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Zhang L, Zhang X, Cui Z, Zhou L, Qu K, Wang N. Effects of high-quality nursing care on psychological outcomes and quality of life in patients with hepatocellular carcinoma: A protocol of systematic review and meta-analysis. Medicine (Baltimore) 2020; 99:e21855. [PMID: 32871909 PMCID: PMC7458187 DOI: 10.1097/md.0000000000021855] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/10/2023] Open
Abstract
BACKGROUND High quality nursing care (HQNC) has been reported to effectively prevent psychological disorders and improve the quality of life (QoL) in patients with hepatocellular carcinoma (HCC) during the treatment. However, the exact effect of HQNC remains controversial. This systematic review will be aimed to assess the effectiveness of HQNC on psychological disorders and QoL in patients with HCC. METHODS Eligible prospective controlled clinical trials were searched from Google Scholar, Medline, Excerpt Medica Database (Embase), PubMed, Web of Science (WOS), Cochrane Library, China Scientific Journal Database (CSJD), China National Knowledge Infrastructure (CNKI), Chinese BioMedical Database (CBM) and Wanfang Database. Papers in English or Chinese published from January 2000 to July 2020 will be included without any restrictions. The clinical outcomes including psychological outcomes, QoL, and adverse events of HQNC in patients with HCC were systematically evaluated.Study selection and data extraction will be performed independently by two reviewers. Stata 14.0 and Review Manager 5.3 were used for data analysis. Methodological quality for each eligible study will be assessed by using Cochrane risk of bias tool. Subgroup and meta-regression analysis will be carried out depending on the availability of sufficient data. RESULTS The results of this systematic review will be published in a peer-reviewed journal. CONCLUSION The results of this study may provide helpful evidence of HQNC on psychological effects and QoL in patients with HCC. INPLASY REGISTRATION NUMBER INPLASY202070096.
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Affiliation(s)
- Lei Zhang
- Department of Oncology, The People's Hospital of Taizhou, Taizhou, Jiangsu Province
| | - Xuan Zhang
- Digestive Endoscopy Center, Liaocheng People's Hospital
| | - Zhaokun Cui
- Department of Anesthesiology, Liaocheng Infectious Diseases Hospital, Liaocheng, Shandong Province
| | - Lijuan Zhou
- Department of Nursing, The People's Hospital of Taizhou, Taizhou, Jiangsu Province
| | - Kai Qu
- Department of Hepatobiliary Surgery, The First Affiliated Hospital of Xi’an Jiaotong University, Xi’an, Shaanxi Province
| | - Nannan Wang
- The Sixth Ward of Hepatology Department, Qingdao Sixth People's Hospital, Qingdao, Shandong Province, PR China
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Mudumbi SK, Bourgeois CE, Hoppman NA, Smith CH, Verma M, Bakitas MA, Brown CJ, Markland AD. Palliative Care and Hospice Interventions in Decompensated Cirrhosis and Hepatocellular Carcinoma: A Rapid Review of Literature. J Palliat Med 2018; 21:1177-1184. [PMID: 29698124 PMCID: PMC6104656 DOI: 10.1089/jpm.2017.0656] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/22/2018] [Indexed: 01/21/2023] Open
Abstract
BACKGROUND Patients with decompensated cirrhosis (DC) and/or hepatocellular carcinoma (HCC) have a high symptom burden and mortality and may benefit from palliative care (PC) and hospice interventions. OBJECTIVE Our aim was to search published literature to determine the impact of PC and hospice interventions for patients with DC/HCC. METHODS We searched electronic databases for adults with DC/HCC who received PC, using a rapid review methodology. Data were extracted for study design, participant and intervention characteristics, and three main groups of outcomes: healthcare resource utilization (HRU), end-of-life care (EOLC), and patient-reported outcomes. RESULTS Of 2466 results, eight were included in final results. There were six retrospective cohort studies, one prospective cohort, and one quality improvement study. Five of eight studies had a high risk of bias and seven studied patients with HCC. A majority found a reduction in HRU (total cost of hospitalization, number of emergency department visits, hospital, and critical care admissions). Some studies found an impact on EOLC, including location of death (less likely to die in the hospital) and resuscitation (less likely to have resuscitation). One study evaluated survival and found hospice had no impact and another showed improvement of symptom burden. CONCLUSION Studies included suggest that PC and hospice interventions in patients with DC/HCC reduce HRU, impact EOLC, and improve symptoms. Given the few number of studies, heterogeneity of interventions and outcomes, and high risk of bias, further high-quality research is needed on PC and hospice interventions with a greater focus on DC.
