Assessment of symptom control in patients with cancer in Northwestern Turkey

Effect of Chemotherapy Patient Education Using the Teach-Back Method on Symptom Management and Quality of Life: A Randomized Controlled Trial

This study aimed to evaluate the impact of the teach-back method in managing chemotherapy symptoms and improving quality of life. A secondary aim was to develop more effective care and education frameworks for cancer treatment. A single-center, randomized controlled trial was conducted with 80 patients who received chemotherapy between June 2022 and May 2023. Patients in the intervention group were educated about the chemotherapy process using the teach-back method, while those in the control group received standard education. Data were collected using a participant information form, the Edmonton Symptom Assessment Scale (ESAS), and the EQ-5D Quality of Life Scale. Statistical significance was accepted as p < 0.05 for all tests. In both groups, EQ-5D scores increased with the number of chemotherapy cycles, indicating a negative impact on quality of life. However, this increase was smaller in the intervention group. As the number of cycles increased, the intervention group scored lower on the Edmonton Symptom Assessment Scale compared to the control group. The results of the study show that using the teach-back method in patient education is effective in the management of chemotherapy-related symptoms and improving overall quality of life.

Loneliness, Social Support Level, Quality of Life and Symptom Management Among Turkish Oncology Patients

This cross-sectional and correlational study was performed in order to determine the relationships between the perceived loneliness and social support levels of Turkish oncology patients, as well as their quality of life and symptom management. A total of 370 oncology inpatients participated in this study. Data were collected using, the FACT-G Quality of Life Scale, the Multi-Dimensional Scale of Perceived Social Support (MSPSS), the UCLA-Loneliness Scale (UCLA-LS), and the Edmonton Symptom Assessment Scale. A negative advanced significant relationship was found between the MSPSS total scores (r = -0.754, p < 0.01) and the UCLA-LS total scores. As the social support levels of the patients increased, their loneliness levels were seen to decrease and their quality of life was seen to increase. The patients were found to experience the symptoms of fatigue, worry, and feeling unwell more often as their loneliness levels increased and social support levels decreased.

Effect of peppermint-lemon aromatherapy on nausea-vomiting and quality of life in pediatric patients with leukemia: A randomized controlled trial

BACKGROUND

Nausea and vomiting, frequently induced by chemotherapy, can delay treatment protocols and the healing process.

PURPOSE

The aim of this study is to determine how aromatherapy inhalation with peppermint and lemon using a diffuser affects nausea-vomiting management and quality of life in 2-12-year-old children undergoing chemotherapy.

DESIGN AND METHODS

The study utilized a pretest-posttest control group experimental design with randomized groups. A total of 90 children who met the inclusion criteria were included in the study. The experimental group received Mentha Piperita and Citrus Lemon essential oils through a diffuser, while the placebo group received water through a diffuser. The control group did not receive any intervention.

RESULTS

Pulse and respiratory rates of children treated with aromatherapy were found to be significantly lower than the other groups. After aromatherapy application, quality of life of the children in the experimental group was significantly higher than the other groups. The change in the Index of Nausea, Vomiting, and Retching scores of the experimental group on the 4th chemotherapy cycle compared to the 1st chemotherapy cycle was significantly higher than the change in the other groups.

CONCLUSIONS

Consequently, it was determined that inhalation aromatherapy with peppermint-lemon was effective in the management of chemotherapy-induced nausea-vomiting symptoms and quality of life compared to the placebo and control groups.

PRACTICE IMPLICATIONS

Inhalation aromatherapy with mint-lemon can be used as an alternative method to improve the quality of life in children with leukemia who suffer from chemotherapy-induced nausea and vomiting.

Sexual Function and Quality of Life Among Turkish Oncology Patients Receiving Chemotherapy

OBJECTIVE

Sexual health and sexual function in oncology patients are inseparable elements of general quality of life and important indicators of emotional well-being. The aim of this study was to determine the relationship between the quality of life and sexual function of oncology patients receiving chemotherapy.

