Supportive interventions for family caregivers of patients with advanced cancer: A systematic review.

OBJECTIVE: Family caregivers are often intensively involved in palliative and end-of-life cancer care. A variety of interventions to support family caregivers have been developed, differing in target population, modality, and components. We aimed to systematically examine characteristics and the effectiveness of interventions to support family caregivers of patients with advanced cancer. METHODS: A systematic review was conducted using Embase, Medline Ovid, Web of Science, Cochrane, Google Scholar, and Cinahl. This review included quantitative studies published from January 2004 until January 2020 reporting on interventions to support family caregivers of patients with advanced cancer in all care settings. RESULTS: Out of 7957 titles, 32 studies were included. Twenty-two studies were randomized controlled trials. Interventions were delivered to four target populations: individual family caregivers (n = 15), family caregiver-patient dyads (n = 11), families (n = 2) and peer groups (n = 4). Most interventions (n = 26) were delivered face-to-face or by phone, two were delivered online. Most interventions included multiple components and were primarily aimed at supporting family caregivers' self-care. Twenty-nine interventions were shown to have beneficial effects on family caregiver outcomes, mostly in the psycho-emotional (n = 24), daily functioning (n = 13) and social dimension (n = 6). Individual interventions were mainly effective in the psycho-emotional dimension, dyad and family interventions in the psycho-emotional and social domain, and group interventions mainly had an effect on daily functioning. CONCLUSIONS: Interventions to support family caregivers in advanced cancer care vary widely. Most intervention studies reported beneficial effects for the wellbeing of family caregivers. There is evidence that the target group is associated with beneficial effects on different outcome dimensions.

Challenges in self-management of persons living with advanced cancer: An exploratory, in-depth interview study.

OBJECTIVE: To obtain insight in self-management challenges of persons with advanced cancer and factors that influence their self-management. METHODS: Exploratory study among persons with advanced cancer. We conducted in-depth interviews and performed an inductive thematic analysis, using open, axial and selective coding. RESULTS: We interviewed 33 persons with advanced cancer. Four self-management challenges were identified: (1) Dealing with physical and psychological symptoms and problems. (2) Navigating the illness trajectory, including management of clinical appointments and treatment regimens, end-of-life planning life and 'maintaining normality'. (3) Managing relations with healthcare professionals, including contributing experiential knowledge to medical decision-making. (4) Navigating changes in the social environment. Some participants responded proactively to these challenges, for example, by actively searching for information to obtain an extensive understanding of their illness and (re)scheduling medical appointments for a better fit in their agenda. Self-management strategies seemed to be influenced by patients' personality, life history, moment in the illness trajectory and the social environment. CONCLUSION: Self-management challenges of persons with advanced cancer are based largely outside the professional care setting. Self-management strategies in response to these challenges are typically aimed at maintaining a normal life. Self-management support should be tailored to patients' needs and part of trustful partnerships with patients and relatives.

Nurse Practitioners' Self-Efficacy and Behavior in Supporting Self-Management of Patients With a Progressive, Life-Threatening Illness and Their Relatives: A Nationwide, Cross-Sectional Online Survey.

This study aimed at investigating nurse practitioners' self-efficacy and behavior in supporting self-management of patients with a progressive, life-threatening illness and their relatives. We adapted an existing validated instrument for this purpose, amongst other things by adding a seventh subscale "attention for relatives," and administered it in a nationwide, cross-sectional online survey among Dutch nurse practitioners. We analyzed associations between self-reported self-efficacy and behavior using Pearson correlations and paired sample t tests. Associations between self-efficacy and behavior with nurse practitioners' characteristics were examined using linear regression models. Most nurse practitioners (n = 327; 26% complete responses) were women (93%). Subscale and total scores for nurse practitioners' self-efficacy were moderately positively correlated with those for their behavior in self-management support. Subscale and total scores were statistically significantly higher for their self-efficacy than for their behavior. Increased work experience with patients with a progressive, life-threatening illness was associated with higher scores on self-efficacy and behavior in self-management support. We conclude that nurse practitioners are confident in their ability to support self-management; yet, they do not always use these competencies in practice.

The prognostic value of the 12-, 6-, 3- and 1-month 'Surprise Question' in cancer patients: A prospective cohort study in three hospitals.

