When Eating Becomes Torturous: Understanding Nutrition-Related Cancer Treatment Side Effects among Individuals with Cancer and Their Caregivers.

Individuals living with cancer often experience multiple nutrition-related side effects from cancer treatment, including changes in taste and smell, nausea, diarrhea, loss of appetite, and pain during eating. These side effects can profoundly impact nutritional status and quality of life. The purpose of this study was to explore experiences with nutrition-related cancer treatment side effects among cancer patients and their family caregivers, the way they manage such side effects, and the resulting changes in food preferences and behaviors. Structured surveys and in-depth interviews were conducted. Interviews focused on the presence and management of treatment side effects, how those changes influenced food preferences, and the extent to which they interfered with quality of life. Most patients (72%) reported treatment side effects; 61% reported that these side effects impacted their eating and drinking. Common side effects included fatigue (58%), dry mouth (30%), nausea (24%), constipation (20%) and diarrhea (20%). Six overarching qualitative themes were identified: Spiral of side effects; Pain of eating; Burden of eating; Loss of taste/change in taste; Symptom management; and Solutions. The authors conclude with implications for food and nutrition practice-moving beyond traditional recommendations of what to eat or avoid-to consider the overall patient and caregiver experience.

Evaluation of interprofessional health care team communication simulation in geriatric palliative care.

An interprofessional education (IPE) simulation-based geriatric palliative care training was developed to educate health professions students in team communication. In health care, interprofessional communication is critical to team collaboration and patient and family caregiver outcomes. Studies suggest that acquiring skills to work on health care teams and communicate with team members should occur during the early stage of professional education. The Interprofessional Education Collaborative (IPEC®) competency-based framework was used to inform the training. An evaluation examined attitudes toward health care teams, self-efficacy in communication skills, interprofessional collaboration, and participant satisfaction with the training experience. One-hundred and eleven participants completed pre- and post-training surveys. Overall, a majority of participants (97.3%) were satisfied with the training and reported more positive attitudes toward health care teams and greater self-efficacy in team communication skills. IPE participants had higher collaboration scores compared to observer learners. Further research is needed to explore long-term effects of IPE in clinical practice.

Faculty facilitators' and standardized family members (SFMs) perceptions of student teamwork during an interprofessional education simulation workshop.

Standardized patients can be trained to portray standardized family members (SFMs) for interprofessional education (IPE) initiatives to maximize student learning. To date, studies of IPE often focus on student learning outcomes rather than on the feedback and perspectives of SFMs and faculty facilitators (FFs), The purpose of our study was to examine SFMs' and FFs' perspectives immediately after participating in an IPE workshop. SFMs and FFs completed a semi-structured questionnaire consisting of open-ended questions to identify positive and challenging aspects of interactions with health professions students during an IPE workshop. A directed content analysis approach was used to assess written feedback (N = 29) from SFMs and FFs. Study findings highlight many similar themes between SFMs and FFs as well as minor differences regarding recognition of emotion and communication transitions. SFMs and FFs both agreed, however, that these are areas for further development by students to improve communication. Our study adds insight into SFMs' and FFs' feedback immediately after an IPE workshop.

An Interprofessional Education Simulation Workshop: Health Professions Learning Palliative Care Communication.

BACKGROUND: Patients with life-limiting illnesses need health professionals who can communicate with each other, as well as with patients and family members. Nursing faculty teach these skills in a variety of formats and, increasingly, via simulation experiences. METHOD: This pilot study aimed to compare a group of interprofessional health professions students' (N = 73) self-reported level of confidence in communication, explore behavior change and professional identity, and identify areas for future interprofessional education. Students participated in a simulated team meeting with a standardized family member of an older adult patient hospitalized with an acute aspiration pneumonia and a chronic, progressive illness. RESULTS: Postworkshop, students rated themselves as significantly more confident in interprofessional and palliative care communication (p ⩽ .001) than preworkshop, identified important areas of behavior change and professional identity, and provided faculty with ideas for future simulation workshops. CONCLUSION: Additional research is needed regarding longitudinal curricular efforts and direct patient care outcomes. [J Nurs Educ. 2018;57(8):493-497.].

