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1.
Hu Li Za Zhi ; 66(6): 90-97, 2019 Dec.
Artigo em Chinês | MEDLINE | ID: mdl-31802459

RESUMO

This report discusses an experience of taking care of a breast cancer patient with rapidly deteriorating, fungating wounds and herpes simplex virus wounds and describes the physical and psychological effects on the patient and the related decreases in the quality of life of both the patient and her caregivers. Nursing care was implemented from December 14th, 2017 to January 23rd, 2018. Data collection was performed through direct caregiving, observation, interviews, and chart review. Three major problems were identified: difficulties with wound care, psychological distress of the patient, and the coping problems of the caregivers. Based on these problems, nursing interventions were implemented. During the period, fungating wound care guidelines were used to teach the patient and her caregivers the core principles of fungating wound management. Meanwhile, the COPE framework (creativity, optimism, planning, and expert information) was applied to train the patient and her caregivers how to develop problem-solving skills and build self-confidence. Finally, the patient and her family successfully overcame these challenges. The patient was relieved of stress and anxiety, became better able to self-manage her symptoms, sustain hope for the future, and improve her perception of body self-image. We suggested that the patient and her family be considered a single, supportive unit and then helped them cope with the disease and build self-care confidence in order to improve their life quality and to coexist with the disease. We hope that our clinical experience will be taken as a reference by patient caregivers.


Assuntos
Neoplasias da Mama/enfermagem , Neoplasias da Mama/psicologia , Cuidadores/psicologia , Feminino , Humanos , Qualidade de Vida , Estresse Psicológico
2.
Rev Infirm ; 68(256): 35-36, 2019 Dec.
Artigo em Francês | MEDLINE | ID: mdl-31870478

RESUMO

With 54,000 new cases per year, breast cancer is most frequently observed among women in France. It is the leading cause of death among women due to cancer: nearly 12,000 deaths per year. Based on her own experience with this disease and the heavy treatments that result from it, a free-lance nurse has developed a home-based consultation to accompany women during their care journey. Sharing of experience.


Assuntos
Neoplasias da Mama , Assistência Domiciliar , Encaminhamento e Consulta , Neoplasias da Mama/enfermagem , Feminino , França , Humanos
5.
Int J Nurs Stud ; 93: 141-152, 2019 May.
Artigo em Inglês | MEDLINE | ID: mdl-30925280

RESUMO

BACKGROUND: Women with breast cancer demand informed shared decision-making. Guidelines support these claims. OBJECTIVES: To investigate whether an informed shared decision-making intervention for women with 'ductal carcinoma in situ' comprising an evidence-based decision aid with nurse-led decision coaching enhances the extent of the mutual shared decision-making behavior of patients and professionals regarding treatment options, and to analyze implementation barriers. DESIGN: Cluster randomized controlled trial with accompanying process evaluation. SETTING: Certified breast care centers in Germany. PARTICIPANTS: Women with ductal carcinoma in situ and no previous history of breast cancer facing a primary treatment decision. METHODS: Sixteen breast centers were randomized to intervention or standard care to recruit 192 patients (partially-blinded). All coaching sessions and physician consultations were videotaped to assess the primary outcome 'extent of patient involvement in shared decision-making' using the MAPPIN-Odyad observer instrument (scores 0 to 4). Secondary endpoints included the sub-measures of the MAPPIN-inventory (MAPPIN-Onurse, MAPPIN-Ophysician, MAPPIN-Opatient, MAPPIN-Qnurse, MAPPIN-Qpatient and MAPPIN-Qphysician), 'informed choice', 'decisional conflict' and 'duration of consultations'. Primary intention-to-treat analyses were on cluster level comparing means of cluster values using t-tests. An accompanying process evaluation was conducted comprising 1) analysis of all video recordings with focus on procedures and intervention fidelity and 2) field notes of researchers and feedback from professionals and patients assessed by questionnaires and interviews with focus on barriers and facilitators for implementation at different time points. RESULTS: Due to protracted recruitment, the study was terminated after 14 centers had included 64 patients (intervention group 36, control group 28). Patient participation in informed shared decision-making was significantly higher in the intervention group (mean (SD) score 2.29 (0.56) vs. 0.42 (0.51) in the control group; difference 1.88 (95% CI 1.26-2.50, p < 0.0001). 47.7% women in the intervention group made informed choices, but none in the control group, difference 47.7% (95% CI 12.6-82.7%, p = 0.016). In the intervention group physician consultations lasted 12.8 (6.6) min. vs. 24.3 (6.3) min. in the control group. Physicians' attitudes, false incentives and structural barriers hindered implementation of informed shared decision-making. Nurses appreciated their new roles. CONCLUSIONS: Informed shared decision-making is not yet implemented in German breast care centers. Nurse-led decision coaching grounded on evidence-based patient information enhances informed shared decision-making. Trial registration No. ISRCTN46305518.


