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  Citation statistics : Table of Contents
   2015| October-December  | Volume 2 | Issue 4  
    Online since November 30, 2015

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Improved sleep after Qigong exercise in breast cancer survivors: A pilot study
Wen Liu, Lauren Schaffer, Natalie Herrs, Christine Chollet, Sarah Taylor
October-December 2015, 2(4):232-239
Objective: Sleep disorder and fatigue are among a few major concerns of breast cancer survivors across the survivorship trajectory. The purpose of this pilot study was to examine feasibility and trends in multiple outcomes after a 6-week Qigong exercise program in breast cancer survivors. Methods: Eight female adults (mean age 55.4 ± 9.4 years, mean time after the completion of cancer treatment 3.9 ± 5.7 years) who had a diagnosis of breast cancer and were at least 3 months postcompletion of primary cancer treatment prior to participation in this study. Baseline evaluation was administered using subjective questionnaires on sleep quality, insomnia, fatigue, and quality of life. All subjects participated in two training sessions to learn the "Six Healing Sound" Qigong exercise and attended group Qigong sessions once per week in the following 6 weeks. In addition to the group sessions, subjects were asked to perform the Qigong exercises twice at home right before going to bed in the evening and immediately after getting up in the morning. Following the 6-week intervention, subjects were re-assessed using the same questionnaires. Pre- and post-intervention scores were analyzed for statistical significance. Results: Compliance rate was 89.6% for group sessions and 78.5% (ranging from 65.6% to 90.7%) for daily home Qigong exercises. No participant reported any adverse event or side effect during the study. All participants indicated in the end-intervention questionnaire that they would highly recommend the intervention to others. Significant improvements were observed in sleeping quality score (from 10.3 ± 3.6 to 5.4 ± 2.3, P < 0.01), insomnia index score (from 16.2 ± 3.2 to 6.8 ± 4.8, P < 0.01), fatigue score (from 60.3 ± 9.4 to 49.1 ± 8.6, P < 0.01), and SF-36 score (from 66.8 ± 7.7 to 80.9 ± 3.9, P < 0.01). Conclusions: Results of this single arm pilot study showed the feasibility and potential of "Six Healing Sounds" Qigong exercise for improving sleep and other symptoms in breast cancer survivors.
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Integrating complementary and alternative medicine into cancer care: Canadian oncology nurses' perspectives
Tracy L Truant, Lynda G Balneaves, Margaret I Fitch
October-December 2015, 2(4):205-214
The integration of complementary and alternative medicine (CAM) and conventional cancer care in Canada is in its nascent stages. While most patients use CAM during their cancer experience, the majority does not receive adequate support from their oncology health care professionals (HCPs) to integrate CAM safely and effectively into their treatment and care. A variety of factors influence this lack of integration in Canada, such as health care professional(HCP) education and attitudes about CAM; variable licensure, credentialing of CAM practitioners, and reimbursement issues across the country; an emerging CAM evidence base; and models of cancer care that privilege diseased-focused care at the expense of whole person care. Oncology nurses are optimally aligned to be leaders in the integration of CAM into cancer care in Canada. Beyond the respect afforded to oncology nurses by patients and family members that support them in broaching the topic of CAM, policies, and position statements exist that allow oncology nurses to include CAM as part of their scope. Oncology nurses have also taken on leadership roles in clinical innovation, research, education, and advocacy that are integral to the safe and informed integration of evidence-based CAM therapies into cancer care settings in Canada.