Factors influencing physical activity behaviors in colorectal cancer survivors.

PURPOSE: To elucidate factors that impact intention (INT) to be active as well as actual physical activity (PA) behavior in colorectal cancer survivors (CRC-S) using the theory of planned behavior (TpB). Planning for PA was explored as a mediator of the INT-behavior relationship. Chemotherapy-induced neuropathy and fatigue were also explored. DESIGN: A cross-sectional quantitative mailed survey was used. SETTING: The study was conducted among community-dwelling adults living in Pennsylvania when diagnosed with colorectal cancer (CRC). SUBJECTS: Subjects comprised 843 CRC-S diagnosed with CRC in Pennsylvania in 2009. MEASURES: The survey included questions about planning for PA, TpB constructs, medical and social variables, and PA as measured by a modified Godin Leisure Time Questionnaire. ANALYSIS: Descriptive statistics were used to characterize the sample. A mediation analysis was used to determine if planning mediated the relationship between INT and actual PA behavior. A stepwise regression was used to determine predictors of INT and PA. RESULTS: Ninety-six CRC-S responded, with 25% meeting PA recommendations for health promotion, suggesting that CRC-S are insufficiently active. Perceived behavioral control (PBC) and social norm (SN) accounted for 43% of the variance in INT, whereas 30% of the variance in PA was explained by PBC and age. Neuropathy negatively impacted PA behavior (p = .008). Both action and coping planning partially mediated the INT-behavior relationship (ß = 20.08, p = .007; ß = 22.85, p = .001, respectively). CONCLUSION: Survivors at risk for inactivity are those with low PBC, low SN, and neuropathy, and those who are older.

A pilot study exploring the role of physical therapists and transition in care of pediatric patients with cystic fibrosis to the adult setting.

BACKGROUND: Cystic fibrosis (CF) is a disease that requires intensive multidisciplinary care, including care by physical therapists (PTs). People with CF are now living well into adulthood, necessitating a transfer of care from the pediatric setting to an adult one. Physical therapists play a large role in the care of the person with CF; however, there is little known about the PT role in transition of care. PURPOSE: To explore transition issues for people with CF from the perspective of PTs. METHODS: An 18-question online survey was sent to PTs via an electronic CF listserv. Questions were derived from an analysis of transition literature in CF and other chronic childhood conditions. Physical therapists who reported treating people with CF gave their opinions on issues impacting transition from their perspective as well as their perception of patient and parent concerns. Descriptive statistics were used for data analysis. RESULTS: A total of 26 PTs completed the survey. A majority, 61.5%, reported that there was a transition program at their facility, with 42.3% involving physical therapy. Common themes for patients and parents included feeling uncertain about: knowledge of the adult physician, acquiring pulmonary infections in the adult setting, and pace of the adult clinic. Physical therapists were concerned about adherence with airway clearance and exercise following transfer to the adult clinic. CONCLUSIONS: The role of PT in transition programs is quite varied. Physical therapists should address common concerns of their patients and families to improve the transition process and possibly impact adherence to the PT plan of care.

Cancer-related fatigue.

UNLABELLED: This self-directed learning module highlights the role of cancer-related fatigue in the rehabilitation of people with oncology diagnoses. It is part of the chapter on cardiac, pulmonary, and cancer rehabilitation in the Self-Directed Physiatric Education Program for practitioners and trainees in physical medicine and rehabilitation. This article identifies the most common causes and features of cancer-related fatigue and presents a general approach and specific recommendations for appropriate intervention. OVERALL ARTICLE OBJECTIVE: To equip physiatrists to evaluate and treat the common problem of cancer-related fatigue in patients with oncologic diagnoses.