Assuntos
Neoplasias da Mama/enfermagem , Carcinoma Intraductal não Infiltrante/enfermagem , Relações Enfermeiro-Paciente , Adulto , Análise por Conglomerados , Feminino , Alemanha , Humanos , Masculino , Pessoa de Meia-Idade
6.
Semin Oncol Nurs ; 35(1): 47-57, 2019 02.
Artigo em Inglês | MEDLINE | ID: mdl-30711354

RESUMO

OBJECTIVES: To review heredity cancer syndromes involving the breasts, ovaries, or breast and ovaries. To recommend useful professional and patient resources on cancer genetics. A case study of germline BRCA genetic testing after allogeneic bone marrow transplant is presented. DATA SOURCES: National guidelines, evidence-based summaries, peer-reviewed studies, editorials, and professional Web sites. CONCLUSION: Advancing genetic/genomic technology in oncology has led to a renaissance of information about hereditary cancer syndromes. IMPLICATIONS FOR NURSING PRACTICE: Nursing competence in genetics/genomics is necessary to provide evidence-based, personalized care for individuals with cancer. Resources are available to help nurses provide quality cancer genetic informed care.


Assuntos
Neoplasias da Mama/genética , Neoplasias da Mama/enfermagem , Neoplasias Ovarianas/genética , Neoplasias Ovarianas/enfermagem , Feminino , Predisposição Genética para Doença , Testes Genéticos , Humanos , Pessoa de Meia-Idade , Enfermagem Oncológica , Pessoas Transgênero
7.
J Clin Nurs ; 28(15-16): 3012-3020, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-30357944

RESUMO

AIMS AND OBJECTIVES: To describe breast cancer (BC) survivors' experiences of participating in a 2-day educational programme (Breast Cancer School, BCS) and their critical reflection on information received during and after adjuvant treatment. The following research questions guided the study. How do BC survivors experience their participation in an educational programme? How do BC survivors experience the information trajectory during and after adjuvant treatment? BACKGROUND: BC is the most prevalent cancer among women in Norway. BC survivors have a substantial need for information about the disease, treatment and recovery. During the past few years, BC treatment in Norway has changed from inpatient- to outpatient-based treatment. Oncology nurses and oncologists are obliged to provide patients and their families with information, which has necessitated reorganisation of the procedures for providing information. New arenas such as the Breast Cancer School (BCS) offer the opportunity to learn from experts and fellow patients. DESIGN: Qualitative, descriptive design. METHODS: Focus groups with 20 BC survivors after having participated in the BCS were used to enable critical reflection. The COREQ checklist was followed to ensure rigour in the study. RESULTS: Two themes emerged from qualitative analysis: Balancing between the need for and the fear of information and Moving from a safe structure to lonely recovery. We identified differences between BC survivors in diversity, uniqueness and need for information. Continuity and expert knowledge provided by a primary oncology nurse and oncologists were highlighted as important. CONCLUSION: The study reveals the need for information tailored to each BC survivor's unique needs. The BC survivors expressed both the need for and the fear of information. BCS takes both a systematic and individual approach to provide expert information, dialog and the opportunity to meet with fellow patients. The transition from the structure of the treatment to lonely recovery after the most intensive treatment was perceived as unsafe and challenging. BC patients' experiences must be continuously valued and used to improve educational programmes, care and treatment. Oncology nurses play an important part in the information chain and continuity. RELEVANCE TO CLINICAL PRACTICE: This study highlights the importance of including BC survivors in the design and evaluation of educational programmes. The provision of information and supportive care with continuity between oncology nurses and oncologists through the trajectory of treatment and care is crucial.


