Articles

Asia Pac J Oncol Nurs. 2020 Jan-Mar;7(1):6-11 Participation in cancer screening and prevention (cessation of or reduction in modifiable health risk behaviors) are the most effective methods of reducing cancer morbidity and mortality. Some members of the lesbian, gay, bisexual, and transgendered (LGBT) communities have not participated in screening for a variety of reasons which have been explored in the literature. Common and unique behavioral risks are also reviewed. Knowledge about Asian members of the LGBT community participation in cancer screening and prevention is limited. This paper reviews the current literature on participation and barriers to cancer screening and prevention for the LGBT community and provides some insights for the Asian LGBT subcommunity. Potential interventions that have been demonstrated to be effective are presented for potential implementation within nursing practice and practice settings. Suggestions for future research are also provided to enhance the care of the LGBT community. PMID: 31879678 [PubMed]

Asia Pac J Oncol Nurs. 2020 Jan-Mar;7(1):18-27 Objective: Cervical cancer is preventable, and early diagnosis is possible using low-cost technologies, but a scant number of women receive cancer screening in Malawi. This study aims to identify facilitators and barriers that influence the uptakes of cervical cancer screening behavior in Malawi. Methods: A rapid ethnographic approach with the goal of optimizing planning for a future intervention study was utilized. Data were collected from three focus groups and seven individual interviews with adults in their communities, stakeholders, and health-care providers. Results: Three categories (sociocultural influences, access to the health-care system, and individual factors) have emerged as facilitators or barriers to cervical cancer screening among Malawian women. The findings also showed that cervical cancer screening behavior is situated socially through cultural and health-care services of a given community. Conclusions: Cancer screenings are only sought when illness symptoms persist or worsen. Awareness and knowledge of cervical cancer and cervical cancer screening is low among both health-care providers and the general population. Health-care systems are donor driven and focus on a single disease, health-care access is the greatest challenge to cervical cancer screening, and health-care providers are not adequately prepared to work for rapid increase in the prevalence of cervical cancer. Integrating cervical cancer screening into the existing health-care system is sustainable way forward, and nurses prepared to handle cervical cancer management can play an essential role to promote cervical cancer screening in a health resource-constrained setting. PMID: 31879680 [PubMed]

Asia Pac J Oncol Nurs. 2020 Jan-Mar;7(1):28-35 Objective: This study identified the level of stress, social support, and sexual adjustment in married women with breast cancer in Korea. Methods: This study used a subgroup analysis, prospective, cross-sectional, and descriptive correlation design. Data were obtained using the perceived stress scale, multidimensional scale of perceived social support, and sexual adjustment subscale of the Korean version of the psychosocial adjustment to illness scale. From May 2015 to April 2016, 272 married female patients who had been diagnosed with breast cancer were recruited at a university hospital in Korea. Data were analyzed using SPSS Win 21.0. Results: The mean score of stress level was 17.53 ± 4.13, social support was 5.37 ± 1.07, and sexual adjustment was 6.36 ± 3.29. A significant positive correlation emerged between sexual adjustment and stress (r = 0.161, P = 0.008). Significant negative correlations were observed among sexual adjustment and family support (r = -0.177, P = 0.003) and friends' support (r = -0.205, P = 0.001). Conclusions: The assessment of stress level and social support may be used in planning sexual-adjustment interventions appropriate for married female breast cancer patients in Korea. PMID: 31879681 [PubMed]

Asia Pac J Oncol Nurs. 2020 Jan-Mar;7(1):36-43 Objective: One of the most difficult challenges regarding hematopoietic stem cell transplantation in Turkey is finding donors for allogeneic transplantation candidates who do not have related donors. This study aims to determine whether there is any difference in the awareness of stem cell donation and transplantation between cancer and noncancer patients and their family caregivers. In addition, this study aims to determine the awareness of stem cell donation and transplantation in the entire study population. Methods: This descriptive study was conducted in Turkey using a data collection form comprising questions about demographics, stem cell transplantations, donations, and medical history. On analyzing the research data, variables were expressed as mean ± standard deviation and as numbers (n) and percentages (%). The Chi-square and Fisher's exact tests were performed to evaluate differences among cancer and noncancer diagnosed patients and their family members. Results: A total of 192 patients and 169 family caregivers participated in the study. In comparison with noncancer patients, cancer patients showed more awareness on what stem cell transplantation is, how lifesaving it is, and how to donate stem cells. Similarly, the family caregivers of cancer patients were more aware of what stem cell transplantation is and how to donate stem cells. Conclusions: The results of this study showed that cancer patients and their families were more aware of stem cell donation and transplantation; however, most of the patients and families did not know enough about the national registry program and how to donate stem cells. PMID: 31879682 [PubMed]

Asia Pac J Oncol Nurs. 2020 Jan-Mar;7(1):44-48 Objective: The objective was to explore factors affecting stress levels in hospitalized patients after implementation of fast-track (FT) protocol in hepatopancreatobiliary surgery. Methods: This was a prospective cross-sectional study, where 90 patients were included. Exploration of environmental postoperative stress levels was conducted by serum adrenocorticotropic hormone and cortisol levels, the Intensive Care Unit Environmental Stressor Scale, and three self-reported Numeric Analog Scale questions, with regard to emotional/stress level, specifically "How sad do you feel right now?" "How stressed do you feel right now?" and "How optimistic do you feel right now, about the future?" at 3 time points: (T1) Before surgery, (T2) the day of surgery, and (T3) the 3rd postoperative day. The trial profile is conformed according to the CONSORT guidelines. Statistical analysis was carried out by SPSS software version 22 (IBM SPSS software, Chicago, Illinois, USA) at a significance level of 0.05. Results: Serum cortisol T2 levels were positively correlated with the day of removal the drainage tube (rho = 0.235, P = 0.027). Furthermore, serum cortisol T3 levels were positively correlated with age and body mass index and negatively with the day of drainage tube removal (rho = 0.231, P = 0.028, rho = 0.235, P = 0.026, and rho = -0.279, P = 0.008, respectively). Conclusions: The findings of this study highlight that after evaluation of stress levels; nurses could interfere and reduce stress levels, knowing the factors which cause the increased stress levels, after the implementation of FT protocols. PMID: 31879683 [PubMed]

Asia Pac J Oncol Nurs. 2020 Jan-Mar;7(1):55-63 Objective: This experimental randomized controlled trial will be to examine the impact of a technology-based psychosocial motivation program on children and families who are being followed up on a diagnosis of cancer. Methods: The research is based on the "Transactional Model of Stress and Coping." This study will be conducted on children with leukemia, aged 9-18 years, and their parents, who will be followed in the consolidation treatment phase in the hematology wards and outpatient clinic of a university hospital. Data collection will consist of the children's and parents' descriptive characteristic form, the Spielberger State Anxiety Inventory for Parents, the State-Trait Anxiety Inventory for Children, the Pediatric Cancer Coping Scale, the Pediatric Quality of Life Inventory, and process evaluation forms. A 10-week program will be implemented for the children in the intervention group through web-based training, coaching interviews and counseling via video mobile calls, mobile messages and children's stories, progressive muscle relaxation and breathing exercises, and imagination interventions. During the same period, parents will also receive web-based training, coaching sessions, counseling, mobile messages, and progressive muscle relaxation exercises. Results: It is thought that after the intervention the stress level of the child and the family will decrease, the coping skills of the children will improve, and their quality of life will increase. Conclusions: It is thought that the treatment process can be affected positively by providing psychosocial support to children and their families who receive cancer treatment. PMID: 31879685 [PubMed]

Asia Pac J Oncol Nurs. 2020 Jan-Mar;7(1):64-71 Objective: To assist weight control among women with breast cancer, improving their food attitudes may be an effective method. Therefore, the present study validated a short instrument assessing food attitudes (i.e., the Short Form of the Food-Life Questionnaire [FLQ-SF]) among Iranian women with breast cancer who are overweight. Methods: Women with breast cancer who were overweight (n = 493; mean ± standard deviation age = 52.3 ± 10.7 years) participated in the study. All of them completed the FLQ-SF, questions designed using the theory of planned behavior (TPB; including subjective norm, perceived behavioral control, and behavioral intention), and food frequency questionnaire (FFQ). Both classical test theory and Rasch models were used to examine the psychometric properties of the FLQ-SF. More specifically, the factorial structure of the FLQ-SF was assessed using confirmatory factor analysis (CFA), the item fit was examined using the Rasch model, and the concurrent validity was evaluated using the correlation between the FLQ-SF, TPB elements, and FFQ. Results: CFA results confirmed the Persian FLQ-SF has a five-factor structure. Rasch models indicated that all the FLQ-SF items fit in the construct of food attitudes. Significant correlations between FLQ-SF and other instruments (TPB elements and FFQ) supported the concurrent validity of the FLQ-SF. Conclusions: The psychometric findings of the present study demonstrated that Persian FLQ-SF is a reliable and valid instrument. Therefore, the Persian FLQ-SF can be applied to assess food attitudes among Iranian women with breast cancer who are overweight. PMID: 31879686 [PubMed]

Asia Pac J Oncol Nurs. 2020 Jan-Mar;7(1):72-80 Objective: In cancer care management, patients or their family are usually responsible for continuing health care. Achieving this goal requires identification of their self-care needs. The purpose of this study is to explore the perception of self-care needs of adolescent cancer survivors. Methods: This study was conducted by the qualitative content analysis method. Participants were 19 adolescent childhood cancer survivors and six parents, nurses, physicians, and charity institution staff from children teaching hospitals in Iran. Participants were selected through purposeful sampling, and individual semistructured interviews were used for data collection. Graneheim and Lundman stages of content analysis were employed for data analysis. Data were managed with the MAXQDA10 software. Results: Content analysis revealed nine subcategories as follows: (1) nutritional protection, (2) prevention from infection, (3) prevention from physical damage, (4) control over cancer recurrence, (5) informational needs, (6) pain management, (7) releasing positive thoughts, (8) continuing routine life, and (9) family protection. The first six subthemes were related to protection against physical distress, and the final three ones were related to protection against psychological distress. These two categories form one theme: "protective self-care need" as an essential self-care need in adolescent cancer survivors. Conclusions: Pediatric and school health nurses can prepare strategies to meet these needs by providing effective informational and psychosocial supports, and healthcare providers are able to check periodically the status of survivors care to provide second or third level of care to prevent escalation and incidence of the adverse outcomes of the disease. PMID: 31879687 [PubMed]

Asia Pac J Oncol Nurs. 2020 Jan-Mar;7(1):81-87 Objective: The objective was to identify and understand the coping strategies of colorectal cancer (CRC) patients. Methods: A mixed-methods approach including quantitative and qualitative methods was used to collect data from Jordanian patients. In the quantitative phase, we aimed to determine the coping strategies employed in a representative sample (n = 200) of Jordanian adult patients with CRC using the Jalowiec Coping Scale. In the qualitative phase, we aimed to understand these coping strategies through an in-depth and detailed exploration. A sample of ten participants was chosen purposefully based on their coping score in the quantitative phase, and interviews were conducted. Quantitative data were analyzed using SPSS software version 23. Qualitative data were analyzed using directed content analysis. Results: Results from the quantitative phase indicated that evasive coping strategies were used predominantly, followed by confrontive coping strategies and optimistic coping strategies. In contrast, fatalistic and emotive coping strategies had the lowest scores. In addition, the results indicated that the total scores for the effectiveness of coping strategies ranged from 42 to 143, with a mean of 93.45 (standard deviation 13.67); higher scores reflected greater effectiveness. Content analysis in the qualitative phase identified three themes, and subcategories emerged, including perceived collaborative support, increased awareness of treatment, and internal power. Conclusions: CRC patients used different coping strategies to face the new challenge. Oncology nurses can play a pivotal role in enhancing these coping strategies through implementing multidisciplinary programs. PMID: 31879688 [PubMed]

Asia Pac J Oncol Nurs. 2020 Jan-Mar;7(1):95-102 Objective: The aim of the current study are to determine the depression levels of adult oncology patients in the cancer treatment phase and identify both cancer-related stigma and the factors affecting their depression levels. Methods: In this correlational study, 303 adult patients who had been treated at a medical outpatient clinic were surveyed using the convenience sampling method. The "questionnaire for measuring attitudes toward cancer - patient version," a sociodemographic characteristics questionnaire, and the beck depression inventory were used. A multivariable linear regression model was used for the analysis. Results: The questionnaire and its subscale scores indicated a positive relationship between depression and attitudes toward cancer. The predictive variables for depression were "being younger than 40-year-old" and "feelings of social exclusion," which accounted for 4% of the total variance. Four factors indicating negative attitudes toward cancer were "being more than 60-year-old," "higher education," "low income," and "feelings of social exclusion," which accounted for 11% of the total variance. Conclusions: Cancer-related stigma, which underlies patients' emotional and behavioral outlooks, should be reduced in cancer patients. Members of health teams should be sensitive to cancer-related stigma. PMID: 31879690 [PubMed]

Asia Pac J Oncol Nurs. 2020 Jan-Mar;7(1):103-112 Objective: The objective of the study was to conduct a concept analysis of "decision-making about the place of death for cancer patients" to develop a theoretical definition of the concept and identify its attributes, antecedents, and outcomes. Methods: The Rodgers' evolutionary model of concept analysis was used. A literature search for papers published from 2000 to 2017 was conducted using the keywords: "cancer," "place," "death," and "decision-making" for the search of the electronic databases. Results: Thirty articles were selected for this analysis. As a result, five attributes, six antecedents, and five consequences were extracted. [options to choose as a place of death], [wishes of the patients themselves], [consideration of the burden on the family], [open discussions with other persons concerned], and [best choice according to circumstances] are considered to be the characteristics in the decision-making about the place of death for cancer patients. Conclusions: This concept is defined as "The best choice according to circumstances of the cancer patients among different options for a place of death, resulting from a careful evaluation of the wishes of these patients and the burden on the family, as well as through open discussions with other persons concerned." Nurses need to assist patients discuss deaths with important others, such as family members, in making decisions about the place of death. Further studies are necessary to elucidate the details of the categories and relationships shown in the attributes in this study, investigating the actual conditions of the patients and their families. PMID: 31879691 [PubMed]

