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   2020| July-September  | Volume 7 | Issue 3  
    Online since June 26, 2020

 
 
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SPECIAL TOPIC ISSUE ON NURSING ROLES IN CANCER CLINICAL TRIALS: EDITORIALS
Specialized Cancer Care Roles: from Clinical Practice to Research and Beyond
Andreas Charalambous
July-September 2020, 7(3):232-234
DOI:10.4103/apjon.apjon_59_19  
  2,384 137 -
SPECIAL TOPIC ISSUE ON NURSING ROLES IN CANCER CLINICAL TRIALS: REVIEW ARTICLE
The Oncology Clinical Research Nurse Study Co-Ordinator: Past, Present, and Future
Elizabeth Ness
July-September 2020, 7(3):237-242
DOI:10.4103/apjon.apjon_10_20  
Clinical research nursing is a specialty practice that has evolved over the past century. Clinical research nurses (CRNs) work directly (e.g., direct care provider and advance clinician) or indirectly (e.g., manager, educator, and study co-ordinator) to support clinic research. For more than 50 years, oncology nurses have contributed to the body of evidence describing and validating the responsibilities and importance of the nurse in clinical research, especially the study co-ordinator role. This article will focus on the CRN study co-ordinator role in oncology clinical trials highlighting the historical evolution of the role, the contributions of dedicated members of the Oncology Nursing Society, and the future landscape of clinical research nursing through the International Association of CRNs.
  1,768 148 -
REVIEW ARTICLE
Challenges Confronting the Practice of Nursing in Singapore
Gek Phin Chua
July-September 2020, 7(3):259-265
DOI:10.4103/apjon.apjon_13_20  
Singapore, a young nation like many developed countries, faced a shortage of nurses. Attempts to resolve the workforce shortage through the employment of foreign nurses started in the mid-1980s. Over the years, workforce recruitment from traditional sources nearby, namely Malaysia and Philippines, has expanded to include nurses from countries such as People Republic of China, India, and Myanmar. Attempts have also been made to train, recruit, and retain local nurses such as improving working conditions and remunerations, raising the profile of nursing, improving career recognition and progression, and encouraging nonpracticing nurses back to the workforce. However, the institutions' and the government's attempts to ameliorate the nursing shortage were met with limited success. Even with the recruitment of foreign nurses, the shortage of workforce persists. The shortage is compounded by the three major health-care challenges confronting Singapore: (1) rapid growth in population; (2) rapid aging of the population; and (3) increasing burden of chronic diseases. As the population continues to grow and as more of the population ages, as life expectancy increases and the burden of chronic diseases increases, not only will the demand for nurses continue, but the intensity and the nursing care they require will also increase. This article describes the challenges confronting the practice of nursing in Singapore and their implications. Although these challenges are daunting, they offer nursing the unprecedented opportunities to shape health-care delivery systems and increase nursing influences everywhere across settings and along the delivery continuum.
  1,094 85 -
SPECIAL TOPIC ISSUE ON NURSING ROLES IN CANCER CLINICAL TRIALS: EDITORIALS
Research Nurse Residency: New Registered Nurses Transition to the Role of A Clinical Trials Nurse
Debbie Cline, Brandi Showalter
July-September 2020, 7(3):229-231
DOI:10.4103/apjon.apjon_9_20  
  781 175 -
E-Clinical Trials: The Future of Clinical Trials and How Nurses Can Be Involved
Maria Kapritsou
July-September 2020, 7(3):235-236
DOI:10.4103/apjon.apjon_11_20  
  828 118 -
ORIGINAL ARTICLES
The Incidence of Oxaliplatin-Induced Peripheral Neurotoxicity at Khartoum Oncology Hospital: A Cross-Sectional Survey
Nadeen T Ali, Amel A Mohamed, Bashir A Yousef
July-September 2020, 7(3):266-272
DOI:10.4103/apjon.apjon_12_20  
Objective: Using oxaliplatin-based chemotherapy in the treatment of cancer patients can cause a unique form of acute and chronic peripheral neurotoxicities. This study mainly aims to assess the incidence of oxaliplatin-induced peripheral neuropathy (OXAIPN). Methods: A cross-sectional study among 121 patients treated with oxaliplatin-based chemotherapy was conducted during the period of January to April 2019 at Khartoum Oncology Hospital. The incidence of acute neurotoxicity was assessed using a descriptive questionnaire for most common hyperexcitability and transient symptoms, while the incidence of chronic neurotoxicity was measured by the 20-item European Organization for Research and Treatment of Cancer Quality of Life Questionnaire for patients with chemotherapy-induced peripheral neuropathy and graded by the National Cancer Institute's Common Terminology Criteria for Adverse Events, Version 4.03. Results: Acute and chronic OXAIPN were found in 49.6% and 41.3% of patients, respectively. Most of the patients who developed acute OXAIPN symptoms manifested cold-induced pharyngolaryngeal dysesthesias (73.3%) or perioral paresthesias (71.7%). No significant association exists between the severity of chronic neurotoxicity and basic demographics. Most (79.1%) of the patients did not inform the doctors about their complaints, and 43.5% of those who informed doctors did not take any medication to manage OXAIPN. Conclusions: This study exhibits that oxaliplatin-based chemotherapy can cause symptoms of peripheral neurotoxicity in most of the patients with colorectal or gastric cancer in the form of acute neurotoxicity or chronic neurotoxicity.