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Affiliation(s)
- Sandhya K. Mudumbi
- Center for Palliative and Supportive Care, University of Alabama at Birmingham, Birmingham, Alabama
- Division of Gerontology, Geriatrics, and Palliative Care, Department of Medicine, University of Alabama at Birmingham, Birmingham, Alabama
- Health Services and Outcomes Research Post-Doctoral Training Program, University of Alabama at Birmingham, Birmingham, Alabama
| | | | - Nicholas A. Hoppman
- Division of Gastroenterology and Hepatology, Department of Medicine, University of Alabama at Birmingham, Birmingham, Alabama
| | - Catherine H. Smith
- Lister Hill Library of the Health Sciences, University of Alabama at Birmingham, Birmingham, Alabama
| | - Manisha Verma
- Division of Hepatology, Department of Transplantation, Einstein Healthcare Network, Philadelphia, Pennsylvania
| | - Marie A. Bakitas
- Center for Palliative and Supportive Care, University of Alabama at Birmingham, Birmingham, Alabama
- University of Alabama at Birmingham School of Nursing, Birmingham, Alabama
| | - Cynthia J. Brown
- Division of Gerontology, Geriatrics, and Palliative Care, Department of Medicine, University of Alabama at Birmingham, Birmingham, Alabama
- Department of Veterans Affairs Birmingham/Atlanta Geriatric Research, Education and Clinical Center, Birmingham, Alabama
- Comprehensive Center for Healthy Aging, University of Alabama at Birmingham, Birmingham, Alabama
| | - Alayne D. Markland
- Division of Gerontology, Geriatrics, and Palliative Care, Department of Medicine, University of Alabama at Birmingham, Birmingham, Alabama
- Department of Veterans Affairs Birmingham/Atlanta Geriatric Research, Education and Clinical Center, Birmingham, Alabama
- Comprehensive Center for Healthy Aging, University of Alabama at Birmingham, Birmingham, Alabama
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Casey G. Diseases of the Liver. Nurs N Z 2016; 22:20-24. [PMID: 30556967] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
IMPAIRED LIVER function affects every aspect of the body's physiology. Diseases of the liver have more widespread and life-threatening impacts than malfunctioning of any of the body's other conditions. accessory organs. Non-alcoholic fatty Liver disease rates are soaring, concurrent with the obesity epidemic and increasing rates of type 2 diabetes. Alcoholic liver disease and viral hepatitis also contribute to high rates of liver damage in the population, making liver disease one of the commonest causes premature death. Liver transplants, hepatocellular carcinomas, and deaths from Liver disease are increasingly due to preventable or treatable liver conditions. Understanding normal liver function allows nurses to predict the impact of Liver disease on their patients' health and well-being. Knowledge of underlying causes of impaired liver function enhances our ability to support and counsel those who are at risk of, or have been diagnosed with liver disease.
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MESH Headings
- Carcinoma, Hepatocellular/metabolism
- Carcinoma, Hepatocellular/nursing
- Carcinoma, Hepatocellular/physiopathology
- Hepatitis, Viral, Human/metabolism
- Hepatitis, Viral, Human/nursing
- Hepatitis, Viral, Human/physiopathology
- Humans
- Liver/cytology
- Liver/metabolism
- Liver/physiology
- Liver Diseases/metabolism
- Liver Diseases/nursing
- Liver Diseases/physiopathology
- Liver Diseases, Alcoholic/metabolism
- Liver Diseases, Alcoholic/nursing
- Liver Diseases, Alcoholic/physiopathology
- Liver Function Tests
- Liver Neoplasms/metabolism
- Liver Neoplasms/nursing
- Liver Neoplasms/physiopathology
- Liver Transplantation/nursing
- Non-alcoholic Fatty Liver Disease/metabolism
- Non-alcoholic Fatty Liver Disease/nursing
- Non-alcoholic Fatty Liver Disease/physiopathology
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Abstract
Cirrhosis results from repeated hepatocellular injury over time, leading to portal hypertension and the development of ascites, hepatic encephalopathy, and varices. Despite improvements in medical care for patients with cirrhosis, mortality from infection, renal failure, and hepatocellular carcinoma remain high.