Asia Pac J Oncol Nurs. 2020 Jan-Mar;7(1):113 [This corrects the article on p. 397 in vol. 6, PMID: 31572760.]. PMID: 31879692 [PubMed - in process]

Asia Pac J Oncol Nurs. 2019 Oct-Dec;6(4):315-317 PMID: 31572749 [PubMed]

Asia Pac J Oncol Nurs. 2019 Oct-Dec;6(4):318-332 Objective: The recent American Society of Clinical Oncology (ASCO) Clinical Guidelines for chemotherapy-induced peripheral neuropathy (CIPN) management (48 Phase III trials reviewed) only recommend duloxetine. However, before concluding that a CIPN intervention is ineffective, scientists and clinicians should consider the risk of Type II error in Phase III studies. The purpose of this systematic review was to characterize internal threats to validity in Phase III CIPN management trials. Methods: The PubMed, CINAHL, EMBASE®, and Scopus databases were searched for Phase III clinical trials testing interventions for CIPN management between 1990 and 2018. The key search terms were neoplasms, cancer, neuropathy, and CIPN. Two independent researchers evaluated 24 studies, using a modified Joanna Briggs Institute Checklist for Randomized Control Trials developed by the authors specific for CIPN intervention trials. Results: Two studies exhibited minimal or no design flaws. 22/24 Phase III clinical trials for CIPN have two or greater design flaws due to sample heterogeneity, malapropos mechanism of action, malapropos intervention dose, malapropos timing of the outcome measurement, confounding variables, lack of a valid and reliable measurement, and suboptimal statistical validity. Conclusions: Numerous CIPN interventions have been declared ineffective based on the results of Phase III trials. However, internal validity threats to numerous studies may have resulted in Type II error and subsequent dismissal of a potentially effective intervention. Patients may benefit from rigorous retesting of several agents (e.g., alpha-lipoic acid, duloxetine, gabapentin, glutathione, goshajinkigan, lamotrigine, nortriptyline, venlafaxine, and Vitamin E) to expand and validate the evidence regarding ASCO's recommendations for CIPN management. PMID: 31572750 [PubMed]

Asia Pac J Oncol Nurs. 2019 Oct-Dec;6(4):333-335 Enhanced Recovery after Surgery (ERAS) is a multicentric program that includes the fields of nursing and anesthesia, nutrition and fluid management, and minimally invasive surgery. ERAS protocols focus on reducing the postoperative complications and stress response, optimizing the postoperative recovery. They have been implemented in many surgical fields, such as cardiac, gastric, and urologic, as they were shown to be effective in reducing morbidity and the overall health costs and in improving patient satisfaction. The aim of this minireview was to investigate the impact of ERAS programs on patients' postoperative outcome after hepato-pancreato-biliary surgery. PMID: 31572751 [PubMed]

Asia Pac J Oncol Nurs. 2019 Oct-Dec;6(4):336-342 Objective: Alopecia is a frequently occurring side effect of chemotherapy and has high impact on many patients. Currently, scalp cooling is the only method to prevent this chemotherapy-induced alopecia (CIA) and it is effective in about half of the patients. Since determinants of the success are largely unknown, all patients should be prepared for potential hair loss. The objective was to provide up-to-date online information about CIA and scalp cooling to support patients in coping with CIA and in their choice regarding scalp cooling. Methods: Essential aspects of delivering information and lack of information were identified during focus groups, interviews, and a questionnaire survey among cancer patients, and in discussions with nurses. Results: The obtained information was used to develop a website (www.scalpcooling.org) and a web-based tool. It combines scientific evidence and practical advice about CIA and regrowth of hair, scalp-cooling tolerance, efficacy and safety, as well as an overview of possible advantages and disadvantages. The web-based tool provides tailored information about the probability of CIA with and without scalp cooling in particular chemotherapy regimens. Besides, the tool offers patients' support in decision-making by allowing them to reflect and consider their values and opinions about scalp cooling. Conclusions: This comprehensive information is useful during nursing consultations. PMID: 31572752 [PubMed]

Asia Pac J Oncol Nurs. 2019 Oct-Dec;6(4):356-362 Objective: The cancer care coordinator (CCC) role has become a priority in providing coordinated, patient-centered, supported care for patients, and their families experiencing cancer. The CCC role exists with heterogeneity across tumor streams, clinical disciplines, and institutions. This study explored CCCs perceptions and experiences of their role, scope of practice, and potential for future role development. Methods: This research used a mixed methods design. Focus groups and individual interviews were conducted with a purposive sample of 16 CCCs from two tertiary public teaching hospitals in Melbourne, Australia. A thematic analysis approach was used. A quantitative record of relative time spent on tasks was also collected. Results: Three major themes were identified: (1) Perceptions of role legitimacy, (2) Structure and funding of the role determines scope of practice, and (3) Reflections on the potential for the role. Variability was evident in predominant tasks undertaken, integration into the unit, level of patient contact, and regard from other professional colleagues. Variability appears to relate to employment time assigned to the role, and history and structure of the role. Conclusions: The findings underline the need when establishing and reviewing CCC roles for explicit attention to be given to the reporting, integration, structural, and collegiate support for the role as this will profoundly influence its success. PMID: 31572755 [PubMed]

Asia Pac J Oncol Nurs. 2019 Oct-Dec;6(4):363-371 Objectives: This study investigated physical symptoms, unmet supportive care needs, and quality of life (QoL) perception among different types of Thai cancer survivors who had completed first-line treatment. Methods: A cross-sectional study recruited breast, gynecological, colorectal, lung, and head and neck cancer survivors (n = 236) who were attending follow-up visits at a regional cancer hospital in central Thailand. Data were collected by the Physical Symptom Concerns Survey, the Cancer Survivors' Unmet Needs Scale, and a single item measuring global QoL. Descriptive statistics, one-way analysis of variance (ANOVA), and Welch's ANOVA were used for data analysis. Results: Cancer survivors generally perceived good QoL, with significantly low QoL for lung cancer survivors (P < 0.001). There were no differences in symptom experiences among the five cancer groups, except for pain, which was significantly higher in lung cancer survivors than in the other four groups. The most frequently reported symptoms across all groups were numbness in the hands/feet, sleep disturbances, fatigue, and pain. The top unmet supportive care need among all participants was related to concerns of cancer recurrence (44.5%). Head and neck cancer survivors reported the highest number of unmet needs among the five cancer groups. Conclusions: This study mapped the unmet supportive care needs in Thai cancer patients and showed that patients with head and neck cancer and lung cancer were strongly affected. A survivorship care plan focusing on managing physical symptoms and providing supportive and psychosocial care should be developed to meet the needs of each cancer survivor group and to enhance QoL after the completion of treatment. PMID: 31572756 [PubMed]

Asia Pac J Oncol Nurs. 2019 Oct-Dec;6(4):372-380 Objective: The purpose of this study was to explore perceptions about barriers to decision-making in Iranian patients with cancer about their care. Methods: Utilizing a qualitative approach, semi-structured interviews were conducted with 15 cancer patients. Results: Data analysis revealed four central categories reflecting patient perceptions about barriers that included medical dominance (uninformed decision-making, perceived inability to disagree secondary to despair, and patient objectification), healthcare system mistrust (physician, nurse, and medical center facility and equipment), healthcare system characteristics (services and facilities' limitations, poor communication, healthcare setting compulsion), and cultural barriers (feeling unfamiliar, insecurity in an unfamiliar environment, language barriers, limited attention to religious beliefs). Conclusions: Barriers may impact the perceived ability of Iranian patients' with cancer ability to participate in decision-making regarding their care. Such barriers contain the potential to disrupt patient-centered care. Perceptions about barriers articulated by patients are modifiable. While some Iranian healthcare systems may have problematic challenges, targeted allocation of resources and education of healthcare providers convey strong possibilities to enhance patient-centered care. PMID: 31572757 [PubMed]

Asia Pac J Oncol Nurs. 2019 Oct-Dec;6(4):389-396 Objective: This study aimed to clarify visiting nurses' perspectives on critical practices to ensure they could advocate for patients who prefer to die at home. Methods: Sixteen nurses, working at home-visit nursing agencies in Japan, participated in this study. Data were generated by interviews with the nurses and participant observations from nursing home-visits for six end-of-life cancer patients and were analyzed using content analysis. Results: Five themes emerged: (1) nursing assessment, (2) support for comfortable daily life of the patient and their family, (3) advocating for the patient's views about continuing homecare until death, (4) supporting the patient's preparedness for death, and (5) coordination with other health professionals and related facilities for a comfortable environment for the patient. In addition, the nurses sometimes used humorous responses to death-related work to change the patient's melancholy thoughts. Conclusion: The present study found that the participants advocated for the patient's views about continuing homecare until death while coordinating views between the patient and their family; they further supported the patient's daily life while helping them prepare for death to achieve their wish for death at home. In addition, our study uncovered the visiting nurses' unconscious practical wisdom of using humorous responses to death-related work to alleviate the patients' feelings of hopelessness. To develop practical wisdom for using humor effectively in end-of-life care, nurses need to verbalize unconscious practices, and accumulate empirical knowledge about nursing interventions using humor, including cultural attitudes, through case study analysis. PMID: 31572759 [PubMed]

Asia Pac J Oncol Nurs. 2019 Oct-Dec;6(4):397-402 Objective: This study aimed to evaluate the effects of warm humidification of anesthetic gas nursing care on physiological factors in elderly patients during laparoscopic cancer surgery. Methods: Sixty elderly laparoscopic surgical patients were recruited from a medical center in Korea. The participants' physiological factors (blood pressure, body temperature, and leukocyte and neutrophil counts) were measured four times. Results: After warm humidification of anesthetic gas nursing care, there were significant differences in body temperatures. Conclusions: These findings indicate that warm humidification of anesthetic gas nursing care is effective in maintaining body temperature. Thus, this type of nursing care can be effective in elderly cancer patients undergoing laparoscopic surgery. PMID: 31572760 [PubMed]

Asia Pac J Oncol Nurs. 2019 Oct-Dec;6(4):403-410 Objective: This study was carried out to investigate the effect of an education program based on the health belief model (HBM) on nursing students' health beliefs and on their practices of breast self-examination (BSE). Methods: This research was a semi-experimental intervention study with a single group, pretest and posttest design. The sample of the research consisted of 48 students in the 3rd year of study. Data were collected before the education program and 6 months and 1 year after the training. A sociodemographic information form, the breast cancer knowledge form, the HBM scale, and the BSE proficiency rating instrument were used. Descriptive statistics and repeated measures ANOVA were used to examine the relationships among the variables. Results: Implementing the educational program was found to be statistically insignificant for the HBM. Knowledge about breast cancer and BSE skills increased after the training. The percentage of students practicing regular BSE was determined as 14.6% before training, 45.8% after 6 months, and 28.1% after 1 year. Conclusions: The education provided to the students increased their HBM scores, knowledge about breast cancer, and BSE skills. However, the frequency of regular BSE was still quite low after training. PMID: 31572761 [PubMed]

Asia Pac J Oncol Nurs. 2019 Oct-Dec;6(4):411-416 Objective: Anxiety in cancer patients can affect recovery time, medication adherence, and patient quality of life. Some studies show that dhikr therapy can improve relaxation and can reduce anxiety, but research on dhikr therapy in cancer patients is still not widely done. This study aims to determine the effect of dhikr therapy on reducing anxiety in cancer patients. Methods: This study used a quantitative method with a quasi-experimental-nonequivalent control group design. The study was conducted in April-May 2018, with respondents 20 people in the intervention group and 20 people in the control group. Dhikr therapy is given once a day in the intervention group with a minimum time of 10 min. Anxiety was measured using the Visual Analog Scale for Anxiety. The effect of dhikr therapy was measured using the Mann-Whitney and effect size (ES). Results: There were a statistically significant differences in the anxiety level of patients in the intervention group and the control group, with a value of P = 0.001 (P < 0.05) and ES = 0.87 (ES > 0.5) indicating the influence of dhikr therapy in reducing patient anxiety. Conclusions: Dhikr therapy has a great effect on reducing anxiety in cancer patients. PMID: 31572762 [PubMed]

Asia Pac J Oncol Nurs. 2019 Oct-Dec;6(4):424-430 Objective: Cancer is one of the most common life-threatening diseases and a great source of stress in patients. The risk factors of depression differ in elder people compared to other age groups. The present study was designed to determine the relationship between depressive symptoms and demographic-medical characteristics among elder people with cancer. Methods: This cross-sectional correlational study recruited 200 elder people with cancer. The eligible patients completed the demographic-medical characteristics questionnaire, the Geriatric Depression Scale, the Abbreviated Mental Test, the Activities of Daily Living Scale, and the Multidimensional Perceived Social Support Scale. The findings were analyzed in SPSS software version 21.0 using the Kruskal-Wallis and Mann-Whitney tests. Results: A total of 50% of the elder people in this study had mild depression, 18.5% had moderate depression, and 2.5% had severe depression. A significant relationship was observed between depression in the elder people and their marital status (P = 0.025), living arrangement (P = 0.013), and income (P = 0.021). Depression also had a significant relationship with diabetes (P = 0.044) and respiratory diseases (P = 0.040). A significant relationship was also observed between depression and colon cancer (P = 0.007), and the mean depression was lower in the patients with colon cancer compared to those with other cancers. Depression had a significant relationship with complications, including pain (P = 0.001), nausea (P < 0.001), vomiting (P = 0.001), hair loss (P < 0.001), and shortness of breath (P = 0.028). Conclusions: Given the high prevalence of depression in this age group, screening and counseling-supportive interventions are recommended for helping prevent depression and come to terms with cancer. PMID: 31572764 [PubMed]

