《临床肿瘤科护理杂志》2016年8月总第20卷第4期
Clinical Journal of Oncology Nursing
August 2016 Vol. 20, No. 4
Article
A Call to Action for Hazardous Drug Safety: Where We Have Been and Where We Are Now
对危险药物安全采取行动的呼吁：过去和现在
The dangers associated with handling hazardous drugs (HDs) have been well documented. Contamination of the healthcare environment, which can occur during compounding and administration, may lead to drug absorption by healthcare workers. Studies have proven that HD exposure causes numerous side effects and chromosomal aberrations. This article examines the complex issues surrounding HD safety, including workplace culture, current guidelines, and misconceptions regarding the risks associated with exposure.
Journal Club Article
Integrating a Question Prompt List on an Inpatient Oncology Unit to Increase Prognostic Awareness
整合肿瘤住院病房问题提示清单以提高预后意识
Many patients with incurable cancer do not accurately understand their prognosis, which can lead to aggressive and, often, futile treatment. Improved prognostic awareness can help patients to appropriately de-escalate aggressive treatment sooner in an illness trajectory. The purpose of this article is to introduce a patient-initiated discussion aid (question prompt list) on an oncology unit to increase prognostic awareness by promoting patient–provider dialogue, which could lead to limitation of life-sustaining treatments at the end of life and increased do-not-resuscitate (DNR) orders and hospice referrals.
Effective Transitional Therapy for Adolescent and Young Adult Patients With Cancer: An Integrative Literature Review
治疗青少年和年轻成人癌症患者的有效过渡治疗：综合性文献综述
The adolescent and young adult (AYA) cancer community has demonstrated a need for psychosocial help transitioning from acute cancer care to survivorship while navigating appropriate developmental challenges. The purpose of this integrative literature review is to examine the transition of AYAs from life as patients with cancer to life as cancer survivors and to evaluate the most effective, therapeutic ways to make this transition.
Prevalence of Substance Use in Patients With Cancer Receiving Radiation Therapy
癌症放射治疗患者的物质使用普遍性
Individuals with cancer and risky alcohol and illicit substance use (AISU) are more likely to suffer diminished quality of life and subpar treatment outcomes. The prevalence of AISU in patients with cancer is poorly understood. This article reports on the results of a needs assessment to quantify AISU in individuals with cancer seeking care in the radiation oncology department of a large, academic medical center.
Online Exclusive Article
Early Intervention With Transplantation Recipients to Improve Access to and Knowledge of Palliative Care
移植患者早期干预以提高姑息治疗获取率和知识
The literature continues to support that patients undergoing hematopoietic stem cell transplantation (HSCT) receive early consultation with palliative care specialists. Nurses can be leaders in this initiative. This quality improvement project was conducted to determine whether patients undergoing HSCT, who were provided an early consultation with palliative care, would report increased knowledge and increased ability to access palliative services.
Online Exclusive Article
Adolescents and Young Adults With Cancer: Oncology Nurses Report Attitudes and Barriers to Discussing Fertility Preservation
身患癌症的青少年和年轻成人：肿瘤科护士报告的患者对保留生育能力讨论的态度和障碍
Fertility issues have been found to be an important topic for adolescents and young adults (AYAs) with cancer. Medical technology has made fertility preservation (FP) increasingly effective for postpubertal patients whose treatment course may inhibit their future ability to achieve biologic parenthood. Oncology providers’ recommendations have been shown to vary, potentially affecting patients’ decision-making processes regarding FP. This study was designed to assess oncology nurses’ recommendations for patients to consider FP options and to explore what patient-related factors may influence discussion of FP with AYAs with cancer.
CJON Writing Mentorship Article
Update on New Therapies With Immune Checkpoint Inhibitors
免疫关卡抑制剂新疗法更新
Immunotherapy has had a long history in cancer treatment and, with recent breakthroughs, new drugs are available that have shown promising results. The current article discusses an overview of immune function, including immunoediting and the theory of immune checkpoints, as well as specific drugs that have been approved as immune checkpoint inhibitors.