DATA SOURCES

This cross-sectional and correlational study was conducted within the chemotherapy unit of a university hospital between June 25, 2017, and June 21, 2018. A total of 410 oncology outpatients participated in this study. Data were collected using the FACT-G Quality of Life Evaluation Scale, the Arizona Sexual Experiences Scale, and the Edmonton Symptom Assessment Scale.

CONCLUSION

A negative and weak statistically significant relationship between the Arizona Sexual Experiences Scale total score and the FACT-G Quality of Life Evaluation Scale total score was found (r = -0.224, P < .01). The regression model where the FACT-G Quality of Life Evaluation Scale total scores (F = 3.263; P < .001) and Arizona Sexual Experiences Scale total scores (F = 8.937; P < .001) of the patients were taken as dependent variables and their sociodemographic and clinical characteristics were taken as independent variables was found to be statistically significant.

IMPLICATION FOR NURSING PRACTICE

Psychosocial and medical evaluation should be performed when a concern or problem regarding the sexual life of an oncology patient is detected. The sexual quality of life of oncology patients should be improved through sexual counseling and education. Patients and their families should be encouraged to participate in family support programs.

Examination of family caregivers of advanced cancer patients within the scope of the cancer family caregiving experience model: An embedded mixed-methods design

OBJECTIVE

This study aimed to examine the stressors and contextual factors that affect the quality of life (QoL) of caregivers of advanced cancer patients and to address their caregiving experiences.

METHODS

The study had an embedded mixed-methods design and was conducted in the medical oncology unit of a training and research hospital in Turkey. In the quantitative phase, 125 patients with advanced cancer and their family caregivers were included. In the qualitative phase, 21 family caregivers were included. The analysis of quantitative data was carried out using SPSS 25.0 statistical program, and qualitative data were carried out using Collaizi's seven-step descriptive analysis approach. QoL was determined as the dependent variable and evaluated with Caregiver QoL Index-Cancer (CQOLC).

RESULTS

The symptoms, care dependency of patients, and preparedness to the care of caregivers showed a direct impact on the CQOLC. Income level, employment status, and daily caregiving hours demonstrated a direct effect on the CQOLC. Four themes emerged from the interviews: Understanding the dynamics of the caregiving process, losing control of life during the caregiving process, limitation of socio-economic freedom in the caregiving process, and the effort to hold on to life in the caregiving process.

CONCLUSION

The cancer family caregiving experience model is a useful model for evaluating the QoL of caregivers from a multidimensional perspective. Health care professionals should not forget that the QoL of family caregivers should be evaluated in multiple ways, and education programmes for family members should be structured.

Correlation of self-efficacy and symptom control in cancer patients

OBJECTIVE

This cross-sectional study was planned to evaluate the self-efficacy and symptom control of cancer patients and to determine the factors affecting them.

METHODS

The sample of the study consisted of 329 cancer patients who were treated in the Medical Oncology Clinic of a university hospital between April and June 2019 and accepted to participate in the study. Data were collected using the Patient Characteristics Information Form, Cancer Behavior Inventory-Short Version (CBI-SV), and Edmonton Symptom Assessment Scale (ESAS). Percentage, mean, Mann-Whitney U test, and Kruskal-Wallis analysis of variance were used in the analysis of the data.

RESULTS

The mean CBI-SV score of the patients was 79.10 ± 17.55. It was determined that the highest mean score of ESAS of the patients was in the symptom of fatigue (3.53 ± 2.81). Some symptoms were statistically lower in patients with good income, who are working, and who are non-smokers. Also it was determined that the self-efficacy levels of the patients with good income and quitting smoking were higher (p < 0.05). At the same time, as the patients' self-efficacy scores increased, the severity of the symptoms they experienced decreased statistically (p < 0.05).

CONCLUSION

It was found that the patients' self-efficacy score was above the moderate level, the most intense symptom experienced by the patients was fatigue, and the severity of the symptoms decreased as the patients' self-efficacy level increased. In line with these results; the symptoms, self-efficacy perceptions, and affecting factors of cancer patients should be evaluated by nurses at regular intervals, and care and consultancy services should be provided.