Asia Pac J Oncol Nurs. 2019 Oct-Dec;6(4):431-439 Objective: Early detection of cancers essentially depends on knowledge of the warning signs. This study, therefore, aimed at investigating the effect of Health Belief Model (HBM)-based educational intervention on the knowledge and perceived beliefs of women about the warning signs of cancer. Methods: This experimental study with intervention (n = 80) and control (n = 80) groups was performed at four urban health centers affiliated to the university. Data collection was done in two phases, before and one month after the educational intervention, using three instruments, a demographic-clinical information questionnaire, the awareness questionnaire on cancer warning signs, and the cancer warning signs-HBM questionnaire. Results: The results of the multivariate repeated-measures analyses of variance indicated that the hypothesis of this study was confirmed. It means that "women's knowledge and their perceived beliefs of cancer warning signs" improved after HBM-based educational intervention in the intervention group, compared to the controls over time. Thus, the "level of knowledge" and perceived beliefs of the women in the intervention group compared to the controls increased, in terms of perceived "sensitivity," "severity," "benefits," "barriers," "cue to action," and "self-efficacy" over time (P < 0.001). Conclusions: It could be hoped that this intervention would be effective for improving the performance of women in health-promoting behaviors of cancer prevention. It is recommended that health-care providers plan for HBM-based educational interventions, based on educational needs of the target groups at different community levels. PMID: 31572765 [PubMed]

Asia Pac J Oncol Nurs. 2019 Oct-Dec;6(4):440-445 [OPEN Access] Objective: Our primary research aim was to determine the prevalence of preoperative anxiety in patients undergoing outpatient cancer surgery. Our secondary aim was to examine the association between preoperative anxiety and negative intraoperative and postoperative outcomes in patients undergoing outpatient cancer surgery, including increased anesthesia requirements, postoperative nausea and vomiting (PONV), extended overnight stay, total length of stay (LOS), transfer to hospital, surgical complications, and postoperative visits to urgent care centers (UCC). Methods: We conducted a retrospective cohort study to investigate the prevalence of preoperative anxiety and its association with postoperative outcomes in patients undergoing outpatient cancer surgery. Our retrospective cohort included 10,048 outpatient procedures performed on 8683 patients at a large comprehensive cancer center between January 1, 2016, and April 30, 2018. Results: The analysis included 8665 patients undergoing procedures at an outpatient facility over 16 months; 16.7% had preoperative anxiety. In patients with preoperative anxiety, higher rates of adverse outcomes were seen, including PONV (adjusted difference 1.8%, 95% confidence interval [CI] 0.12%, 3.4%, P = 0.029), unplanned overnight admission (adjusted difference 1.1%, 95% CI 0.07%, 2.0%, P = 0.021), and urgent care visits within 30 days (adjusted difference 1.5%, 95% CI 0.44%, 2.6%, P = 0.002). Conclusions: Even assuming a causal relationship between preoperative anxiety and postoperative outcomes, preventing one instance of PONV would require treating at least 30 patients for anxiety, and preventing longer-term outcomes such as urgent care visits or readmissions within 30 days would require treating even larger numbers of patients. Future studies should attempt to elucidate the causal pathway between preoperative anxiety and postoperative adverse events in outpatients undergoing outpatient cancer surgery. PMID: 31572766 [PubMed]

Asia Pac J Oncol Nurs. 2019 Jul-Sep;6(3):207-208 PMID: 31259214 [PubMed]

Asia Pac J Oncol Nurs. 2019 Jul-Sep;6(3):212-226 Over the past two decades, immunotherapy has emerged as a promising treatment option for patients with cancer. However, newer versions of immunotherapy, such as checkpoint inhibitors, may be associated with unusual adverse effects (AEs) that can range in severity from mild to life-threatening. Unlike common AEs of conventional chemotherapy, which have a predictable nadir or cyclic pattern after administration, AEs of these newer immunotherapies are variable, depending on the type of immunotherapy, route of administration, and mechanism of action. The onset and resolution of these AEs may be present at any time, during administration of treatment, a few weeks after administration of treatment, or several months after completion of treatment. Therefore, improving outcomes in patients undergoing oncologic immunotherapy requires oncology nurses' knowledge and understanding of various immunotherapy agents, as well as early recognition and management of potential AEs, especially AEs associated with checkpoint inhibitors and other therapies that manipulate T-cell activation causing autoimmune toxicity. This article draws upon current evidence from systematic reviews, meta-analyses, and expert consensus guidelines to provide a brief overview of common immunotherapies used in cancer and management of their associated AEs. PMID: 31259216 [PubMed]

Asia Pac J Oncol Nurs. 2019 Jul-Sep;6(3):227-233 Cachexia is an old disease but a new research area that has recently been vigorously investigated. The diagnostic and staging criteria for cancer-associated cachexia have been established through an international consensus report (CR) published in 2011, which may greatly influence the designs and interventions of future clinical trials. However, no standard treatment has been established so far. This may be partially due to the lack of a widely accepted common endpoint for clinical trials. This review aimed to summarize designs and endpoints of 65 randomized controlled trials for cancer cachexia in the past 16 years and seek clinically relevant patient-centered outcomes for future clinical trials. Compared with trials before the CR, trials after the report revealed that the study populations tended to be at the earlier stage of cachexia and included patients with precachexia or those at risk for cachexia. Nonpharmacological interventions have been widely tested, and functional endpoints have increasingly been selected in combination with standard endpoints of body mass or lean body mass. Disability-free survival has recently been used as a functional endpoint in clinical trials in several research fields. It might be also a suitable patient-centered outcome responsive to multiple physical changes in cancer cachexia, and patients might find it more acceptable than other classical endpoints. More efforts would be needed to identify an optimal measurable endpoint and establish a better combination of pharmacological and nonpharmacological interventions to improve the functional prognosis for patients with cancer cachexia. PMID: 31259217 [PubMed]

Asia Pac J Oncol Nurs. 2019 Jul-Sep;6(3):234-237 In recent years, the clinical context for cancer has changed, and it is now characterized by extended survival rates and more diverse and complex cancer trajectories and symptomatology. The changes in the landscape of cancer care also include a shift towards the home setting or the outpatient setting with an increased amount of care being delivered at home or transferred to the patients themselves and their family caregivers. These changes have also impacted the type and amount of information required by the patients and their caregivers as well as the type of care needs that are to be addressed by health-care professionals. Finally, the transitions within the health-care setting might also create a caring gap that the patient is left to deal with independently or with minimal support. These changes have led to the emergence of innovative digital/technological solutions for supporting patients during their cancer care continuum. PMID: 31259218 [PubMed]

Asia Pac J Oncol Nurs. 2019 Jul-Sep;6(3):238-245 Fibrosis is a descriptive appellation referring to the obliteration of normal tissue components replaced by matrix and disorganized and varied collagen fibrils that result in the loss of organ function and frequent tissue contraction leading to death or significant deterioration in the quality of life. Radiation fibrosis syndrome (RFS) is a progressive fibrotic tissue sclerosis with various clinical symptoms in the irradiation field. It is usually a late complication of radiation therapy and may occur weeks or even years after treatment. It may affect the musculoskeletal, soft tissue, neural tissue, and cardiopulmonary systems. RFS is a serious and lifelong disorder that, nevertheless, may often be prevented when identified and rehabilitated early. Genetic factors likely play a significant role in the development of chronic fibrotic response to radiation injury that persists even after the initial insult is no longer present. Management of this syndrome is a complex process comprising medication, education, rehabilitation, and physical and occupational therapy. A bibliographical search was carried out in PubMed using the following keywords: "radiation fibrosis," "radiation fibrosis syndrome," and "radiation-induced fibrosis." We also reviewed the most relevant and recent series on the current management of RFS, and the reviewed data are discussed in this article. This review discusses the pathophysiology, evaluation, and treatment of neuromuscular, musculoskeletal, and functional disorders as late effects of radiation treatment. PMID: 31259219 [PubMed]

Asia Pac J Oncol Nurs. 2019 Jul-Sep;6(3):246-252 Objective: To present a structured evaluation process that provides evidence that the single-checking (SC) system is not only a viable option in reducing medication errors, but also has the added advantage of increasing staff satisfaction. Methods: The structured evaluation involved one work improvement process and conducting a survey establishing registered nurses' (RNs') attitude toward SC of medicines. The survey questionnaire included 12 questions with a 5-point Likert scale. Results: In spite of the increased number of patients, the number of medication errors actually reduced (P < 0.001; two-sample test of proportions) with the implementation of SC of medication for competent and experienced staff. A survey was conducted to establish RNs' attitudes toward SC of medicines 3 years post SC implementation. RNs viewed the single-nurse checking protocol positively. In particular, the nurses considered single-nurse checking as an encouragement to update their drug knowledge and as a time-saving measure, enhancing the quality of patient care. Nonetheless, they also expressed concerns on single-nurse checking. Conclusions: The findings provide evidence that SC system is a viable way to reducing medication errors and also confer the added advantage of staff satisfaction. Assuring quality and safety involves the need to challenge the status quo based on revealed evidence. PMID: 31259220 [PubMed]

Asia Pac J Oncol Nurs. 2019 Jul-Sep;6(3):253-260 Objective: We investigated the incidence of falls and functional impairments in breast cancer patients with chemotherapy-induced peripheral neuropathy (CIPN). Additionally, we examined whether taxane-induced peripheral neuropathy was associated with the patients' falls and functional impairments. Methods: We conducted a cross-sectional study including 88 patients with breast cancer who received taxane-based chemotherapy and were recognized as having peripheral neuropathy symptoms (Common Terminology Criteria for Adverse Events Grade ≥1). Patients completed the Functional Assessment of Cancer Therapy-Gynecologic Oncology Group-Neurotoxicity questionnaire for neuropathy and described falls from the onset of the taxane-based chemotherapy to the time of the survey. Functional impairments were defined using the Activities of Daily Living subsection of the Vulnerable Elder's Scale. Data were analyzed using descriptive statistics and logistic regression. Results: Of the participants, 40.9% experienced falls and 38.4% reported functional impairments. Most falls occurred on flat ground. Bone fracture due to falls was observed in 11.4% of the participants. Logistic regression revealed that CIPN was not significantly associated with the reported incidence of falls. However, it was significantly associated with functional impairments (odds ratio, 6.415; 95% confidence interval: 1.271-32.379; P = 0.024). Conclusions: CIPN was associated with functional impairments, but not with the incidence of falls. Patients should be informed prior to the onset of anticancer therapy that CIPN is a risk factor for functional impairments. PMID: 31259221 [PubMed]

Asia Pac J Oncol Nurs. 2019 Jul-Sep;6(3):261-268 Objective: The objective of this study is to explore the predictive role of emotional intelligence (EI) and its elements for health-related quality of life (HRQoL) dimensions in a sample of breast cancer survivors. Methods: This cross-sectional study was conducted in a single oncology clinic at a university hospital. A sample of breast cancer survivors (n = 180) completed three questionnaires: Short-Form Health Survey SF-36 (the RAND 36-item) with 8 dimensions; Cyberia Shrink EI Test (with five elements); and demographic Characteristics. The data were analyzed using SPSS version 20 (IBM Corporation, Armonk, NY, USA). A series of multiple linear regression models were used to analyze the data. Results: EI was a predictor for two dimensions of HRQoL components in survivors: mental (β = 0.45, P < 0.001); and physical (β = 0.27, P < 0.001). However, it was a better predictor for the mental HRQoL than for physical. More specifically, several elements of EI, including self-motivation, self-awareness, and self-control, demonstrated significant variance with a medium effect for prediction of dimensions of HRQoL. "Self-motivation" (β = 0.27, P < 0.001) and "self-awareness" (β = 0.29, P < 0.01) together were the best predictors of the variances of survivors' "general health" (R 2 = 28%). "Self-motivation" (β = 0.39, P < 0.001), and "self-control" (β = 0.19, P < 0.05), also together, were the best predictors of the variances of survivors' "emotional well-being" (R 2 = 28%). Conclusions: Educational intervention programs should be planned by concentrating on special elements of EI, including self-motivation, self-awareness and self-control, to improve HRQoL dimensions in breast cancer survivors. PMID: 31259222 [PubMed]

Asia Pac J Oncol Nurs. 2019 Jul-Sep;6(3):269-276 Objective: Survival chances of people with cancer in Nigeria are far worse than those in developed countries. While the chance of finding a lasting solution to cancer in Nigeria is remote, patients living with cancer still need treatment regardless of the terminal outcome, and hence cancer palliative care is necessitated. Caring patterns and expressions differ in diverse contexts. Therefore, this article aimed to present the meanings and expectations of caring and the resulting transformative theory of practice. Methods: A descriptive, qualitative inquiry was conducted with a purposive sample of 12 cancer palliative patients, 9 nurses, 3 physicians, and 5 relatives who were approached for an in-depth interview about their conceived meanings and expectations of caring for or being cared for in the cancer palliative unit. Results: Cancer palliative care in Nigeria is best exemplified through the processes/themes of "knowing," "revealing," and "humanizing." The meaning of care and the expectations of the patients and caregivers were grouped into these three overarching processes which then informed the conceptualization of a germinal theory of knowing-revealing-humanizing (TKRH) as expressions of caring in cancer palliative care. Conclusions: The application of the KRH practice processes is illustrated as a transformative germinal theory of practice. This TKRH as expressions of caring is transformative and can restore positive meanings in the life-world of persons in the cancer palliative care setting. PMID: 31259223 [PubMed]

