Using care plans to enhance care throughout the cancer survivorship trajectory.

The Oncology Nursing Society (ONS) recognizes the importance of cancer survivorship and has launched several initiatives focused on cancer care since 2008. Cancer survivors are those who have been diagnosed with cancer, from the time of diagnosis until death. Recognizing the pivotal role that oncology nurses play in helping patients and their families navigate all phases of the cancer continuum, ONS has partnered with Journey Forward in the development of a survivorship care plan builder.

Evaluation of the psychometric properties of the BCPT Symptom Checklist with a sample of breast cancer patients before and after adjuvant therapy.

OBJECTIVE: The purpose of this analysis was to provide psychometric information related to the Breast Cancer Prevention Trial (BCPT) Symptom Checklist in women with breast cancer prior to the initiation of adjuvant therapy and 6 months post-initiation of therapy. METHODS: This investigation was a secondary analysis of baseline data from the Anastrozole Use in Menopausal Women (AIM) Study (R01 CA 107408). The data used in this study were obtained from women diagnosed with Stage I, II, and IIIa breast cancer and who received adjuvant therapy that included chemotherapy alone, anastrozole alone, and chemotherapy plus anastrozole. Data were examined before adjuvant therapy (n=278), and at 6 months post-adjuvant therapy (n=195). Construct validity was examined through exploratory and confirmatory factor analysis (CFA), and the internal consistency of each resulting subscale was computed. Discriminant validity evidence was obtained by correlating BCPT subscales with subscales from the MOS SF-36. RESULTS: A seven-factor structure was extracted from the 42 items at baseline; an eight-factor structure was found using 6-month data. CFA was performed to compare the baseline and 6-month models as well as an eight-factor model recommended by Cella et al. Findings revealed that the two eight-factor models best represented the data. Low negative correlations with the subscales of the MOS SF-36 provided discriminant validity evidence. CONCLUSION: This analysis provides evidence for the reliability, discriminant validity, and factor structure of the BCPT Symptom Checklist. Further testing of this instrument is needed to confirm the factor structure of this measure.

Putting evidence into practice: prevention and management of bleeding in patients with cancer.

The primary cause of bleeding in patients with cancer is thrombocytopenia and it commonly is attributed to myelosuppressive chemotherapy, radiation therapy, or bone marrow infiltration of the malignancy. Oncology nurses have a critical role to play in the prevention and management of bleeding in patients with cancer. As part of an Oncology Nursing Society Putting Evidence Into Practice (PEP) project team, the authors of this article reviewed the current literature to identify effective interventions in the prevention and management of bleeding in patients with cancer. The authors evaluated research studies conducted since 1991, current clinical practice guidelines, and systematic reviews. The literature was reviewed, synthesized, and developed into evidence tables that were ultimately published in a PEP card. All data were reviewed by experts in the field of thrombocytopenia. The Prevention of Bleeding PEP card was unveiled at the 8th Annual Institutes of Learning in November 2007.

Putting evidence into practice: evidence-based interventions to prevent and manage anorexia.

Anorexia is defined as an involuntary loss of appetite.Approximately 50% of newly diagnosed patients with cancer experience the symptom, which often is accompanied by weight loss and most typically associated with advanced disease.Anorexia significantly affects the clinical course of cancer; it can lead to the development or exacerbation of disease- or treatment-related symptoms, decreased functional status, and diminished quality of life.As part of the Oncology Nursing Society's Putting Evidence Into Practice initiative, a team of oncology nurses examined and evaluated published research literature for the purpose of developing an evidence-based practice resource focused on the management of cancer-related anorexia.Even though anorexia is common among newly diagnosed patients and those with advanced disease, interventions to prevent, treat, and manage the symptom are limited.The evidence revealed that only two pharmacologic interventions, corticosteroids and progestins, can be recommended for use in clinical practice, and dietary counseling was identified as likely to be effective.This article summarizes selected empirical literature on interventions used to prevent and manage anorexia in patients with cancer.Familiarity with the literature will assist oncology nurses in proactively identifying and effectively managing patients experiencing this distressing symptom.