Women’s Educational Needs and Perceptions About Survivorship Following Bilateral Mastectomy
妇女的教育需求及对双侧乳房切除术后生成的认识
More women are choosing to have a bilateral mastectomy to treat unilateral breast cancer despite it not being considered the standard of care. Women are making this choice for various reasons, including anxiety of follow-up screening of the other breast, risk of cancer recurrence for the rest of their lives, and desire to maintain control over the localized cancer. Currently, evidence-based information is lacking regarding this treatment choice. In addition, the concept of survivorship has yet to be examined in this population of women.
Online Exclusive Article
Diarrhea in Multiple Myeloma: A Review of the Literature
多发性骨髓瘤患者的腹泻：文献综述
One of the most common and inadequately managed symptoms that patients with multiple myeloma (MM) experience as a result of cancer treatment is diarrhea. Diarrhea in patients with MM often is severe enough to warrant dose reduction, delays, or discontinuation of chemotherapy. Short-term diarrhea can occur as a side effect of drugs, such as bortezomib (Velcade®) or panobinostat (Farydak®). Late-onset diarrhea from lenalidomide (Revlimid®) can occur 17–24 months after the start of therapy.
A Sustainable Smoking Cessation Program for Patients With Lung Cancer
肺癌患者的持续戒烟计划
Lung cancer is the most preventable leading cause of cancer death in the United States. Smoking while receiving treatment for lung cancer can decrease the effectiveness of the treatment and may reduce quality of life. Although many smoking cessation proposals have focused on how to deliver various interventions, they have neglected the issue of how to sustain the interventions and integrate them into practice.
A Work Sampling Assessment of the Nursing Delivery of Palliative Care in Ambulatory Cancer Centers
门诊癌症中心姑息治疗护理服务工作抽样评估
Most cancer care occurs within infusion rooms at ambulatory cancer centers, which are staffed by RNs administering chemotherapies and other cancer care medications. Many patients receiving these therapies have basic palliative care needs that could be addressed by the RNs. However, the extent to which these RNs spend their time on basic, or “primary,” palliative care is unknown.
Sisters Saving Lives: Instituting a Protocol to Address Breast Cancer Disparities
拯救生命的姐妹们：制定针对乳腺癌差异的处理方案
Caucasian women have a higher incidence of breast cancer compared to African American women; however, African American women are more likely to die from the disease than their Caucasian counterparts. Many efforts have been made to address this disparity, but it still exists. Data have shown factors contributing to this disparity, such as inequalities in health status, environment, access and use of care, socioeconomic status, knowledge, and cultural beliefs. Train-the-trainer programs have been widely used to address breast cancer disparities.
Editorial
Oncology Nurses and the Cancer Moonshot 2020
肿瘤科护士和2020癌症月探测器
When Vice President Joe Biden’s son, Beau, died of a brain tumor in May 2015, the Vice President’s grief was profound. Yet, his grief generated an idea, a big idea: Let’s collaborate and focus the talent and resources in our country to eliminate cancer as we know it. When Vice President Biden shared his idea with President Barack Obama in the fall of 2015, not only did President Obama endorse the idea, he announced the National Cancer Moonshot Initiative during his January 2016 State of the Union Address. The goal is to double progress against cancer and break down silos that prevent science and industry from working together. The initiative centers around the development and implementation of new vaccine-based immunotherapies to target individual tumors based on their genomic signature.
Supportive Care
Mindfulness as an Intervention for Breast Cancer Survivors
正念疗法作为乳腺癌幸存者的一种干预措施
Breast cancer survivors often turn to complementary health approaches (CHAs) to address the effects of treatment. Mindfulness-based stress reduction (MBSR) is a type of CHA that uses attentional and meditative exercises to minimize stress and increase awareness of the present. This article aims to determine whether adequate evidence-based research with uniform methodologies and outcomes to support MBSR as an intervention for breast cancer survivors exists.
Quality
Evaluation of a Chemotherapy and Medication Education Process for Patients Starting Cancer Treatment
对启动癌症治疗的患者的化疗和药物教育过程的评价
A cancer diagnosis, along with accompanying chemotherapy treatments and new medication regimens, can significantly affect patients’ overall health, well-being, and quality of life. Chemotherapy and medication teaching that meets patients’ learning needs enhances knowledge and supports adherence to instructions. These interventions promote optimal patient outcomes, satisfaction, and overall safety.
