Journal of the advanced practitioner in oncology最新文献

{"title":"Increasing Advance Care Planning Discussions and Documentation.","authors":"Allison K Mclendon, Annmarie L Walton, Mariah S Prince, Julie A Thompson, Thomas LeBlanc, Mary L Affronti","doi":"10.6004/jadpro.2025.16.7.7","DOIUrl":"https://doi.org/10.6004/jadpro.2025.16.7.7","url":null,"abstract":"<p><strong>Background: </strong>Advance care planning (ACP) is an important aspect of care for the oncology patient population, leading to improved outcomes, less aggressive care toward the end of life, and reduced costs.</p><p><strong>Purpose: </strong>The objective of this project was to increase ACP discussions and easily accessible documentation for patients with hematologic malignancies at increased risk of mortality based on a mortality prediction model. Additionally, the project aimed to avoid increasing perceived provider disruption to workflow.</p><p><strong>Methods: </strong>A validated mortality prediction model utilized objective patient data to predict inpatient mortality. Providers caring for at-risk patients were notified, asked to consider an ACP discussion, and instructed on consistent and easily accessible ACP documentation. Retrospective chart reviews evaluated whether ACP discussions were documented and whether they used the suggested bookend format. After 4 months, a provider education session reinforced the importance of ACP and included a demonstration of the documentation process. After another 4 months, chart reviews assessed ACP documentation rates. Rates were compared before and after education to determine the effectiveness of the implementation. A provider survey assessed perceived disruption to workflow.</p><p><strong>Results: </strong>Fifteen at-risk patients (eight before the education session and seven after the education session) were identified over 8 months. Three of eight patients (37.5%) had a documented ACP before the education session, and three of seven patients (42.9%) had a documented ACP discussion after the education session, which was not statistically significant. Most providers (83%) did not find the ACP implementation disruptive to workflow. Advance care planning documentation did not significantly increase after a provider education session, possibly due to low numbers of identified patients. However, 43% of at-risk patients after the education session had a documented ACP conversation, and most providers found bookends an efficient way to document ACP.</p><p><strong>Conclusion: </strong>The survey findings suggest that the project received provider buy-in and that continuing the bookend documentation expectation is reasonable.</p>","PeriodicalId":94110,"journal":{"name":"Journal of the advanced practitioner in oncology","volume":" ","pages":"1-7"},"PeriodicalIF":0.0,"publicationDate":"2025-03-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11982135/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144059459","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"An Overview of the Management of Electrolyte Emergencies and Imbalances in Cancer Patients.","authors":"Katherine Byar, Andrea Anderson","doi":"10.6004/jadpro.2025.16.7.9","DOIUrl":"https://doi.org/10.6004/jadpro.2025.16.7.9","url":null,"abstract":"<p><p>Electrolyte imbalances are common in patients with cancer. They may arise from tumor- or treatment-related factors or other causes. These imbalances can lead to life-threatening oncologic emergencies, such as tumor lysis syndrome, syndrome of inappropriate antidiuretic hormone secretion, and hypercalcemia of malignancy. Early recognition and management are crucial to prevent serious complications and improve patient outcomes. Advanced practice providers must be aware of the symptoms in order to incorporate preventive measures and manage these abnormalities appropriately. This article will review the current evidence-based literature on electrolyte abnormalities and emergencies associated with electrolytes in the care of oncology patients.</p>","PeriodicalId":94110,"journal":{"name":"Journal of the advanced practitioner in oncology","volume":" ","pages":"1-15"},"PeriodicalIF":0.0,"publicationDate":"2025-03-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11982136/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144061765","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"GISOAPP Onboarding Tool: Optimizing Onboarding for GI Surgical Oncology Advanced Practice Providers.","authors":"Lauren T Sullivan, S Blake Foley, Angela F Bazzell, Lydia T Madsen","doi":"10.6004/jadpro.2025.16.7.11","DOIUrl":"https://doi.org/10.6004/jadpro.2025.16.7.11","url":null,"abstract":"<p><p>Advanced practice providers (APPs) are key members of the gastrointestinal (GI) surgical oncology team. For newly hired APPs, a comprehensive onboarding program provides guidance to help improve the quality of care provided to patients, as well as APP job satisfaction and retention. There is currently limited information on the components of a structured onboarding program for APPs in GI surgical oncology. The GI surgical oncology APP team identified the need to develop a standardized process with established competencies, education, evaluation, and mentorship. The development of the GI Surgical Oncology APP Onboarding Tool (GISOAPP-OT) provides a comprehensive, 12-month onboarding process that can be adapted for any surgical specialty to standardize and augment training in a complex cancer care environment.