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Ibrahim M, Lau GJ, Smirnow N, Buono AT, Cooke A, Gartshore K, Loiselle CG, Johnson K. A Multidisciplinary Preoperative Teaching Session for Women Awaiting Breast Cancer Surgery: A Quality Improvement Initiative. Rehabil Process Outcome 2018. [DOI: 10.1177/1179572718790937] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Purpose: Most of the breast cancer diagnoses are recommended for breast surgery. Unfortunately, many patients report preoperative anxiety, which can affect postoperative recovery. Preoperative teaching sessions have been shown to reduce anxiety and improve recovery for the patients with breast cancer. To better support the patients at our cancer center, a multidisciplinary preoperative teaching session was developed and delivered as a quality improvement initiative. Methods: Participants scheduled for breast surgery were invited to attend a group-delivered preoperative teaching session, either for breast-conserving surgery or mastectomy. The sessions were presented by a nurse, occupational therapist, and physiotherapist. Data were collected through a researcher-developed 2-item questionnaire administered before and after sessions to compare self-reported anxiety and knowledge levels, along with qualitative feedback. Results: A total of 94 participants attended the preoperative sessions, piloted over a year. The majority were scheduled for breast-conserving surgery. Wilcoxon signed rank tests showed that after session, self-reported levels of anxiety decreased, whereas levels of knowledge increased. Most participants found the session to be very helpful and would recommend it to other patients/families awaiting surgery. Conclusions: Patients awaiting surgery for breast cancer may be better supported through a multidisciplinary group teaching session by decreasing anxiety and improving knowledge related to the procedure. Future directions could explore the effect of specific session elements on anxiety, knowledge, and postoperative complications using psychometrically sound instruments and additional time points. Implications for cancer survivors: Standardization of these preoperative teaching sessions may enhance breast cancer care, reduce postoperative complications, and improve patient recovery.
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Affiliation(s)
- Marize Ibrahim
- Rehabilitation & Exercise Oncology Program, Hope & Cope, Jewish General Hospital, Montréal, QC, Canada
- Lady Davis Institute for Medical Research, Jewish General Hospital, McGill University, Montréal, QC, Canada
- Department of Oncology, McGill University, Montréal, QC, Canada
- Breast & Bone Health Program, Hope & Cope, Jewish General Hospital, Montréal, QC, Canada
| | - Garnet J Lau
- Breast & Bone Health Program, Hope & Cope, Jewish General Hospital, Montréal, QC, Canada
| | - Nadia Smirnow
- Rehabilitation & Exercise Oncology Program, Hope & Cope, Jewish General Hospital, Montréal, QC, Canada
| | - Anna T Buono
- Segal Cancer Centre, Jewish General Hospital, Montréal, QC, Canada
| | - Andrea Cooke
- Segal Cancer Centre, Jewish General Hospital, Montréal, QC, Canada
- Ingram School of Nursing, McGill University, Montréal, QC, Canada
| | - Kimberley Gartshore
- Segal Cancer Centre, Jewish General Hospital, Montréal, QC, Canada
- Ingram School of Nursing, McGill University, Montréal, QC, Canada
| | - Carmen G Loiselle
- Department of Oncology and Ingram School of Nursing, McGill University, Montréal, QC, Canada
- Hope & Cope, Jewish General Hospital, Montréal, QC, Canada
| | - Kyla Johnson
- Occupational Therapy Department, Segal Cancer Centre, Jewish General Hospital, Montréal, QC, Canada
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Lau GJ, Loiselle CG. E-health tools in oncology nursing: Perceptions of nurses and contributions to patient care and advanced practice. Can Oncol Nurs J 2018; 28:118-124. [PMID: 31148816 DOI: 10.5737/23688076282118124] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Abstract
As oncology nurses confront a rapidly evolving field with increased workplace pressure, the integration of evidence-based connected health platforms within practice presents promise. This study explores nurses' perceptions regarding the utility of e-health tools, with a focus on the Oncology Interactive Navigator (OINTM), as a potential contributor to their practice and interactions with patients. Focus groups with oncology nurses were conducted at two time points: prior to exposure to the OINTM (T1, n=8) and four weeks post unrestricted tool access (T2, n=7). Using qualitative constant comparison analysis, three themes emerged: (1) Key factors driving e-health use are multidimensional and evolving; (2) Dual role of e-health in meeting patient needs and supporting practice; (3) E-health as a catalyst for professional development and networking. E-health is appealing to oncology nurses, as it serves to advance practice and support patient care. Future research should explore best practices for optimal clinical implementation among all stakeholders involved.