Assuntos
Neoplasias da Mama/psicologia , Sobreviventes de Câncer/psicologia , Educação de Pacientes como Assunto/métodos , Idoso , Neoplasias da Mama/enfermagem , Feminino , Grupos Focais , Humanos , Pessoa de Meia-Idade , Noruega , Desenvolvimento de Programas/métodos , Pesquisa Qualitativa
8.
Cancer Nurs ; 42(1): 20-34, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-28926349

RESUMO

BACKGROUND: Healthcare providers are facing the challenge of helping cancer patients cope with the impact of outpatient-based chemotherapy. A nurse-led care program was proposed to address this challenge. OBJECTIVE: The aim of this study was to examine the effects of a nurse-led care program for patients receiving outpatient-based chemotherapy. METHODS: This was a single-center, open-label, 2-arm parallel trial with equal randomization (NCT02228200). Breast cancer patients in Hong Kong were randomly allocated to the intervention arm or the control arm. The control arm received routine hospital care. The intervention arm received the nurse-led care plus the routine hospital care. The quality of life, self-efficacy, symptom distress levels, and satisfaction with care were evaluated with questionnaires before randomization (T0), in the middle of chemotherapy (T1), and 1 month after chemotherapy (T2). Individual interviews were conducted with some participants in the intervention arm at T2. RESULTS: The intervention arm participants reported significantly lower distress levels from oral problems, fatigue, peripheral neuropathy, distressful feelings, and higher satisfaction with care. According to the satisfaction evaluation and the interviews, the participants stated that the service was helpful in providing information and communication opportunities, filling the service gap after drug administration, providing psychological support, relieving discomfort, and building confidence. CONCLUSION: Breast cancer patients received support from the provision of comprehensive, continuous, and individualized care. IMPLICATIONS FOR PRACTICE: The nurse-led care program could be applied to breast cancer patients in other hospitals in Hong Kong. Exploring its applicability to cancer settings in other countries is recommended.


Assuntos
Antineoplásicos/uso terapêutico , Neoplasias da Mama/enfermagem , Hospital Dia/organização & administração , Padrões de Prática em Enfermagem , Adulto , Neoplasias da Mama/tratamento farmacológico , Feminino , Hong Kong , Humanos , Pessoa de Meia-Idade , Pesquisa em Avaliação de Enfermagem
9.
BMJ Open ; 8(12): e021366, 2018 12 09.
Artigo em Inglês | MEDLINE | ID: mdl-30530574

RESUMO

OBJECTIVES: Nurses are generally found to be vulnerable to burnout, but nurses working in cancer care are even more so, since this profession is characterised by continuous confrontation with suffering and death. This study was designed to identify cut-off scores for job strain, that is, low job control and high job demands, for a sample of nurses working in breast cancer care. The main goal was to find cut-off scores, which predict the risk of nurses of developing a mental disorder from high job strain. DESIGN: The design was a cross-sectional survey study. SETTING: The study is based on an employee survey in breast cancer centres in Germany. PARTICIPANTS: 688 nurses received a questionnaire; 329 nurses from 33 hospitals participated in the survey (return rate: 50.2%). PRIMARY AND SECONDARY OUTCOME MEASURES: Dependent variable: psychological well-being, measured by the WHO-5 Well-being Index; independent variables: job control and job demands, measured by the Job Content Questionnaire (JCQ). RESULTS: Multivariable analysis indicates that low job control and high job demands are prognostic factors for low well-being. In a receiver operating curve (ROC) analysis, the cut-off scores, which demonstrated a maximum Youden index, were 34.5 for job control and 31.4 for job demands. The combination of both scales from a logistic regression analysis resulted in an area under the curve of 0.778. Sensitivity and specificity are 70.3% and 74.2%, respectively. The total of correct classification was 63.3%. CONCLUSION: The determined cut-off scores indicate that there is a risk of becoming psychologically ill from a high workload when an individual reaches a score of ≤34.5 for job control and ≥31.4 for job demands. The described method of establishing risk-based cut-off scores is promising for nursing practice and for the field of occupational health. Transferability and generalisability of the cut-off scores should be further analysed.