Asia Pac J Oncol Nurs. 2019 Jul-Sep;6(3):277-282 Objective: Chemotherapy-induced alopecia is a common and distressful side effect, especially among breast cancer patients. Scalp cooling (SC) can reduce hair loss during anthracycline- and taxane-based chemotherapy. This study assessed the effectiveness of SC in daily clinical practice in three Italian oncology units. Methods: From 2014 to 2016, we prospectively included 220 female early-stage breast cancer patients undergoing curative chemotherapy in combination with SC using the Paxman device. Effectiveness was defined as the severity of hair loss according to the Common Terminology Criteria for Adverse Events Version 4.0 as follows: Grade 0, no hair loss; Grade 1, <50% hair loss not requiring a wig; and Grade 2, ≥50% hair loss at each cycle and at completion of chemotherapy. The tolerability and safety were also evaluated. Results: The overall success rate of SC (hair loss Grade 0-1) was 68%. Severe hair loss was avoided in 89% of women receiving taxane-based chemotherapy and in 78% of women receiving both anthracyclines and taxanes. Among women undergoing anthracycline-based chemotherapy, 47% experienced hair preservation. SC was well tolerated, as only 20 patients discontinued SC for reasons other than hair loss. Conclusions: Our study confirmed that SC provides a reliable chance for breast cancer patients to keep their hair during taxane- and/or anthracycline-based chemotherapy. PMID: 31259224 [PubMed]

Asia Pac J Oncol Nurs. 2019 Jul-Sep;6(3):283-291 Objective: The family caregivers of patients receiving palliative care experience high levels of anxiety and depression. The aim of the present study was to investigate the factors associated with family caregivers' anxiety and depression when caring for patients with advanced cancer in Greece. Methods: The sample consisted of 100 patients undergoing palliative radiotherapy and their respective caregivers. Patients completed the Hospital Anxiety and Depression Scale (HADS) and the MD Anderson Symptom Inventory. Their respective caregivers completed the Oberst Caregiving Burden Scale, the Bakas Caregiving Outcomes Scale, and the HADS. Correlational and multiple regression analyses were conducted to identify potential predictors of anxiety and depression. Results: The majority of patients were male (63.0%), whereas the majority of their caregivers were female (76.0%). The mean ages of patients and caregivers were 63.9 ± 10.8 and 53.3 ± 12.6 years, respectively. Caregiving anxiety and depression were associated with patients' variables, such as gender (P < 0.0005), primary cancer (P = 0.008), and past surgery (P = 0.002), and caregiver's variables, such as gender (P = 0.001), co-residence (P = 0.05), previous care experience (P = 0.04), and means of transport (P = 0.038). In multiple regression analyses, caregiving anxiety and depression were significantly predicted by caregivers' and patients' characteristics, in a model that accounted for 48% of the anxiety variance (P < 0.0005) and 39% of the depression variance (P < 0.0005). Conclusion: The caregivers who experienced more anxiety and depression shared the following traits: they were women, cared for men with lung cancer, cared for patients not undergoing surgery, lived together, were younger, went to the hospital by private means of transport, had previous care experience, and perceived an increased degree of general burden. Further investigation of the factors that may affect caregivers' psychological state is required to better identify parameters that may predict it. PMID: 31259225 [PubMed]

Asia Pac J Oncol Nurs. 2019 Jul-Sep;6(3):292-299 Objective: This quasi-experimental, single-group study with a pre- and post-repeated measures design was carried out at the Pediatric Stem Cell Transplant Unit of a University Hospital. The study was aimed at investigating the effect of an evidence-based nursing intervention program, held for nurses providing care for pediatric stem cell transplant patients, on their skills in diagnosing oral mucositis (OM). Methods: Before training, data were collected from all the nurses using a sociodemographic characteristics questionnaire. Six patients who were admitted to the clinic and started chemotherapy (CT) were followed up for a maximum of 1 month during their hospitalization to find whether the diagnosis of OM was performed. During the intervention stage, the researcher provided nurses with training on the importance of the use of evidence-based research results in the clinic, including evidence regarding OM. After the training, the records of six patients who were admitted to the clinic and started CT were tracked for up to 1 month during their hospitalization to find whether the diagnosis of OM was performed. Results: At the end of the study, the rate of OM diagnosis was performed by nurses, which was 2.8% before the program and increased to 8.7% after the program. The difference between the percentages of performing OM diagnosis by the nurses before and after the program was 5.9%, which was considered statistically significant (χ2 = 11.004, P < 0.01). The postprogram rate of diagnosis of OM was 3.12 times higher (212% increase) than the preprogram rate (P < 0.01). Conclusions: One of the most important recommendations of the present study is to provide regular and continuous training sessions for nurses to improve and update their knowledge on oral care. It is also concluded that the establishment of oral diagnosis as a follow-up parameter, similar to vital signs in the clinic, will enable nurses to improve their skills in performing daily diagnosis and keeping proper records of the patients' outcomes. PMID: 31259226 [PubMed]

Asia Pac J Oncol Nurs. 2019 Jul-Sep;6(3):300-307 Objectives: Human papillomavirus (HPV) causes cervical cancer. This study aimed to determine the knowledge and attitude of university students toward HPV infection and vaccine prevention in Turkey. Methods: A total of 1563 female and male university students participated in the study. The study design was descriptive and cross-sectional. The study included students enrolled in the departments of faculties and vocational schools. Results: In total, 16.8% of students stated that they had heard of HPV. There was a statistically significant relationship between the mean awareness of HPV and different variables, such as age, gender, marital status, family history of cancer, and conversation about sexual matters (P < 0.01). As the age of the students increased, the chance of hearing about HPV also increased. Of all the students, 1.5% took HPV vaccination. Furthermore, 87.7% of the female students stated that they had heard of cervical cancer. Conclusions: The depth of knowledge among Turkish university students toward cervical cancer, HPV infection, and vaccination was inadequate. It is important to provide educational and counseling services by nurses to make university students aware of HPV infection and vaccination. PMID: 31259227 [PubMed]

Asia Pac J Oncol Nurs. 2019 Jul-Sep;6(3):308-314 Objective: Cervical cancer is one of the most common malignancies among women. The present study aims to assess the risk factors for cervical cancer in women aged 25-80 years. Methods: The current study was a case-control study. In total, 75 age matched cases and 75 controls were enrolled. In case group sampling technique was total enumeration. Sampling for control group is done by purposive sampling. Women who satisfied the inclusion criteria were included in the study. A questionnaire was developed to assess the risk factors of cervical cancer among the participants. Face to Face interview were conducted with the participants. Results: There was a significant association (P < 0.05) of cervical cancer with education, place of residence, using an old cloth sanitary napkins, young age at marriage, number of husband's partners, washing the genitalia after sexual intercourse, and availability of health services. Bathing daily and during menstruations was found to be preventive factors for cervical cancer. In logistic regression, the utilization of health services and the presence of sexually transmitted infections showed a significant association with the development of cervical cancer. Conclusions: The present study aimed to assess the risk factors of cervical cancer. With prior knowledge of risk factors, cervical cancer can be identified. Identification of high-risk populations and starting early screening is found to be effective in early recognition of cervical cancer. PMID: 31259228 [PubMed]

Asia Pac J Oncol Nurs. 2019 Apr-Jun;6(2):101-103 PMID: 30931352 [PubMed]

Asia Pac J Oncol Nurs. 2019 Apr-Jun;6(2):137-144 Objective: The nature of cancer increases the spiritual needs of patients and necessitates the provision of holistic care for them. By trying to meet the spiritual needs of patients, oncology nurses can help them adapt, gain inner peace, and develop positive thoughts and attitudes. This study aimed to explore the consequences of spiritual care for cancer patients and oncology nurses from the perspective of the patients, family members, nurses, and other health-care team members. Methods: The present qualitative study was conducted using conventional content analysis in 2016-2017. The data were collected through semi-structured deep interviews of the 18 participants. Results: The theme extracted from the data was "spiritual growth" and comprised the major categories of "nurse's spiritual development" and "patient's spiritual development." There were three subcategories in the nurse's spiritual development and 11 subcategories in the patient's spiritual development. Conclusions: Spiritual care places the cancer patient and the oncology nurse on the path to spiritual growth. The achievement of peace by the patient and the nurse was a common consequence of spiritual care. It helps the nurse promote comfort and a sense of peace in the patient and eventually to obtain inner satisfaction. Considering the transcendental effects of spiritual care, a systematic plan should be devised to enhance sensitivity in oncology nurses and encourage them to make spiritual care a component of interventional plans. PMID: 30931357 [PubMed]

Asia Pac J Oncol Nurs. 2019 Apr-Jun;6(2):145-150 Objective: Although there has been increasing emphasis on the importance of spirituality in patients with cancer, few studies have examined the spiritual experiences of an ethnically diverse sample of Asian women with breast cancer. The objective of this study was to examine the spiritual experiences of Singaporean women with breast cancer in the first year of diagnosis. Methods: A qualitative exploratory study design was used and data were gathered using individual semi-structured interviews. Purposive sampling selected the participants and data saturation sample size was reached after interviews with 28 participants. Data were analyzed using Braun and Clarke's thematic approach. Results: The participants were aged between 28 and 64 years and included women from the three major ethnic groups. The three themes that emerged from the data included transcendental experiences, meaning and purpose, and changing perspectives. Conclusions: This study informs that while spiritual needs are common, Singaporean women in their first year of the breast cancer diagnosis express spirituality in culturally specific ways. The clinical implications of the study emphasize the importance of addressing women's spiritual concerns, with attention to cultural differences so as to render holistic patient-centered care. PMID: 30931358 [PubMed]

Asia Pac J Oncol Nurs. 2019 Apr-Jun;6(2):151-153 [OPEN Access] The goal of the 4th edition of the National Consensus Project Clinical Practice Guidelines for Quality Palliative Care (NCP Guidelines) is to improve access to quality palliative care for all people with serious illnesses regardless of setting, diagnosis, prognosis, or age. The NCP Guidelines are intended to encourage and guide health-care organizations and clinicians (including nonpalliative care specialists) across the care continuum to integrate palliative care principles and best practices into routine assessment and care of all seriously ill patients. On an international level, we recognize that nursing practice is very different in some respects, but we hope that these guidelines will prove helpful in the practice of palliative care for the seriously ill worldwide... PMID: 30931359 [PubMed]

Asia Pac J Oncol Nurs. 2019 Apr-Jun;6(2):154-160 Successful targeting and inhibition of the cytotoxic T-lymphocyte-associated antigen 4 and programmed cell death-1 protein/programmed cell death ligand 1 immune checkpoint pathways has led to a rapidly expanding repertoire of immune checkpoint inhibitors for the treatment of various cancers. The approved agents now include ipilimumab, nivolumab, pembrolizumab, atezolizumab, durvalumab, avelumab, and cemiplimab. In addition to antitumor responses, immune checkpoint inhibition can lead to activation of autoreactive T-cells resulting in unique immune-related adverse events (irAEs). Therefore, it is imperative that oncology nurses, and other clinicians involved in the care of cancer patients, are familiar with the management of irAEs which differ significantly from the management of adverse events from cytotoxic chemotherapy. Herein, we review the mechanisms of irAEs and strategies for management of irAEs and highlight similarities as well as differences among clinical guidelines from the National Comprehensive Cancer Network, American Society of Clinical Oncology, Society for Immunotherapy of Cancer, and European Society for Medical Oncology. Understanding these similarities and key differences will facilitate the development and implementation of a practice site-specific plan for the management of irAEs. PMID: 30931360 [PubMed]

Asia Pac J Oncol Nurs. 2019 Apr-Jun;6(2):170-176 Objective: This study aimed to clarify the relationships between the acceptance of disability and daily life difficulties in patients after total laryngectomy. Methods: An anonymous questionnaire was mailed to 135 patients who were participating in a self-help group after laryngectomy. The questionnaire included items on personal attributes, daily life difficulties, and acceptance of disability according to the Nottingham Adjustment Scale - Japanese Laryngectomy version (NAS-J-L). Multiple regression analysis was conducted using the NAS-J-L acceptance of disability subscale score as the dependent variable and daily life difficulties as the independent variables. Results: Among the 57 respondents, 43 who provided valid answers were included in the analysis (41 men and 2 women; mean age = 67.5 ± 10.6 years). Acceptance of disability was significantly associated with difficulties in defecation (β = -0.409, P < 0.01) and breathing (β = -0.356, P < 0.05). Conclusions: Our findings suggested that difficulties in defecation and breathing due to airway alterations influence acceptance of disability after laryngectomy. Therefore, nurses should carefully assess daily life difficulties and patient's ability to perform self-care activities such as defecating and breathing to promote acceptance of disability and facilitate adaptation to daily life after total laryngectomy. PMID: 30931362 [PubMed]

Asia Pac J Oncol Nurs. 2019 Apr-Jun;6(2):177-186 Objective: Diagnosis and treatment of gynecologic cancers can have a negative impact on sexuality. Identification of sexual problems and concerns is key to enable appropriate management. Therefore, there is a need for a valid and reliable instrument for evaluating the sexuality of patients. This study aimed to adapt the sexuality scale for women with gynecologic cancer for Turkish patients with gynecologic cancer. Methods: A cross-sectional study of 150 volunteer patients with gynecologic cancer was undertaken in Turkey. The patients completed a semi-structured demographic data form and the sexuality scale for women with gynecologic cancer. We assessed the reliability, language accuracy, and content and construct validities of the Turkish version of the scale. Results: Exploratory and confirmatory factor analyses showed that the scale had four factors. In the exploratory factor analysis, seven items were discarded from the scale because their load values were <0.3. In the confirmatory factor analysis, the coefficients were higher than 0.3. The total Cronbach's α was 0.72. Conclusions: The sexuality scale for women with gynecologic cancer (Turkish version) is a valid and reliable instrument for evaluating the sexuality of Turkish patients with gynecologic cancer. PMID: 30931363 [PubMed]