Evidence-Based Practice
The Evidence Behind Integrating Palliative Care Into Oncology Practice
支持将姑息治疗与肿瘤学实践相结合的证据
Palliative care services provided alongside traditional oncology care have been shown to be beneficial to patients and families. This article provides a brief history of palliative care, a pathway to implementing these services into currently established oncology programs, and a brief discussion of common barriers.
Novel Approaches
An Interdisciplinary Approach to the Development and Implementation of Electronic Treatment Orders in a Medical Oncology Department
开发和实施肿瘤内科电子治疗医嘱的跨学科途径
This article provides a review of the interdisciplinary approach, implementation methods, and subsequent outcomes of transitioning to an electronic-based chemotherapy and biotherapy ordering system in a community hospital–based ambulatory medical oncology department. The electronic medical record solution system platform that was used in this setting was Cerner PowerChart®, which is certified by the Certification Commission for Healthcare Information Technology.
Safety
Implementation of an Early Warning Scoring System to Identify Patients With Cancer at Risk for Deterioration
识别癌症患者恶化风险的早期预警评分系统的启用
Early warning scoring systems are tools for nurses to help monitor their patients and improve how quickly a patient experiencing a sudden decline receives clinical care. Nurse leaders and frontline staff at a major academic medical center implemented a new early warning system that gives clear guidelines to nurses, nursing assistants, and other clinicians about vital-sign parameters and changes in patients’ mental status.
Oncology Essentials
Applying Health Literacy Principles: Strategies and Tools to Develop Easy-to-Read Patient Education Resources
健康素养原则的应用：开发易于阅读的病人教育资源的策略与工具
Health literacy is an important construct in health care that affects patient outcomes and overall health. The impact of limited health literacy in cancer care is wide, and it can affect patients’ ability to make treatment decisions, follow directions on a prescription label, or adhere to neutropenic precautions. This article describes strategies and tools for nurses to use when developing written patient education resources in their daily practice.
Advanced Practice Nursing Issues
Subcutaneous Immunoglobulin in Oncology Clinical Practice
肿瘤学临床实践中的皮下免疫球蛋白
The administration of gammaglobulin as replacement therapy to boost immune function in patients with immunodeficiency secondary to malignancy is traditionally given in the IV formulation. A pilot program at a large Canadian cancer center led by an advanced practice nurse (APN) demonstrated that transitioning patients to home-based, self-administered subcutaneous infusions (subcutaneous immunoglobulin [SCIG]) led to savings and benefits for patients and the institution. The implementation of SCIG in oncology by an APN is a novel and innovative patient-centered approach to supportive care.
Professional Issues
Increasing the Number of Oncology Nurses Serving on Boards
增加肿瘤科护士数量
Nurses have knowledge about quality, safety, and the patient experience that is valuable to governing boards. In 2011, the Health and Medicine Division of the National Academies of Sciences, Engineering, and Medicine recommended that nurses be prepared and enabled to lead change to advance health care. Five years after the recommendation, work toward this goal is still needed.
Patient & Family Perspectives
Cate’s Story: Hereditary Diffuse Gastric Cancer
Cate的故事：遗传性弥漫型胃癌
Gastric cancer is a major cause of cancer-related mortality worldwide and is thought to be responsible for about 10% of cancer-related deaths across the globe. A small proportion of all gastric cancers arise because of a known hereditary syndrome, the most common of which is hereditary diffuse gastric cancer (HDGC). This is an autosomal dominant genetic disease characterized by an increased risk of developing diffuse gastric cancer at a young age. The gene responsible for HDGC is CDH1, also known as E-cadherin, a germline mutation conferring an 80% risk of developing gastric cancer during the lifetime of the carrier. Females with germline CDH1 mutations face an additional risk of developing lobular breast cancer, with a reported cumulative risk of 60% by the age of 80 years.
Heart of Oncology Nursing
You Want Me in Outpatient Oncology Nursing? A New Graduate Story
门诊肿瘤护理需要我？一位新研究生的故事
When I was in nursing school, I was one of a handful of students presented with a unique opportunity to fulfill our medical-surgical nursing requirement: a six-week clinical rotation at a large, outpatient, National Cancer Institute–designated comprehensive cancer center. This opportunity was an innovative experiment between the College of Nursing at Seattle University and the Seattle Cancer Care Alliance (SCCA). The collaboration was coined the Dedicated Education Unit (DEU) by nursing management.
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