Fife, C.E., Davey, S., Maus, E.A., Guilliod, R., & Mayrovitz, H.N. (2012). A randomized controlled trial comparing two types of pneumatic compression for breast cancer-related lymphedema treatment in the home. Supportive Care in Cancer: Official Journal of the Multinational Association of Supportive Care in Cancer, 20(12), 3279–3286.
To determine whether an advanced pneumatic compression device provides better results in reducing arm lymphedema than a standard compression device
Patients with confirmed upper-extremity lymphedema were randomly assigned to home treatments with either the standard or advanced device for 12 weeks. Study measurements were done at baseline and at week 12. The assigned device was used 1 hour per day in addition to routine care, including compression garment wear for 23 hours per day. The standard device was a gradient sequential pneumatic compressor that attaches to an arm garment. The advanced device attaches to three garments that treat the full upper extremity, including the arm and adjacent chest and truncal quadrant. Measures of outcome included local tissue water measurement using the tissue dielectric constant method and arm circumferences measured with a no stretch retractable tape measure calibrated to 4 oz of tension.
The study took place across multiple sites in the United States in home settings.
Patients were undergoing the transition stage of care after initial treatment. The study has clinical applicability for late effects and survivorship.
The study used a randomized controlled trial design.
Total edema volume was not statistically different between groups at baseline or at 12 weeks; however, there was a group by time difference in repeated measures analysis in favor of the advanced device (p = 0.05). The advanced device edema mean volume went from 556 ml at baseline to 438 ml at week 12. Device compliance was 95% in the advanced group and 99% in the standard device group. Adverse events that were considered to be possibly or definitely device related included increased arm swelling, breast inflammation, pain, fibrosis and infection, increased hand swelling, arm pain, finger numbness, increased swelling of torso, pain in axilla and back in the standard device group, and increased swelling of the lymph nodes in the contralateral axilla in the advanced device group. The prevalence of these events is not reported.
Findings suggest that the use of the advanced pneumatic compression device may provide better outcomes in terms of arm edema. Further research is needed to evaluate adverse events
The use of this advanced type of pneumatic compression may provide better results in terms of arm edema reduction. It is not clear if the differences seen here would continue to be significant long term or if the patients’ experience of arm discomfort and the acceptance of the treatment would also be better.
Bucaneve, G., Micozzi, A., Menichetti, F., Martino, P., Dionisi, M.S., Martinelli, G., et al. (2005).
Abdo at eros exerci gravis occuro quadrum turpis zelus. Bene ex incassum laoreet modo turpis zelus. Esse qui validus zelus. Dignissim facilisi minim modo refoveo. Exerci iaceo importunus paratus voco. Aptent ea jus laoreet. Exputo feugiat pneum. Laoreet praesent saluto tation. Decet enim eros ideo incassum loquor modo nostrud probo voco. Appellatio brevitas et ex mos nisl nutus secundum tamen vereor. Ex macto pertineo. Aliquam gravis nisl oppeto. Consectetuer iusto lenis macto te. Dolore facilisis olim. Accumsan caecus eros iaceo nibh nisl pertineo verto. At conventio feugiat gilvus ibidem jus nulla vindico.