  517 107 -
Reliability and Validity Testing of the FAMCARE-2 Scale: Thai Translation
Ladarat Ooraikul, Virapun Wirojratana, Rochana Phuackchantuck, Payuree Chompukeaw, Chiraporn Khaisuwan
July-September 2020, 7(3):280-286
DOI:10.4103/apjon.apjon_5_20  
Objective: Measuring the satisfaction of family caregivers regarding the palliative care provided to their family members is very important for quality improvement in the palliative care system. The aim of this study was to test the psychometric properties (i.e., reliability and validity) of the FAMCARE-2 Scale: Thai Translation for measuring family caregiver satisfaction. Methods: A forward–backward translation process was utilized to produce the 17-item FAMCARE-2 Scale: Thai Translation. The questionnaire and the demographic data form were hand-delivered to the primary family caregivers of 66 palliative care patients of the inpatient wards at Maharaj Nakorn Chiang Mai Hospital, Faculty of Medicine, Chiang Mai University, on the patient discharge date. Internal consistency reliability testing of the FAMCARE-2 Scale: Thai Translation was assessed by calculating the Cronbach's alpha coefficient. Factor analysis was used to test construct validity. Results: The FAMCARE-2 Scale: Thai Translation showed a high level of internal consistency (Cronbach's alpha coefficient of 0.94) and an item-to-total correlation coefficient of 0.13–0.77. Factor analysis of FAMCARE-2 revealed a four-factor structure: management of physical symptoms and comfort, patient care and sharing information, symptoms and side effects, and family and patient support. Conclusions: The FAMCARE-2 Scale: Thai Translation was found to be a valid psychometric tool for measuring family caregiver satisfaction within the Thai context of palliative care.
  528 81 -
Effectiveness of Spiritual Intervention toward Coping and Spiritual Well-being on Patients with Gynecological Cancer
Lina Anisa Nasution, Yati Afiyanti, Wiwit Kurniawati
July-September 2020, 7(3):273-279
DOI:10.4103/apjon.apjon_4_20  
Objective: Coping and spiritual well-being are two important things in improving quality of life of patients with gynecological cancer. However, both of them are still neglected. Spiritual interventions are one of the alternatives in improving coping and spiritual well-being of patients with gynecological cancer. Right now, this intervention is not developed yet in Indonesia, especially about the effect on coping and spiritual well-being. This study aims at determining the effectiveness of spiritual intervention toward coping and spiritual well-being on patients with gynecological cancer. Methods: This was a quantitative research with quasi-experimental method and used a pre- and posttest with control design. The number of respondents in this study was 108 patients (54 patients in each group) and used consecutive sampling. The intervention group received spiritual intervention and the control group received usual care. Spiritual intervention was provided by certified oncology nurses of spiritual training. The instrument used for measuring coping is Brief COPE Scale and Functional Assessment of Chronic Illness Therapy-Spiritual Therapy (FACIT-Sp-12) for measuring spiritual well-being. Results: There was a positive change in the average scores of coping (P = 0.001) and spiritual well-being in the intervention group after receiving spiritual intervention (P = 0.006). The result of this research also shows that there was a significant difference in the average score of coping (P = 0.004) and spiritual well-being (P = 0.001) after spiritual intervention between intervention and control groups. Conclusions: This study shows that coping and spiritual well-being in the intervention group increased significantly after receiving spiritual intervention.
  373 110 -
Development of the Breast Cancer Stigma Scale for Arab Patients
Mashael F Dewan, Dena Hassouneh, MinKyoung Song, Karen S Lyons
July-September 2020, 7(3):295-300
DOI:10.4103/apjon.apjon_14_20  
Objective: Health-related stigma is associated with depression, but there is a lack of studies examining the stigma of cancer in Arab patients. The purpose of this study was to establish the reliability and validity of a newly developed, culturally sensitive measure of stigma among Arab women with breast cancer. Methods: The sample consisted of 59 Arab women with breast cancer who were Muslim, on active oncology treatment. The mean age of women was 49 years (standard deviation = 8.31). Content validity was assessed by calculating a Content Validity Index (CVI) based on ratings from seven oncology experts. Convergent validity was assessed by examining the association with a measure of depressive symptoms. Reliability was assessed by calculating Cronbach's alpha.Results: The measure demonstrated strong content validity (item-CVIs ranged from 0.85 to 1.0 and the scale-CVI was 1.0) and good convergent validity (higher levels of stigma were significantly associated with higher levels of depressive symptoms). Finally, the reliability of the measure was also found to be adequate (alpha = 0.79).Conclusions: The initial examination of the Breast Cancer Stigma Scale for Arab Patients indicated that the scale is both valid and reliable to be used in Arab women with breast cancer.