</p>","PeriodicalId":94110,"journal":{"name":"Journal of the advanced practitioner in oncology","volume":" ","pages":"1-12"},"PeriodicalIF":0.0,"publicationDate":"2025-03-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11982137/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144050633","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparison of Quality of Life in Tongue Cancer Patients Following Various Glossectomy Reconstructive Techniques.","authors":"Crystal Lu, Ashley Martinez, Joyce Dains","doi":"10.6004/jadpro.2025.16.7.10","DOIUrl":"https://doi.org/10.6004/jadpro.2025.16.7.10","url":null,"abstract":"<p><p>Tongue cancer treatment often involves glossectomy and flap reconstruction. Since the tongue plays a vital role in swallowing, chewing, speaking, airway protection, and taste, it also plays a major role in the patient's quality of life (QOL) after reconstruction. Therefore, the flap that best preserves QOL should be determined. A literature review was conducted using PubMed, Scopus, and Ovid MEDLINE, with a total of 446 articles retrieved. Four studies were included in this integrative review, which all utilized the University of Washington Quality of Life questionnaire to assess QOL in tongue cancer patients post-glossectomy and flap reconstruction. The articles specifically compared radial forearm free flap to pectoralis major myocutaneous flap, submental island pedicled flap, anterolateral thigh flap, and lateral upper forearm flap. Based on the included articles, no flap significantly preserved QOL. However, a certain flap may be more suitable for a patient based on the patient's preferences, lifestyle, health status, and goals. Therefore, it is important for providers to complete a thorough history and assessment prior to surgery so that the flap chosen upholds the patient's goals and preserves overall QOL.</p>","PeriodicalId":94110,"journal":{"name":"Journal of the advanced practitioner in oncology","volume":" ","pages":"1-9"},"PeriodicalIF":0.0,"publicationDate":"2025-03-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11982138/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144016010","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Survivorship and Advance Care Planning in Cancer.","authors":"Beth Faiman","doi":"10.6004/jadpro.2025.16.2.1","DOIUrl":"https://doi.org/10.6004/jadpro.2025.16.2.1","url":null,"abstract":"","PeriodicalId":94110,"journal":{"name":"Journal of the advanced practitioner in oncology","volume":"16 2","pages":"49-50"},"PeriodicalIF":0.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11981882/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144061219","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Decreasing Pain Intensity in Adult Patients With Cancer Through Music Therapy: A Complementary Non-Pharmacological Approach.","authors":"Leighann B Montoya, Dorothie Durosier Mertilus","doi":"10.6004/jadpro.2025.16.2.2","DOIUrl":"https://doi.org/10.6004/jadpro.2025.16.2.2","url":null,"abstract":"<p><strong>Background: </strong>Adequate pain management continues to be an unmet need in patients with cancer. Pain is known to impact the quality of life. It is recommended that treatment plans include pharmacological and complementary non-pharmacological methods for managing pain. Music listening therapy is an evidence-based intervention used to manage acute and chronic pain in adult patients with cancer.</p><p><strong>Methods: </strong>This evidence-based practice project applied the use of music therapy in adult patients with cancer experiencing moderate to severe pain despite current pharmacological treatment in a rural outpatient oncology clinic. Pre- and post-intervention pain scores were assessed using a numeric rating scale, and results were analyzed using a Wilcoxon signed-rank test.</p><p><strong>Results: </strong>The results showed 83% of participants reported a reduction in pain intensity by at least one pain level after using music listening therapy. Additionally, 100% of participants expressed a willingness to continue music listening therapy at home as a self-guided technique to reduce pain severity.</p><p><strong>Conclusion: </strong>The role of the advanced practice provider must include comprehensive pain management and pain monitoring to assess its impact on patient quality of life. Patients are more willing to perform complementary interventions that have minimal barriers to physical, economic, and environmental factors, particularly in rural settings where the lack of additional health resources is significant. Music listening therapy may be conducted in any environment with known positive impacts on acute and chronic pain. Therefore, music listening therapy is a viable non-pharmacological complementary intervention that should be included in the education provided to our patients in their fight against cancer.</p>","PeriodicalId":94110,"journal":{"name":"Journal of the advanced practitioner in oncology","volume":"16 2","pages":"57-64"},"PeriodicalIF":0.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11981881/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144056874","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Digging into the Cause of Drug-Induced Thrombocytopenia: A Case Report.","authors":"Vivian A Pham, Christopher Selby","doi":"10.6004/jadpro.2025.16.2.3","DOIUrl":"https://doi.org/10.6004/jadpro.2025.16.2.3","url":null,"abstract":"<p><p>Thrombocytopenia can be caused by various etiologies, one of which is immune-mediated destruction. Within the realm of immune thrombocytopenia, there can be multiple pathways and mechanisms that lead to platelet destruction. Finding the exact mechanism can be a crucial diagnostic step in deciding the most appropriate treatment of the platelet loss and in the therapeutic planning of a patient's comorbidities, especially in patients with malignancies. In this case report, we describe a patient with metastatic clear cell renal cell carcinoma who developed acute thrombocytopenia while preparing to initiate therapy for his malignancy.</p>","PeriodicalId":94110,"journal":{"name":"Journal of the advanced practitioner in oncology","volume":"16 2","pages":"65-71"},"PeriodicalIF":0.