  6 6,087 715
Review complementary and integrative interventions for cancer-related cognitive changes
Jamie S Myers
October-December 2015, 2(4):215-226
Cognitive sequelae from a diagnosis of cancer and the subsequent treatment impact survivors' quality of life and can interfere with both social relationships and employment. The search for evidence-based prevention and intervention strategies continues for both central nervous system (CNS) and non-CNS cancer-related cognitive changes. Complementary therapies in conjunction with conventional medicine are being included in integrative programs designed to maximize symptom management in cancer treatment centers providing survivorship care. The purpose of this article is to review the existing evidence for the use of complementary and integrative interventions to prevent or treat cancer-related cognitive changes and to discuss the rationale for current and future research. Search terminology included: Complementary, alternative, and integrative medicine, cognition, cognitive function, and cancer, and yielded 20 studies that met criteria for inclusion. Preliminary results published to date indicate that some complementary therapies may be beneficial to cancer survivors experiencing cognitive concerns. A number of gaps in the literature remain primarily due to preliminary study designs, small sample sizes, lack of objective cognitive testing, and cognitive function not being a primary endpoint for much of the published work.
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Ethnicity, traditional healing practices, and attitudes towards complementary medicine of a pediatric oncology population receiving healing touch in Hawaii
Asad Ghiasuddin, Joyce Wong, Andrea M Siu
October-December 2015, 2(4):227-231
Objective: Cultural competence among healthcare providers is becoming increasingly important. Hawai'i is an ethnically diverse island state that has a high rate of traditional and complementary medicine use. We previously reported on the feasibility of delivering Healing Touch (HT) to pediatric oncology patients, and its impact on pain, distress and fatigue. Our current objective is to examine the ethnic and cultural characteristics of this patient population, including traditional health related beliefs. Methods: Demographic data and feedback from subjects and their families from the 2009-2010 HT study conducted in Honolulu were analyzed. Results: The majority of the participants were Asian American and/or Native Hawaiian or other Pacific Islander. Almost half of the participants were more than one race. Traditional cultural health related beliefs, as reported by patients and families, sometimes aligned with patient's experiences with HT, however, degree of acculturation/ time living in the United States seemed to play a role as well, with younger generation perhaps being less "traditional". Common health related themes/values across the predominant cultures were 1) emphasis on family/clan and 2) mind/body connection. Conclusions: HT appeared to be well accepted by subjects from a variety of ethnic backgrounds. Several patients had attitudes/beliefs around healthcare that were rooted in their traditional cultural values, but this was not universal. Knowledge of different cultural attitudes on health, and traditional/complementary medicine, will improve patient care. Future areas of research could examine the acceptance of HT among pediatric oncology patients in geographic areas with differing cultural demographics (i.e., continentalUnited States or internationally).
  2 2,951 499
Oncology nurses awareness of drug interactions
Azize Karahan, Sevcan Avcı Isik, Sultan Kav, Aysel Abbasoglu
October-December 2015, 2(4):271-275
Objective: The aim of this study was to determine oncology nurses awareness of drug interactions. Methods: This descriptive study was conducted with nurses working in the oncology clinics who are a member of Oncology Nursing Association of Turkey. A total of 115 nurses (response rate %20) were responded to the online survey that consists of 28 questions. Results: The mean age of the nurses was 33 ± 6.8. The majority of nurses work in university hospital (60%) as a clinical nurse (62.6%) and have a Bachelor Degree in Nursing (63.5%). The mean working years in oncology was 4 years. Half of them stated receiving information on drug interactions mostly through in-service education and courses/congresses in last 5 years. The majority of them (84.3%) indicated that they are considering the possibility of drug interactions when they are scheduling the medication administration time. More than half of the responders (59.1%) encountered drug interactions; however, few explored drug interactions with food, drinks, and nutritional supplements. Their practices to assess possibility of drug interactions were reviewing the drug prospectus (78.3%); consulting with their colleagues (58.3%) and searching on the available website (42.6%) and looking at the drug interaction (39.1%). More than half (65.2%) stated lack of any system to identify drug interactions in their workplace. Nearly half of them indicated to including the drug interaction into patient education mostly for food-drug (73.9%) and drug-drug (63.5%) interactions. Conclusions: Almost all indicated the needs for further education on drug interactions and suggested to have guideline/packet guide.