Asia Pac J Oncol Nurs. 2019 Apr-Jun;6(2):187-192 Objective: Breast cancer survivors are increasing in number among survivors of all types of cancer, and survivors returning to work are extremely important. The development of outpatient chemotherapy has increased the working population of patients undergoing cancer therapy. Consequently, a significant number of breast cancer survivors experience physical, psychological, and social problems. This study aimed to clarify differences in concerns among patients with breast cancer receiving outpatient chemotherapy according to their employment status. Methods: Twenty-eight patients with breast cancer undergoing outpatient chemotherapy were recruited. A questionnaire was used to survey the attributes, employment status, and levels of concern in these patients based on the Cancer-chemotherapy Concerns Rating Scale (CCRS). Data from three groups (employed full time, employed part-time, and unemployed) were analyzed using multiple comparison tests. Results: The patients' mean age was (55.1 ± 9.9) years. According to the CCRS findings, the following three parameters differed between the three groups: scores for the items "I always think about my disease" (employed vs. unemployed, P = 0.005) and "I can't work (housework/schoolwork)" (employed full time vs. part time, P = 0.045), and scores for the "self-existence" subscale (employed vs. unemployed, P = 0.024). Conclusions: This study revealed the characteristics of concerns in patients with breast cancer according to their employment status. Being able to continue working is considered to enhance the social health of these patients. Predicting concerns in employed patients will help gain perspective in early nursing interventions. PMID: 30931364 [PubMed]

Asia Pac J Oncol Nurs. 2019 Apr-Jun;6(2):193-197 Objective: The purpose of this study was to determine the effectiveness of mindfulness-based art therapy (MBAT) in promoting quality of life in Neyshabur women with breast cancer. Methods: This study was an interventional design that was conducted on 124 women with breast cancer (any stage) in Iran 2018. One hundred and fourteen women with breast cancer were paired by age and randomized to either 12-week MBAT intervention group or a wait-list-control group. One hundred and fourteen women with breast cancer completed both the pre-and post-study measurements. As compared to the control group, the MBAT group demonstrated a significant decrease in symptoms of distress and significant improvements in key aspects of the health-related quality of life (as measured by the World Health Organization Quality-of-Life - BREF questionnaire). Results: The MBAT interventions had a significant effect on improving quality of life behaviors (P < 0.05). Among the dimensions of quality of life, the highest mean score was for subpsychological (18.14 ± 2.35), and the lowest score was achieved by the subdomains of social relationships (13.54 ± 1.12). The mean (standard deviation) scores of physical health and environment were 17.19 ± 3.55 and 16.10 ± 1.87, respectively. Conclusions: This investigation of MBAT provides initial encouraging data that support a possible future role for the intervention as a psychosocial option for decrease in symptoms of women with breast cancer and quality of life. PMID: 30931365 [PubMed]

Asia Pac J Oncol Nurs. 2019 Apr-Jun;6(2):198-205 Objective: A huge amount of the efforts made by health teams is dedicated to caring for cancer patients. This study has aimed to investigate the effect of self-care training on life expectancy and quality of life (QOL) in patients with gastrointestinal cancer who were under radiotherapy. Methods: In this clinical trial, 50 patients were selected using the block randomization method. The intervention was performed at Ayatollah Khansari Hospital in Arak, Iran. The patients in the intervention group received three sessions of face-to-face training. The data collection tools included Schneider's Life Expectancy Questionnaire and EORTC QOLQ-C30. Data were analyzed by SPSS version 23. Results: In the control group, 16 were male (64%) and 9 female (36%), and in the intervention group, 14 were male (56%) and 11 were female (44%). Before the intervention, the two groups were homogenous regarding all variables. After the intervention, the mean of QOL was 67 ± 22.62 in the intervention group and 56 ± 18.55 in the control group (P < 0.05). In examining the different dimensions of QOL, improvement in all functional dimensions was observed in the intervention group. After the intervention, the mean score of life expectancy showed a significant difference (P < 0.05) between the intervention group (39.52 ± 5.26) and the control group (31.6 ± 7.13). Conclusions: It was found that self-care training improved the QOL and life expectancy of patients with gastrointestinal cancer who were under radiotherapy. Therefore, self-care training is recommended to improve the QOL and the life expectancy of cancer patients. PMID: 30931366 [PubMed]

Asia Pac J Oncol Nurs. 2019 Jan-Mar;6(1):1-3 PMID: 30599007 [PubMed]

Asia Pac J Oncol Nurs. 2019 Jan-Mar;6(1):4-6 PMID: 30599008 [PubMed]

Asia Pac J Oncol Nurs. 2019 Jan-Mar;6(1):7-9 PMID: 30599009 [PubMed]

Asia Pac J Oncol Nurs. 2019 Jan-Mar;6(1):10-16 The article reviews the development of oncology nurses' role, training, education, practice, and service provision in Hong Kong, highlighting milestones over the past two decades and providing directions for future training, practice, and research. There was an expansion of the diversity of roles and practice from the 2000s onward, reflecting the importance of contribution by nurses to clinical practice and service for cancer patients. These areas include advanced roles and competence development, advanced training, service delivery model, cross-cluster collaboration, quality improvement initiatives, and new nurse clinic model. Recognizing the challenges and the opportunities, it helps to identify the future work with newer and more advanced practice foci as well as training initiatives in advanced practice being developed to meet the increased needs of increasing service load and populations in need of ongoing access to oncology care. The role and the continuous efforts of the clinical, academic, and professional bodies to meet this goal will be crucial and strategic in the future. PMID: 30599010 [PubMed]

Asia Pac J Oncol Nurs. 2019 Jan-Mar;6(1):24-27 The current era is characterized by the vibrant and rapidly evolving communication technologies. Communication in any form has evolved and now includes media such as Facebook, Twitter, and Instagram to report a few. Communicating and consuming information has shifted from the more traditional ways to new ones as part of this communication evolution. Cancer is an area of healthcare where such social media have been championed either to promote public awareness and drive campaigns or influence political decision-making. Although health-care lags behind many other industries in adopting social media as a part of a business or policy strategy, the increasing engagement of patients, the public, and the policymakers in social media raised the need for integrating these tools as a part of an overall program to support the strategic imperatives of the health care. As these and other new ways to communicate are introduced to the world and injected into our cultural and political systems, the question that raises here is: "How successful are social media in influencing health policy?" PMID: 30599012 [PubMed]

Asia Pac J Oncol Nurs. 2019 Jan-Mar;6(1):28-34 Objective: Over the four years to 30 June, 2017 the McGrath Foundation's Second Federal Government Breast Care Nurse (BCN) Initiative funded 57 McGrath BCNs (MBCNs) to deliver better continuity of care and provide specialized support to those diagnosed with and undergoing treatment for breast cancer. This article summarizes the findings generated through a mixed-method evaluation of the program's appropriateness, effectiveness, and efficiency. Methods: The evaluation comprised surveys and semi-structured interviews with patients, multidisciplinary clinicians and MBCNs. The research also drew on secondary materials, including MBCN activity and patient caseload data, a review of existing programs and costing information. Results: The evaluation generated evidence that access to an MBCN results in an improved experience for patients and clinicians, and that these impacts are more profound when MBCNs come into contact with their patients at the time of diagnosis. The economic modeling component of the evaluation revealed that there are cost savings to the health system when breast cancer patients have early access to an MBCN (through reduced health service utilization). The net saving produced by the program was estimated to be worth $6,323,257 per year, or $1,527 per new breast cancer patient seen. Stakeholders indicated that the MBCN model of care could be evolved to respond to emerging trends in breast cancer care pathways, such as a greater role in survivorship. Conclusion: This research advances the current understanding of the impact of BCNs on different levels of the health system and holds relevance for health-care funders, providers, and policy-makers. The evaluation demonstrates that access to an MBCN results in an improved experience for patients and clinicians, along with savings to the health system (through reduced health service utilization). The evaluation also shows that these impacts are more profound when MBCNs come into contact with their patients at the time of diagnosis. PMID: 30599013 [PubMed]

Asia Pac J Oncol Nurs. 2019 Jan-Mar;6(1):43-49 Objective: This study investigated the prevalence of frailty in older patients with hematologic cancer and assessed the association between older patients' characteristics and frailty. Methods: This descriptive study enrolled 90 older patients undergoing treatment for hematological malignancies at an oncology hospital. Frailty was assessed with the Edmonton Frailty Scale as not frail (0-4), apparently vulnerable (5-6), mildly frail (7-8), moderately frail (9-10), and severely frail (11-17). The association of frailty and older patient characteristics and diagnosis was assessed by logistic regression. Results: The prevalence of frailty (mild, moderately, and severely) was 42.2%, and "apparently vulnerable" frailty was 60%. The mean scale score was 5.59 ± 3.13. Frailty was more prevalent in patients who were ≥75 years of age, had ≥4 children, were diagnosed with leukemia, and were diagnosed for ≥2 years. Gender, diagnosis, and employment were factors associated with the presence of frailty. Female gender and lack of employment were factors associated with a high risk of frailty. A diagnosis of multiple myeloma was associated with a low risk of frailty. Conclusions: The prevalence of frailty was high in older patients. Female and unemployed patients were at high risk for frailty. Frailty characteristics of older patients with hematologic cancer highlighted the need for comprehensive geriatric assessment and frailty screening, provided prevalence and characteristics of frailty in this group of patients during treatment, and highlighted the need for holistic care approach. PMID: 30599015 [PubMed]

Asia Pac J Oncol Nurs. 2019 Jan-Mar;6(1):50-56 Objective: Little is known about the skin-related quality of life (QOL) among women receiving external radiotherapy (EBT) and who experience breast radiodermatitis. This pilot study aimed to describe the thoughts and experiences of women experiencing breast radiodermatitis of the breast at a comprehensive community cancer program. Methods: A printed survey was used to solicit feedback on the Dermatology Life Quality Index (DLQI) during the 5th week of EBT. An open-ended question inquired which DLQI-related issue was most important and why. A directed qualitative content analysis was conducted on the narrative responses. Results: Twenty-eight women provided a response to the "most important" question. Sixty narratives led to the identification of 35 codes and six themes during content analysis. Themes included perspectives on having radiodermatitis, sensations caused by radiodermatitis, knowledge, and preparation for radiotherapy, prevention of radiodermatitis, emotions induced by skin changes, and physical appearance of the breast skin. Conclusions: The study results provide a glimpse into the perceptions of skin-related QOL among community-dwelling women who experienced breast radiodermatitis. Some women expressed that radiodermatitis had a profound impact on their QOL while other were surprised that EBT was easy compared to chemotherapy. Our findings parallel those found in a previous study conducted in an urban setting. Results provide insight into the thoughts and needs of women undergoing breast EBT. Assessing individual differences in skin-related QOL can provide needed information for tailoring care to the unique needs of each woman. Additional studies focusing specifically on skin-related QOL are needed. PMID: 30599016 [PubMed]

Asia Pac J Oncol Nurs. 2019 Jan-Mar;6(1):57-63 Objective: The purpose of this article is to examine the relationships of illness perception, self-care, self-efficacy, and self-care strategies and their effects on Chinese cancer patients' quality of life (QOL). Methods: Questionnaires include data on demographic characteristics, illness perception, symptom self-care activity, and QOL. A secondary analysis was conducted on a sample of ethnic Chinese breast-and-colon cancer patients (n = 159) to examine multivariate associations. Descriptive statistics, bivariate correlational analysis, and hierarchical regression analysis were used to analyze quantitative data. Results: The hierarchical regression model explained 43% of variance in QOL. Perceived illness consequence, personal control, and performance functioning status were found to be significant predictors in the model. Comparisons between breast-and-colon cancer patients showed that colon cancer patients significantly perceived higher levels of chronicity and negativity toward cancer than breast cancer patients. Conversely, breast cancer patients had significantly higher level of QOL and efficacy in making decision. Stress and overwork were the common perceived causes of cancer reported by these patients. Conclusions: These findings suggest that improving self-care efficacy and positive personal control can improve Chinese cancer patients' QOL. Variation in illness perceptions of cancer by different types of cancer should be considered in cancer survivorship planning and patient education. PMID: 30599017 [PubMed]

Asia Pac J Oncol Nurs. 2019 Jan-Mar;6(1):64-71 Objective: The objective of this paper is to provide a practical illustration of methods useful for translating and testing questionnaire instruments for nursing and healthcare to ensure reliability, validity, and appropriateness for the target culture. Methods: We present the process used to create the Japanese version of a well-established quality of life (QOL) instrument, originally developed in American English. The Ferrans and Powers Quality of Life Index (QLI)-Cancer Version III was translated into Japanese by a team of bilingual translators and tested using an iterative process involving cognitive interviewing with monolingual Japanese cancer patients. Results: Discussions among the translation team made it possible to find and resolve linguistic, cultural, and practical issues regarding the translation. Problems stemming from question interpretation and information retrieval were resolved through the cognitive interviewing process. One problem related to response editing could not be remedied with altered phrasing, namely a question referring to the respondents' sex lives. This item was retained in the Japanese version of the QLI as an indispensable component of QOL, particularly in a healthcare context. Conclusions: The final Japanese version captured the intended meaning of the original, and also was culturally appropriate and clearly understood by Japanese cancer patients. PMID: 30599018 [PubMed]