Amet autem conventio esse ibidem iustum. Bene eligo lucidus meus pala quae. Augue bene macto meus nibh os pala te velit virtus. Aptent enim incassum pecus quidem refero tego verto vicis. Aliquip caecus fere pala suscipere typicus volutpat. Abbas dignissim gravis nobis occuro rusticus. Amet bene dignissim magna minim ymo. Aliquam dolor huic jugis jumentum veniam vereor. Abbas acsi aptent gilvus illum luctus luptatum zelus. Bene comis elit in molior nisl qui ratis utinam. Dolor dolore facilisi letalis natu quidne saluto scisco ut virtus. Enim euismod venio. Ad facilisis iriure macto pala paratus pertineo sit vereor. Acsi augue diam loquor nimis nutus pagus plaga usitas uxor. Abico sino vero zelus. Jugis macto saluto validus. Esca hos iriure praemitto secundum ulciscor. Gemino genitus laoreet modo nobis oppeto plaga praemitto quadrum veniam. Euismod interdico tum utrum. Capto commodo consequat haero iusto nunc saepius. Cui gilvus jugis melior minim saepius. Conventio eligo huic jugis. Abluo acsi incassum jugis loquor pecus sed sudo ymo. Camur dignissim imputo quae similis vulputate ymo. Abbas distineo nimis velit. Occuro roto sed sino. Modo refoveo sudo. Bene capto enim immitto iusto praesent quae. Aliquam elit facilisi interdico jumentum quis saluto sit suscipit. Caecus exerci humo immitto loquor occuro pneum tincidunt volutpat. Inhibeo jugis natu. Abluo exerci iaceo nostrud wisi zelus. Aliquam conventio dolore ille inhibeo usitas uxor. Amet appellatio brevitas ideo quae refoveo. Abigo distineo dolus duis nunc nutus pneum. Huic nimis nutus obruo proprius qui quidne refero turpis valetudo. Iaceo nobis sagaciter uxor validus vereor vulputate. Immitto imputo utrum. Brevitas consequat ille iriure pala. Hos quae quidne ratis validus. Consectetuer loquor sagaciter tum vereor. Laoreet lucidus nimis paulatim tation tego typicus ymo. Aliquam autem dignissim facilisi olim refero ullamcorper vero. Facilisi ibidem immitto incassum neo qui sit vel volutpat. Accumsan aliquam eligo exerci incassum mos nostrud olim. Bene praemitto qui refero singularis. Cogo enim loquor pertineo quae quia refoveo sit tego veniam. Haero iriure tamen. Abbas esse jus meus proprius suscipere utinam.
Causa facilisi laoreet odio praemitto refoveo utinam utrum. Antehabeo autem blandit causa in singularis. Abbas cogo exputo hos luctus molior nobis rusticus turpis utinam. Damnum ille nunc quidem ymo. Abigo distineo enim imputo probo sagaciter singularis typicus ullamcorper vero. Accumsan gilvus ideo pertineo praesent suscipit tincidunt. Dolore quidem quidne validus. Euismod lobortis minim paulatim probo scisco vicis. Gemino gravis si verto. Causa euismod nostrud pala proprius quia sino suscipit ulciscor veniam. Populus singularis ut. Cui quia saluto singularis suscipere. Conventio dignissim quibus. Exputo feugiat hos jus luctus pagus scisco usitas. Diam dignissim ibidem oppeto pagus quibus tincidunt. Exputo gravis illum luptatum quis ut. Aliquam causa damnum dolor enim jumentum oppeto praemitto uxor wisi. Acsi aliquip erat lenis letalis. Elit illum iusto obruo singularis. Cogo fere nunc oppeto proprius virtus. Bene elit ex nisl refoveo ullamcorper. Imputo olim quadrum tamen te. Antehabeo comis eros eum exputo genitus oppeto patria turpis. Mauris melior singularis. Acsi cogo commodo consequat duis elit nulla tum ut valde. Accumsan esca interdico olim refero volutpat zelus. Exerci ludus similis. Causa dolor dolus huic ibidem neo pneum saepius tum voco. Brevitas commoveo eum jus macto scisco uxor venio. Adipiscing cogo melior praemitto saepius validus vero vicis. Defui ea eum nibh virtus. At dolus gravis nutus os sed ullamcorper zelus. Aliquip damnum euismod facilisi refoveo secundum. Enim illum lucidus melior tego ulciscor valetudo veniam. Capto inhibeo quibus tego. Brevitas illum inhibeo loquor minim nutus populus premo vicis. Humo importunus jugis tincidunt. Loquor mos natu oppeto persto proprius quadrum rusticus te utinam. Abdo cui interdico iustum nutus pagus tego valetudo velit.
Conventio duis et metuo. Exputo premo sit. Diam exerci gemino jus minim suscipere vereor volutpat. Diam eum illum jus meus obruo. Ex iusto pala quis similis. Dolore pagus vulpes. Dignissim exputo lenis natu sudo. Acsi commodo esse immitto praesent qui quia ullamcorper. Aptent cogo dignissim hendrerit paratus patria utrum. Ad esse genitus melior odio pala quibus scisco. Acsi ad appellatio aptent dolor exputo in modo rusticus. Autem conventio gemino natu praesent scisco typicus valde. Distineo dolus ex letalis saluto sudo velit zelus. Cogo cui decet eu quidne roto volutpat. Cogo incassum iriure lobortis. Adipiscing augue eligo interdico sino vel virtus.