Assuntos
Neoplasias da Mama/enfermagem , Esgotamento Profissional/epidemiologia , Institutos de Câncer , Descrição de Cargo , Recursos Humanos de Enfermagem no Hospital/estatística & dados numéricos , Estresse Ocupacional/enfermagem , Controle Social Formal , Adolescente , Adulto , Idoso , Neoplasias da Mama/psicologia , Esgotamento Profissional/psicologia , Estudos Transversais , Feminino , Alemanha , Humanos , Controle Interno-Externo , Satisfação no Emprego , Masculino , Pessoa de Meia-Idade , Recursos Humanos de Enfermagem no Hospital/psicologia , Estresse Ocupacional/epidemiologia , Estresse Ocupacional/psicologia , Qualidade de Vida/psicologia , Medição de Risco/estatística & dados numéricos , Inquéritos e Questionários , Carga de Trabalho/psicologia , Carga de Trabalho/estatística & dados numéricos , Adulto Jovem
10.
Rev Gaucha Enferm ; 39: e20180015, 2018 Oct 22.
Artigo em Inglês, Português | MEDLINE | ID: mdl-30365760

RESUMO

OBJECTIVE: It was to evaluate the degree of complexity of nursing care required for breast cancer patients who are readmitted to hospital. METHODS: Cross-sectional study whose 108 subjects were breast cancer patients in unplanned readmission into the oncological unit of hospital in Brazil. Used for documentary analysis and the data analyzed statistically. RESULTS: The predominant degrees of complexity of complexity of nursing care were semi-intensive (36.1%) and intensive care (36.1%). In the multivariate analysis, only performance status (p<0.001) and arterial hypertension (p=0.024) remained associated with the degree of complexity. CONCLUSIONS: The degree of complexity of patients readmitted was predominantly semi-intensive and intensive. This evaluation implies in the management of the care by means of the knowledge of the the profile breast cancer patients in hospital readmission and the detection of the characteristics associated to the degree of complexity.


Assuntos
Neoplasias da Mama/enfermagem , Cuidados de Enfermagem/normas , Análise de Sistemas , Estudos Transversais , Feminino , Humanos , Oncologia , Pessoa de Meia-Idade , Enfermagem Oncológica , Estudos Retrospectivos
11.
Oncol Nurs Forum ; 45(6): 683-685, 2018 11 01.
Artigo em Inglês | MEDLINE | ID: mdl-30339147

RESUMO

An article by Lally et al. (2018) in the current issue describes the process of collecting end-user feedback from a sample of rural Nebraskan women with breast cancer regarding a web-based, psychosocial distress management program, CaringGuidance™. The current article uses that study to inform discussion on future work in the realm of interventions for rural cancer survivors.


Assuntos
Neoplasias da Mama/enfermagem , Neoplasias da Mama/psicologia , Sobreviventes de Câncer/psicologia , Assistência à Saúde Culturalmente Competente/métodos , Enfermagem Oncológica/métodos , Psico-Oncologia/métodos , População Rural , Adulto , Idoso , Idoso de 80 Anos ou mais , Feminino , Humanos , Pessoa de Meia-Idade , Nebraska
12.
Clin J Oncol Nurs ; 22(5): 493-495, 2018 10 01.
Artigo em Inglês | MEDLINE | ID: mdl-30239503

RESUMO

The discovery of an abnormality in the breast may provoke anxiety for patient and clinician alike. Fortunately, most lesions in the breast are benign. Physical examination and breast imaging, including mammography, ultrasound, and magnetic resonance imaging, assist in the diagnosis of benign breast diseases. Understanding benign breast diseases is important for advanced practice nurses because these diseases are commonly seen in daily clinical practice.


Assuntos
Prática Avançada de Enfermagem/métodos , Doenças Mamárias/diagnóstico , Doenças Mamárias/enfermagem , Neoplasias da Mama/diagnóstico , Neoplasias da Mama/enfermagem , Adulto , Feminino , Humanos , Masculino , Pessoa de Meia-Idade
13.
Clin J Oncol Nurs ; 22(5): 576, 2018 10 01.
Artigo em Inglês | MEDLINE | ID: mdl-30239506

RESUMO

I worked for the Louisiana Tumor Registry for years, coding pathology reports and doing my part to make a difference, but ultimately, I grew bored. I wanted to hear the stories behind the reports I entered into a database and craved interaction with patients. When the opportunity to become a patient navigator presented itself, I jumped at the chance. I sold myself as an eager and capable member of the community who knew the patients' frustrations firsthand. I guess it worked, because I was hired by the Louisiana Cancer Control Program in July 2010 as a patient navigator for patients beginning cancer treatment.


