Symptom Monitoring and Self-care Practices Among Filipino Cancer Patients

Dietary self-management behavior and associated factors among breast cancer patients receiving chemotherapy: A latent profile analysis

PURPOSE

Breast cancer patients experience more gastrointestinal symptoms during chemotherapy than during the survival period post-treatment. This can interfere with daily dietary intake and increase the risk of malnutrition. This study aimed to evaluate the level and classification of dietary self-management behavior and the influence of self-care self-efficacy, outcome expectations, treatment self-regulation and perceived social support guided by "Integrated theory of Health Behavior Change".

METHODS

A multicenter cross-sectional study was conducted. The assessment tools included self-designed demographic and clinical instruments, Dietary Management Behavior Questionnaire, Strategies Used by People to Promote Health, Consideration of Future Consequences Scale-Food, the Treatment Self-regulation Questionnaire and Perceived Social Support Scale.

RESULTS

A total of 760 samples were analysed. The best-fitting model of the 4 classes was determined, with the lowest-to-highest scores as follows: Class 1-poor behavior group (17.84%), Class 2-medium behavior group (28.26%), Class 3-good behavior group (22.67%) and Class 4-excellent behavior group (31.23%). In the control group, being underweight (OR = 0.131), having no spouse (OR = 0.235), having a lower educational level (OR = 0.147-0.384), being premenopausal (OR = 0.220-0.255), having immediate consequence considerations (OR = 0.866-0.909) and receiving other support (OR = 0.830) were risk factors (all P < 0.05).

CONCLUSIONS

The performance of dietary self-management behavior needs to be improved. This study may provide a reference for determining key intervention populations that are underweight during premenopause, have no spouse and have lower education. Specific intervention content, including future consequence consideration, positive attitudes, decision-making, autonomous motivation, introjected regulation and friend support, should be added to improve the dietary practices during chemotherapy precisely.

Dietary Behavior and Its Association with Nutrition Literacy and Dietary Attitude Among Breast Cancer Patients Treated with Chemotherapy: A Multicenter Survey of Hospitals in China

Background

Chemotherapy often negatively impacts the nutritional status of breast cancer patients, and healthy dietary behaviors are important for patient wellbeing. With the guidance of the "Knowledge, Attitude and Practice model" (KAP model), the objective of this survey was to determine the frequency with which patients engage in healthy dietary behaviors and to explore the association between healthy dietary behaviors and nutrition literacy and dietary attitudes.

Methods

This study included a total of 284 breast cancer patients undergoing chemotherapy from three hospitals spanning three cities in China. Face-to-face interviews were conducted to collect demographic and clinical characteristics as well as the Dietary Nutritional Knowledge, Attitude and Practice Questionnaire (DNKAPQ) and the Nutrition Literacy Measurement Scale for Chinese Adult (NLMS-CA).

Results

Participants exhibited medium to high scores for nutrition literacy, dietary attitude and dietary behavior. Nutrition literacy (r = 0.505, p < 0.001) and dietary attitude (r= 0.326, p < 0.001) scores were both positively correlated with the total dietary behavior score. The total nutrition literacy score was positively correlated with the total dietary behavior score (r = 0.286, p < 0.001). In the univariate analysis, age, body mass index, living environment, education level, monthly family income, work status, menopausal status, number of comorbidities, relapse and endocrine therapy were significantly associated with dietary behavior (p < 0.05). In the multiple linear regression analysis, patients' dietary behavior was significantly associated with nutrition literacy (β = 0.449, p < 0.001) and dietary attitude (β = 0.198, p < 0.001). These two factors accounted for 28.6% of the variation in the patients' dietary behavior scores.

Conclusion

There is an important need for targeted dietary and nutritional interventions designed and implemented by health professionals to improve dietary behaviors. Intervention design and content should take the patients' nutrition literacy and dietary attitudes into consideration. In particular, women who are older, overweight, unemployed, and postmenopausal and live in rural areas, exhibit fewer comorbidities, have a lower family income and education level, have not relapsed and are currently receiving endocrine therapy are in urgent need of diet-specific intervention.