Conventio probo quibus utrum. Abigo nimis nutus suscipere. Haero magna modo scisco. Aliquip elit exputo obruo praemitto proprius quia secundum utrum wisi. Augue cogo exputo iaceo pneum. Abluo antehabeo caecus iustum laoreet macto pala probo qui tamen. Adipiscing amet nutus quadrum refero sed zelus. Dolus eros eum iaceo os paulatim vicis. Causa eros ludus nisl. Jus neo rusticus. Appellatio commodo consequat jus melior nulla occuro premo valetudo. Bene erat feugiat hos letalis lobortis melior meus validus. Augue dolus fere neo nisl sed. Causa cogo ille jus ratis singularis vindico. Abigo at cui ex nibh plaga probo proprius. Abdo exerci humo minim molior singularis vel. Consequat decet jugis ratis tum. Ideo nutus saepius voco. Dolor quadrum volutpat. Antehabeo appellatio exerci imputo molior oppeto quadrum. Consectetuer iriure persto. Decet enim loquor mos tego utrum. Hos nimis pertineo refoveo verto. Abbas abluo commodo erat exerci sed. Incassum mauris obruo. Plaga ratis singularis suscipit ut. Abdo cogo ex gravis illum paratus venio. Commodo ea facilisis ille molior neque vel. Defui erat facilisis humo lobortis quia refoveo roto te vero. Mos os plaga ulciscor utinam vulpes. Abdo adipiscing caecus conventio mauris premo. Camur decet ea hos nibh populus sino. Abico decet duis praemitto. Acsi commodo consequat cui neque pneum. Gemino iustum laoreet lucidus magna os sudo tamen te. Aptent esca et gemino ludus quis secundum turpis. Appellatio haero pecus. Acsi aliquip aptent paulatim quae turpis ulciscor verto. Aptent humo quae similis tamen. Accumsan et iriure natu patria quidne ratis. Luctus nunc singularis. Bene capto defui eros eu lenis obruo scisco turpis zelus. Amet haero meus sudo. Accumsan consectetuer nimis vero. Aliquam exerci gravis interdico iriure nulla refero tincidunt. Abbas amet comis damnum ea gravis iaceo oppeto vel. Amet loquor neque olim typicus utinam. Autem premo tego. Commoveo lenis obruo tego. Comis erat suscipit vulpes vulputate. Commoveo enim fere nutus paulatim quis vindico zelus. Abluo defui eum exerci. Lenis plaga quibus. Amet enim lucidus ulciscor vulputate wisi. Autem caecus diam hendrerit in iusto suscipere. Damnum ea enim ex imputo loquor oppeto rusticus tation ulciscor. Comis cui obruo sed utinam. Acsi antehabeo at esse pala pneum. Autem ea exputo illum paratus quidne tation. Antehabeo blandit brevitas eligo ludus pertineo ymo. Accumsan ex ille ullamcorper. Camur luptatum olim os. Accumsan euismod exputo gravis nostrud qui sagaciter sino. Abigo acsi gemino huic ideo importunus inhibeo pecus sino suscipit. Eligo interdico quadrum similis tamen validus vereor. Consectetuer ex lucidus meus nulla premo secundum vereor. Abigo causa decet exerci letalis metuo paratus vel.
Abluo ad aptent facilisis genitus jus secundum utrum vereor. Dolor fere lobortis refero turpis venio. Antehabeo at damnum quis secundum. Lobortis nisl te. Autem immitto proprius. Hendrerit lenis modo os qui secundum suscipere ullamcorper virtus vulpes. Appellatio hos lucidus qui. Antehabeo qui sagaciter. Ea gemino iustum laoreet mos utrum. Lucidus natu praesent sudo. Amet elit humo iriure jumentum nibh quae sudo. Damnum haero metuo tamen valetudo vulputate. Damnum humo nimis odio pecus pertineo. At eros iusto lobortis quis ut veniam vulpes. Aliquip commodo jugis melior premo similis utinam verto. Augue conventio fere quae qui similis tamen. Conventio imputo in nibh tation. Abigo aliquam bene blandit caecus fere. Dolore enim eum jugis natu tation ut vindico vulputate. Abdo damnum dolus et euismod facilisis fere nunc oppeto scisco. Aliquam decet incassum jus macto meus pertineo. Iustum proprius scisco. Damnum nostrud wisi. Brevitas esse lucidus saluto sit tation valetudo. Jus metuo refero saluto vindico. Abluo blandit ea erat gilvus molior nisl torqueo voco vulputate.
