Understanding the needs and preferences for cancer care among First Nations people: An integrative review

AIM

This systematic review aimed to identify the needs and preferences for cancer care services among Australian First Nations people.

DESIGN

Integrative review.

DATA SOURCES

An integrative review was conducted. A wide range of search terms were used to increase the sensitivity and specificity of the searches in electronic databases. Methodological quality assessment, data extraction, was conducted independently by two reviewers, and a narrative synthesis was conducted.

RESULTS

Forty-two studies were included. A total of 2965 Australian First Nations adults, both men and women of various ages across the lifespan, were represented; no First Nations children affected by cancer were represented in the studies. Three themes emerged which included: (1) discrimination, racism and trauma, resulting from colonization, directly impacted First National people's cancer care experience; (2) cultural ways of knowing, being and doing are fundamental to how First Nations people engage with cancer care services; and (3) First Nations people need culturally safe person-centred cancer care services that address practical needs.

CONCLUSION

Most participants represented in this review experienced discrimination, racism and trauma, resulting from colonization, which directly negatively impacted Aboriginal peoples' cancer care experience. While the Optimal Cancer Pathway (OCP) was launched in Australia several years ago, people with cancer may continue to experience distressing unmet care needs.

PATIENT OR PUBLIC CONTRIBUTION

Our team includes both First Nations people, non-First Nations researchers and healthcare professionals with expertise in cancer care. The researchers employed decolonizing restorative approaches to ensure voice, respect, accountability and reciprocity in this review work.

IMPLICATIONS FOR NURSING PRACTICE

Members of the multidisciplinary team including nurses and policymakers should reflect on these findings, ensure that they have up-to-date cultural safety training and stand together with Indigenous and non-Indigenous cancer leaders to take proactive steps to stamp out and dismantle oppression in health, and safely implement the OCP.

Exploring Experiences Among People Diagnosed With Cancer During the COVID-19 Pandemic: A Qualitative Descriptive Study

OBJECTIVES

To describe the experiences of people diagnosed with cancer during the COVID-19 pandemic.

DATA SOURCES

Qualitative data were collected through semistructured interviews conducted with people affected by cancer in the Australian context. Following institutional ethical approval, interviews were conducted over Microsoft Teams and Zoom platforms and complied with confidentiality requirements. Data were transcribed verbatim and analyzed, and emergent themes were developed using thematic analysis to understand patient experiences of cancer care during the COVID-19 pandemic.

CONCLUSIONS

The COVID-19 pandemic was disruptive to the daily experiences of supportive care. Four overarching themes were identified related to: 1) the impact on accessing healthcare services, 2) encounters with healthcare professionals, 3) the impact on daily living, and 4) the impact of COVID on psychological well-being.

IMPLICATIONS FOR NURSING PRACTICE

As the COVID-19 pandemic held global consequences on cancer practices, it is recommended that nursing and other multidisciplinary healthcare professionals reflect upon these findings, in the context of planning for future pandemics. We encourage further exploration into the sustainability of telehealth services universally, given the issues highlighted in this study.

What are the experiences of supportive care in people affected by brain cancer and their informal caregivers: A qualitative systematic review

PURPOSE

To critically synthesise qualitative research to understand experiences of supportive care in people affected by brain cancer and their informal caregivers.

METHODS

A qualitative systematic review was conducted according to the Joanna Briggs methodology and has been reported according to the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) Guidelines. Electronic databases were searched by an expert systematic review librarian for all qualitative studies irrespective of research design. All publications were double screened by two reviewers using a pre-determined exclusion and inclusion criteria. The review was managed using Covidence systematic review software. Methodological quality assessment and data extraction were performed. Qualitative findings accompanied by illustrative quotes from included studies were extracted and grouped into categories, which created the overall synthesised findings.

RESULTS

A total of 33 studies were included which represented a total sample of 671 participants inclusive of 303 patients and 368 informal caregivers. There was a total of 220 individual findings included in this review, which were synthesised into two findings (1) caregivers and patients perceived supports which would have been helpful and (2) caregiver and patient experiences of unmet supportive care needs.

CONCLUSION

This review highlighted the suffering and distress caused by brain cancer and associated treatments. Both patients and their informal caregivers experienced disconnect from themselves in renegotiating roles, and a profound sense of loneliness as the physical deterioration of the disease progressed. Both patients and informal caregivers reported similar unmet needs within the current service provision for brain cancer. However, what is apparent is that current cancer services are provided solely for patients, with little or no consideration to the support needs of both the patient and their informal caregiver. Service re-design is needed to improve care coordination with individualised informational support, implementation of holistic needs assessments for both the patients and their caregivers, better community support provision, improved opportunities for emotional care with early referral for palliative care services.