Symptom Occurrence, Severity, and Self-Care Methods by Ethnicity and Age Group Among Adults With Cancer

OBJECTIVES

To examine the relationships among cancer therapy-related symptom occurrence and severity, selected cancer-related variables, and demographic variables. Secondary purposes were to examine participants' reported symptom occurrence and severity by ethnicity and by age group and to identify self-care methods.

SAMPLE & SETTING

Convenience sampling was used and included 110 adults receiving cancer treatment from a major hospital in the northeast region of the United States.

METHODS & VARIABLES

A descriptive correlational design was used. Study variables were symptom occurrence and severity and selected demographic and cancer-related variables. The Therapy-Related Symptom Checklist was used to measure symptom occurrence and severity, and the Symptom Alleviation.

RESULTS

Significant relationships were found between symptom occurrence and severity and gender, economic status, and disease stage. Feeling sluggish was the most frequently reported symptom.

IMPLICATIONS FOR NURSING

Oncology nurses are in an influential position to educate and manage participants' cancer therapy-related symptoms.

Quality of life and self-care in elderly patients with cardiovascular diseases: The effect of a Traditional Chinese Medicine health educational intervention

AIMS

To explore the effects of a Traditional Chinese Medicine health educational intervention on the quality of life and self-care agency of elderly patients living with chronic cardiovascular disease.

BACKGROUND

Cardiovascular disease is a leading cause of morbidity and mortality worldwide. The secondary prevention and treatment for chronic cardiovascular disease emphasize the importance of lifestyle modification. However, behavior-changing is difficult and individual choices are influenced by broader environmental factors. The lifestyle intervention for the purpose of self-care enhancing should be considered the driving force from the cultural element.

METHODS

The study was conducted from April 2014 to October 2014. Ninety-eight community dwelling individuals with chronic cardiovascular disease were recruited from Shaoxing and randomized. 48 participants were in the intervention group with a 6-month Traditional Chinese Medicine health education and 50 participants were in the control group with routine care. The main measurements included health-related quality of life and self-care agency, which was assessed by the Short Form-36 Chinese version and the Exercise of Self-Care Agency Scale respectively, and were measured at the baseline and post intervention (6months after baseline).

RESULTS

After 6months of intervention, the quality of life and self-care agency in the intervention group were significantly improved.

CONCLUSIONS

The traditional Chinese medicine health education is an effective method for promoting quality of life and self-care agency in cardiovascular disease patients. It could be applied as adjunctive care for cardiovascular disease patients self-care supporting.

Complementary and alternative medicine self-care strategies for nausea in patients undergoing abdominal or pelvic irradiation for cancer: A longitudinal observational study of implementation in routine care

OBJECTIVE

To longitudinally describe practice of Complementary and Alternative Medicine (CAM) self-care strategies for nausea during radiotherapy.

METHODS

Two hundred patients daily registered nausea and practice of CAM self-care strategies, beside conventional antiemetic medications, for nausea during abdominal/pelvic irradiation (median five weeks) for gynecological (69%) colorectal (27%) or other tumors (4%).

RESULTS

During radiotherapy, 131 (66%) experienced nausea, and 50 (25%) practiced self-care for nausea at least once, for a mean (m) of 15.9days. The six of 50 patients who stayed free from nausea practiced self-care more frequent (m=25.8days) than the 44 patients experiencing nausea (m=14.5) (p=0.013). The CAM self-care strategies were: modifying eating (80% of all self-care practicing patients, 80% of the nauseous patients versus 83% of the patients free from nausea; ns) or drinking habits (38%, 41% vs 17%; ns), taking rests (18%, 20% vs 0%; ns), physical exercising (6%, 2% vs 33%; p=0.035), acupressure (4%, 5% vs 0%; ns) and self-induced vomiting (2%, 2% vs 0%; ns).

CONCLUSION

A fourth of patients undergoing emetogenic radiotherapy practiced CAM self-care for nausea, mostly by modifying eating or drinking habits. The CAM self-care practicing patients who did not become nauseous practiced self-care more frequent than the nauseous patients did. To make such self-care evidence based, we need studies evaluating its efficacy.

Symptom alleviation and self-care among breast cancer survivors after treatment completion

BACKGROUND

This article elucidates the symptom experiences of breast cancer survivors after completion of their treatment. It also provides self reports of the types, frequency of use, and effectiveness of self-care measures to treat the symptoms they are experiencing.