Assuntos
Neoplasias da Mama/enfermagem , Papel do Profissional de Enfermagem/psicologia , Recursos Humanos de Enfermagem no Hospital/psicologia , Enfermagem Oncológica/métodos , Navegação de Pacientes/métodos , Adulto , Feminino , Humanos , Louisiana
14.
Zhong Nan Da Xue Xue Bao Yi Xue Ban ; 43(6): 656-661, 2018 Jun 28.
Artigo em Chinês | MEDLINE | ID: mdl-30110009

RESUMO

OBJECTIVE: To investigate the effect of the aroma therapy and music intervention on anxious and pain for the breast cancer patients in the perioperative period and the potential mechanisms.
 Methods: A total of 100 breast cancer patients who received surgical treatment in the comprehensive hospitals of Hunan province were recruited for this study. Patients were assigned randomly into a control group, an aroma therapy group, a music intervention group, and a joint-therapy group (n=25 per group). The patients in the control group received regular post-surgical nursery, while the patients from other groups received aroma therapy, music intervention, or both in addition to the regular nursery. The scale of anxiety and pain were measured. The measurements were carried at three time points, namely 30 min before the surgery (T1), 30 min after the recovery period of anesthesia (T2), and 4 hours after the removal of anesthesia tubing (T3). Repeated ANOVA was used to perform statistic analysis.
 Results: The scale of pain was significantly increased at the post-operation (T2, T3) compared to pre-surgery (T1). The therapeutic group showed significant decrease in pain at post-operation (T3) comparing with the control group (P<0.05). The scale of anxiety was the highest at pre-surgery (T1). During anaesthesia recovery, the anxiety of patients at post-operation T2 and T3 in the therapeutic groups significantly decreased compared with the control group (P<0.05).
 Conclusion: Both the aroma therapy and the music therapy can decrease the stress-responsive anxiety and pain for the breast cancer patients in the perioperative period.


Assuntos
Ansiedade/terapia , Aromaterapia , Neoplasias da Mama/psicologia , Neoplasias da Mama/cirurgia , Musicoterapia , Dor Pós-Operatória/terapia , Análise de Variância , Neoplasias da Mama/enfermagem , Feminino , Humanos , Período Perioperatório , Cuidados Pré-Operatórios , Fatores de Tempo
15.
Pain Manag Nurs ; 19(6): 627-636, 2018 12.
Artigo em Inglês | MEDLINE | ID: mdl-29937228

RESUMO

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.


Assuntos
Neoplasias da Mama/psicologia , Medição da Dor , Dor Intratável/prevenção & controle , Adulto , Idoso , Neoplasias da Mama/enfermagem , Neoplasias da Mama/patologia , Análise por Conglomerados , Feminino , Humanos , Pessoa de Meia-Idade , Metástase Neoplásica , Ohio , Dor Intratável/enfermagem , Cuidados Paliativos , Valor Preditivo dos Testes , Psicometria , Qualidade de Vida
16.
Eur J Cancer Care (Engl) ; 27(5): e12872, 2018 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-29956873

RESUMO

Caregiver guilt (i.e., feeling of inadequacy in providing care to patients) is commonly experienced and studied among husbands of breast cancer survivors in Western countries. However, little is known about the psychosocial correlates of caregiver guilt in their Chinese counterparts. A total of 176 husbands of Chinese breast cancer survivors completed a cross-sectional survey in Weifang, Shandong province, China. As expected, hierarchical regression results showed that higher caregiving burden was associated with higher levels of caregiver guilt. However, for those who had stronger endorsement of the "Masculinity strength" gender-role norm, higher seeking social support from spouse was associated with higher guilt; for those with higher levels of marital satisfaction, higher protective buffering (i.e., hiding of concerns and negative emotions to protect others) was associated with lower caregiver guilt. Western assumptions on the harm of protective buffering and the benefits of support seeking as well as related supportive evidence among Western populations do not directly apply to the Chinese culture, which should be brought awareness to research and practice. Practitioners should consider the cultural background of the caregivers and should not simply encourage support seeking and discourage protective buffering.