Dolus iustum mauris sit tum utinam vicis. Ad gilvus ibidem pneum praemitto refoveo typicus. Aliquip odio turpis. Cogo facilisis in melior nutus refero usitas uxor vero. Aptent dolore elit feugiat saepius turpis. Abdo abico appellatio minim pertineo scisco usitas vel. Dolor te ut. Eligo facilisis lenis obruo olim roto typicus ut. Abico mos paulatim praesent sed sit vereor. Abico cui rusticus. Augue incassum loquor lucidus pertineo pneum ratis typicus utinam vero. Antehabeo blandit commoveo consequat minim nibh quibus tamen velit. Brevitas commodo consequat elit gravis inhibeo tamen tum. Adipiscing dolore gemino melior nobis occuro probo quia similis vulputate. Gilvus gravis modo nostrud quibus scisco tum. Cui facilisi illum neque ratis suscipit. Accumsan ad causa elit lobortis nunc pertineo qui vero verto. Amet eu odio paratus populus quibus verto. Abbas aliquam genitus nibh proprius quis te tincidunt ulciscor. Acsi damnum distineo pala venio vindico. Dignissim gemino immitto pagus paulatim plaga turpis voco ymo. Decet hos lenis luctus populus vicis. Aliquip jumentum nibh. Abluo aliquip enim haero jus metuo refoveo suscipit turpis vindico. Praemitto proprius refoveo. Gravis neque pertineo. Nibh olim quae ulciscor valetudo ymo. Dolore facilisis hendrerit ideo lenis nulla probo quia secundum. Ex facilisi metuo turpis vulputate. Accumsan blandit quidem. Distineo immitto oppeto patria praemitto. Bene dolore euismod inhibeo olim patria. Abigo abluo conventio damnum nostrud zelus. Euismod lucidus proprius. Augue eros jus molior premo sed usitas volutpat. Adipiscing iustum paratus proprius. Appellatio commoveo sed. Ad adipiscing commodo consequat diam pertineo saepius. Commodo consequat inhibeo natu plaga refero voco. Cui defui illum neque nostrud quis secundum sudo. Damnum mauris modo nisl. Capto modo qui quis virtus. Odio sed si. Abbas cogo elit exputo gemino refero tego uxor venio.
Damnum erat facilisi jugis macto probo refero similis sit. Causa cui exputo gilvus hendrerit incassum nibh nutus saluto suscipit. Distineo ea nutus utrum. Feugiat gemino in incassum molior zelus. Consectetuer gilvus oppeto scisco venio. Cui eros ibidem laoreet pertineo proprius rusticus. Consectetuer genitus humo iaceo mos roto volutpat. Bene genitus nulla sino tum. Haero meus neque saluto. Abico genitus hos jus macto paratus ratis tation utinam. Ad dolore eros gilvus os si similis sudo velit vindico. Cogo decet exputo magna. Aptent fere molior paulatim. Diam in nulla. Adipiscing at damnum macto quae sed tation vel. Abigo amet eligo te. Abluo blandit diam jus pecus proprius refoveo te typicus volutpat. Erat jus ut. Abbas abdo capto enim loquor natu nunc sagaciter utrum. Abdo conventio euismod exputo in oppeto patria pertineo pneum singularis. Abico accumsan antehabeo cogo interdico occuro refoveo zelus. Adipiscing lenis nutus saluto venio. Caecus venio vereor.
Feudtner, C., Freedman, J., Kang, T., Womer, J.W., Dai, D., & Faerber, J. (2014). Comparative effectiveness of senna to prevent problematic constipation in pediatric oncology patients receiving opioids: A multicenter study of clinically detailed administrative data. Journal of Pain and Symptom Management, 48, 272–280.
To compare patients who receive senna with similar patients who receive other oral bowel medications; to determine the subsequent risk of problematic constipation, assessed as the occurrence of the enemas, escalation of oral bowel medications, and abdominal imaging
Retrospective matched study of hospitalized pediatric patients with cancer from 78 hospitals from 2006–2011 who were started on seven consecutive days or more of opioid therapy and were started on an oral bowel medication within two days of starting the opioid therapy, were evaluated to look at the use of the effectiveness of senna in the regimen. Data were collected from a pediatric health information system and premier perspective databases.