OBJECTIVES

The purpose of this article is to describe the self-care strategies used to alleviate symptoms reported by breast cancer survivors recruited from a secure state coalition database.

METHODS

The Therapy-Related Symptom Checklist (TRSC) was used to identify the occurrence and severity of ongoing symptoms in breast cancer survivors who were six months or more post-treatment. Two groups were identified for further exploration of self-care.

FINDINGS

The self-care method category most commonly reported was diet/nutrition/lifestyle and the least common category was herbs/vitamins/complementary therapy. With few exceptions, the reported methods were perceived as effective.

Music's Relevance for People Affected by Cancer: A Meta-Ethnography and Implications for Music Therapists

BACKGROUND

Evidence supports music-based oncologic support interventions including music therapy. By comparison, little is understood about music-based self-care. This meta-ethnography examined five published qualitative studies to extend understanding of music's relevance, including helpfulness, for people affected by cancer; including children, adolescents, and adults with cancer, carers, and the bereaved.

OBJECTIVE

To improve understanding of music's broad relevance for those affected by cancer.

METHODS

Meta-ethnography strategies informed the analysis. Five studies were synthesized that included 138 participants: 26 children and 28 parents of children with cancer; 12 adolescents and young adults with cancer; 52 adults with cancer; 12 carers; and 8 bereaved. Studies' category and thematic findings were compared and integrated into third-order interpretations, and a line of argument. Perspectives from the five studies that illuminated the line of argument were developed.

RESULTS

Music usage can remain incidental, continue normally, and/or change because of cancer's harsh effects. Music can be a lifeline, support biopsychosocial and spiritual well-being, or become elusive, that is, difficult to experience. Music helps or intrudes because it extends self-awareness and social connections, and prompts play, memories, imageries, and legacies. Music therapists may help patients and carers to recover or extend music's helpful effects.

CONCLUSIONS

Cancer care can be improved through offering music-based resources/services, which give cancer patients and carers opportunities to extend music usage for personal support and, for carers, to support patients. Music therapists can advocate for such resources and educate health professionals about assessing/recognizing when patients' and carers' changed music behaviors signify additional support needs.

Symptoms and symptom clusters in non Hodgkin's lymphoma patients in Turkey

BACKGROUND

Non-Hodgkin's lymphoma (NHL) patients demonstrate multiple symptoms in diagnosis and treatment processes. This cross-sectional descriptive study aimed to determine the symptoms and symptom clusters in such patients receiving chemotherapy.

MATERIALS AND METHODS

The study was carried out on a total of 110 inpatients and outpatients receiving treatment in 7 hospitals in Ankara, Turkey. A questionnaire form and the Memorial Symptom Assessment Scale (MSAS) were applied. Percentages, means, t test, one way analysis of variance (ANOVA) and cluster analysis were used for statistical analyses.

RESULTS

The most prevalent symptoms in this study were lack of energy, hair loss and change in the way food tastes. The most severe symptoms were hair loss, change in the way food tastes and constipation. The top three most distressing symptoms were taste change, constipation and mouth sores. Seven symptom clusters were determined in this study.

CONCLUSIONS

Findings of the study will provide an understanding of symptom experiences of Non-Hodgkin's lymphoma patients receiving chemotherapy and will guide determining appropriate nursing interventions. Receiving care of desired quality will contribute to increasing quality of life of affected individuals.

Treatment-related symptom severity and occurrences among oncology adults in Australia

Objective:

Cancer treatments cause a range of distressing symptoms that can be well managed with pharmacological and nonpharmacological interventions. Treatment-related symptom screening and management by health care professionals is required to provide appropriate guidance to help patients to complete successfully their treatment regimen and achieve the best possible outcomes for patients. The aims of this study were to explore treatment-related symptom severity and occurrences among oncology adults in Australia and compare the results with the Chinese and Filipino studies.

Methods:

A cross-sectional descriptive survey of 84 adult patients over 18 years of age undergoing chemotherapy (CT) and/or radiotherapy (RT) in the Radiation Oncology and Medical Oncology Departments in one public teaching hospital in Canberra, Australia using the 25-item treatment-related symptom checklist (TRSC) was used in this study.