OBJECTIVE: This prospective study aimed to evaluate the performance of the 'Surprise Question' (SQ) 'Would I be surprised if this patient died in the next 12 months?' in predicting survival of 12, 6, 3 and 1 month(s), respectively, in hospitalised patients with cancer. METHODS: In three hospitals, physicians were asked to answer SQs for 12/6/3/1 month(s) for inpatients with cancer. Sensitivity, specificity, positive and negative predictive values were calculated. RESULTS: A total of 783 patients were included, of whom 51% died in the 12-month period after inclusion. Sensitivity of the SQ predicting death within 12 months was 0.79, specificity was 0.66, the positive predictive value was 0.71 and the negative predictive value was 0.75. When the SQ concerned a shorter survival period, sensitivities and positive predictive values decreased, whereas specificities and negative predictive values increased. In multivariable logistic regression analysis, the SQ was significantly associated with mortality (OR 3.93, 95% CI 2.70-5.71, p < 0.01). CONCLUSIONS: The 12-month SQ predicts death in patients with cancer admitted to the hospital reasonably well. Shortening the timeframe decreases sensitivities and increases specificities. The four surprise questions may help to identify patients for whom palliative care is indicated.

Right-sided lateralization of skin temperature in healthy young persons.

PURPOSE: Previous studies reported a peripheral immune asymmetry and lateralization of different paired organ cancers. Because of the close relationship of immune system with body temperature, the aim of the study was to test the possible lateralization of skin temperature. MATERIALS AND METHODS: Four hundred sixty three healthy subjects (325 women, 138 men) with an average age of 23.62 years (SD = 8.65) participated in this study. All skin temperature measurements were done 8:00-9:00 a.m. Skin temperature was assessed for three different points in skin: axillary, thumb and external auditory. RESULTS: Skin temperature was statistically significantly higher on the right side of the body than on the left side, when measured by axillary and thumb temperatures. But there was no statistically significant difference in external auditory temperature. CONCLUSION: The asymmetry of skin temperature may result from the peripheral immune asymmetry or the asymmetric lymph node distribution.

Healthcare Workers at Dialysis Centers and Students Studying in Dialysis Departments: Behavioural Assessment.

PURPOSE: The purpose of this study was to determine the behaviours of students studying dialysis and health personnel working at dialysis centers and the influencing factors. METHODS: Students studying dialysis department at Turgut Özal University (n=70) and healthcare personnel working at eight Dialysis Centers located in the center of Ankara (n=83) were recruited. Data was collected from personal information forms and Healthy Life Style Behaviours (HLSB)-II scale. Data were analysed Student's t test, Man Whitney U test, Kruskal Wallis Test and Pearson correlation analysis; p.

The effect of traditional wet cupping on shoulder pain and neck pain: A pilot study.

OBJECTIVES: Wet cupping therapy (WCT) is a traditional complementary method recommended to decrease the symptoms of a lot of diseases and used in the treatment of pain syndromes. In this pilot study, the possible effects of wet cupping therapy on nonspecific neck and upper shoulder pain were investigated. METHODS: Sixty one eligible volunteer participants with nonspecific neck and upper shoulder pain for at least 3 months were allocated. The Numeric Rating Scale (NRS) was used to assess pain scores. Pain scores were recorded before and after wet cupping therapy. RESULTS: The mean scores of neck pain in study group were 7.02 (SD = 1.8) before and 3.70 (SD = 2.2) after cupping therapy. The decrease of pain scores between pre- and post-test was statistically significant (p < 0.05). DISCUSSION: It can be stated that WCT has potential therapeutic effect in nonspecific neck and upper shoulder pain. Future full-scale randomized controlled trials will be needed to provide firm evidence of the effectiveness of this intervention.

Effects of multimedia nursing education on disease-related depression and anxiety in patients staying in a coronary intensive care unit.

AIM: We evaluated the effectiveness of an accessibility-enhanced multimedia informational educational program in reducing depression and anxiety increasing satisfaction with the information and materials received by patients in coronary care unit. METHODS: We selected 100 patients from among the patients who stayed at or who underwent surgery at one of two ICUs for any reason who satisfied the eligibility criteria, and agreed to participate in the research. The participants were included in the control or experimental group by random selection. The patients completed the Hospital Anxiety Depression Scale during ICU admission and 1week after hospital discharge. RESULTS: The difference in HADSA score was significantly greater in patients who received education than in patients who did not receive multimedia nursing education (4.2±0.58 vs. 0.6±0.42; p<.01). Additionally, the difference in HADSD score was significantly greater in patients who received multimedia nursing education (2.2±0.53 vs. 0.64±0.46; p<.01). CONCLUSION: This study showed that anxiety and depression associated with hospital can be reduced with multimedia nursing education.

