Journal of Nursing最新文献

{"title":"[Care Needs of Elderly Patients With Cancer Receiving Treatment].","authors":"Hung-Ru Lin","doi":"10.6224/JN.202412_71(6).02","DOIUrl":"https://doi.org/10.6224/JN.202412_71(6).02","url":null,"abstract":"<p><p>Cancer incidence is closely related to age. With the sharp increase in the elderly population in recent decades, the number of older adults with cancer has increased each year. Compared to middle-aged patients, older adults with cancer have relatively more-complex health problems during treatment, with aging, debilitation, comorbidities, cognitive dysfunction, and polytherapy important factors affecting the benefit received by these patients from their treatment. In view of the prevalence and particularities of cancer in the elderly population, health professionals must focus on individual needs in treatment and care as well as provide complete assessments and appropriate care plans to enable their safe and complete care management. Health professionals may use interprofessional teamwork and comprehensive geriatric assessments to understand the functional and cognitive statuses, comorbidities, nutritional status, treatment tolerance, and personal preferences of their patients and then provide care that meets their specific physical, mental, social and spiritual needs. In addition to having professional cancer care training, oncology care specialists should have professional knowledge of geriatric care to increase their sensitivity in assessing the needs of their elderly patients with cancer, provide treatment and care plans that meet their needs, and improve quality of care.</p>","PeriodicalId":35672,"journal":{"name":"Journal of Nursing","volume":"71 6","pages":"8-14"},"PeriodicalIF":0.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142773107","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[The Unique Challenges of Treating and Caring for Older Adult Patients With Cancer].","authors":"Yuan-Yuan Fang","doi":"10.6224/JN.202412_71(6).01","DOIUrl":"https://doi.org/10.6224/JN.202412_71(6).01","url":null,"abstract":"&lt;p&gt;&lt;p&gt;In older age, tissue degeneration, decreased cellular competition, and the declining efficiency of clearance mechanisms lead to higher rates of survival and accumulation for cells with adaptive mutations, which increase the risk of cancer cell development (Laconi et al., 2020). Thus, age is a significant risk factor for cancer. It is projected that by 2050, the global population aged 60 and above will rise to 2.1 billion, with those aged 80 and above expected to reach 426 million (World Health Organization, 2024). Taiwan, which became an aging society in 2018, is expected to be a nation in which older adults constitute 46.5% of the total population by 2070 (National Development Council, 2024). As the older adult population increases, the number of patients with cancer will also almost certainly continue to rise. Older adults respond differently to traditional cancer treatments than younger individuals, often experiencing declines in physical function, frailty, and cognitive impairment (Extermann, 2000). Moreover, older adult patients frequently have multiple chronic diseases (e.g., cardiovascular disease, diabetes, pulmonary, renal, liver diseases) that increase the complexity and risks associated with cancer treatment (Dale et al., 2012). They may also use over-the-counter medications or herbal supplements in addition to prescription drugs (Maggiore et al., 2010), which raises the risk of treatment toxicity and complications, presenting challenges for treatment decision-making. According to a survey by the National Cancer Institute, only 32% of patients with cancer participating in clinical trials were over 65 years old (Murthy et al., 2004). This may relate to the common exclusion of patients with comorbidities, physician attitudes, and/or the lower willingness of older adult patients to participate (Lewis et al., 2003). Thus, existing data may be insufficient to support the development of optimal treatment plans for older adult patients with cancer (Dale et al., 2012; Extermann, 2000). Age discrimination may lead to undertreatment or overtreatment, affecting patients' functional status and quality of life (Extermann, 2000; Hamaker et al., 2022). Currently, most oncology research relies on either the Eastern Cooperative Oncology Group performance status scale or Karnofsky Performance Scale to assess health status. However, neither adequately differentiates for the characteristics of older adult patients (Pal et al., 2010). In assessing quality of life in patients with cancer, the European Organization for Research and Treatment of Cancer Core Quality of Life Questionnaire or Medical Outcomes Study 36-item Short Form Health Survey is commonly used. However, these tools lack targeted assessments for cognitive function, activities of daily living, and autonomy (such as cooking, shopping, making phone calls, and managing finances), which are issues of particular concern in older adult patients (Terret et al., 2011). The American Society of Cl","PeriodicalId":35672,"journal":{"name":"Journal of Nursing","volume":"71 6","pages":"4-7"},"PeriodicalIF":0.