Asia Pac J Oncol Nurs. 2019 Jan-Mar;6(1):78-85 Objective: This qualitative descriptive exploratory study aimed to explore the lived experiences of married Pakistani women, 2 years post-mastectomy. Methods: Twelve participants were recruited through purposive sampling from outpatient oncology clinic from a tertiary care hospital in Pakistan. Interviews were audio-taped and transcribed, and then themes and sub-themes were identified. Results: Women verbalized a range of their experiences throughout the span from diagnosis to mastectomy. One over arching theme, quality of life and four main themes and their subthemes emerged from the data. Following are the themes; from history to diagnosis, worries, coping strategies, and recommendations. Conclusions: The study findings revealed that effective coping strategies were beneficial for these women, as these women coped well after being diagnosed with breast cancer. Strong recommendations were made by the participants for the formulation of support groups, which could help them reduce their anxiety through information exchange. PMID: 30599020 [PubMed]

Asia Pac J Oncol Nurs. 2019 Jan-Mar;6(1):86-93 Objective: Although the purposes and outcomes of screening and diagnostic tests are different, they are often confused. Therefore, it is important to delineate the clinical concept of cancer screening tests to be clear in our communication not only among healthcare professionals but also with client populations. The aim of this study is to both describe and analyze the concept of cancer screening and explain their practical meaning in global contexts. Methods: Comparative case studies of cervical and liver cancer screening tests were used as the basis for developing an understanding of a specific concept (phenomenon) of cancer screening and for delineating the relationships between factors that cause screening to occur. Results: A cancer screening is defined as an action taken by both the patient and health-care provider to detect a possible pre-cancerous condition among healthy and asymptomatic individuals who are at sufficient risk of a specific disorder to warrant further investigation or treatment. The case study-based concept analysis has been shown to be useful for improving our understanding of the multi-dimensional nature of the concept in global contexts. Conclusions: New paradigms maximizing participation in cancer screening to detect diseases before symptoms are manifested rather than focusing on diagnosis and treatment of symptomatic infectious diseases need to be developed and implemented. PMID: 30599021 [PubMed]

Asia Pac J Oncol Nurs. 2019 Jan-Mar;6(1):94 PMID: 30599022 [PubMed]

Asia Pac J Oncol Nurs. 2019 Jan-Mar;6(1):95-97 PMID: 30599023 [PubMed]

Asia Pac J Oncol Nurs. 2018 Oct-Dec;5(4):355-357 PMID: 30271816 [PubMed]

Asia Pac J Oncol Nurs. 2018 Oct-Dec;5(4):358-368 People receiving cancer treatment are at nutritional risk. Their eating problems can lead to malnutrition and weight loss. Involuntary weight loss is also a defining characteristic of tumor-induced cachexia. Weight loss is associated with poor tolerance of treatment, poor treatment outcomes, morbidity, and mortality. Support for self-management of nutritional risk may protect against malnutrition and be important in multimodal therapies to arrest the progression of cachexia. Nurses can help patients by supporting self-management of eating problems. This scoping review is about eating problems during cancer treatment. It considers patient experience and self-management of eating problems during cancer treatment for the proactive management of malnutrition and cachexia. It draws on a systematic search of Medline, CINAHL, PsycINFO, and the Cochrane Library for publications about people with cancer who have eating problems during treatment. Limits were English language; January 2000 to December 2017; adults. The search found studies about eating problems in patients treated with chemotherapy or radiotherapy for head-and-neck cancer, lung cancer, gastrointestinal cancer, breast cancer, testicular cancer, and ovarian cancer. Nutritional counseling can improve nutritional intake, quality of life, and weight. However, the patient perspective on self-management and how to motivate engagement in nutritional care is unexplored. There is a potential for reducing nutritional risk during cancer treatment using psychoeducation to support behavioral change, thus empower self-management of eating problems. Benefits are likely in subgroups of people receiving cancer treatment, such as those with head and neck, gastrointestinal, and lung cancers. PMID: 30271817 [PubMed]

Asia Pac J Oncol Nurs. 2018 Oct-Dec;5(4):369-376 The objective of this article is to introduce the Clinical Framework for Quality Improvement of Cancer Cachexia (Cachexia Care Framework) as a tool to demonstrate the relevance of integrating the clinical components of cancer cachexia and the organizational strategies of a cancer institution on the quality of patient care and delivery of services throughout the cancer cachexia continuum. The data sources included peer-reviewed literature relevant to cancer cachexia and quality cancer care, and the authors' expertise. The Cachexia Care Framework results from a combination of the international consensus definition of cancer cachexia, the Institute of Medicine report Ensuring Quality Cancer Care, and the authors' experience with a cancer cachexia clinic. This framework is proposed as a guidance for oncology nurses and other healthcare providers to improve the quality of care of cancer cachexia patients. Specifically, the framework can be used by oncology nurses involved in the care of patients diagnosed with cancer cachexia either in direct patient care, administration, research, or education. Nurses can use the framework in clinical practice to identify specific assessments and interventions based on the cachexia stage of the patient; in nursing administration, the framework offers a wide view of potential errors that can happen and the opportunity to prevent them; in nursing research, the framework illustrates the several factors and processes that can impact patient outcomes; and in nursing education, the framework outlines the elements necessary to develop and implement a continuum education curriculum to educate the workforce of oncology nurses, and in the academic setting, an interprofessional curriculum to educate nurses and many other healthcare disciplines. PMID: 30271818 [PubMed]

Asia Pac J Oncol Nurs. 2018 Oct-Dec;5(4):377-382 Objective: New or worsening disability can develop in elderly patients in just 1 week of hospitalization for acute illness. Elderly patients with cancer, particularly those with cancer cachexia, are vulnerable to disability. This study aimed to explore the impact of hospitalization and cachexia on physical activity (PA) in elderly patients during chemotherapy. Methods: We prospectively enrolled 18 patients aged ≥70 years with newly-diagnosed, advanced non-small-cell lung cancer scheduled to initiate first-line chemotherapy. PA was measured using an accelerometer (Lifecorder®, Suzuken Co., Ltd., Japan). Mean daily steps at baseline, during hospitalization, and subsequent weeks (1st, 2nd, and 3rd week after discharge) were compared. Results: A total of 30 hospitalizations for chemotherapy were evaluated in 18 patients with a median age of 74.5 years. The median number of baseline daily steps was 3756. Fifteen cases (50%) showed fewer daily steps during hospitalization and no recovery to baseline level during the 1st week after discharge. Long hospitalizations (≥8 days) and the presence of cachexia were associated with persistent physical inactivity. One patient developed disability within 30 days after hospitalization. Conclusions: Physical inactivity was frequently seen after hospitalization for chemotherapy in elderly patients with advanced lung cancer. Longer in-hospital days and the presence of cancer cachexia caused slow recovery from physical inactivity. Individualized hospitalization planning based on careful consideration of patient age and the presence of cancer cachexia may be needed to prevent physical inactivity and disability. PMID: 30271819 [PubMed]

Asia Pac J Oncol Nurs. 2018 Oct-Dec;5(4):383-390 Objective: Physical activity (PA) may improve the quality of life (QOL) of cancer survivors. However, the impact on patients with advanced cancer with high cachectic potential is unknown. We analyzed the feasibility of PA intervention using the multimodal program Nutrition and Exercise Treatment for Advanced Cancer (NEXTAC) and the impact on QOL in elderly patients with advanced cancer. Methods: We recruited 30 patients aged ≥70 years who were scheduled to receive the first-line chemotherapy for newly diagnosed advanced pancreatic or non-small-cell lung cancer. The QOL was assessed using the European Organization for Research and Treatment of Cancer QOL Questionnaire version 3.0, while the PA was measured using a pedometer/accelerometer. Instructors counseled patients to increase daily activity in an 8-week educational intervention. We assessed patient attendance, compliance, and intervention efficacy. Results: The median patients' age was 75 years (range, 70-84 years). Twelve patients (40%) were cachectic at baseline. Twenty-eight (93%) patients attended all sessions. Six (21%) and 15 (52%) patients increased their indoor and outdoor activity, respectively. There were significant differences in measured PA, global QOL, and role and emotional functioning between the patients who increased outdoor activity and those who did not. Conclusions: The PA intervention of the NEXTAC program was feasible as the elderly patients with advanced cancer in this study were highly compliant. The majority of patients demonstrated behavioral changes that were associated with the improvement in global QOL. We conduct a randomized phase II study to measure the impact of the NEXTAC program on QOL and functional prognosis. PMID: 30271820 [PubMed]

Asia Pac J Oncol Nurs. 2018 Oct-Dec;5(4):408-414 Objective: This study aimed to identify the needs for home care of patients with prostate cancer. Methods: A correlational descriptive study was conducted with 116 patients with prostate cancer who were admitted to a university hospital. The data were collected usingby means of surveys developed by the researchers. The analysis was carried outperformed with SPSS 20, using the t- test, Chi-square, post hoc test, and logistic regression. Results: It was found that the level of need for home care was high among the patients who had low education level and were residing in villages with a nuclear family. In addition, the level of need for home care increased among the patients who were in the recurrence phase of their illness, who had somebody in the family to meet the need for home care, and who had other family members in need of care. It was found that the level of the need for home care was high among patients whose lives were severely affected by prostate cancer and who considered their health to be poor. Within this context, it is advisable for medical staff to include training and consultancy services in their caring process to promote patient independence. Conclusions: It was found that patients with prostate cancer have some needs for home care. The professional medical staff in this field should carry out studies to define the needs for home care that will be a benefit in improving men's health. PMID: 30271824 [PubMed]

Asia Pac J Oncol Nurs. 2018 Oct-Dec;5(4):415-420 Objective: The utilization of cervical cancer screening services remains low among Female Sex Workers (FSWs) in Sub-Saharan Africa, with few or no studies conducted in Nigeria. However, the prevalence of human papillomavirus in this population is reportedly high because of associated risk factors. This study examined the pattern of cervical cancer screening service utilizations among FSWs in the Abuja metropolis. Methods: This descriptive cross-sectional survey used a purposive sampling technique to select 406 respondents via a structured questionnaire including questions regarding whether they had been screened for cervical cancer, the frequency of screening and type of screening method. Data were analyzed using SPSS version 22 and presented using frequency tables and percentages. Results: The response rate among the participants was 97.6%. The mean age of the FSWs was 32 ± 5.1 years. Regarding the pattern of screening age, the mean age at the first screening was 28 ± 4.3 years. Only 81 (20%) participants had been screened annually, and visual inspection with acetic acid was most frequently used (20.9%). Respondents preferred to undergo screening in their brothels. The awareness of screening services was high (n = 290, 71.4%); however, the utilization of cervical cancer screening services remained low, as 246 (60.6%) FSWs had never been screened. The nonutilization of screening services was related to poor accessibility and a lack of awareness and interest. Conclusions: Although a high level of awareness that would be expected to influence uptake, cervical cancer screening services were rather underutilized by the study respondents. Therefore, a concerted effort is needed to ensure that FSWs understand cervical cancer and its consequences. Hopefully, this effort will improve the uptake. PMID: 30271825 [PubMed]

Asia Pac J Oncol Nurs. 2018 Oct-Dec;5(4):421-429 Objective: The present study aims to examine the relationships between and among cancer treatment-related decisional conflict, quality of life, and comorbidity in older adults with cancer. Methods: A convenience sample of 200 older adults was recruited from outpatient medical oncology and radiation oncology practices in the northeastern United States. A cross-sectional, descriptive, correlational study design was used employing a survey method. Survey instruments included the Decisional Conflict scale (DCS) (with five subscales, including informed, values clarity, support, uncertainty, and effective decision); Self-administered comorbidity questionnaire (SCQ); European Organization for Research and Treatment of Cancer Quality of Life Questionnaire (including five function scales, three symptom scales, a global health/quality of life scale, and six single items); and an investigator-developed demographic form. Results: The mean total DCS score was 22.1 (±12.5). The uncertainty subscale had the highest mean of the subscales (29.2 ± 18.2). The mean score for global health status/quality of life was 44.2 (±20.7). The mean score of the SCQ was low (9.6 ± 4.1). Significant positive relationships were identified between decisional conflict and quality of life (P = 0.009) and quality of life and comorbidity (P = 0.001). Multiple linear regression analysis found statistically significant relationships for total decisional conflict score and the five decisional conflict scale subscales. Conclusions: Results may suggest a relationship between decisional conflict and quality of life, as well as the quality of life and comorbidity. In addition, there are several physical, emotional, and spiritual factors that may positively or negatively impact decisional conflict. PMID: 30271826 [PubMed]

Asia Pac J Oncol Nurs. 2018 Oct-Dec;5(4):430-434 Objective: The aim of this study was to evaluate the effectiveness of a rash team management intervention designed by certified nurses, medical physicians, and certified pharmacists. The quality of life (QOL) of patients administered epidermal growth factor receptor (EGFR)-tyrosine kinase inhibitors (TKIs) was assessed using the dermatology life quality index (DLQI) and Skindex-29 QOL questionnaires. Methods: A total of 51 patients with nonsmall cell lung cancer who were treated using EGFR-TKIs were examined between November 1, 2014, and October 31, 2015, at the Institute of Biomedical Research and Innovation in Kobe city, Japan. All the patients were treated daily with erlotinib, gefitinib, or afatinib. The common terminology criteria for adverse events (version 4.0) system were used to grade treatment-induced toxicity events. The multimodality rash management team included nurses, pharmacists, and physicians. The team intervened before the initiation of treatment with EGFR-TKIs and at every visit. Patient QOL characteristics were evaluated using the DLQI and Skindex-29 assessment tools. Results: The number of patients with high-grade toxicity decreased when the multimodal approach was used. No grade 3 skin toxicities were recorded in the postintervention cohort. QOL scores for symptoms and feelings (emotions) were impaired in patients who were treated with EGFR-TKIs. Conclusions: The rash team management approach may be useful for patients treated with EGFR-TKIs. Specific QOL evaluation tools for the assessment of the effects of a team approach for rash management should be developed. PMID: 30271827 [PubMed]