Results:

Six symptom clusters emerged from combining the 25 symptoms. Patients receiving CT experienced highest fatigue symptom occurrences (95.8%) and greater symptom severity (mean = 2.59) for fatigue symptom cluster for patients receiving a combination of CT-RT. Australians treatment-related symptom severity and occurrences were higher compared with the Filipino and Chinese adult cancer patients.

Conclusions:

Nurses in oncology settings are uniquely placed to assess patients’ therapy-related symptoms that will assist them to target education to cancer patients’ individual needs. For all types of cancer, it is important to assess treatment-related symptoms and to provide the most appropriate interventions in consideration to the patients’ preferences.

Living through pelvic radiotherapy:A mixed method study of self-care activities and distressful symptoms

PURPOSE

To explore patients' experience of their illness when undergoing pelvic radiotherapy by describing the presence and severity of distressful symptoms and to explore initiated self-care activities in response to illness and symptoms.

METHODS

A mixed-method study was performed which included a core qualitative dataset and a supplementary quantitative dataset. Twenty-nine women undergoing five weeks of radiotherapy were prospectively interviewed during five weeks of treatment in order to capture experiences, distressful symptoms and quality of life during treatment. Grounded theory formed collection and analysis of the qualitative dataset and statistics were used to analyze the quantitative dataset.

RESULTS

A maintained self-identity was concluded as being central during the trajectory of treatment. Initiated self-care activities served to alleviate physical, emotional, and social suffering; helping the respondents keep their integrity and sense of self. Previous life experiences influenced the process of being able to maintain self-identity. The gastrointestinal symptoms and pain caused most distress.

CONCLUSIONS

In order to be able to maintain self-identity patients endure treatment by focusing on symptoms, on getting cured and on their self-image. Several distressful symptoms implied social limitations and a sense that the body would not take the strain. The result of this study can help health care professionals to gain a better understanding of the struggle to endure pelvic radiotherapy. Further, health care professionals should be more proactive in alleviating their patients' distressful symptoms. The results imply that previous life experiences should precede initiated interventions because these life experiences affect the patients' self-care activities.

Exploring the influence of Traditional Chinese Medicine on self-care among Chinese cancer patients

PURPOSE

The aim of this study was to explore the influence of traditional Chinese medicine (TCM) on self-care among Chinese cancer patients.

METHODS

This was an exploratory qualitative study. A purposive sample of thirty cancer patients who were currently undergoing either chemotherapy or radiotherapy was interviewed. Qualitative content analysis was conducted for data analysis.

RESULTS

Two core categories were emerged from their accounts of experiences with practising TCM-supported self-care activities: perceived beneficial effects and concerns about undesirable effects. The perceived beneficial effects of these self-care activities were mainly stemmed from the traditional beliefs in TCM, which included: strengthening the "origin", removing toxins, and mind-soothing. Concerns about undesirable effects of these self-care activities were raised due to lack of knowledge and unpleasant experience with these self-care activities.

CONCLUSION

The findings revealed that the philosophy of TCM had been deeply integrated by Chinese cancer patients into their self-care. While Western medicine is the mainstream cancer treatment, Chinese cancer patients also practised various TCM-supported self-care activities. However, they were perplexed about the effects of these self-care activities. They could not ascertain whether the perceived benefits were just due to their own belief in the TCM philosophy, and their lack of knowledge in this aspect and unpleasant experience further confused them. Nurses have to be proactive in identifying the unique health-deviation self-care requisites of their clients in a culturally sensitive manner, explore how their self-care experience affects their wellbeing and treatment compliance, and be prepared to clarify misconceptions about their conditions and progress.

Fatigue self-management: a survey of Chinese cancer patients undergoing chemotherapy

AIMS AND OBJECTIVES

To examine Chinese cancer patients' fatigue self-management, including the types of self-management behaviours used, their confidence in using these behaviours, the degree of relief obtained and the factors associated with patients' use of fatigue self-management behaviours.

BACKGROUND

Fatigue places significant burden on patients with cancer undergoing chemotherapy. While some studies have explored fatigue self-management in Western settings, very few studies have explored self-management behaviours in China.