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Affiliation(s)
- Christopher Fowler
- Transplant Clinical Operations at Methodist Dallas Medical Center, Dallas, TX, USA
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5
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Zheng R, Dong F, Qiang W, Wang Y. Nurses' experiences with catastrophic upper gastrointestinal bleeding in patients with hepatocellular carcinoma: a qualitative study. Eur J Oncol Nurs 2013; 17:408-15. [PMID: 23337318 DOI: 10.1016/j.ejon.2012.12.001] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2012] [Revised: 11/21/2012] [Accepted: 12/01/2012] [Indexed: 11/15/2022]
Abstract
PURPOSE To explore how nurses experienced catastrophic upper gastrointestinal bleeding in hepatocellular carcinoma (HCC) patients. METHODS A qualitative descriptive method was used. Data were collected by semi- structured interviews. Twenty-one registered nurses who had taken care of HCC patients with catastrophic upper gastrointestinal bleeding were purposely recruited from the Department of Hepatobiliary Cancer, Tianjin Medical University Cancer Institute and Hospital located in mainland China. RESULTS Four themes explicated from the study were: feelings expressed during the process of rescuing the lives of patients, feelings expressed from succeeding or failing to save the lives of patients, feelings expressed from family members response to nurses' actions, the impact of the experience on the personal life, work and philosophy of life of the nurse subjects. CONCLUSIONS The findings of this study indicate that it is necessary for nursing leaders to take effective measures to improve nurses' nursing skills, to provide more education in care of the dying, to offer nurses services that address their psychosocial health and to provide them with emotional support.
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Affiliation(s)
- Ruishuang Zheng
- Department of Hepatobiliary Cancer, Tianjin Medical University Cancer Institute and Hospital, Huanhu Middle Road, Tiyuanbei, Hexiqu, 300060 Tianjin, China.
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Reig M, Matilla A, Bustamante J, Castells L, de La Mata M, Delgado M, Moreno JM, Forner A, Varela M. [Recommendations for the management of Sorafenib in patients with hepatocellular carcinoma]. Gastroenterol Hepatol 2010; 33:741-52. [PMID: 20851505 DOI: 10.1016/j.gastrohep.2010.05.007] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/26/2010] [Accepted: 05/29/2010] [Indexed: 12/21/2022]
Affiliation(s)
- María Reig
- Unidad de Oncología Hepática (BCLC), Servicio de Hepatología, Hospital Clínic, Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (Ciberehd), IDIBAPS, Universidad de Barcelona, Barcelona, España
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8
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Abstract
Hepatocellular carcinoma (HCC) is the fifth most common cause of all malignancies and causes approximately one million deaths each year. Surgical liver resection is the only cure for HCC; however, few patients are eligible to undergo this procedure. Hepatic artery chemoembolization (HACE) is a technique that delivers high concentrations of chemotherapeutic agents and blocks the blood supply to the liver for prolonged periods of time. HACE has demonstrated an overall increase in survival. The HACE procedure, pre- and postprocedure complications, and the care required by patients with HCC are critical for oncology nurses to understand.
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Affiliation(s)
- Bridget A Cahill
- Department of Medicine, Northwestern Medical Faculty Foundation, Chicago, IL, USA.
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Abstract
Hepatocellular carcinoma (HCC) is one of the leading causes of cancer death in Taiwan. In order to delineate the unique demographic features and clinical profile of terminal HCC, we conducted a retrospective study in a hospital-based hospice in Taiwan. Of a total of 991 terminally ill cancer patients (654 men and 337 women, mean age 66.1 years) admitted to our palliative care unit during a three-year period, 110 patients (11.1%) were diagnosed as having HCC (93 men and 17 women, mean age 60.5 years). The most common metastatic sites were bone and lung. Eighty-five HCC patients (77.3%) also had associated liver cirrhosis. The most common symptoms of HCC patients upon admission to the hospice ward were pain, fatigue or weakness, anorexia/vomiting, peripheral edema, cachexia, and ascites. Hypoalbuminemia, anemia, hyponatremia and jaundice were common laboratory abnormalities. Eighty-four patients (76.4%) required opiates for pain management. Upper gastrointestinal bleeding or varices bleeding developed in 76 patients (69.1%). Ninety-four patients (85.5%) died at the hospital, and the overall median survival time at hospice ward was 12 days. Because of more severe underlying portal hypertension and deteriorated liver function, terminal HCC patients with decompensated liver cirrhosis (Child-Pugh class C) had a significantly higher prevalence of peripheral edema, ascites, dyspnea, jaundice, thrombocytopenia, and stage III-IV hepatic encephalopathy than noncirrhotic or Child-Pugh class A and B terminal HCC patients. Symptoms and signs resulting from these portal hypertensions frequently complicated the symptomatic management of terminal HCC patients in the hospice ward. The treatment of these complications is mostly empirical in hospice ward, where intensive laboratory or diagnostic tests are usually not performed. In conclusion, symptoms and signs of terminally ill HCC patients in hospice are unique and should be managed appropriately.