Asia Pac J Oncol Nurs. 2018 Oct-Dec;5(4):435-441 Objective: The aim was to evaluate the reliability and the validity of the Turkish version of the chemotherapy-induced peripheral neuropathy assessment tool (CIPNAT) in cancer patients using taxane. Methods: This methodological study was carried out to evaluate the validity and the reliability of the CIPNAT. The sample cohort comprised 430 breast cancer patients who were administered taxane, a chemotherapeutic agent, between April and December 2017. Data were collected by the CIPNAT and by a demographic data form. The CIPNAT content reliability was checked after completing it in Turkish. Validity was tested after the translation as well. Cronbach's alpha and test-retest reliability were utilized for reliability analyses. Results: Cronbach's alpha value was 0.87 in this study. The test-retest reliability ranged between 0.90 and 0.96 for all items. No difference existed between the means of test and retest scores of the CIPNAT. A statistically significant positive relationship materialized between the item's test and retest scores. There were statistically significant positive relationships among all levels of the CIPNAT. Factor analysis resulted in a size value higher than 1 and explained 66% of total variation. These results show that the Turkish version of the CIPNAT is a valid and reliable scale in Turkish society. Conclusions: This study showed that the CIPNAT in Turkey is a reliable and valid tool to evaluate taxane chemotherapy in breast cancer patients. PMID: 30271828 [PubMed]

Asia Pac J Oncol Nurs. 2018 Oct-Dec;5(4):442-443 PMID: 30271829 [PubMed]

Asia Pac J Oncol Nurs. 2018 Jul-Sep;5(3):245-247 PMID: 29963585 [PubMed]

Asia Pac J Oncol Nurs. 2018 Jul-Sep;5(3):254-261 The objective of the study was to conduct a concept analysis of "self-management of cancer pain" to develop a theoretical definition of the concept and identify its attributes, antecedents, and outcomes. The Rodgers' evolutionary model of concept analysis was used. Literature published from January 2000 to February 2017 containing the terms, "cancer pain" and "self-management" in their title and/or abstract was assessed. Twenty-seven studies were selected for this analysis. Self-management of cancer pain is defined as "the process in which patients with cancer pain make the decision to manage their pain, enhance their self-efficacy by solving problems caused by pain, and incorporate pain-relieving strategies into daily life, through interactions with health-care professionals." The attributes of self-management of cancer pain were classified into the following five categories: Interaction with health-care professionals, decision-making to pain management, process for solving pain-related problems, self-efficacy, and incorporating strategies for pain relief into daily life. The antecedents were classified into the following seven categories: Physical functions, cognitive abilities, motivation, undergoing treatment for pain, receiving individual education, receiving family and health-care professionals' support, and health literacy. The outcomes were classified into the following three categories: pain relief, well-being, and empowerment. The attributes of self-management of cancer pain can be used as components of nursing practice to promote patient self-management of cancer pain. The categories of antecedents can be used as indicators for nursing assessment, and the outcomes can be used as indicators for evaluations of nursing intervention. PMID: 29963587 [PubMed]

Asia Pac J Oncol Nurs. 2018 Jul-Sep;5(3):285-289 Nursing as a discipline has consistently borrowed ideas from science and philosophy to establish reality and truth. To improve the care of patients with cancer, oncology nursing science must focus on areas of study that address relevant cancer care issues and have a major impact on people with cancer. This article attempted to explore the philosophical views of Immanuel Kant in relation to the present oncology nursing realities. The connections of the views of this philosopher as applied to modern cancer care were explored. The researchers attempted to identify certain components in these philosophies that best suit the present nursing realities in cancer care, especially regarding ethical and moral practices. From the analysis, Kant identified strategic issues that are directed toward strengthening the oncology nurse's commitments to the patients with cancer. PMID: 29963590 [PubMed]

Asia Pac J Oncol Nurs. 2018 Jul-Sep;5(3):290-295 PMID: 29963591 [PubMed]

Asia Pac J Oncol Nurs. 2018 Jul-Sep;5(3):296-306 Approximately 3.1 million women in the US are living with breast cancer and up to 75% of these women experience cancer-related cognitive impairment (CRCI). CRCI is described as impairments in memory, verbal fluency, thought processes, and attention span. Despite the high prevalence of breast cancer, only a few studies have been published on CRCI and most of these studies primarily focused on its pathophysiological mechanism. However, recent evidence has demonstrated that breast cancer patients with CRCI are more likely to have high level of psychologic distress, suggesting a possible relationship between CRCI and psychologic distress. This review aims to examine existing literature that describes CRCI in relation to psychological distress among breast cancer patients. One thousand four hundred and ninety-eight articles were searched using PubMed, CINAHL, and PsycINFO. Thirteen studies met inclusion criteria, and one article was additionally pulled from article reference lists. Of these19 studies, psychologic distress has been operationalized in varied ways such as anxiety (n = 3), depression (n = 2), both anxiety and depression (n = 4), stress (n = 4), worry (n = 2), mental fatigue (n = 1), and undefined psychological distress (n = 2). Except for six studies designed as a longitudinal study, the rest of studies used a cross-sectional design. Twelve studies used both subjective and objective measures to assess cognitive function. We found that the patients with high psychological distress displayed lower performance on cognitive function tests. Our finding indicates that psychological variables contributed to CRCI that breast cancer patients experienced. Areas for further investigation are proposed that will advance the care of breast cancer patients with CRCI. PMID: 29963592 [PubMed]

Asia Pac J Oncol Nurs. 2018 Jul-Sep;5(3):307-313 Objective: This study aims to ascertain the incidence and association of falls and physical inactivity in patients with gastrointestinal cancer and hand-foot syndrome (HFS) after receiving chemotherapy or targeted therapy. Methods: The present cross-sectional study was conducted on 50 outpatients with HFS of Grade 1 or above, according to the National Cancer Institute Common Terminology Criteria for Adverse Events, following the receipt of chemotherapy or targeted therapy for gastrointestinal cancer in Japan between November 2016 and February 2017. For measurement, Dermatology Life Quality Index (DLQI) and the International Physical Activity Questionnaire were used. Data were analyzed by logistic regression analysis. Results: Of the participants, 18% experienced falls and 60% reported physical inactivity. Multivariate logistic regression revealed that the DLQI treatment domain score was the only factor associated with falls (odds ratio [OR] =8.01, 95% confidence interval [CI] =1.27-50.63, P = 0.027). Physical inactivity was associated with DLQI symptom and feeling domain scores (OR = 5.54, 95% CI = 1.26-24.33, P = 0.023) and the with-oxaliplatin or paclitaxel regimen (OR = 3.71, 95% CI = 1.06-13.03, P = 0.041). Conclusions: The results of the present study suggest patients should be informed that HFS is a risk factor for physical inactivity and falls. PMID: 29963593 [PubMed]

Asia Pac J Oncol Nurs. 2018 Jul-Sep;5(3):314-319 Objective: Cancer is considered a global health problem and its prevalence has been growing in recent years. The present study was conducted to investigate the role of hopelessness and perceived social support for Iranian patients with cancer. Methods: Convenience sampling was used to select the study sample comprising 100 patients with cancer presenting to the Education and Treatment Center of Valiasr in Zanjan, Iran. A demographic questionnaire, the Beck Hopelessness Scale, and the Social Support from Family and Friends Scale were used to collect the data. Collected data were analyzed using SPSS-16. Results: Of the 98 study patients, 52 (53.1%) were female and the remainder were male. Lung cancer constituted the most prevalent type of cancer (25.5%). The mean hopelessness score was 5.93 ± 4.71. The mean scores for social support provided by family and friends were 10.89 ± 5.61 and 14.94 ± 4.16, respectively. Significantly negative correlations were observed between the mean scores of hopelessness and social support provided by family (P = 0.007; r = -0.270) and friends (P = 0.001; r = -0.327). Conclusion: According to the findings of the present study, Iranian patients with cancer have relatively mild levels of hopelessness and moderate levels of social support. Perceived social support was also found to affect the patients' hopefulness. Given the lack of studies on this subject, it is recommended that further studies are performed. PMID: 29963594 [PubMed]

Asia Pac J Oncol Nurs. 2018 Jul-Sep;5(3):320-326 Objective: Quality of life (QOL) in cancer patients can be influenced by the presence of medical conditions, such as oral mucositis (OM). There is still limited knowledge about this issue among patients in Jordan, and this could be related to the absence of research instruments testing QOL among cancer patients with OM. This study measured the QOL among cancer patients using the Functional Assessment of Cancer Therapy-General (FACT-G), Arabic version. Methods: This was a cross-sectional study on 118 head-and/or-neck cancer patients with OM in Jordan. Data were submitted to measures of normality, reliability, and validity using exploratory factor analysis. The study also measured QOL among the study sample. Results: FACT-G demonstrated good internal consistency reliability and validity. Factor analysis indicated the presence of four factors explained by 24 items representing a valid FACT-G, Arabic version. Scores reflected low QOL compared to reported normative values in the literature. The values used to compare findings from this study were extracted from international literature; no similar values were present in published literature. Conclusions: FACT-G, Arabic version, is valid and reliable when applied to this study population. Further testing is recommended, which would include the establishment of normative values. PMID: 29963595 [PubMed]

Asia Pac J Oncol Nurs. 2018 Jul-Sep;5(3):327-336 Objective: The main objective of this study was to explore factors affecting missed nursing care in oncology units from the perspective of nurse managers. Methods: Twenty nurse managers working at oncology units of referral teaching hospitals in Iran participated in this study. Data were collected through individual face-to-face and telephonic interviews using an interview guide. Focus groups were also conducted. Data were analyzed using conventional content analysis. Results: System structure, underlying factors, and barriers to missed-care reports were identified as factors that affect missed nursing care. Conclusions: Nurse managers should reduce the effects of nursing staff shortages and increased workloads in addition to providing materials and equipment. They need to distribute experienced staff according to the type of ward or patients' needs. Nurse managers should create a favorable environment for reporting missed nursing care by having an open relationship with nurses by teaching and emphasizing nursing practice. Moreover, using a nonpunitive managerial approach and minimizing the use of an apathetic management style can be helpful. PMID: 29963596 [PubMed]

Asia Pac J Oncol Nurs. 2018 Jul-Sep;5(3):337-341 Objective: The objective of the study is to evaluate the use of the Pap smear screening method for detection of precancerous lesions. Methods: All women who visited the outpatient gynecology clinic of the Department of Obstetrics and Gynaecology at King Georges Medical University, Lucknow, UP, India, over 1 year for different clinical problems were recruited for the study. A total of 1650 women who were sexually active and over 21 years of age were enrolled in the study. A clinical examination, an examination per speculum, and a vaginal examination were performed and a history taken for all women. A Pap smear was used for all women to screen for cervical cancer. The smear was obtained using an Ayre spatula and spread over a marked glass slide, which was placed in 95% ethyl alcohol and sent to the Department of Pathology for cytopathological examination. All data were recorded using a predetermined pro forma. Women who had visible malignant cervical lesions were excluded from the study. Results: Most women were in the age range of 30-50 years and multiparous. Vaginal discharge was the most common complaint, occurring in 36.96% of the women. An irregular menstrual cycle was the complaint of 12.78% and abdominal pain of 25.63% of women, while 15.15% were asymptomatic. The Pap smear test of 93.57% of the women was adequately taken, while 6.42% of the individuals had an inadequate sample. The test was negative for malignancy in 48.84%, and 42.66% had infection or inflammation. Atypical squamous cells of undetermined significance (ASCUS), low-grade squamous intraepithelial lesion (LSIL), and high-grade squamous intraepithelial lesion (HSIL) were detected in 2.90%, 5.09%, and 0.48%, respectively. Women with Pap tests positive for ASCUS, LSIL, and HSIL underwent a colposcopy and guided biopsy. Conclusions: Women with an abnormal Pap test should undergo a colposcopy, and those with abnormal colposcopy findings should be advised to undergo a biopsy. A Pap smear is simple, noninvasive, cost-effective, and easy to perform for detection of precancerous lesions in a gynecological patient. PMID: 29963597 [PubMed]

Asia Pac J Oncol Nurs. 2018 Jul-Sep;5(3):342-352 Objective: The complex process of taking care of patients with cancer can affect various aspects of the needs and health of their family caregivers. The present study aims to determine the unmet needs of the family caregivers of patients with cancer and to compare it according to background variables. Methods: The present descriptive study recruited 200 family caregivers of patients with cancer visiting a referral hospital in Iran. Sampling was carried out through the convenience method. Data were collected using Shin's comprehensive needs assessment tool in seven domains (health and psychological problems, family/social support, healthcare staff, information, religious/spiritual support, hospital facilities/services, and practical support). Results: The mean (±standard deviation) of the total scores of the unmet needs of the family caregivers was 81.73 (±16.82), with a possible range of 0-123. A significant percentage of the family caregivers of patients with cancer had unmet needs in all of the seven domains with different severities. The mean scores were higher in the information, healthcare staff (physicians and nurses), and health and psychological problems domains as compared to the other domains. Conclusions: The results showed that the majority of the family caregivers of patients with cancer have many unmet needs, which should be addressed by professional care providers through the development of holistic care programs targeting family caregivers by focusing on information needs and a proper communication process. PMID: 29963598 [PubMed]

Asia Pac J Oncol Nurs. 2018 Jul-Sep;5(3):353 [This corrects the article on p. 201 in vol. 5, PMID: 29607381.]. PMID: 29963599 [PubMed - in process]

Asia Pac J Oncol Nurs. 2018 Apr-Jun;5(2):131-133 PMID: 29607372 [PubMed]

