the NL-SMP in addition to usual care. Data were collected at the first (time 1), third (time 2), and last chemotherapy cycle (time 3). Repeated measures analysis of variance, Cochran-Q, and t tests were used to analyze the data. RESULTS: In the intervention group, the QoL was significantly higher; symptom severity was lower than that of the control group at time 2 and time 3. At time 3, more women in the control group reported at least 1 sexual difficulty and were not satisfied with their sexual function, whereas there was no change for women in the intervention group. CONCLUSION: The NL-SMP, which consisted of systematic symptom assessment, prioritization of symptoms, providing symptom, and patient-specific education, decreased deterioration in the QoL and symptom severity of women. IMPLICATIONS FOR PRACTICE: Conducting multisymptom assessments, prioritizing symptoms, providing symptom- and patient-specific education, and supporting symptom self-management throughout treatment can lead to effective symptom management.

Palliative care needs of the cancer patients receiving active therapy.

PURPOSE: To identify cancer patients' palliative care needs with problem burden, problem intensity, and felt needs related to these problems while receiving cancer treatment. METHODS: This is a descriptive survey study conducted at a tertiary hospital with no palliative care services in Istanbul, Turkey, from September 2019 to February 2020. Data were collected using the Patient Information Form and the Three Levels of Needs Questionnaire (3LNQ). Descriptive statistics (frequency and percentage) were used to present data. RESULTS: The mean age of patients was 60.2 ± 13.0, and the mean duration since the diagnosis was 11.6 ± 21.4 months. Of the patients, 40.4% were diagnosed with gastrointestinal (GI) cancer, and 34.4% had stage 4 cancer. Patients mostly received help for their pain (85.7%), lack of appetite (64.8%), and nausea (73/7%). The most frequent unmet needs were problems with concentration (70%), worrying (68%), difficulties with sex life (63.6%), problems with being limited in work and daily activities (61.4%), and being depressed (58.5%) among patients who reported to have these symptoms. CONCLUSION: This study shows that patients with cancer require supportive and palliative care along with medical treatment for cancer and its treatment-induced physical and psychological symptoms. The study results have the potential to guide the development of palliative care services, especially for outpatient oncology settings in countries where palliative care services mostly focus on the end-of-life care. Further studies are also needed to focus on interventions to meet cancer patients' palliative care needs during the medical cancer treatment process with tailored palliative care delivery models.

Professional Values in a Sample of Nursing Students from Different Countries.

AIM: This study aimed to determine the professional values of nursing students from different countries. METHODS: This descriptive study was conducted with a convenience sample of nursing students from different countries. The data were collected using an identification form and the Nurses' Professional Values Scale-Revised. A total of 305 nursing students from Turkey, Tanzania, and Spain were included in the analysis. RESULTS: In this study, the mean nursing professional values scores were 113.5±12.8, 105.8±16.0, 107.9±8.4 for Turkey, Tanzania, and Spain, respectively (minimum-maximum: 44-130). There were no statistically significant differences between the Turkish and the Spanish students' professional value scores, but the Turkish students' scores were higher than the Tanzanian students. CONCLUSION: The factors affecting the level of professional values of students for each country were different. For educators, it is important to develop teaching strategies to empower professional values. Understanding cultural differences can guide professional values and universal ethics in nursing practice, education, and research.

Interventions aiming to improve informed decision on prenatal screening and testing: A scoping review of the literature.

The aim of this scoping review was to explore interventions and their effect in facilitating decision making on prenatal screening and testing among pregnant women. This review was conducted according to the Joanna Briggs Institute Methods Manual for scoping reviews. Studies published 2000-2019 that consist of interventions to facilitate pregnant women's decision making in prenatal screening and testing were specifically reviewed. A total of 27 studies are included in this scoping review. In these studies, various methods, including face-to-face individual or group interventions, e-Health interventions, video-based interventions, written educational materials, and decision aid interventions, were developed and tested for their effectiveness in facilitating informed decision making on prenatal screening and testing. While these methods appeared to be effective, further studies involving diverse populations are needed to integrate them into practice. Genetic counselors and healthcare providers working with individuals who are referred for genetic education and counseling need to work collaboratively to facilitate informed decisions on prenatal screening of women and/or their partners.

Experiences of breast cancer survivors during the COVID-19 pandemic: a qualitative study.

PURPOSE: This study aimed to explore the impacts of the COVID-19 pandemic on the quality of life of breast cancer survivors. METHODS: This qualitative descriptive study included 18 breast cancer survivors who completed cancer treatment within the last five years in Istanbul, Turkey. A directed content analysis was performed using the quality-of-life domains as guiding themes. RESULTS: The mean age was 51 ± 5.9, and the average months since active treatment were 26.5 ± 9.8 (9-48). Six themes and associated categories are as follows: Physical functioning; Changes in physical activity and weight, new physical symptoms, Role functioning; Work-life, changes in household chores, Emotional functioning; Emotional changes, fear of having the COVID-19 infection, Cognitive Functioning; Risk Perception about the COVID-19 infection, reactions to the COVID-19 pandemic' measures, Social Functioning; Familial relationship changes, social interactions, General Health/Utilization of Healthcare services; Changes in routine follow-ups, changes in diet. CONCLUSION: Breast cancer survivors had different challenges causing new physical and psychological symptoms such as lymphedema, pain, burnout, and anxiety that may have long-term effects on their quality of life.

Genetic Literacy of pregnant women and their use of prenatal screening and diagnostic tests in Turkey.

This study evaluated how genetic literacy of pregnant women in Turkey affects their use of prenatal screening and diagnostic tests. As a descriptive cross-sectional study, a Participant Identification Form and the Genetic literacy and Comprehension Measure (GLAC) were used to collect data. The sample of study consisted of 189 pregnant women who made regular antenatal care visits in Giresun, Turkey. The mean age was 29.5 ± 5.9 years and mean gestational week was 34.9 ± 5.09. Of the women, 76.7% had undergone prenatal screening tests, and 85.5% of them had learned about the tests from their doctors. The mean GLAC score of familiarity was 3.67 ± 1.78 (out of seven), and the genetic concepts answered correctly were 5.30 ± 1.79 (out of eight). No statistically significant relationship emerged between the women's genetic literacy and their use of prenatal screening or diagnostic tests. However, relationships were statistically significant between the genetic literacy of the women and the educational levels of the women themselves or their spouses, consanguineous marital status, parity, and use of folic acid supplements. Primiparous women who were highly educated, had a highly educated spouse, were not in consanguineous marriages, and had taken folic acid supplements during pregnancy were more literate in genetics. There is a need for more educational opportunities in order for women to increase their familiarity with genetic terms. Educating women will improve their understanding of genetics-related health services and increase their awareness of genetic diseases, which will allow them to take the appropriate actions for primary prevention.