  2 2,837 312
Effect of an education program on knowledge, self-care behavior and handwashing competence on prevention of febrile neutropenia among breast cancer patients receiving Doxorubicin and Cyclophosphamide in Chemotherapy Day Centre
Wai Chi Mak, Shirley Siu Yin Ching
October-December 2015, 2(4):276-288
Objective: To evaluate the efficacy of an education program on the prevention of febrile neutropenia (FN) among breast cancer patients receiving AC regimen. Methods: Randomized controlled trial with the repeated-measures design was conducted in a Chemotherapy Day Centre of an acute hospital in Hong Kong. Twenty-five subjects in the intervention group received an individual education session followed by three follow-up sessions and routine care. Twenty-four subjects in the control group received routine care. Primary outcomes included the incidence of admission due to FN, the self-care behavior adherence, the knowledge level on prevention of FN and the self-efficacy in self-management, handwashing competence were assessed by self-designed questionnaires, Chinese version of patient activation measure, and handwashing competence checklist. Results: No statistically significant difference between the intervention group and the control group on the incidence of admission due to FN, the self-efficacy in self-management, and the knowledge on prevention of FN. The self-care behavior adherence was significant at cycle 4 of AC regimen in favor of the intervention group (P = 0.036). Handwashing competence improved more significantly among subjects in the intervention group than the control group (P = 0.009). Conclusions: The education program on the prevention of FN had significantly favorable effects on self-care behavior adherence and handwashing competence across time. However, the intervention did not lead to statistically significant improvement on the incidence of admission due to FN, the self-efficacy in self-management and the knowledge level on prevention of FN.
  2 9,386 834
Promoting emancipated decision-making for surgical treatment of early stage breast cancer among Jordanian women
Rana F Obeidat
October-December 2015, 2(4):257-263
To use the critical social theory as a framework to analyze the oppression of Jordanian women with early stage breast cancer in the decision-making process for surgical treatment and suggest strategies to emancipate these women to make free choices. This is a discussion paper utilizing the critical social theory as a framework for analysis. The sexist and paternalistic ideology that characterizes Jordanian society in general and the medical establishment in particular as well as the biomedical ideology are some of the responsible ideologies for the fact that many Jordanian women with early stage breast cancer are denied the right to choose a surgical treatment according to their own preferences and values. The financial and political power of Jordanian medical organizations (e.g., Jordan Medical Council), the weakness of nursing administration in the healthcare system, and the hierarchical organization of Jordanian society, where men are first and women are second, support these oppressing ideologies. Knowledge is a strong tool of power. Jordanian nurses could empower women with early stage breast cancer by enhancing their knowledge regarding their health and the options available for surgical treatment. To successfully emancipate patients, education alone may not be enough; there is also a need for health care providers' support and unconditional acceptance of choice. To achieve the aim of emancipating women with breast cancer from the oppression inherent in the persistence of mastectomy, Jordanian nurses need to recognize that they should first gain greater power and authority in the healthcare system.
  2 2,337 273
Study of collaboration methods between nurses and medical social workers during facility transfer of end-of-life cancer patients
Miyuki Hoshina
October-December 2015, 2(4):264-270
Objective: The purpose of this study is to clarify how nurses and medical social workers (hereafter, MSW) collaborate in providing nursing and support to cancer patients who will transition to end-of-life care. Methods: Informants were comprised of 18 nurses and 8 MSW working at a large hospital practicing state-of-the-art cancer treatment. Interviews were conducted by forming focus groups comprised of a mix of nurses and social workers. The focus group interview survey involved the author transcribing audio recordings of these interview sessions, extracting sections relevant to the study purpose, and performing qualitative analysis. Codes relevant to the study purpose were extracted and compiled into cards. These cards were then grouped according to similarity of contents. Sentences expressing the contents of each group were composed, and small tags were appended to meaningful codes. These groups were further grouped together if similar groups were found. Large tags were appended to meaningful codes. Results: Seventeen small tags and six large tags were appended. Based on the remarks of informants in the focus group interview facilitated by the author, storylines were drawn up by arranging the small tags and large tags. The storylines were then compiled into a results diagram. Even if the patient and the family were in agreement as to his care after hospital discharge, the patient himself agreed to the transfer, and good relations had been established between the nurse and patient and the MSW and patient, as collaboration between the nurses and MSW had been insufficient, there were cases in which the hospital transfer did not proceed smoothly. Conclusions: This study reflects how a transfer will not proceed smoothly simply by establishing trusting relations between the patient and nurses, and this study demonstrated that the collaboration between nurses and MSW is indispensable when it concerns transferring the patient to end-of-life care at another facility.