The effects of reflexology on anxiety, depression and quality of life in patients with gynecological cancers with reference to Watson's theory of human caring

OBJECTIVES

This study aimed to examine the effects of reflexology based on Watson's theory of human caring on anxiety, depression, and quality of life in gynecological cancer patients.

MATERIAL AND METHODS

The study was a prospective, single-blind, randomized controlled trial with a pretest-posttest and a control group. The clinical trial was conducted at a university hospital in the Aegean region between October 2016 and June 2018. It was completed with 62 women, of whom 31 were in the intervention group and 31 were in the control group. Data were collected by using a personal information form, the Beck Anxiety Inventory, the Beck Depression Inventory, and the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire Core 30-version 3.0.

RESULTS

Anxiety and depression levels were lower in the intervention group than in the control group. Besides, the quality of life was higher in the intervention group than in the control group. Reflexology significantly reduced symptoms due to chemotherapy, such as fatigue, pain, insomnia, and loss of appetite. Although there was a decrease in symptoms, such as nausea, vomiting, diarrhea and constipation immediately after reflexology, an increase in symptoms was observed in the intervention group two weeks later.

CONCLUSION

These results showed that reflexology based on Watson's theory of human caring is effective in reduction of anxiety and depression and improves the quality of life in gynecological cancer patients during chemotherapy. It can be suggested that offering reflexology at certain intervals during chemotherapy will increase the duration of its effect.

The effect on gastrointestinal system functions, pain and anxiety of acupressure applied following laparoscopic cholecystectomy operation: A randomised, placebo-controlled study

The aim of this randomised, placebo-controlled, 3-way blinded study was to determine the effect on GIS symptoms, pain and anxiety of acupressure applied for a total of 12 min, as 3 min at each of the ST25, CV12, TH6, and HT7 acupuncture points, at 0, 4 and 8 h after laparoscopic cholecystectomy operation. The research data were collected using a patient data collection form, the Numeric Pain Intensity Scale and the State-Trait Anxiety Inventory. The patients were evaluated in respect of the time to first flatus and defecation, pain and the State-Trait Anxiety points at 0, 4, and 8 h postoperatively. The application of acupressure was determined to have signficantly reduced acute postoperative pain and shortened the time to defecation (p < 0.05). The application of acupressure can be recommended in the nursing interventions following laparoscopic cholecystectomy to reduce acute pain and shorten the time to defecation.

The effect of breathing exercise on nausea, vomiting and functional status in breast cancer patients undergoing chemotherapy

OBJECTIVE

The aim of this study is to determine the effect of breathing exercise on nausea, vomiting, and functional status in breast cancer patients undergoing chemotherapy.

METHODS

This randomized controlled trial was conducted with a total of 60 breast cancer patients in the ambulatory chemotherapy unit of a university hospital. The data were collected using Patient Information Form, Functional Living Index-Cancer (FLI-C), Visual Analog Scale, and Patient Diary. The patients were followed up for the first seven days. While the control group received routine nursing care until the posttest, the intervention group received breathing exercise for six days. On the seventh day, FLI-C was repeated for all the patients.

RESULTS

It was determined that the patients in the intervention group had less number of nausea, vomiting, and retching episodes after the breathing exercise (p < 0.05) and experienced lower severity of nausea (p < 0.05) compared to patients in the control group.

CONCLUSION

Consequently, it was determined that the breathing exercise reduced chemotherapy-induced nausea, vomiting and retching in breast cancer patients and affected positively functional status of patients.

A cross-sectional study of distress: A cancer response

Aim

To describe the experience of distress in people with cancer of working age.

Design

A cross-sectional study.

Methods

In this cross-sectional study, patients (N = 168) with both ongoing (N = 56) and completed treatment (N = 105) completed the Distress Thermometer and the detailed problem list. Data were analysed by descriptive and analytical statistics.

Results

A large proportion of patients (29%) continued to experience high distress (>3 according to the Distress Thermometer) even after treatment was completed. Patients experienced several problems after treatment had ended such as fatigue (44%), sleep problems (34%), worries (31%), pain (31%), tingling in hands and feet (31%) and problems with memory/concentration (30%). Patients with financial/insurance problems had significantly higher distress than those who did not have these problems.