Asia Pac J Oncol Nurs. 2018 Apr-Jun;5(2):134-136 [OPEN Access] Creativity and innovation are words in common use when discussing the challenges facing cancer care delivery. Creativity in cancer care yields almost 3 million hits on Google, while innovation in cancer care yields almost 6 million. For peer-reviewed papers, the figures in Google Scholar are 87,000 and 460,000, respectively. For nurses working on the frontline of cancer care, the challenge is to work through this mass of information to consider how best to approach redesigning the delivery of care to get best outcomes for patients and make best use of the skilled workforce...  PMID: 29607373 [PubMed]

Asia Pac J Oncol Nurs. 2018 Apr-Jun;5(2):137-155 Today, personalized cancer therapy with targeted agents has taken center stage, and offers individualized treatment to many. As the mysteries of the genes in a cell's DNA and their specific proteins are defined, advances in the understanding of cancer gene mutations and how cancer evades the immune system have been made. This article provides a basic and simplified understanding of the available (Food and Drug Administration- approved) molecularly and immunologically targeted agents in the USA. Other agents may be available in Asia, and throughout the USA and the world, many more agents are being studied. Nursing implications for drug classes are reviewed. PMID: 29607374 [PubMed]

Asia Pac J Oncol Nurs. 2018 Apr-Jun;5(2):156-164 Increased incidence of children diagnosed with cancer and survivors was an impact on changes in pediatric hemato-oncology nursing care. In this review article, it is aimed to investigate the new trends and recent care approaches in pediatric oncology nursing. The recent care topics were common in the literature as family-centered care, technology-based care, program development, primary care of child, health-care provider, survivors and home care, and nonpharmacological care. All of the topics contribute to perform evidence-based care for health promotion and well-being in pediatric hemato-oncology nursing. Research reviews showed that many current topics for the care of children and their parents have entered in the literature. There is a need for more randomized controlled studies to improve the level of evidence of new nursing approaches. PMID: 29607375 [PubMed]

Asia Pac J Oncol Nurs. 2018 Apr-Jun;5(2):165-171 [OPEN Access] Objective: Reliable and valid needs assessment measures are important assessment tools in cancer survivorship care. A new 30-item short-form version of the Survivor Unmet Needs Survey (SF-SUNS) was developed and validated with cancer survivors, including hematology cancer survivors; however, test-retest reliability has not been established. The objective of this study was to assess the test-retest reliability of the SF-SUNS with a cohort of lymphoma survivors (n = 40). Methods: Test-retest reliability of the SF-SUNS was conducted at two time points: baseline (time 1) and 5 days later (time 2). Test-retest data were collected from lymphoma cancer survivors (n = 40) in a large tertiary cancer center in Western Australia. Intraclass correlation analyses compared data at time 1 (baseline) and time 2 (5 days later). Cronbach's alpha analyses were performed to assess the internal consistency at both time points. Results: The majority (23/30, 77%) of items achieved test-retest reliability scores 0.45-0.74 (fair to good). A high degree of overall internal consistency was demonstrated (time 1 = 0.92, time 2 = 0.95), with scores 0.65-0.94 across subscales for both time points. Conclusions: Mixed test-retest reliability of the SF-SUNS was established. Our results indicate the SF-SUNS is responsive to the changing needs of lymphoma cancer survivors. Routine use of cancer survivorship specific needs-based assessments is required in oncology care today. Nurses are well placed to administer these assessments and provide tailored information and resources. Further assessment of test-retest reliability in hematology and other cancer cohorts is warranted. PMID: 29607376 [PubMed]

Asia Pac J Oncol Nurs. 2018 Apr-Jun;5(2):172-177 Objective: Targeted therapy-induced facial skin toxicities may reduce overall quality of life (QoL) in cancer patients. We investigated whether facial skin toxicities affect QoL and attempted to identify factors related to QoL in patients with advanced/recurrent cancer. Methods: We performed a cross-sectional study in 34 outpatients with advanced/recurrent cancer showing targeted therapy-induced facial skin toxicities in Japan between November 2016 and February 2017. For measurement, we used the Kessler Psychological Distress Scale (K6), Mental Adjustment to Cancer (MAC) Scale, and Dermatology Life Quality Index (DLQI). Data were analyzed using Spearman's rank correlation coefficient. Results: Mean DLQI score in 34 patients was 4.59 (standard deviation ± 4.70), which was interpreted as a small effect on a patient's life. Acneiform rash was the most common skin condition noted, followed by xerosis, pruritus, and erythema. Analysis of DLQI scores revealed that symptoms and feelings was the domain most commonly affected among different domains constituting the DLQI. MAC analysis revealed that the fighting spirit score was the highest among MAC scales. We found that age, K6, and fatalism construct in MAC were significantly correlated with total DLQI scores (age: Spearman's ρ= -0.48, P = 0.004; K6: ρ= 0.58, P < 0.001; fatalism; ρ= -0.39, P = 0.025). Conclusions: This is the first study investigating targeted therapy-induced facial skin toxicities in cancer patients. Our results suggest potential negative effects of facial skin toxicities on overall QoL in patients with advanced/recurrent cancer in middle and early old age. PMID: 29607377 [PubMed]

Asia Pac J Oncol Nurs. 2018 Apr-Jun;5(2):178-183 Objective: This study is carried out to determine the symptoms and information necessity on chemotherapy (CT) treatment of the women with breast cancer. Methods: A total of 170 women older than 18 years old, who receive CT with breast cancer diagnosis, are volunteered to participate in the study. Mixed method was used in the study. Data are collected using Descriptive Data Form, Interview Form and Memorial Symptom Assessment Scale. Results: As a result of the cluster analysis, four clusters and the symptoms within have been obtained. These are: pain, lack of energy, feeling drowsy, sweat, swelling of hands, and feet in the first cluster; feeling nervous, difficulty sleeping, feeling sad, worrying in the second cluster; nausea, feeling bloating, change in the way food tastes, hair loss, constipation in the third cluster; vomiting, diarrhea, problems with sexual interest, lack of appetite, dizziness, and weight loss in the forth cluster. Women's information necessity related to the CT are follows: the effects of CT, other treatment options beyond CT, complementary methods, the effect of the CT treatment on reproductive health and sexuality, nutrition, and symptom control. Conclusions: The results of this study will enable determination of symptom clusters, which health professionals are easier to focus on these symptoms. An understanding information need of patients can help to ensure that individual's coping strategies and self-management. PMID: 29607378 [PubMed]

Asia Pac J Oncol Nurs. 2018 Apr-Jun;5(2):184-194 Objective: This study aimed to explore the experiences of female breast cancer patients undergoing radiotherapy (RT) in a public hospital in Peshawar, Pakistan. Methods: This study employed a descriptive exploratory method. A purposive sample of 14 breast cancer women undergoing RT was selected for this study. Data were collected over the period of 5 months, using a semi-structured interview guide and conducting in-depth face-to-face interviews. These interviews were audio taped and transcribed by a bilingual transcriber. The translated version of the interview was coded, and the analysis was done manually. Results: Four main categories emerged from data analysis, which were: feelings and perceptions of the patients, their challenges, coping strategies, and teaching and informational needs. Conclusions: Women undergoing RT in this culture experience more intense psychological effects, as compared to the physical effects. Keeping in mind, the magnitude of the emotional stress experienced by the participants, recommendations for policy reforms, and training for female RT staff are suggested based on findings of this research. PMID: 29607379 [PubMed]

Asia Pac J Oncol Nurs. 2018 Apr-Jun;5(2):195-200 Objective: To evaluate the effectiveness of interventional package on the level of anxiety, depression, and fatigue. Methods: The study was conducted in room no. 5, first floor, B Block, Department of Radiotherapy, Nehru Hospital, Postgraduate Institute of Medical Education and Research, Chandigarh Quasi experimental pretest-posttest design was used in the study. A total of 60 patients receiving radiotherapy/chemotherapy were assigned in two groups of 30 each, through total enumeration sampling technique. The tools used for the study were Zung Anxiety Scale, Beck Depression inventory, and Fatigue Scale. The protocol used for the study includes the Jacobson's Progressive muscle relaxtion technique, counsling and home care techniques. Results: Sociodemographic variables and clinical profile of participants in both groups were comparable. Interventional package significantly reduces the anxiety, depression, and fatigue (P < 0.001 in 3 variables) in experimental group. Conclusions: Interventional package for patients with cervical cancer proved to be an effective modality in reducing the anxiety, depression, and fatigue. PMID: 29607380 [PubMed]

Asia Pac J Oncol Nurs. 2018 Apr-Jun;5(2):201-207 Objective: Sexual function in patients with breast cancer, especially in younger patients, is an important issue from clinical and psychosocial perspectives. Theory of planned behavior (TPB) is one of the important theories that explain the main process of adopting healthy behaviors. This study investigated the effect of education based on TPB on sexual function of women with breast cancer in Mashhad, Iran. Methods: In this quasi-experimental study, 120 women (60 women in education group, 60 women in control group) visiting Razavi Hospital of Mashhad city were studied, selected by using the random method in 2016. The data collection tool was a questionnaire which was completed during the interview. The validity and reliability of this questionnaire were determined through the face and content validity and through Cronbach's alpha and test-retest, respectively. Results: Data were analyzed using statistical SPSS 22 software. Using linear regression analysis, it was determined that attitudes, subjective norm, and perceived behavioral control (PBC) predict 0.85 overall of the total variance of sexual function intention, which among these variables, the effect of the subjective norm was more than the other ones (P < 0.05). After educational intervention, the average rates of knowledge, attitude, PBC, and intention of sexual function in sex education group were significantly increased (P < 0.05); these changes were not meaningful in the control group. There was no statistically significant difference in subjective norm between the two groups after intervention. Conclusions: The results of this research suggest that TPB can be used in sex education interventions and have relevant results. PMID: 29607381 [PubMed]

Asia Pac J Oncol Nurs. 2018 Apr-Jun;5(2):208-216 [OPEN Access] Objective: Illness-related information can be significant for cancer patients after gastrointestinal (GI) surgery in terms of their performing adaptive tasks. This study longitudinally investigated the health outcomes of Japanese patients who read a booklet about cancer patients' problems and adaption tasks and evaluated the association between the responses to the booklet and the patients' health outcomes. Methods: A questionnaire survey about quality of life (QOL), fatigue, anxiety, cognitive plight, and resilience was administered to postoperative patients with GI cancer 1 week after their discharge from hospital and 6 months after surgery. The questionnaires were returned by email. Results: The mean age of the 32 patients at 1 week was 60.9 years; nearly 68.8% of them were men. As a whole, only two variables, QOL and anxiety, were significantly improved at 6 months over those at 1 week. Three statements were taken to gauge the responses to the booklet. In the two-way ANOVA that took QOL and responses to the booklet as independent variables, the post hoc test found that QOL was significantly improved in patients who agreed with the statement "I vaguely understood the content" or "I will deal with my tasks as described in the scenarios" but not in patients who agreed with the statement "The scenarios reflect my situation." The anxiety in patients who agreed with the statement "The scenarios reflect my situation" was high at both survey points. Conclusions: This study suggests that associations between the responses to the informational booklet and patients' health outcomes partially indicate the directional property of how to support their information usage. PMID: 29607382 [PubMed]

Asia Pac J Oncol Nurs. 2018 Apr-Jun;5(2):217-222 Objective: This study aimed to assess the relationship between religiosity and quality of life (QoL) in patients with breast cancer in a Muslim population. Methods: This descriptive-correlational study was conducted in 84 Muslim patients with breast cancer who were admitted to Ahvaz Shafa Hospital, Iran, during 2015. QoL and religiosity were measured with the Short Form-36 questionnaire and Muslim Religiosity questionnaire based on the Glock and Stark model, respectively. Data were analyzed using a software program for descriptive statistics, the Chi-square test, Pearson's correlation, and an independent sample t-test. Results: Most patients had high religiosity (69%) and moderate QoL (46.5%) scores. Total scores and all subscales scores for QoL were significantly higher in patients with high religiosity than patients with moderate religiosity (P < 0.0001). Moreover, a direct correlation was found between religiosity (total and all subscales) and QoL (total and all subscales) (P < 0.0001). Conclusions: A significant relationship was found between religiosity and QoL in patients with breast cancer. Accordingly, care team members, especially midwifery and nursing staff, should pay more attention to religious beliefs among these patients to improve their QoL. PMID: 29607383 [PubMed]

Asia Pac J Oncol Nurs. 2018 Apr-Jun;5(2):223-230 Objective: The aim of this study is to evaluate the effect of nursing intervention on mothers' knowledge of cervical cancer and acceptance of human papillomavirus (HPV) vaccination for their adolescent daughters in Abuja, Nigeria. Methods: This was a quasi-experimental study that utilized two groups pre and post-test design. The study was carried out among civil servant mothers in Bwari (experimental group [EG]) and Kwali (control group[CG]) Area Councils of Abuja, Nigeria. One hundred and forty-six women who met the inclusion criteria were purposively selected for this study. EG consists of 69 women while 77 are from CG. The intervention consisted of two days workshop on cervical cancer and HPV vaccination. Descriptive and inferential analyses of the data were performed using SPSS software 20 version. Results: The mean age of the respondents was 35 years ± 6.6 in the EG and 41 years ± 8.2 in the CG. The mean knowledge score of cervical cancer was low at baseline in both EG (9.58 ± 7.1) and CG (11.61 ± 6.5). However, there was a significant increase to 21.45 ± 6.2 after the intervention in EG (P < 0.0001). The baseline acceptance of HPV vaccination was high in EG after intervention from 74% to 99%. Exposure to nursing intervention and acceptance of HPV vaccination was statistically significant after intervention (P < 0.0001). Conclusions: The nursing intervention has been found to increase mothers' knowledge of cervical cancer and acceptance of HPV vaccination. It is therefore recommended that nurses should use every available opportunity in mothers' clinic to educate on cervical cancer and HPV vaccination. PMID: 29607384 [PubMed]