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Acknowledgement of Peer Reviewers

October-December 2015, 2(4):291-293
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October-December 2015, 2(4):289-290
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Special issue on complementary and alternative medicine on cancer care
Qi Wang
October-December 2015, 2(4):203-204
  - 2,290 2,131
Living in limbo: Being diagnosed with oral tongue cancer
Genevieve Philiponis, Kelly M Malloy, Sarah H Kagan
October-December 2015, 2(4):242-249
Objective: Oral tongue cancer presents clinical challenges to effective diagnosis that affect patient experience. Patient experience of the diagnostic process is poorly described, making opportunities for nursing intervention unclear. Methods: We qualitatively describe, using constant comparative analysis, oral tongue cancer diagnosis using data from a larger grounded theory study of oral tongue cancer survivorship. Using constant comparative analysis - in keeping with the methodology of the main study - we analyzed 16 survivor interviews for themes explaining the patient experience of oral tongue cancer diagnosis. Results: We termed the broader diagnostic process "living in limbo." This process includes the themes describing the peri-diagnostic process itself - "self-detected lesion," "lack of concern," "seeking help," "not a straightforward diagnosis," and "hearing the diagnosis." Entry into treatment concludes "Living in Limbo" and is described by the theme "worry and trust." Conclusions: Our findings are limited by retrospective interviews and participant homogeneity among other features. Future research with prospective designs and diverse groups of people at risk for and diagnosed with oral tongue cancer, as well as targeting those who have had negative biopsies with no eventual diagnosis of oral tongue cancer, will build on our findings. Further, study of patient experience in other sociocultural context and healthcare systems is needed to inform nursing science and practice. Finally, "living in limbo" suggests that clinician and public education about oral tongue cancer diagnosis is needed.
  - 2,995 268
Speaking legibly: Qualitative perceptions of altered voice among oral tongue cancer survivors
Genevieve Philiponis, Sarah H Kagan
October-December 2015, 2(4):250-256
Objective: Treatment for oral tongue cancer poses unique challenges to restoring and maintaining personally acceptable, intelligible speech. Methods: We report how oral tongue cancer survivors describe their speech after treatment in a qualitative descriptive approach using constant comparative technique to complete a focal analysis of interview data from a larger grounded theory study of oral tongue cancer survivorship. Interviews were completed with 16 tongue cancer survivors 3 months to 12 years postdiagnosis with stage I-IV disease and treated with surgery alone, surgery and radiotherapy, or chemo-radiation. All interview data from the main study were analyzed for themes describing perceptions of speech as oral tongue cancer survivors. Results: Actual speech impairments varied among survivors. None experienced severe impairments that inhibited their daily lives. However, all expressed some level of concern about speech. Concerns about altered speech began when survivors heard their treatment plans and continued through to survivorship without being fully resolved. The overarching theme, maintaining a pattern and character of speech acceptable to the survivor, was termed "speaking legibly" using one survivor's vivid in vivo statement. Speaking legibly integrate the sub-themes of "fears of sounding unusual," "learning to talk again," "problems and adjustments," and "social impact." Conclusions: Clinical and scientific efforts to further understand and address concerns about speech, personal presentation, and identity among those diagnosed with oral tongue are important to improving care processes and patient-centered experience.
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Précis for living in limbo and speaking legibly: Reporting qualitative description of oral tongue cancer experience
Sarah H Kagan
October-December 2015, 2(4):240-241
  - 1,910 223