  335 89 -
Effectiveness of A Traditional Training Method in Increasing Long-Term End-of-Life Care Perception and Clinical Competency among Oncology Nurses: A Pilot Clinical Trial
Khaled Omidi, Mahlagha Dehghan, Parvin Mangolian Shahrbabaki
July-September 2020, 7(3):287-294
DOI:10.4103/apjon.apjon_15_20  
Objective: Patients with cancer face numerous problems at the end of their lives, which makes palliative care necessary for a peaceful death. Considering the important role nurses play in the provision of end-of-life care, the present study was conducted to study the effect of a traditional training method on nurses' perception of and clinical competency in providing end-of-life care to patients with cancer in a hospital in Southeastern Iran. Methods: This was a pilot clinical trial in which the nurses in an oncology ward were allocated to two groups, experimental (n = 24) and control (n = 33), using a table of random numbers. The experiment group received three sessions of workshop training. The nurses' perception and clinical competency were measured before and 3 months postintervention. Results: The results showed the perception scores in the experimental and control groups to be 171.75 ± 19.54 and 170.03 ± 17.03 before education and 176.16 ± 19.54 and 176.12 ± 16.12 postintervention, respectively. The scores of clinical competency were 98.71 ± 10.24 and 99.58 ± 12.17 before education and 101.5 ± 14.67 and 104.97 ± 12 postintervention in the experimental and control groups, respectively. According to the findings, neither of the groups showed a significant difference between pre- and post-intervention in terms of perception of or clinical competency in end-of-life care. Conclusions: A traditional training method such as workshop training cannot cause long-term improvement in nurses' end-of-life care perception or clinical competency. It seems that nurses would benefit from acquiring cognitive and behavioral skills and knowledge through a more continuous form of instruction delivered through modern blended educational methods.
  300 67 -
SPECIAL TOPIC ISSUE ON NURSING ROLES IN CANCER CLINICAL TRIALS: SHORT REPORTS
Integrating Palliative Care for Patients on Clinical Trials: Opportunities for Oncology Nurses
Betty Ferrell, Tami Borneman, Anna Cathy Williams, Angela Scardina, Patricia Fischer, Thomas J Smith
July-September 2020, 7(3):243-249
DOI:10.4103/apjon.apjon_2_20  
The purpose of this article is to describe the lessons learned in the course of a 5-year research study on a palliative care intervention for persons on a Phase 1 clinical trial. Patients who are participating in Phase 1 trials and the families who care for them may be especially vulnerable and require special attention. The patients are generally experiencing the effects of advanced disease, and they also may soon experience unknown side effects, intense treatment regimens, and the emotional stress of an uncertain future as a result of clinical trial participation. Oncology nurses in all roles including clinical trials/research nurses, clinicians, educators, and advanced practice registered nurses play a critical role in addressing the quality-of-life concerns in this population. Palliative care can provide better symptom control and information on treatment options and facilitate a better understanding of patient/family goals. Attending to these factors can ultimately mean improved survival for the advanced cancer patient, and support for these patients can assist in advancing the field of oncology as these investigational therapies hold the promise for enhancing survival.
  274 91 -
Oncology Nurse Coordinators in Clinical Trials – Shaking up the Melanoma Team
Hani Steinberg
July-September 2020, 7(3):250-254
DOI:10.4103/apjon.apjon_19_20  
In recent years, melanoma research has undergone a renaissance. The disease that was once viewed, at least in a metastatic setting, as intractable and untreatable is now revealing its molecular “weaknesses.” The year 2011 was a landmark year for melanoma therapy, with the introduction of two new agents – the anti-cytotoxic T-lymphocyte-associated protein 4 (CTLA-4) antibody ipilimumab and the BRAF (V-raf murine sarcoma viral oncogene homolog B1) inhibitor vemurafenib. These two agents were shown to confer a survival benefit, which was followed by the approval by the Food and Drug Administration (FDA). In 2014, other immune checkpoint inhibitors, such as pembrolizumab and nivolumab, were approved for the treatment of metastatic melanoma. By 2019, the FDA had also approved pembrolizumab as adjuvant therapy. Target therapy and immunotherapy are now the standard of care for melanoma patients. Clinical trials are currently ongoing for new neoadjuvant therapies. Rapidly evolving knowledge will perhaps downgrade melanoma to the level of a chronic, manageable disease from the intractable “black cancer,” it was in the past and a disease that struck fear into the hearts of those who were diagnosed. Changes in immunotherapy treatments were followed by a large volume of clinical trials. This situation has resulted in the need for changes in the roles of existing melanoma multidisciplinary team members, including the clinical trials nurse (CTN). The role of the CTN is not suitable for these new conditions. A new role and tasks need to be established, evolving the CTN into an oncology nurse coordinator (ONC). In this article, we have described the role and responsibilities of an ONC and the changes that have taken place within the multidisciplinary melanoma team.
  257 75 -
EDITORIAL
Proposing a Comprehensive Prehabilitation Model for Individuals with Operable Pancreatic Cancer
Shiow-Ching Shun
July-September 2020, 7(3):255-258
DOI:10.4103/apjon.apjon_18_20  
  256 65 -
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