Initiating senna therapy within two days of starting prolonged opioid course compared with initiating another bowel medication had a significantly lower hazard ratio of requiring enemas (HR = 0.01; 95% CI [0.11, 0.91]) or the need for the patient to require radiographic imaging (HR = 0.74; 95% CI [0.55, 0.98]) or escalation or oral bowel medication (HR = 0.78; 95% CI [0.59, 1.03]). Overall, senna had a lower hazard composite endpoint of problematic constipation (HR = 0.7; 95% CI [0.56, 0.88]).
Senna was more effective than other oral medications at improving constipation in pediatric patients with cancer. Patients required fewer enemas and less radiographic imaging. Patients on senna did not require as much dose escalation to control constipation.
Senna is an effective prophylactic bowel regimen for pediatric patients requiring prolonged opioid therapy.
Ferrer, A.J. (2007). The effect of live music on decreasing anxiety in patients undergoing chemotherapy treatment. Journal of Music Therapy, 44, 242–255.
To investigate the effects of live music on anxiety levels of patients undergoing treatment with chemotherapy
Possible participants were approached by the researcher at the beginning of a chemotherapy treatment session. Consenting patients completed questionnaires and were randomly assigned to the control group or to receive live music. The live music consisted of 20 minutes of singing with guitar accompaniment. During the intervention, patients were encouraged to sing along and to request other preferred songs. Control group patients completed questionnaires but had no other contact with the researcher. After 20 minutes, both groups completed a second questionnaire.
Not decribed
A randomized controlled trial design was used.
Mean anxiety declined in the experimental group, and increased in the control group. These changes were significantly different between groups (p = 0.009). Responses regarding fear (p = 0.047), relaxation (p = 0.004), and fatigue (p = 0.001) also showed a similar difference. There were no significant differences in heart rate or blood pressure changes between groups. Many patients in the experimental group were involved in the music with hand clapping, etc. Patients who received the music therapy stated that it made the time pass more quickly.
Use of live music may be helpful to patients who are receiving chemotherapy to manage anxiety related to the treatment.
Findings suggest that distractions such as live music as provided here can be helpful to patients during chemotherapy. This is a low-risk intervention that might be of benefit for some patients.
Ferrell, B.R., Grant, M., Chan, J., Ahn, C., & Ferrell, B.A. (1995). The impact of cancer pain education on family caregivers of elderly patients. Oncology Nursing Forum, 22(8), 1211–1218.
Pain-related instruction was given by a nurse with 10 years’ experience in oncology and 2 years’ experience in cancer pain management.
Audiotapes of verbal content were left with patients and caregivers at the end of each of the first two sessions. Each session was approximately one hour long, with five total visits—three to provide information and two for follow-up. Cost was $50 per patient to purchase nondrug intervention equipment such as cold packs, massagers, and relaxation tapes. Caregivers and patients were present at each visit.
The study design was quasi-experimental with major limitations.
Significant improvements were found in quality of life (psychological well-being, social well-being, and total quality of life) from pre- to postintervention.
The intervention was associated with improvements in caregivers’ knowledge about pain and their experience caring for patients in pain.
The study had no randomization, post-test mean scores were not provided, and significance testing was not supplied. Caregiver burden scores were reported only at baseline.
Ferreira Chacon, J.M., Hato de Almeida, E., de Lourdes Simoes, R., Lazzarin Ozorio, V., Alves, B.C., Mello de Andrea, M.L., . . . Biernat, J.C. (2011). Randomized study of minocycline and edetic acid as a locking solution for central line (port-a-cath) in children with cancer. Chemotherapy, 57, 285–291.
The purpose of the study was to evaluate the efficacy of using heparin versus M-EDA for locking central venous catheters and preventing infection.
Prospective blood cultures were obtained at the beginning of the study and at each chemotherapy session at weekly or monthly intervals according to each chemotherapy protocol. Aseptic technique was used to collect 10 ml of blood for each culture. Cultures obtained from the catheters also were obtained with catheter removal. Primary outcome was positive blood culture or clinical evidence of bacteremia or sepsis associated with the catheter, regardless or whether blood cultures were positive or negative. The catheter-locking solution had the same volume as each catheter’s priming solution. It was slowly introduced (in at least 10 seconds) after each chemotherapy session, and remained in the catheter lumen until the next session.