The effects of listening to music on the postoperative nausea and vomiting

AIM

To determine the effect of music on the severity of postoperative nausea and vomiting after the laparoscopic cholecystectomy.

METHODS

This study was a randomized, controlled clinical study. The subjects were randomly divided into two groups (intervention group and control group). The numerical scale of nausea was used in rating the nausea complaints of the patients and the vomiting incidence assessment form in determining the incidence of vomiting.

RESULTS

There were statistically significant difference between the groups in terms of the severity of nausea complaint (W = 110.826 p < 0.001). When compared to the control group, the vomiting incidence of the patients was statistically significantly lower in intervention group.

CONCLUSIONS

This study demonstrated that listening to music decreased the severity nausea and the incidence of vomiting in the postoperative period.

Reflexology in the management of chemotherapy induced peripheral neuropathy: A pilot randomized controlled trial

PURPOSE

The current experimental study aimed to evaluate the effectiveness of reflexology on the management of symptoms and functions of chemotherapy-induced peripheral neuropathy (CIPN) in cancer patients.

METHOD

This study was conducted as a randomized controlled trial in 60 patients (30 experimental and 30 control patients) who had chemotherapy-induced Grade II-IV peripheral neuropathy complaints from July 2013 to November 2015. Data were collected using the patient identification form, European Organization for the Research and Treatment of Cancer Quality of Life Questionnaire Chemotherapy-Induced Peripheral Neuropathy (EORTC-CIPN-20) form, and BPI (used for related chemotherapy-induced peripheral neuropathy symptoms).

RESULTS

The majority of the patients were being treated for gastrointestinal or breast cancer and were primarily receiving Eloxatine- or taxane-based treatment. It was found that reflexology applications did not lead to differences in either group in terms of peripheral neuropathy severity and incidence (p > 0.05) and only led to improvement in sensory functions in the experimental group (p < 0.05).

CONCLUSIONS

It was determined that reflexology is not an effective method in the management of patients' activity levels, walking ability etc. and motor, autonomic functions related CIPN, but reflexology is effective method in the management of patients' sensory functions related CIPN. Key Words: Peripheral neuropathy, reflexology, chemotherapy, EORTC QLQ-CIPN-20, BPI.

A modified Edmonton Symptom Assessment Scale for symptom clusters in radiation oncology patients

Patient‐reported outcomes regarding symptom burden may provide valuable information in addition to physician assessment. Systematic collection of patient‐reported outcomes may be an important metric to identify unmet needs and improve quality of patient care. To understand common symptoms of patients seen in radiation oncology clinic, we examined the prospectively collected modified Edmonton Symptom Assessment Scale (ESAS‐r) data to explore symptom clusters. Our clinic established use of a modified Edmonton Symptom Assessment Scale in August 2015. All outpatients presenting for radiation oncology services completed the form at each clinic visit. Symptom clusters are defined by two or more symptoms that are interrelated and occur simultaneously with a high degree of predictability. A sample of 916 de‐identified surveys was assessed statistically using principal component analysis (PCA) with varimax rotation to determine independent clustering between the symptoms queried. We found four major clusters of symptoms: Tiredness (tired, drowsiness; PC1), Loss of Appetite (nausea, lack of appetite; PC2), Low Well‐Being (overall & spiritual well‐being; PC3), and Depression (depression, anxiety; PC4). These accounted for 46%, 9.2%, 7.6%, and 7% of total variance, respectively. Internal consistency using Cronbach's alpha was 0.87, 0.7, 0.82, and 0.87, respectively. The most frequent write‐in item was itchiness, present in 24% of the 148 patients responding. Assessment of patients seen in a large radiation oncology clinic revealed several symptom clusters. {Tiredness and drowsiness} represents a major symptom cluster. Itchiness may be underrecognized.

Development and Assessment of the Feasibility of a Nurse-Led Care Program for Cancer Patients in a Chemotherapy Day Center: Results of the Pilot Study

BACKGROUND

The increasing number of cancer patients and inadequate communication in clinics are posing challenges to cancer patients receiving outpatient-based chemotherapy and healthcare providers. A nurse-led care program was proposed as one way of dealing with at least some of these challenges.