Oral intake of ginger for chemotherapy-induced nausea and vomiting among women with breast cancer.

BACKGROUND: Chemotherapy-induced nausea and vomiting (CINV) is among the most common and distressing symptoms experienced by patients receiving cancer treatment. Nurses play a substantial role in the prevention and management of CINV. Ginger (Zingiber officinale Roscoe) is often advocated as beneficial for nausea and vomiting. Whether the herb is truly efficacious for this condition is, however, still a matter of debate. OBJECTIVES: This experimental randomized, controlled trial was done to assess the effect of ginger on chemotherapy-related nausea and vomiting. METHODS: All patients in the study (N = 60) received standard antiemetic drugs. The patients in the study group (n = 30) also received oral ginger for the first three days of the chemotherapy cycle. No intervention was performed in the control group (n = 30) except for the routine antiemetic treatment. Nausea severity and the number of vomiting and retching episodes were measured four times each day for the first five days of the chemotherapy cycle in the patient diary. Nausea severity was evaluated using a numeric scale ranging from 0 (no nausea) to 10 (very severe nausea). FINDINGS: The researchers analyzed the five-day mean score of nausea severity and the number of vomiting and retching episodes. Based on this comparison, nausea severity and the number of vomiting episodes were significantly lower in the intervention group than in the control group (p > 0.05). However, the change in the number of retching episodes between the intervention and control groups was not statistically significant (p > 0.05).

Wet-cupping removes oxidants and decreases oxidative stress.

OBJECTIVES: Wet-cupping therapy is one of the oldest known medical techniques. Although it is widely used in various conditions such as acute\chronic inflammation, infectious diseases, and immune system disorders, its mechanism of action is not fully known. In this study, we investigated the oxidative status as the first step to elucidate possible mechanisms of action of wet cupping. MATERIAL AND METHODS: Wet cupping therapy is implemented to 31 healthy volunteers. Venous blood samples and Wet cupping blood samples were taken concurrently. Serum nitricoxide, malondialdehyde levels and activity of superoxide dismutase and myeloperoxidase were measured spectrophotometrically. RESULTS: Wet cupping blood had higher activity of myeloperoxidase, lower activity of superoxide dismutase, higher levels of malondialdehyde and nitricoxide compared to the venous blood. CONCLUSION: Wet cupping removes oxidants and decreases oxidative stress.

Heart rate variability differs between right- and left-handed individuals.

Previous studies reported reduced longevity in left-handers with the suggestion that it may be associated with different heart diseases. Therefore, differences in heart rate variability (HRV), an index of autonomic cardiac activity, were examined for right- and left-handed individuals. 120 healthy young university students (75 women, 45 men; M age = 20.4 yr., SD = 1.5) volunteered. Handedness was assessed with the Edinburgh Handedness Inventory and HRV was measured via electrocardiography. The results suggest that the left-handers' HRV was significantly different from that of right-handers on several parameters. The atypical cerebral organization of left-handers may be related to an imbalanced autonomic system that results in higher frequencies of heart irregularities.

Wet cupping therapy restores sympathovagal imbalances in cardiac rhythm.

OBJECTIVES: A recent study showed that cupping had therapeutic effects in rats with myocardial infarction and cardiac arrhythmias. The current studyaimed to investigate the possible useful effects of cupping therapy on cardiac rhythm in terms of heart rate variability (HRV). MATERIALS AND METHODS: Forty healthy participants were included. Classic wet cupping therapy was applied on five points of the back. Recording electrocardiography (to determine HRV) was applied 1 hour before and 1 hour after cupping therapy. RESULTS: All HRV parameters increased after cupping therapy compared with before cupping therapy in healthy persons. CONCLUSIONS: These results indicate for the first time in humans that cupping might be cardioprotective. In this study, cupping therapy restored sympathovagal imbalances by stimulating the peripheral nervous system.