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142773136","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Factors Affecting Loyalty in International Patients in Taiwan].","authors":"Hui-Chu Huang, Whei-Mei Shih, Ai-Hua Hsu, Lan Ni Pai, Cheng-Yen Chiang, Mei-Chu Tsai","doi":"10.6224/JN.202412_71(6).06","DOIUrl":"https://doi.org/10.6224/JN.202412_71(6).06","url":null,"abstract":"<p><strong>Background: </strong>After the Coronavirus disease 2019 (COVID-19) pandemic, international medical services have continued to flourish and reconfigure, leading to the current intense competition among medical institutions. Understanding loyalty in international patients and its related factors may be referenced and used to enhance loyalty among patients visiting a hospital, thereby enhancing the competitiveness of that medical institution.</p><p><strong>Purpose: </strong>This study was designed to explore the significant factors that influence the loyalty of international patients.</p><p><strong>Methods: </strong>The international medical services patient database of a northern medical center was used to extract information on patients who had received services from the international medical center between 2018 and 2022 (n = 3,325). Binary logistic regression analysis was used to calculate the increase in patient loyalty at each quartile, the estimated relative odds ratio (OR) of international patient loyalty, and its 95% confidence interval (CI). Potentially relevant factors controlled in the statistical model included: age, source of information from the unit, and total medical expenses.</p><p><strong>Results: </strong>This study found that the level of international medical service patient loyalty to the target hospital averaged approximately 15.1%. International medical service patient loyalty differed significantly by age group (45-64 years old), using non-internet sources for information, and spending at least 1 million NT dollars on medical expenses (p < .001). The information source used (OR: 1.72; p < .001; 95% CI [1.33, 2.23]) and total medical expenses (OR: 4.56; p < .001; 95% CI [3.49, 5.95]) were identified as significant predictors of loyalty.</p><p><strong>Conclusions / implications for practice: </strong>It is hoped the results of this study provide a reference for institutions to promote international medical services, improve international competitiveness, and demonstrate the quality of medical care provided in Taiwan.</p>","PeriodicalId":35672,"journal":{"name":"Journal of Nursing","volume":"71 6","pages":"38-46"},"PeriodicalIF":0.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142773114","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Family Caregivers' Burden in Taking Care of Older Cancer Patients at Home].","authors":"Chia-Tai Hung, Jui-Chun Chan, Szu-Ying Lee","doi":"10.6224/JN.202412_71(6).05","DOIUrl":"https://doi.org/10.6224/JN.202412_71(6).05","url":null,"abstract":"<p><p>The aging population in Taiwan increases the demand for care services for older adult patients with cancer, presenting significant challenges to both healthcare and social systems. Family caregivers perceive caregiver burden since they assist patients with daily activities, health management, and medical decision-making face physical, psychological, economic, and social stressors that impact their overall well-being. Taking care of older patients causes more complicated caregiving tasks because of the treatments and care related to cancer and multiple chronic conditions. Caregiver burden is known to be influenced by age, health, education, and disease awareness. Furthermore, in Taiwan, the participation of foreign spouses and migrant workers in family care increases cultural and resource-related challenges and highlights the need for integrated long-term care resources and social support. Using family caregiver assessments testing caregiver burden and quality of life can specify family caregiver needs that assist healthcare teams in developing family care plans. Interventions, including cancer education, psychological support, caregiving training, and collaborative models involving both patients and caregivers, may alleviate caregiver stress, improve quality of life, and enhance coping abilities. Moving forward, nursing professionals should advocate for integrated care models that incorporate comprehensive geriatric assessments and design interventions tailored to the specific needs of diverse family caregivers of older cancer patients. These approaches will help improve the quality of life for both caregivers and older cancer patients and foster a supportive care environment through interdisciplinary collaboration to address the health challenges of an aging society.</p>","PeriodicalId":35672,"journal":{"name":"Journal of Nursing","volume":"71 6","pages":"30-37"},"PeriodicalIF":0.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142773116","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Treatment Decision-Making in Elderly Cancer Patients: Principles, Challenges, and Evaluation Strategies].","authors":"Yun-Hsiang Lee, Chia-Li Siao, Mei-Chih Wu","doi":"10.6224/JN.202412_71(6).03","DOIUrl":"https://doi.org/10.6224/JN.202412_71(6).03","url":null,"abstract":"<p><p>The treatment decision-making process used by elderly cancer patients is crucial because, with advancing age, patients experience a decline in physical function and often face multiple comorbidities, reducing their tolerance to cancer treatments and increasing toxic reactions. Therefore, in considering multiple factors such as treatment effectiveness, quality of life, and survival time, the treatment of elderly cancer patients must take into account individualized factors and utilize relevant assessment tools to help minimize treatment-related risks. However, understanding and assessing treatment decisions by nursing staff regarding elderly patients are issues that have rarely been discussed. Thus, in this paper, the principled considerations, challenges, and evaluation strategies related to treatment decision-making in elderly cancer patients are discussed. It is hoped that this paper will assist future clinical healthcare professionals to fully utilize the roles and functions of nurses in the treatment decision-making process when caring for elderly cancer patients. The objectives are to enhance understanding of the considerations and challenges specific to this demographic and to implement relevant assessment content in order to better guide treatment decision-making processes and positively impact the decisions made.