Cancer nursing
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Randomized Controlled Trial
Telephone intervention and quality of life in patients with breast cancer.
The aim of this quasi-experimental study was to examine the effectiveness of a telephone support intervention 1 week after surgery on the quality of life (QOL) of patients with breast cancer. The sample consisted of 228 patients with breast cancer allocated to an intervention group (n = 120) and control group (n = 108). The data were collected using Ferrans and Powers Quality of Life Index-Cancer Version (QLI-CV) and European Organization for Research and Treatment of Cancer Quality of Life Questionnaire Breast Cancer Module (EORTC QLQ-BR23). ⋯ The QOL in patients with breast cancer was better in subscales of body image, future perspective, and postoperative side effects. The intervention group showed significantly better body image; they worried less about the future and had less postoperative side effects than the control group did. These results may help in discussing QOL issues and should be considered when planning and implementing interventions for patients with breast cancer.
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Family caregivers' quality of life (QOL) is an important indicator for end-of-life care, but appropriate assessment tools are unavailable in Taiwan. This correlational study therefore tested the psychometric properties of the Caregiver Quality of Life Index-Cancer Mandarin version (CQOLC-M) in 359 dyads of cancer patients with terminal illness and their family caregivers from 5 teaching hospitals throughout Taiwan. Caregivers' QOL, spiritual well-being, social support, pain intensity, and economic situation were assessed using the CQOLC-M and 4 established scales. ⋯ We suggest removing 4 items with factor loading of less than 0.4. Since caregivers' QOL depends on patients' and caregivers' physical dimensions, we recommend adding physical-related items to the CQOLC-M. Clinicians can improve caregivers' QOL not only by maintaining their health, social support, and spirituality but also by better managing the pain of patients with terminal illness.
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Comparative Study
Supporting cancer patients dying at home or at a hospital for Taiwanese family caregivers.
Most Taiwanese patients with cancer prefer to die at home, but this preference is often unexpressed due to concern about burdening family caregivers (FCs). However, few studies have compared the caregiving burden of FCs while providing end-of-life care to a relative who eventually dies at home or hospital. This prospective, longitudinal study investigated differences in amount of assistance provided, subjective caregiving burden, depressive symptoms, and quality of life between FCs of Taiwanese patients with cancer who were terminally ill, then died at home and at a hospital. ⋯ However, caregiving did not impact their health, daily schedule, perceived family support, or depressive symptoms to a greater negative extent. Instead, there is a trend for these caregivers to enjoy higher quality of life and to find more positive meaning in providing caregiving at home than do FCs whose relative died in hospital. In conclusion, supporting patients with cancer who are terminally ill and dying at home did not create a greater burden for Taiwanese FCs compared with those whose relatives are dying at a hospital.
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Breast cancer survivors (BCSs) on aromatase inhibitor (AI) therapy often experience musculoskeletal symptoms (joint pain and stiffness, bone and muscle pain, and muscle weakness), and these musculoskeletal symptoms may be related to low serum levels of vitamin D. The primary purpose of this pilot exploratory study was to determine whether serum levels of 25-hydroxyvitamin D (25[OH]D) concentration were below normal (<30 ng/mL) in 29 BCSs on AI therapy and if musculoskeletal symptoms were related to these low vitamin D levels. The mean (SD) serum 25(OH)D level was 25.62 (4.93) ng/mL; 86% (n = 25) had levels below 30 ng/mL. ⋯ This sample of BCSs taking AIs had below normal levels of serum 25(OH)D despite vitamin D supplements. This is one of the few studies to document a significant relationship between vitamin D levels and muscle pain in BCSs on AI therapy. Findings from this pilot study can be used to inform future studies examining musculoskeletal symptoms in BCSs on AI therapy and relationships with low serum levels of vitamin D.
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Randomized Controlled Trial
Effects of an intervention aimed at improving nurse-patient communication in an oncology outpatient clinic.
In an ever more burdened healthcare system, there is an urgent need to investigate whether patients benefit from the resources allocated to nurses' communication skills training in terms of improved patient outcomes. This study aimed to evaluate a standardized two 2-day (33 hours) communication skills training program in nursing cancer care. Twenty-four nurses in an oncology outpatient clinic participated and were randomly assigned to the intervention program or a control group. ⋯ Nurse group differences in change scores between time points (baseline, 1 week, and 3 months after the communication skills training) on measures related to communication and work-related stress were all nonsignificant. Time-by-group analyses of patient data showed no training effect on patient perception of nurse empathy and attentiveness, and we found no training effect on patients' anxious/depressed, angry, or positive mood, as well as no effect on cancer-related self-efficacy. The results were unable to support the hypotheses that nurse communication skills training would be associated with improved nurse and patient outcomes.