IMPLICATIONS FOR CANCER SURVIVORS

It is recommended that members of the multidisciplinary brain cancer team reflect on these findings to target holistic needs assessments and develop shared self-management care plans for both the patient and the informal caregiver.

Prostate Cancer Prehabilitation and the Importance of Multimodal Interventions for Person-centred Care and Recovery

BACKGROUND

Prostate cancer is the second most commonly diagnosed cancer globally. Cancer prehabilitation is defined as a process on the continuum of care that occurs between the time of a cancer diagnosis and the beginning of acute treatment. This article will discuss the importance of prostate cancer prehabilitation interventions in optimising physical and psychological recovery to enhance person-centred care.

DATA SOURCES

Electronic databases including CINAHL, MEDLINE, PsychINFO, Scopus, professional websites, and grey literature were searched using Google Scholar.

CONCLUSION

Prehabilitation in cancer care aims to enhance perioperative care and recovery. An emerging field of research suggests that the preoperative period may be physically and psychologically salient to introduce modifiable self-management behaviours to optimise overall recovery.

IMPLICATIONS FOR NURSING PRACTICE

Prostate cancer specialist nurses provide the hub of person-centred care across the entire cancer care continuum embedded within the multidisciplinary team. Individually tailored interventions such as exercise and pelvic floor muscle training programmes, nutritional advice, anxiety and depression reduction, and sexual well-being interventions should be considered in the prehabilitation phase of the cancer care continuum.

Baculovirus expressed 2C of foot-and-mouth disease virus has the potential for differentiating convalescent from vaccinated animals

Determining whether animals have been infected with foot-and-mouth disease virus or vaccinated is important because infected animals frequently become carriers of the virus, shed it intermittently and thus may be the source of new outbreaks of the disease. We had shown previously that the sera of convalescent animals contain antibodies to 2C, a highly conserved non-structural protein, whereas the sera of vaccinated animals do not. This is explained by observation that 2C is retained on the membranes of cells used for growing the virus for vaccine production. In contrast, the non-structural protein 3D, which is released into the medium, is not removed by centrifugation or filtration during vaccine production and therefore stimulates an immune response in both vaccinated and convalescent cattle. In this study we produced 2C and 3D in insect cells infected with recombinant baculoviruses. As demonstrated by serology and electron microscopy, 2C is also retained on the membranes of the insect cells. Both expressed proteins react with sera of convalescent animals, indicating that they are conformationally similar, but the 2C does not react with sera from vaccinated animals. The baculovirus expressed 2C appears to be a suitable antigen for the development of a reliable diagnostic test.

Human immunodeficiency virus envelope V1 and V2 regions influence replication efficiency in macrophages by affecting virus spread

The V3 hypervariable region of the HIV-1 envelope protein is a major determinant of viral tropism for macrophages. However, the replication of macrophage-tropic HIV-1 strains varies considerably in macrophages, and this variability has been linked to the V1 and V2 envelope regions. In the present study, recombinant HIV clones were generated by inserting V1 and V2 sequences from the Ba-L HIV isolate, which has a high macrophage replication level, into the genomic background of a macrophage-tropic clone with a low macrophage replication level. Infection of macrophages with varying multiplicities of infection and direct detection of the number of infected macrophages per culture showed that the Ba-L V1 and V2 envelope sequences enhanced the ability of virus to spread in the cultures. In contrast, macrophage-tropic clones with low replication efficiency infected macrophages initially but showed no evidence of spread to additional cells during the culture period. This effect on virus spread appeared to be macrophage-specific as it was not observed in cultures of T lymphocytes. Comparison of recombinant clones containing V1, V2, and V3 envelope sequences from high-efficiency Ba-L and JR-FL strains indicated that markedly different V1 and V2 sequences could impart the same rapidly spreading phenotype in macrophages.

ELISA for detection of antibodies to a type D retrovirus, SRV-W

An ELISA was developed to detect antibodies to a Type D retrovirus, SRV-W. The interpretation of the ELISA results were based on: 1) Comparisons of known antibody positive (to a closely related type D retrovirus) and negative serum samples, 2) the ability of ELISA reactivity to be absorbed with a Type D virus but not a mock virus preparation, and 3) analysis by a Western Blot assay as an alterative way to identify antibody to the Type D retrovirus.