OBJECTIVE

The objectives of the pilot study were to assess the feasibility of the subject recruitment, care, and data collection procedures and to explore the acceptability of this program.

METHODS

A pilot study with a 1-group pretest-posttest design was conducted. Five cancer patients receiving chemotherapy in a chemotherapy day center participated. Each patient had a nurse consultation before chemotherapy and received 2 telephone calls after the first and second cycles of chemotherapy. Four questionnaires were adopted to evaluate the subjects' quality of life, self-efficacy, symptom experiences, and satisfaction with care. Questionnaires were completed before the chemotherapy and after the second cycle. The subjects were also interviewed to understand their comments on the service.

RESULTS

The recruitment, care, and data collection procedures were completed smoothly. Slight changes were observed in quality of life and self-efficacy. All 5 subjects were highly satisfied with the care.

CONCLUSIONS

The nurse-led care program is feasible and acceptable.

IMPLICATIONS FOR PRACTICE

The effect of the nurse-led care program will be evaluated in a single-center, open, randomized controlled trial. If the encouraging results can be confirmed, it may be an effective approach to improving the quality of ambulatory chemotherapy care. It would also shed light on the development of nurse-led care in other areas.

Cancer Care Professionals' Attitudes Toward Systematic Standardized Symptom Assessment and the Edmonton Symptom Assessment System After Large-Scale Population-Based Implementation in Ontario, Canada

CONTEXT

Cancer patients experience a high symptom burden throughout their illness. Despite this, patients' symptoms and needs are often not adequately screened for, assessed, and managed.

OBJECTIVES

This study investigated the attitudes of cancer care professionals toward standardized systematic symptom assessment and the Edmonton Symptom Assessment System (ESAS) and their self-reported use of the instrument in daily practice in a large healthcare jurisdiction where this is routine.

METHODS

A 21-item electronic survey, eliciting both closed and open-ended anonymous responses, was distributed to all 2806 cancer care professionals from four major provider groups: physicians, nurses, radiotherapists, and psychosocial oncology (PSO) staff at the 14 Regional Cancer Centres across Ontario, Canada.

RESULTS

A total of 1065 questionnaires were returned (response rate: 38%); 960 were eligible for analysis. Most respondents (88%) considered symptom management to be within their scope of practice. Sixty-six percent of physicians considered the use of standardized tools to screen for symptoms as "best practice," compared to 81% and 93% of nurses and PSO staff, respectively. Sixty-seven percent of physicians and 85% of nurses found the ESAS to be a useful starting point to assess patients' symptoms. Seventy-nine percent of physicians looked at their patient's ESAS scores at visits either "always" or "often," compared to 29%, 66%, and 89% of radiotherapists, PSO staff, and nurses, respectively. Several areas for improvement of ESAS use and symptom screening were identified.

CONCLUSION

Findings show significant albeit variable uptake across disciplines in the use of the ESAS since program initiation. Several barriers to using the ESAS in daily practice were identified. These need to be addressed.

Symptoms and Quality of Life: Before and after stem cell transplantation in cancer

Objective: This study was conducted thinking that it was extremely important in terms of the disease and treatment to assess the symptoms that may be encountered before and after a stem cell transplantation and quality of life.

Methodology: A prospective longitudinal design was used.The study was completed in two years on 82 patients who underwent transplantation at the bone marrow transplantation unit. Data were collected using a questionnaire, the Edmonton Symptom Assessment Scale, and the Short Form-36 quality of life scale.

Results: It was observed that the patients had low mean scores of physical and mental quality of life both before and after transplantation; there was an increase in the mean scores of all the symptoms and primarily of fatigue after the stem cell transplantation as compared to before it; and the mean scores of physical and mental quality of life further declined (p<0.05).

Conclusion: Quality of life of patients who underwent stem cell transplantation is adversely affected in the periods immediately before and after transplantation. Patients’ quality of life worsens as the severity of symptoms experienced by patients increases.