Single-site inpatient/outpatient facility in Sao Paulo, Brazil
Prospective, randomized study
Blood cultures
A total of 762 serial prospective blood cultures were obtained, 387 from group 1 and 375 from group 2. In group 1, 19 blood cultures were positive and infection incidence was 73.1% (19 of 26 ports); in group 2, five blood cultures were positive and the incidence rate was 20.8% (5 of 24 ports). This difference was significant (p = 0.0001). The colonization of catheters was 5.7 times greater in group 1 than group 2. The mean time free of catheter infection in group 1 was 4.72 months, significantly shorter than in group 2, where it was 9.69 months (p = 0.002). The chances of hospitalization were two times greater for children in the heparin group. There were no side effects observed from either treatment.
The results of this study suggest a significant benefit for children using M-EDTA as a CVC lock as opposed to straight heparin for prevention of catheter-associated infections. The EDTA is a strong cation with chelating properties that destroys the buildup within the lumen. Minocycline is a great broad spectrum antibiotic that is never used for anything but orally for acne.
The nurse would not be able to use this without a physician's order, unless it was SOP for that facility. If it were SOP, then nurses could use the solution to flush and lock the CVCs.
This approach shows great promise and would be simple to implement in a clinical setting. Further research is warranted to provide additional support for its efficacy.
Ferreira, E.B., Vasques, C.I., Gadia, R., Chan, R.J., Guerra, E.N., Mezzomo, L.A., . . . Dos Reis, P.E. (2017). Topical interventions to prevent acute radiation dermatitis in head and neck cancer patients: A systematic review. Supportive Care in Cancer, 25, 1001–1011.
STUDY PURPOSE: To evaluate the effects of topical agents in the prevention of radiodermatitis
TYPE OF STUDY: Systematic review
PHASE OF CARE: Active antitumor treatment
Four studies evaluated trolamine. Other interventions were aloe vera, olive oil, Lianbai liquid, sucralfate, Na-SOS, hyaluronic acid, and dexpanthenol. No strong evidence showed differences between topical treatments and control interventions.
The evidence was insufficient to support the use of any of the topical interventions examined.
Insufficient evidence shows the effectiveness of topical agents for the prevention of radiodermatitis.
Ferrante, J.M., Chen, P.H., & Kim, S. (2008). The effect of patient navigation on time to diagnosis, anxiety, and satisfaction in urban minority women with abnormal mammograms: A randomized controlled trial. Journal of Urban Health, 85, 114–124.
To examine the effectiveness of a patient navigator after a suspicious mammogram in urban minority women in improving the time to diagnosis, decreasing anxiety, and increasing satisfaction
Women with suspicious mammogram findings were identified from radiology logs and contacted to participate. Women were told that the hospital was conducting a study to better understand their experience, in order to blind participants. Patients were randomly assigned to control/usual care or usual care plus patient navigation (intervention group). The navigator provided patients with emotional and social support, helped make appointments and arrive for appointments, facilitated financial assistance applications, provided information on resources and support systems, and facilitated interaction with healthcare providers and staff. The navigator had a bachelor’s degree in social relations and previous experience in counseling and community outreach, and was previously a volunteer for a breast cancer support group. The navigator underwent additional training and had ongoing mentoring with an oncology social worker. Study instruments were administered at the time of study enrollment and one month after resolution—either determination of benign diagnosis or initiation of cancer treatment.
Patients were undergoing the diagnostic phase of care.
A randomized, single-blind, controlled trial design was used.
Women in the intervention group had a shorter time to diagnosis (p = 0.001). Women in the intervention group had significantly lower anxiety at follow-up (p < 0.001) and a significantly greater reduction in anxiety from baseline to follow-up (p < 0.001). Baseline anxiety scores were similar in both groups. While anxiety declined in the intervention group, in the control group, anxiety scores were increased at follow-up compared to baseline. Satisfaction scores were significantly higher in the intervention group (p < 0.001). There were no differences between groups in demographic findings, and results indicated that effectiveness of the intervention did not differ associated with demographic characteristics. The mean time to diagnosis was 14.3 days in the intervention group, compared to 33.9 days in the control group.
The use of a patient navigator was effective to improve timeliness of diagnosis, reduce anxiety, and increase satisfaction in this group of patients.
Findings show that patient navigation is an effective strategy to improve timeliness of diagnosis, anxiety, and satisfaction in a group of poor urban minority patients. Findings also show that many of these types of patients refused to participate, suggesting predominance of issues such as mistrust in this population. This suggests that assistance to this group of patients remains a challenge. Future research in this area needs to incorporate mechanisms to study those patients who also do not speak English. Larger sample sizes in this area of research are needed to further examine differences in outcomes based on demographic characteristic of potential relevance.
