Nurse Faculty Scholars - Cancer

Exploring the Role of Community Health Workers in Providing Cancer Navigation: Perceptions of African American Seniors

kdeming — Tue, 02 Oct 2012 18:15:29 +0000

Published Date:

Tue, 2012-05-01 (All day)

The purpose of this study was to to obtain experiential data regarding African American older adult survivors' perceptions of and recommendations on the role of community health workers (CHWs) in providing a cancer navigation intervention.

Purpose/Objectives: To obtain experiential data regarding African American older adult survivors' perceptions of and recommendations on the role of community health workers (CHWs) in providing a cancer navigation intervention.

Research Approach: Focus groups.

Setting: Rural Virginia and urban Maryland.

Participants: 48 African American solid-tumor cancer survivors, aged 65 years or older, with Medicare insurance.

The symptom cluster experience profile framework

kdeming — Wed, 22 Jun 2011 13:24:44 +0000

Published Date:

Mon, 2010-11-08 (All day)

Purpose/Objectives: To present the novel Symptom Cluster Experience Profile (SCEP) framework for guiding symptom research in adult survivors of childhood cancers and other subgroups at risk for high symptom burden.

Data Sources: Empirically derived model of symptom cluster experience profiles, existing theoretical frameworks, and data-based literature on symptoms and quality of life in adult survivors of childhood cancers.

Data Synthesis: In a previous study, the authors generated a preliminary model to characterize subgroups of adult survivors of childhood cancers with high-risk symptom cluster profiles. The authors developed the SCEP framework, which depicts symptom cluster experiences as subgroup-specific profiles that are driven by multiple sets of risk and protective factors. The risk and protective factors may directly and indirectly contribute to or alleviate symptoms through their effects on systemic stress. Systemic stress instigates and sustains the symptom experience that, in turn, is expressed through negative diffusion into other components of quality of life, such as functional status, general health perceptions, and overall quality of life.

Conclusions: The SCEP framework is an initial approach to unbundle the complex heterogeneity that underlies the clustering of symptoms. By measuring a wide range of risk and protective factors in future studies of adult survivors of childhood cancers and other subgroups at risk for high symptom burden, further development and validation of the SCEP framework will occur.

Implications for Nursing: The SCEP framework can be used to specify mechanisms underlying symptom cluster profiles and derive interventions targeted to high-risk symptom profiles. Findings from future studies can be translated to risk-based surveillance and symptom management clinical practice guidelines.

Purpose/Objectives: To present the novel Symptom Cluster Experience Profile (SCEP) framework for guiding symptom research in adult survivors of childhood cancers and other subgroups at risk for high symptom burden.
Data Sources: Empirically derived model of symptom cluster experience profiles, existing theoretical frameworks, and data-based literature on symptoms and quality of life in adult survivors of childhood cancers.

Interventions with Family Caregivers of Cancer Patients: Meta-Analysis of Randomized Trials

lsharp — Sun, 10 Apr 2011 16:08:22 +0000

Published Date:

Fri, 2010-08-13 (All day)

Family caregivers of cancer patients receive little preparation, information, or support to perform their caregiving role. However, their psychosocial needs must be addressed so they can maintain their own health and provide the best possible care to the patient. The purpose of this article is to analyze the types of interventions offered to family caregivers of cancer patients, and to determine the effect of these interventions on various caregiver outcomes. Meta-analysis was used to analyze data obtained from 29 randomized clinical trials published from 1983 through March 2009. Three types of interventions were offered to caregivers: psychoeducational, skills training, and therapeutic counseling. Most interventions were delivered jointly to patients and caregivers, but they varied considerably with regard to dose and duration. The majority of caregivers were female (64%) and Caucasian (84%), and ranged in age from 18 to 92 years (mean age, 55 years). Meta-analysis indicated that although these interventions had small to medium effects, they significantly reduced caregiver burden, improved caregivers' ability to cope, increased their self-efficacy, and improved aspects of their quality of life. Various intervention characteristics were also examined as potential moderators. Clinicians need to deliver research-tested interventions to help caregivers and patients cope effectively and maintain their quality of life.

Feasibility of a Mindfulness-Based Stress Reduction Program for Early-Stage Breast Cancer Survivors

lsharp — Sun, 10 Apr 2011 15:43:40 +0000

Published Date:

Mon, 2010-11-01 (All day)

Purpose: To assess the feasibility of whether mindfulness-based stress reduction (MBSR) has a positive effect on breast cancer survivors’ psychological status, psychosocial characteristics, symptoms, and quality of life (QOL) during the critical transition period from end of treatment to resumption of daily activities.