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Affiliation(s)
- Garnet J Lau
- Ingram School of Nursing, McGill University; Garnet Lau is now at Clinical Research Program, Jewish General Hospital
| | - Carmen G Loiselle
- Department of Oncology and Ingram School of Nursing, McGill University and Hope & Cope, Lady Davis Institute, and Segal Cancer Centre, Jewish General Hospital
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Lau GJ, Godin N, Maachi H, Lo CS, Wu SJ, Zhu JX, Brezniceanu ML, Chénier I, Fragasso-Marquis J, Lattouf JB, Ethier J, Filep JG, Ingelfinger JR, Nair V, Kretzler M, Cohen CD, Zhang SL, Chan JS. Bcl-2-modifying factor induces renal proximal tubular cell apoptosis in diabetic mice. Diabetes 2012; 61:474-84. [PMID: 22210314 PMCID: PMC3266424 DOI: 10.2337/db11-0141] [Citation(s) in RCA: 40] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
This study investigated the mechanisms underlying tubular apoptosis in diabetes by identifying proapoptotic genes that are differentially upregulated by reactive oxygen species in renal proximal tubular cells (RPTCs) in models of diabetes. Total RNAs isolated from renal proximal tubules (RPTs) of 20-week-old heterozygous db/m+, db/db, and db/db catalase (CAT)-transgenic (Tg) mice were used for DNA chip microarray analysis. Real-time quantitative PCR assays, immunohistochemistry, and mice rendered diabetic with streptozotocin were used to validate the proapoptotic gene expression in RPTs. Cultured rat RPTCs were used to confirm the apoptotic activity and regulation of proapoptotic gene expression. Additionally, studies in kidney tissues from patients with and without diabetes were used to confirm enhanced proapoptotic gene expression in RPTs. Bcl-2-modifying factor (Bmf) was differentially upregulated (P<0.01) in RPTs of db/db mice compared with db/m+ and db/db CAT-Tg mice and in RPTs of streptozotocin-induced diabetic mice in which insulin reversed this finding. In vitro, Bmf cDNA overexpression in rat RPTCs coimmunoprecipated with Bcl-2, enhanced caspase-3 activity, and promoted apoptosis. High glucose (25 mmol/L) induced Bmf mRNA expression in RPTCs, whereas rotenone, catalase, diphenylene iodinium, and apocynin decreased it. Knockdown of Bmf with small interfering RNA reduced high glucose-induced apoptosis in RPTCs. More important, enhanced Bmf expression was detected in RPTs of kidneys from patients with diabetes. These data demonstrate differential upregulation of Bmf in diabetic RPTs and suggest a potential role for Bmf in regulating RPTC apoptosis and tubular atrophy in diabetes.
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Affiliation(s)
- Garnet J. Lau
- Centre de recherche du Centre hospitalier de l’Université de Montréal (CRCHUM), Hôtel-Dieu Hospital, Université de Montréal, Montreal, Quebec, Canada
| | - Nicolas Godin
- Centre de recherche du Centre hospitalier de l’Université de Montréal (CRCHUM), Hôtel-Dieu Hospital, Université de Montréal, Montreal, Quebec, Canada
| | - Hasna Maachi
- Centre de recherche du Centre hospitalier de l’Université de Montréal (CRCHUM), Hôtel-Dieu Hospital, Université de Montréal, Montreal, Quebec, Canada
| | - Chao-Sheng Lo
- Centre de recherche du Centre hospitalier de l’Université de Montréal (CRCHUM), Hôtel-Dieu Hospital, Université de Montréal, Montreal, Quebec, Canada
| | - Shyh-Jong Wu
- Centre de recherche du Centre hospitalier de l’Université de Montréal (CRCHUM), Hôtel-Dieu Hospital, Université de Montréal, Montreal, Quebec, Canada
| | - Jian-Xin Zhu
- Centre de recherche du Centre hospitalier de l’Université de Montréal (CRCHUM), Hôtel-Dieu Hospital, Université de Montréal, Montreal, Quebec, Canada
| | - Marie-Luise Brezniceanu
- Centre de recherche du Centre hospitalier de l’Université de Montréal (CRCHUM), Hôtel-Dieu Hospital, Université de Montréal, Montreal, Quebec, Canada
| | - Isabelle Chénier
- Centre de recherche du Centre hospitalier de l’Université de Montréal (CRCHUM), Hôtel-Dieu Hospital, Université de Montréal, Montreal, Quebec, Canada
| | - Joelle Fragasso-Marquis
- Centre de recherche du Centre hospitalier de l’Université de Montréal (CRCHUM), Hôtel-Dieu Hospital, Université de Montréal, Montreal, Quebec, Canada
| | - Jean-Baptiste Lattouf
- Centre de recherche du Centre hospitalier de l’Université de Montréal (CRCHUM), Hôtel-Dieu Hospital, Université de Montréal, Montreal, Quebec, Canada
| | - Jean Ethier
- Centre de recherche du Centre hospitalier de l’Université de Montréal (CRCHUM), Hôtel-Dieu Hospital, Université de Montréal, Montreal, Quebec, Canada
| | - Janos G. Filep
- Research Centre, Maisonneuve-Rosemont Hospital, Montreal, Quebec, Canada
| | - Julie R. Ingelfinger
- Pediatric Nephrology Unit, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts
| | - Viji Nair
- Nephrology/Internal Medicine, Center for Computational Medicine and Bioinformatics, University of Michigan, Ann Arbor, Michigan
| | - Matthias Kretzler
- Nephrology/Internal Medicine, Center for Computational Medicine and Bioinformatics, University of Michigan, Ann Arbor, Michigan
| | - Clemens D. Cohen
- Division of Nephrology, Institute of Physiology, University Hospital of Zurich, University of Zurich, Zurich, Switzerland
| | - Shao-Ling Zhang
- Centre de recherche du Centre hospitalier de l’Université de Montréal (CRCHUM), Hôtel-Dieu Hospital, Université de Montréal, Montreal, Quebec, Canada
| | - John S.D. Chan
- Centre de recherche du Centre hospitalier de l’Université de Montréal (CRCHUM), Hôtel-Dieu Hospital, Université de Montréal, Montreal, Quebec, Canada
- Corresponding author: John S.D. Chan,
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