Assuntos
Adaptação Psicológica , Neoplasias da Mama , Cuidadores/psicologia , Culpa , Cônjuges/psicologia , Adulto , Idoso , Neoplasias da Mama/enfermagem , Neoplasias da Mama/psicologia , China , Efeitos Psicossociais da Doença , Estudos Transversais , Feminino , Humanos , Masculino , Casamento/psicologia , Pessoa de Meia-Idade , Apoio Social , Estresse Psicológico/psicologia
17.
Eur J Cancer Care (Engl) ; 27(4): e12854, 2018 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-29726050

RESUMO

Breast cancer is the most common neoplasm among women worldwide. Improvements in early detection and treatment have resulted in improved survival rates; however, the continuation of unhealthy behaviours after diagnosis can increase the risk of second primary tumours. The aim of the study was to evaluate the effectiveness of two nurse-led health education interventions aiming at improving dietary behaviours among women diagnosed with breast cancer. Participants (n = 492) were included in a double-blind randomized controlled trial with three arms: a control group received usual care; women in the first intervention group received a booklet containing dietary advice; women in the second intervention group received the same booklet plus a tailored telephone intervention delivered by a trained nurse. One year after the intervention, women in both intervention groups were more likely to adhere to the recommendation of decreasing the consumption of animal fats compared with the control group (OR:5.0; 95% CI:1.5-16.9 and OR:6.6; 95% CI:2.0-22.6, respectively). Moreover, compared with the control group, the adjusted probability of eating the recommended amount of fruit and vegetables was higher in the second intervention group (OR:2.7; 95% CI:1.4-5.3). In summary, the booklet containing dietary advice for breast cancer survivors, either alone or supplemented with a nurse-led telephone intervention, was effective in promoting adherence to diet recommendations.


Assuntos
Neoplasias da Mama/enfermagem , Sobreviventes de Câncer , Dietoterapia , Educação de Pacientes como Assunto/métodos , Padrões de Prática em Enfermagem , Gorduras na Dieta , Método Duplo-Cego , Feminino , Frutas , Humanos , Pessoa de Meia-Idade , Folhetos , Verduras
18.
BMC Womens Health ; 18(1): 63, 2018 05 08.
Artigo em Inglês | MEDLINE | ID: mdl-29739384

RESUMO

BACKGROUND: Women who have been treated for breast cancer may identify vasomotor symptoms, such as hot flushes and night sweats (HFNS), as a serious problem. HFNS are unpleasant to experience and can have a significant impact on daily life, potentially leading to reduced adherence to life saving adjuvant hormonal therapy. It is known that Cognitive Behavioural Therapy (CBT) is effective for the alleviation of hot flushes in both well women and women who have had breast cancer. Most women with breast cancer will see a breast care nurse and there is evidence that nurses can be trained to deliver psychological treatments to a satisfactory level, whilst also maintaining treatment fidelity. The research team will assess whether breast care nurses can effectively deliver a CBT intervention to alleviate hot flushes in women with breast cancer. METHODS: This study is a multi-centre phase III individually randomised controlled trial of group CBT versus usual care to reduce the impact of hot flushes in women with breast cancer. 120-160 women with primary breast cancer experiencing seven or more problematic HFNS a week will be randomised to receive either treatment as usual (TAU) or participation in the group CBT intervention plus TAU (CBT Group). A process evaluation using May's Normalisation Process Theory will be conducted, as well as practical and organisational issues relating to the implementation of the intervention. Fidelity of implementation of the intervention will be conducted by expert assessment. The cost effectiveness of the intervention will also be assessed. DISCUSSION: There is a need for studies that enable effective interventions to be implemented in practice. There is good evidence that CBT is helpful for women with breast cancer who experience HFNS, yet it is not widely available. It is not yet known whether the intervention can be effectively delivered by breast care nurses or implemented in practice. This study will provide information on both whether the intervention can effectively help women with hot flushes and whether and how it can be translated into routine clinical practice. TRIAL REGISTRATION: ISRCTN 12824632 . Registered 25-01-2017.