Design: Single-group, quasi-experimental, pretest–posttest design. Method: A sample of 19 women who completed breast cancer treatment with lumpectomy, radiation, and/or chemotherapy was recruited from the Moffitt Cancer Center and Research Institute, a National Cancer Institute– designated cancer center, and the University of South Florida. The authors assessed the feasibility, compliance, and whether an 8-week MBSR program positively influenced changes in psychological status (fear of recurrence, perceived stress, anxiety, depression), psychosocial characteristics (optimism, social support, spirituality), physical symptoms, and QOL. Findings: Seventeen women (89.5%) com- pleted the study. The mean age was 57 years; the majority of participants (94%) were white. The estimated compliance rate for the program was 67%. Paired t tests indicated significant improvements fear of recurrence, perceived stress, anxiety, depression, and QOL through MBSR participation.

Conclusions: Participants enrolled in the MBSR classes generally were compliant. Significant improvement in psy- chological status, symptoms, and QOL can be achieved with MBSR use in this population.

The Symptom Cluster Experience Profile Framework

lsharp — Mon, 07 Feb 2011 15:39:26 +0000

Published Date:

Mon, 2010-11-08 (All day)

Data Sources: Empirically derived model of symptom cluster experience profiles, existing theoretical frameworks, and data-based literature on symptoms and quality of life in adult survivors of childhood cancers.

Data Synthesis: In a previous study, the authors generated a preliminary model to characterize subgroups of adult survivors of childhood cancers with high-risk symptom cluster profiles. The authors developed the SCEP framework, which depicts symptom cluster experiences as subgroup-specific profiles that are driven by multiple sets of risk and protective factors. The risk and protective factors may directly and indirectly contribute to or alleviate symptoms through their effects on systemic stress. Systemic stress instigates and sustains the symptom experience that, in turn, is expressed through negative diffusion into other components of quality of life, such as functional status, general health perceptions, and overall quality of life.

Conclusions: The SCEP framework is an initial approach to unbundle the complex heterogeneity that underlies the clustering of symptoms. By measuring a wide range of risk and protective factors in future studies of adult survivors of childhood cancers and other subgroups at risk for high symptom burden, further development and validation of the SCEP framework will occur.

Implications for Nursing: The SCEP framework can be used to specify mechanisms underlying symptom cluster profiles and derive interventions targeted to high-risk symptom profiles. Findings from future studies can be translated to risk-based surveillance and symptom management clinical practice guidelines.

Interventions with Family Caregivers of Cancer Patients: Meta-Analysis of Randomized Trials

lsharp — Thu, 27 Jan 2011 21:17:44 +0000

Published Date:

Fri, 2010-08-13 (All day)

Family caregivers of cancer patients receive little preparation, information, or support to perform their caregiving role. However, their psychosocial needs must be addressed so they can maintain their own health and provide the best possible care to the patient. The purpose of this article is to analyze the types of interventions offered to family caregivers of cancer patients, and to determine the effect of these interventions on various caregiver outcomes. Meta-analysis was used to analyze data obtained from 29 randomizedclinical trials published from 1983 through March 2009. Three types of interventions were offered to caregivers: psychoeducational, skills training, and therapeutic counseling. Most interventions were delivered jointly to patients and caregivers, but they varied considerably with regard to dose and duration. The majority of caregivers were female (64%) and Caucasian (84%), and ranged in age from 18 to 92 years (mean age, 55 years). Meta-analysis indicated that although these interventions had small to medium effects, they significantly reduced caregiver burden, improved caregivers' ability to cope, increased their self-efficacy, and improved aspects of their quality of life. Various intervention characteristics were also examined as potential moderators. Clinicians need to deliver research-tested interventions to help caregivers and patients cope effectively and maintain their quality of life. CA Cancer J Clin 2010. © 2010 American Cancer Society, Inc.

Family caregivers of cancer patients receive little preparation, information, or support to perform their caregiving role.

Family and Friend Interactions among African-American Men Deciding Whether or not to have a Prostate Cancer Screening

lsharp — Tue, 19 Oct 2010 14:29:14 +0000

Published Date:

Thu, 2010-08-26 (All day)

Prostate cancer disproportionately affects African-American men. Family, friends, and trust in health care providers are factors that influence the decision making of African-American men when determining whether or not to get a prostate cancer screening done.