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Affiliation(s)
- Ming-Hwai Lin
- Division of Hospice Palliative Care, Department of Family Medicine, Taipei Veterans General Hospital, Taipei, Taiwan
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Abstract
Hepatocellular carcinoma (HCC) ranks as the eighth most common cancer in the world. Although uncommon in North America, the incidence of HCC in the United States has increased by 70% since the 1980s (Yu, Yuan, Govindarajan, & Ross, 2000). The most frequent causes of malignant hepatic disease in the United States are metastases from melanoma and primary tumors of the gastrointestinal tract, breast, and lung. Surgical resection and systemic chemotherapy are the standard treatments for this disease. However, surgery is not an option for patients with advanced disease, and the response rate from systemic chemotherapy remains low. An alternative therapy for patients with HCC or cancers with liver metastases is hepatic arterial infusion of chemotherapy directly into the liver. This method allows a high total body clearance and hepatic extraction to generate high hepatic and low systemic exposures. Nursing care of patients receiving hepatic arterial infusion of chemotherapy includes patient education and monitoring for complications.
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Abstract
This article describes a clinical research protocol designed to determine the value of Radiofrequency Ablation (RFA) for the treatment of histologically proven primary or metastatic liver cancer. RFA is a localized thermal technique that destroys tumor tissue. The research protocol is described, including enrollment criteria, performance of RFA, and the follow-up necessary to ascertain protocol success or failure. The complementary and collaborative roles of the research nurse and clinic nurse in carrying out the RFA protocol are described.
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Affiliation(s)
- D M Melliza
- Ambulatory Treatment Center, University of Texas, M. D. Anderson Cancer Center, Houston, Texas, USA
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12
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Affiliation(s)
- P A Evetts
- M.D. Anderson Cancer Center, Houston, Texas, USA
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13
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Abstract
OBJECTIVES To review liver physiology, the disease process, diagnostic tests, and current treatment options for primary and metastatic liver cancer. DATA SOURCES Research studies, review articles, and textbooks relating to liver cancer. CONCLUSIONS Surgical resection offers the best available treatment modality, but only a small percentage of patients are eligible. However, combined treatment of radiation therapy and chemotherapy (systemic and intra-arterial), as well as chemoembolization, cryosurgery, and transplantation, offers hope of palliation, conversion of unresectable to resectable disease, and prolonged survival. IMPLICATIONS FOR NURSING PRACTICE Understanding and knowledge of the disease process and treatment modalities for primary and metastatic liver cancer will assist the oncology nurse in educating patients and families during their diagnostic and treatment phases.
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Affiliation(s)
- K A Groen
- Department of Surgery, Georgetown University Medical Center, Washington, DC 20008, USA
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14
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Lynes AC. Percutaneous hepatic arterial chemotherapy and chemoembolization. Cancer Nurs 1993; 16:283-7. [PMID: 8402604] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
Abstract
Percutaneous hepatic arterial chemotherapy and chemoembolization are treatment options for patients who have been diagnosed with hepatocellular carcinomas or with metastatic carcinomas of the liver. Nursing care of these patients is challenging and complex. Patients present with varying symptoms of the disease, and progression requires varying degrees of intervention. Some patients may have already had systemic chemotherapy, and others may be facing their first experience with chemotherapy. Patient and family education requires presentation of correct, thorough information on an ongoing basis. To care for these patients, the nurse must understand the techniques of chemoembolization and hepatic arterial chemotherapy administration. This article addresses the introduction of hepatic arterial chemotherapy through the process of chemoembolization, as well as the nursing management to be considered throughout the treatment.
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Affiliation(s)
- A C Lynes
- Graduate Nursing Program, Vanderbilt University, Nashville, Tennessee
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15
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Dong X. [Nursing care of totally implantable drug delivery system for hepatic arterial chemotherapy in primary liver cancer]. Zhonghua Hu Li Za Zhi 1992; 27:20-1. [PMID: 1315623] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
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Richard's story. Nurs Times 1990; 86:74-6. [PMID: 2156239] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
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Watabe Y, Mizuno T, Yasukawa M. [Manual for pre- and postoperative patient care. Hepatoma]. Kango Gijutsu 1989; 35:184-7. [PMID: 2538668] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
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Moon KH. [Patient care in long-term illness (III). Conversation with patients with liver disease]. Taehan Kanho 1988; 27:21-6. [PMID: 2845189] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
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Held J, McLaughlin P. Antiferritin immunoglobulin therapy for treatment of hepatoma. Oncol Nurs Forum 1987; 14:27-31. [PMID: 2821514] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
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Mizoro S, Yoshida R. [Nursing care of a patient with ascites due to hepatoma and liver cirrhosis]. Kango Gijutsu 1979; 25:72-7. [PMID: 228100] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
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