DESIGN

Cross-sectional self- and/or interviewer-administered survey.

METHODS

A total of 271 participants with self-reported fatigue in the past week were recruited from a specialist cancer hospital in south-east China. Participants completed measures assessing the use of fatigue self-management behaviours, corresponding self-efficacy, perceived relief levels plus items assessing demographic characteristics, fatigue experiences, distress and social support.

RESULTS

A mean of 4.94 (± 2.07; range 1-10) fatigue self-management behaviours was reported. Most behaviours were rated as providing moderate relief and were implemented with moderate self-efficacy. Regression analyses identified that having more support from one's neighbourhood and better functional status predicted the use of a greater number of self-management behaviours. Separate regression analyses identified that greater neighbourhood support predicted greater relief from 'activity enhancement behaviours' and that better functional status predicted greater relief from 'rest and sleep behaviours'. Higher self-efficacy scores predicted greater relief from corresponding behaviours.

CONCLUSIONS

A range of fatigue self-management behaviours were initiated by Chinese patients with cancer. Individual, condition and environmental factors were found to influence engagement in and relief from fatigue self-management behaviours.

RELEVANCE TO CLINICAL PRACTICE

Findings highlight the need for nurses to explore patients' use of fatigue self-management behaviours and the effectiveness of these behaviours in reducing fatigue. Interventions that improve patients' self-efficacy and neighbourhood supports have the potential to improve outcomes from fatigue self-management behaviours.

"A quiet still voice that just touches": music's relevance for adults living with life-threatening cancer diagnoses

PURPOSE

Music has historically aided health and loss-adaptation, however, cancer patients' experience of music for self-care is not well understood. This study examines adult cancer patients' views about music's role before and after diagnosis.

METHODS

Constructivist approach, with grounded theory informed design using convenience, snowball and theoretical sampling. Patients from Australian metropolitan cancer and hospice settings completed demographic questionnaires and participated in semi-structured interviews. Qualitative inter-rater reliability was applied.

RESULTS

Fifty-two patients reported comparable time spent experiencing music pre-post diagnosis. Music may remain incidental; however, many patients adapt music usage to ameliorate cancer's aversive effects. Patients often draw from their musical lives and explore unfamiliar music to: remain connected with pre-illness identities; strengthen capacity for enduring treatment, ongoing survival (even when knowing "you're going to die"), or facing death; reframe upended worlds; and live enriched lives. Patients can ascribe human or physical properties to music when describing its transformative effects. Familiar lyrics maybe reinterpreted, and patients' intensified emotional reactions to music can reflect their threatened mortality. Sometimes music becomes inaccessible, elusive, and/or intensifies distress and is avoided. Families', friends' and professionals' recognition of patients' altered musical lives and music-based suggestions can extend patients' use of music for self-care.

CONCLUSION

Health professionals can support patients by inquiring about their music behaviours and recognising that altered music usage may signify vulnerability. Although commonly recommended, hospital concerts and music broadcasts need sensitive delivery. Patients' preferred music should be available in diagnostic, treatment and palliative settings because it can promote endurance and life enrichment.

An intervention to manage patient-reported symptoms during cancer treatment

Patients with cancer receiving therapy may face a variety of complicated and stressful symptoms. Oncology nurses can advocate for patients by performing their roles as educators and comanagers of cancer-related side effects. In addition, symptom-focused education provided by oncology nurses can enable patients to administer self-care more effectively.

Supporting dignified dying in the Philippines

PURPOSE

This study aimed to assess the appropriateness of the International Classification for Nursing Practice (ICNP) Palliative Care for Dignified Dying catalogue for palliative nursing in the Philippines.

METHODS

The study recruited 230 nurses to complete the ICNP Dignified Dying survey. Participants rated ICNP nursing intervention items and identified additional interventions for promoting dignified dying.

RESULTS

All of the intervention items were scored on average as being at least 'slightly important'. The three top-ranked nursing intervention categories were providing social support, maintaining privacy boundaries, and relieving psychological distress.

CONCLUSIONS

The ICNP Palliative Care for Dignified Dying catalogue lists nursing interventions that are appropriate to promoting dignity at the end of life in the Philippines.