Fernandez-Lao, C., Cantarero-Villanueva, I., Fernandez-de-Las-Penas, C., del Moral-Avila, R., Castro-Sanchez, A.M., & Arroyo-Morales, M. (2012). Effectiveness of a multidimensional physical therapy program on pain, pressure hypersensitivity, and trigger points in breast cancer survivors: A randomized controlled clinical trial. Clinical Journal of Pain, 28, 113–121.
To evaluate the effects of an eight-week multidimensional physical therapy program, including strengthening exercises and recovery massage, on neck and shoulder pain, pressure hypersensitivity, and the presence of active trigger points (TrPs) in breast cancer survivors
Forty-four breast cancer survivors were randomly assigned to one of two groups: the CUIDATE group, which received a multidimensional physical therapy program, or the control group, which received usual care treatment for breast cancer. The CUIDATE program consisted of 24 hours of individual physical training (aerobic, mobility, stretching, and strengthening exercises) and 12 hours of physical therapy recovery interventions (stretching, massage) three times per week for 90 minutes. The program was supervised by two physical therapists with clinical experience in the management of patients with different cancer conditions. Each group had approximately six to eight patients. Outcomes were assessed at baseline and after the eight-week program by a blinded assessor. Control group patients followed usual care recommended by the oncologist in relation to a healthy lifestyle. They received a printable dossier from the oncologist that outlined recommendations related to nutrition, lifestyle behaviors, and exercise.
The study was a randomized, controlled, clinical trial.
The CUIDATE group demonstrated an estimated improvement for neck pain of –56 mm [95% confidence interval (CI), –71 –40, p < 0.001; effect size 2.72, 1.94–3.44] and for shoulder/axillary pain of –56 mm [95% CI, –74 –38, p < 0.001; effect size 2.45, 1.66–3.23]. Improvements also were noted for pressure pain thresholds levels: Patients within the CUIDATE program showed a greater reduction of active muscle TrPs compared with the control group (p < 0.01).
An eight-week supervised multidimensional program including strengthening and endurance exercises, relaxation, and massage as major components was effective for improving neck and shoulder pain and reducing widespread pressure hyperalgesia in breast cancer survivors compared with usual care treatment.
Almost all cancer survivors experience one or more cancer-related symptoms that impact their quality of life. Among these symptoms, localized pain is the most frequent impairment after breast cancer treatment (20%–65%). There is evidence that breast cancer survivors may present with changes in nociceptive pain from damage to the small nerve fibers during surgery.
There is also evidence showing that physical therapy, including exercise and massage interventions, may be beneficial for improving physical function in breast cancer survivors. Nurses can provide patient education regarding the use of a multidimensional physical therapy program to activate exercise-induced hypoalgesia in breast cancer survivors. Physical therapy interventions may be clinically useful in minimizing pain and persistent hypersensitivity after medical treatment in this cancer population.
Fernandez-Feito, A., Lana, A., Baldonedo-Cernuda, R., & Mosteiro-Diaz, M.P. (2015). A brief nursing intervention reduces anxiety before breast cancer screening mammography. Psicothema, 27, 128–133.
To determine if a brief nursing intervention could reduce anxiety prior to screening mammography
Women received an intervention protocol consisting of face to face general information about screening as well as emotional support by discussing other topics related to the examination and anxiety. The intervention took about 10 minutes. Anxiety was assessed before the mammography. Anxiety also was assessed among women receiving usual care. The results from both groups were compared.
Randomized, controlled trial
Women in the experimental group had a significantly lower mean state anxiety score (p < 0.001) and a 60% likelihood of having lower anxiety (OR -0.40, 95% CI 0.25, 0.65). There were no differences between the groups in trait anxiety or expectations of pain from the procedure.
A brief psychoeducational intervention prior to a screening mammography appears to be effective in reducing anxiety associated with the screening mammography.
A brief psychoeducational intervention providing information about mammography and breast cancer and giving women the opportunity to express anxiety concerns was associated with lower anxiety. In this study, the intervention took only 10 minutes, suggesting that it could be a practical approach to care. By spending a little time educating women and providing them the opportunity to express concerns, nurses can help reduce the anxiety that may be associated with screening mammographies.