Introduction: African-American men are approximately 2.4 times more likely to die of prostate cancer when compared to Caucasian men. Since prostate cancer screening is controversial, there lies a greater need to understand the decision-making factors for screening. Purpose: Cancer patients and patients at high risk for cancer face difficult decisions in choosing what is most appropriate for them and how to access resources. The purpose of this study was to examine how rural African-American men decide whether or not to have a prostate cancer screening. Methods: A qualitative research design was used to examine rural African-American men's experiences in decision making as it relates to prostate cancer screening. A hermeneutic phenomenological approach was used to analyze data. This approach focuses on the lived experiences of participants, as well as the meanings of their experiences. Findings: Seventeen rural African-American men were interviewed about whether or not to have a prostate cancer screening. Three themes emerged from the findings: 1) family and friend involvement is important, 2) trust in the doctor is necessary, and 3) knowing a friend or family member with prostate cancer impacts decision making. The involvement of family and friends in the decision-making process for prostate cancer screening became prominent among the participants. Conclusions: Opinions of family and friends were highly valued and had a great impact on the participants' decision-making process. A combination of informal and formal support resources influenced the men's decision for prostate cancer screening.

Strategies for recruiting African American men into prostate cancer screening studies.

lsharp — Tue, 19 Oct 2010 14:25:56 +0000

Published Date:

Sun, 2009-11-01 (All day)

OBJECTIVES: The aim of this study was to focus on innovative and effective recruitment strategies for research on prostate cancer with minorities.

METHODS: A systematic description is provided of the recruitment efforts for a hermeneutic phenomenological qualitative study of African American men's experiences in decision making on whether to have a prostate cancer screening.

RESULTS: Seventeen African American men were enrolled from rural Central Virginia. Recruiting strategies were targeted on places where African American men usually are found but that are rarely used for recruitment: barbershops, community health centers, and churches. Word of mouth was also used, and most of the participants (n = 11) were reached through this method.

DISCUSSION: Recruitment efforts have been noted to be particularly challenging among minorities, for numerous reasons. Making minority recruitment a priority in any research or clinical trial is essential in gaining a representative sample. Word of mouth is a powerful tool that is often forgotten but should be looked at in further detail.

BACKGROUND: Recruitment for research and clinical trials continues to be challenging. Prostate cancer is the most commonly diagnosed cancer in men and disproportionately affects African American men; thus, effective recruitment strategies are essential for this population.
OBJECTIVES: The aim of this study was to focus on innovative and effective recruitment strategies for research on prostate cancer with minorities.

How African American men decide whether or not to get prostate cancer screening.

lsharp — Tue, 19 Oct 2010 14:23:06 +0000

Published Date:

Sun, 2009-03-01 (All day)

Prostate cancer is the most commonly diagnosed cancer in men in the United States and affects African Americans disproportionately when compared to other ethnic groups. There are unclear reasons for this disparity, but several factors may include race, nutrition, family history of cancer, and screening. With early detection of prostate cancer, survival is much better; thus, screening may be helpful, especially for high-risk individuals. Prostate cancer screening continues to be controversial. A paucity of data exists on what prostate cancer screening means to African Americans, particularly in rural areas, and how they make the decision whether or not to undergo prostate cancer screening. This study interviewed 17 African American men to explore how and when they decided about prostate cancer screening. Most of the men (n = 9) said that they had prostate cancer screening. Three themes emerged from the data: (1) these men had information on prostate cancer; (2) family and friends played an important role in the men's decision-making process; and (3) for screening, it was necessary for the men to have a trusting relationship with their healthcare provider. These findings confirm that the decision-making process is not a simple process. The study's results can help healthcare providers understand some of the important decision-making factors in prostate cancer screening for African American men.

Exploring cancer support needs for older African-American men with prostate cancer.

lsharp — Tue, 19 Oct 2010 14:18:34 +0000

Published Date:

Sun, 2010-08-22 (All day)

PURPOSE: The purpose of this study was to explore cancer support and financial issues related to cancer care experienced by African-American men with prostate cancer and to understand whom they relied on for resource issues during diagnosis and treatment.

METHODS: This is a descriptive qualitative study of 23 rural and urban 65 years old and older African-American prostate cancer survivors. Five focus groups were conducted containing African-American prostate cancer survivors who were recruited from community-based centers (e.g., churches, barbershops, diners, and primary care clinics) in central Virginia and Maryland. Focus group discussions were audiotaped, transcribed, and coded. Data were organized and managed using a qualitative analysis software program. Emerging themes uncovered specific problems for older rural African-American men with cancer, and focus group data were examined for potential solutions to these problems.

RESULTS: Two common themes emerged: (1) family and physician support are important, and (2) insurance is a necessity for appropriate health care. A difference between rural and urban African-American prostate cancer survivors emerged as well: difference in spirituality during diagnosis and treatment.

CONCLUSIONS: Rural and urban African-American prostate cancer survivors' major support resource was their wives. Health insurance played a critical role as a support source by decreasing anxiety and financial hardships. Understanding rural and urban African-American prostate cancer survivors' support needs and challenges in relation to cancer diagnosis and treatment will allow nurses and other health-care providers to tailor cancer health plans more effectively for this population.