</p>","PeriodicalId":35672,"journal":{"name":"Journal of Nursing","volume":"71 6","pages":"15-21"},"PeriodicalIF":0.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142773138","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Caring Recommendations for Cancer-Related Cognitive Impairment in Older Patients With Cancer].","authors":"Shiow-Ching Shun","doi":"10.6224/JN.202412_71(6).04","DOIUrl":"https://doi.org/10.6224/JN.202412_71(6).04","url":null,"abstract":"<p><p>Increasing average life expectancy has been accompanied by a steady increase in the number of older patients with cancer. Notably, age-related declines in cognitive function are further exacerbated by cancer-related cognitive impairment in this patient population. Therefore, cancer-related cognitive impairment in older patients with cancer has attracted increasing attention, and care recommendations for this population are needed. The diverse factors affecting cognitive function present significant challenges for clinical healthcare providers and researchers caring for this population. In this article, the current status of cognitive dysfunction and its related factors in older patients with cancer are introduced and recommendations for clinical care and future research are discussed based on empirical evidence to provide appropriate clinical care and develop future interventions for older adults with cancer.</p>","PeriodicalId":35672,"journal":{"name":"Journal of Nursing","volume":"71 6","pages":"22-29"},"PeriodicalIF":0.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142773108","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Effects of Qigong on Cancer-Related Fatigue, Sleep Disturbance, Cognitive Impairment, and Quality of Life in Breast Cancer Survivors: A Systematic Literature Review and Meta-Analysis].","authors":"Ting-Wan Tan, Min-Fang Hsu, Yu-Chu Chung","doi":"10.6224/JN.202412_71(6).09","DOIUrl":"10.6224/JN.202412_71(6).09","url":null,"abstract":"<p><strong>Background: </strong>The National Comprehensive Cancer Network recommends qigong as an aerobic exercise for reducing cancer-related fatigue in breast cancer survivors. However, findings regarding the effects of qigong on cancer-related fatigue, sleep disturbance, cognitive impairment, and quality of life in this population remain inconclusive and contradictory. Further study is warranted to better understand the impact of this exercise.</p><p><strong>Purpose: </strong>The aim of this study was to assess the effects of qigong on cancer-related fatigue, sleep disturbance, cognitive impairment, and quality of life in breast cancer survivors using a systematic literature review and meta-analysis.</p><p><strong>Methods: </strong>The search of the literature was conducted in accordance with PRISMA 2020. The databases searched included PubMed, EMBASE, Cochrane Library, CINAHL, and Airiti Library, and relevant articles published between inception and March 2024 were retrieved systematically. The quality of the retrieved articles was assessed using the Risk of Bias 2.0 tool, and statistical analyses were performed using Comprehensive Meta-Analysis Version 2.0.</p><p><strong>Results: </strong>Eight randomized controlled trials with a total of 469 participants were analyzed. Qigong was shown to significantly reduce cancer-related fatigue (SMD = -0.86, 95% confidence interval, 95% CI [-1.24, -0.48], p < .001) and sleep disturbance (SMD = -1.03, 95% CI [-1.36, -0.69], p < .001) and to improve overall quality of life (SMD = 0.59, 95% CI [0.27, 0.92], p < .001).</p><p><strong>Conclusions / implications for practice: </strong>Qigong exercises that include specific \"moving meditation\" and \"dynamic posture\" components and are performed for session durations of 60 to 90 minutes with 3 to 5 sessions per week for a period of 8 to 12 weeks may reduce cancer-related fatigue and sleep disturbance in survivors of breast cancer. Furthermore, the overall effects of these improvements were shown to enhance survivor quality of life.</p>","PeriodicalId":35672,"journal":{"name":"Journal of Nursing","volume":"71 6","pages":"72-82"},"PeriodicalIF":0.