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11981883/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144048474","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Psychosocial Impact of Ostomies in Women With Colorectal Cancer: An Integrative Review.","authors":"Cytauni Johnson, Ashley Martinez, Joyce Dains","doi":"10.6004/jadpro.2025.16.7.4","DOIUrl":"10.6004/jadpro.2025.16.7.4","url":null,"abstract":"<p><p>Colorectal cancer (CRC) is a significant cause of morbidity and mortality, with incidence on the rise, particularly in younger adults. Surgery is a key treatment modality and often results in the construction of an ostomy, either temporary or permanent. This integrative review discusses psychosocial implications of ostomies in women with CRC. A literature review was conducted using Cumulative Index to Nursing and Allied Health Literature (CINAHL), PsycINFO, and PubMed. The search included articles published between January 1, 2012, and December 31, 2022. The search yielded 684 articles, with a total of six included in the final review. Articles were excluded for not being specific to CRC, not being specific to ostomates, lacking data specific to women, and focusing solely on sexual health. The main issues that emerged were the loss of bodily control, impaired social support and acceptance, social limitations, altered body image, and alterations in sense of self. This review found that factors such as time since surgery, age, relationship status, and cultural background may influence the degree of psychosocial impact of ostomies in women with CRC. Given these factors are substantial and multifaceted, future research should be directed at identifying the subset of women with ostomies as a result of CRC with high-risk demographics.</p>","PeriodicalId":94110,"journal":{"name":"Journal of the advanced practitioner in oncology","volume":" ","pages":"1-11"},"PeriodicalIF":0.0,"publicationDate":"2025-01-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11840330/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143485120","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluating the Use of Recommended Screening and Preventive Practices for Adult Allogeneic Transplant Patient Survivors Performed by Advanced Practice Providers.","authors":"D'ana Brooks, Denise Bourassa, Joy Elwell, Julie Baker","doi":"10.6004/jadpro.2025.16.7.3","DOIUrl":"10.6004/jadpro.2025.16.7.3","url":null,"abstract":"<p><strong>Purpose: </strong>The purpose of this quality improvement project was to evaluate the use of a posttransplant screening care guidelines template performed by advanced practice providers (APPs) that included standards of care and published recommendations from the American Society for Transplantation and Cellular Therapy (ASTCT) for adult allogeneic transplant patient survivors.</p><p><strong>Methods: </strong>The theoretical framework used for this project was the Model for Improvement with the Plan-Do-Study-Act (PDSA) cycle process. A screening template was built to include institutional standards of care and recommendations from the ASTCT's guidelines within the electronic medical record system for APP use. Weekly chart reviews were performed for data extraction and assessment for APP documentation and completion of day +30 and day +100 posttransplant recommended screenings/testing. Data were documented and tracked utilizing Excel securely over a 3-month period.</p><p><strong>Results: </strong>The APPs performed and documented the recommended screenings for 64% of patients at day +30 and for 80% of patients at day +100. Opportunities for unit and system improvements were identified to increase performance, expand utilization, allow clinicians to recognize complications earlier, and potentially improve patient outcomes.</p><p><strong>Conclusion: </strong>This project addresses implications for APP care delivery and patient outcomes. Future project cycles' success will be ensured by utilizing the APP role at the maximum scope of practice.</p>","PeriodicalId":94110,"journal":{"name":"Journal of the advanced practitioner in oncology","volume":" ","pages":"1-8"},"PeriodicalIF":0.0,"publicationDate":"2025-01-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11840328/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143485118","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Reducing Distress in Caregivers of Patients Undergoing Hematopoietic Stem Cell Transplantation With Remotely Accessible Interventions: An Integrative Review.","authors":"Jessica Osburn, Ashley Martinez, Joyce Dains","doi":"10.6004/jadpro.2025.16.7.5","DOIUrl":"10.6004/jadpro.2025.16.7.5","url":null,"abstract":"<p><p>Hematopoietic stem cell transplantation (HSCT) is an intensive treatment requiring the support of a caregiver. This role is a highly demanding responsibility, and caregivers often face distress. In a world that has become highly technological, the aim of this integrative review is to determine the availability and impact of remote interventions in reducing distress in caregivers of HSCT patients. A literature review was conducted using PubMed and Scopus databases. The search included articles published between January 1, 2013, and February 20, 2023. The search yielded 699 unique articles, of which four were included in the final review. The four included studies of the impact of remote interventions on distress or burden in caregivers of adult HSCT patients. Two organizing themes emerged: availability and impact. Availability encompassed intervention accessibility and delivery type while impact considered caregiver quality of life (QOL), mental health, and perceived usefulness. These themes were evaluated in the articles via a variety of validated assessment tools and structured interviews. Ultimately, this integrative review suggests that while remote interventions for caregivers of patients undergoing HSCT are relatively limited, initial studies are perceived as useful and are promising in their potential to improve caregiver QOL and mental health and reduce distress.</p>","PeriodicalId":94110,"journal":{"name":"Journal of the advanced practitioner in oncology","volume":" ","pages":"1-10"},"PeriodicalIF":0.0,"publicationDate":"2025-01-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11840329/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143485122","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}