Assuntos
Neoplasias da Mama/complicações , Terapia Cognitivo-Comportamental , Fogachos/terapia , Padrões de Prática em Enfermagem , Sudorese , Neoplasias da Mama/enfermagem , Neoplasias da Mama/terapia , Terapia Cognitivo-Comportamental/economia , Terapia Cognitivo-Comportamental/normas , Análise Custo-Benefício , Feminino , Humanos , Psicoterapia de Grupo , Projetos de Pesquisa
19.
Oncol Nurs Forum ; 45(3): 389-398, 2018 05 01.
Artigo em Inglês | MEDLINE | ID: mdl-29683115

RESUMO

OBJECTIVES: To understand what, if any, differences exist in the perception of a breast care nurse (BCN) consultation between women who experienced a preoperative, face-to-face counseling and education opportunity with a BCN, and those who required a telephone consultation or were unable to experience a preoperative BCN consultation. SAMPLE & SETTING: A convenience sample of women in a private hospital in Western Australia who had breast surgery for breast cancer, BRCA gene mutation, or breast cancer risk reduction, and who experienced face-to-face contact, telephone contact, or no preoperative contact with a BCN. METHODS & VARIABLES: A single-center, mixed-methods, descriptive study comparing timing and mode of consultation. RESULTS: Women who experienced a timely face-to-face consultation with a BCN in the preoperative period reported that they received superior education and emotional and practical support than women who experienced a telephone consultation or postoperative consultation with a BCN. IMPLICATIONS FOR NURSING: When a patient's circumstances allow, a consultation with a BCN in the preoperative period should be offered. Ideally, this consultation should be conducted face-to-face to provide the education and psychosocial and practical support that patients undergoing breast surgery require. When this is not possible, a telephone consultation should be offered, as opposed to waiting until after surgery.


Assuntos
Neoplasias da Mama/enfermagem , Neoplasias da Mama/psicologia , Aconselhamento/normas , Papel do Profissional de Enfermagem , Enfermagem Oncológica/normas , Satisfação do Paciente , Apoio Social , Adulto , Idoso , Idoso de 80 Anos ou mais , Aconselhamento/estatística & dados numéricos , Feminino , Humanos , Pessoa de Meia-Idade , Guias de Prática Clínica como Assunto , Período Pré-Operatório , Medição de Risco/métodos , Telefone , Fatores de Tempo , Austrália Ocidental
20.
Oncol Nurs Forum ; 45(3): 359-371, 2018 05 01.
Artigo em Inglês | MEDLINE | ID: mdl-29683125

RESUMO

OBJECTIVES: To determine the relationship among gait, grip strength, cognition, depression, pain, and fatigue, and to identify which variables are most predictive of poor sleep. SAMPLE & SETTING: 60 women with breast cancer aged 69 years or older who were receiving treatment in the Senior Adult Oncology Program at the James Cancer Hospital at the Ohio State University. METHODS & VARIABLES: The variables were gait and grip strength (functional domains), cognition, depression, pain, and fatigue. Patients were tested using the Timed Up and Go Test (TUG), Jamar Hydraulic Hand Dynamometer, Mini-Cog, Numeric Pain Rating Scale, Brief Fatigue Inventory, Geriatric Depression Scale, and Pittsburgh Sleep Quality Index. Pearson correlation coefficients and logistic regression models were used. RESULTS: The mean age of the sample was 78 years. Pain and fatigue, depression and pain, and depression and fatigue each were positively related, and grip strength and TUG scores were negatively related. Fatigue was the strongest predictor of poor sleep. IMPLICATIONS FOR NURSING: These findings are important to the comprehensive care of older women diagnosed with breast cancer. Understanding symptoms associated with poor sleep helps nurses develop comprehensive care plans for older adults with breast cancer.


Assuntos
Neoplasias da Mama/complicações , Neoplasias da Mama/enfermagem , Avaliação Geriátrica/métodos , Enfermagem Oncológica/métodos , Distúrbios do Início e da Manutenção do Sono/etiologia , Transtornos do Sono-Vigília/etiologia , Avaliação de Sintomas/métodos , Idoso , Idoso de 80 Anos ou mais , Feminino , Humanos , Ohio , Qualidade de Vida , Índice de Gravidade de Doença
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