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142773111","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Evidence-Based Knowledge Transition: An Integrative Nursing Experience With Chemotherapy-Induced Peripheral Neuropathy].","authors":"Tsui-Ju Chang, Li-Yu Chien","doi":"10.6224/JN.202412_71(6).13","DOIUrl":"https://doi.org/10.6224/JN.202412_71(6).13","url":null,"abstract":"<p><p>Chemotherapy-induced peripheral neuropathy (CIPN) is a common side effect of oxaliplatin in colorectal cancer patients that may impact both physical and mental well-being significantly. When Western medical care alone is unable to satisfy patient needs, integrative care combining traditional Chinese and Western medicine approaches is an alternative option. This article shares the integrative care experience of a post-operative rectal cancer patient who suffered from chemotherapy-induced peripheral neuropathy. An intervention that followed a holistic assessment approach in traditional Chinese medicine (TCM; i.e., observation, auscultation, inquiry, and pulse feeling) combined with listening and communication was conducted between April 11th and May 27th, 2022. The patient's health problems were identified as chronic pain syndrome, sleep disturbances, and death anxiety. During the caring process, evidence-based practices were applied, the scientific literature was systematically reviewed using an evidence-based approach, and an integrative care plan was developed in collaboration with the medical team. Exercise, acupuncture, aromatherapy massage, music, and auricular acupressure therapies were administered to reduce the severity of the patient's health problems. It is hoped that this experience combining evidence-based knowledge with integrative care offers a reference for providing alternative patient care in a broad range of clinical settings.</p>","PeriodicalId":35672,"journal":{"name":"Journal of Nursing","volume":"71 6","pages":"109-118"},"PeriodicalIF":0.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142773112","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Strategies for Promoting Timely Palliative Care in Outpatient Clinics].","authors":"Pei-Yu Lee, Kuei-Min Chen, Wei-Ting Lai, Hsiu-Hung Wang","doi":"10.6224/JN.202412_71(6).12","DOIUrl":"https://doi.org/10.6224/JN.202412_71(6).12","url":null,"abstract":"<p><p>With cancer now the leading cause of death, the importance of palliative care importance is increasingly evident. However, the focus of current policies is on inpatient and home-based care, which neglects the specialized needs of outpatients and results in many not receiving timely palliative care. Integrating palliative care into outpatient clinics using standardized referral criteria and automated systems will allow for timely patient selection and intervention, early symptom management, and psychological support as well as promote patient autonomy in treatment decision-making. Specialized oncology palliative care nurses play a crucial role in related assessment, care planning, and implementation activities. They help patients and families cope with disease progression and end-of-life care through education and support. Early outpatient palliative care benefits many patients and families, realizing a holistic and comprehensive care model.</p>","PeriodicalId":35672,"journal":{"name":"Journal of Nursing","volume":"71 6","pages":"102-108"},"PeriodicalIF":0.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142773120","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Resilience Among Patients With Chronic Mental Illnesses Residing in Halfway Houses].","authors":"Yu-Ling Hsiao, Su-Jung Huang, Ke-Hsin Chueh","doi":"10.6224/JN.202412_71(6).07","DOIUrl":"https://doi.org/10.6224/JN.202412_71(6).07","url":null,"abstract":"<p><strong>Background: </strong>Resilience, an increasingly important concept in the field of mental illness, refers to the active process by which individuals with mental illness positively adapt to adversity, facilitating their reintegration into society and return to the community. However, the recent pandemic has significantly impacted rehabilitation facility operations, affecting rehabilitation processes and personnel management. Thus, in the post-pandemic period, there is a need for empirical studies to revalidate the resilience of patients in halfway houses and the factors influencing it.</p><p><strong>Purpose: </strong>The aims of the study were to explore the resilience and important factors of influence in patients with schizophrenia residing in halfway houses.</p><p><strong>Methods: </strong>A cross-sectional survey design was employed, targeting individuals with schizophrenia residing in community rehabilitation homes in northern Taiwan. A convenience sampling method was used and 228 participants were enrolled. Research tools used in this study included measures of personal demographics, psychiatric symptoms, cognitive functions, attitudes towards medication, social support, and resilience.</p><p><strong>Results: </strong>The average resilience score was 21.87 (SD = 8.24), with 62.7% of the participants classified with low resilience. Resilience was found to correlate significantly with age group, educational level, ability to self-administer medication, participation in computer-based rehabilitation programs, cognitive functions, attitudes towards medication, and level of social support. However, the factors identified as statistically significant were limited to attitudes toward medication, ability to self-administer medication, and participation in computer-based rehabilitation programs.</p><p><strong>Conclusions / implications for practice: </strong>A majority of the participants, patients with schizophrenia residing in community rehabilitation homes, exhibited low resilience. This highlights the need for community mental health case managers and rehabilitation home nursing staff to work closely with these patients to enhance their resilience. Particular attention should be paid to patients' ability to self-administer medication, their attitudes toward medication, and their participation in computer-based rehabilitation programs.</p>","PeriodicalId":35672,"journal":{"name":"Journal of Nursing","volume":"71 6","pages":"47-58"},"PeriodicalIF":0.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142773118","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}