Translating Evidence-Based Self-Management Interventions Using a Stepped-Care Approach for Patients With Cancer and Their Caregivers: A Pilot Sequential Multiple Assignment Randomized Trial Design.

Background: Self-directed interventions are cost-effective for patients with cancer and their family caregivers, but barriers to use can compromise adherence and efficacy.

Aim: Pilot a Sequential Multiple Assignment Randomized Trial (SMART) to develop a time-varying dyadic self-management intervention that follows a stepped-care approach in providing different types of guidance to optimize the delivery of Coping-Together, a dyadic self-directed self-management intervention.

Methods: 48 patients with cancer and their caregivers were randomized in Stage 1 to: (a) Coping-Together (included a workbook and 6 booklets) or (b) Coping-Together + lay telephone guidance.

It is time to address fear of cancer recurrence in family caregivers: protocol for the feasibility and acceptability of a randomized pilot study of the online version of the Family Caregiver-Fear Of Recurrence Therapy (FC-FORT).

Background: Fear of cancer recurrence (FCR) is common, persistent, and is associated with lower quality of life, impaired functioning, and psychological distress in cancer patients. Studies suggest that family caregivers of cancer patients experience equal or greater levels of FCR than patients themselves. In the past 5 years, several interventions have demonstrated their ability to reduce FCR among cancer patients and in patient-caregiver dyads.

Design and implementation of a prototype radiotherapy menu in a patient portal.

Purpose: Radiotherapy patients often face undue anxiety due to misconceptions about radiation and their inability to visualize their upcoming treatments. Access to their personal treatment plans is one way in which pre-treatment anxiety may be reduced. But radiotherapy data are quite complex, requiring specialized software for display and necessitating personalized explanations for patients to understand them.

It's time to address fear of cancer recurrence in family caregivers: usability study of an virtual version of the Family Caregiver-Fear Of Recurrence Therapy (FC-FORT).

Background: Family caregivers of cancer survivors experience equal or greater levels of fear of cancer recurrence (FCR) than survivors themselves. Some interventions have demonstrated their ability to reduce FCR among cancer survivors and dyads (patient and caregivers). However, to date, no validated intervention exists to focus solely on family caregiver's FCR.

Adaptive web-based stress management programs among adults with a cardiovascular disease: A pilot Sequential Multiple Assignment Randomized Trial (SMART).

Objective: To assess the feasibility and acceptability of using a Sequential Multiple Assignment Randomized Trial (SMART) to optimize the delivery of a web-based, stress management intervention for patients with a cardiovascular disease (CVD).

Methods: 59 patients with a CVD and moderate stress were randomized to a self-directed web-based stress management program (n = 30) or the same intervention plus lay telephone coaching (n = 29). After 6 weeks, non-responders were re-randomized to continue with their initial intervention or switched to motivational interviewing (MI).

Chronic Illness Management in Culturally and Linguistically Diverse Patients: Exploring the Needs, Access, and Understanding of Information.

In Canada, people from culturally and linguistically diverse (CALD) backgrounds are at a greater risk of developing a chronic illness, and are more likely to experience adverse health effects and challenges in accessing high-quality care compared with Canadian-born individuals. This, in part, has been attributed to having inadequate access to information and resources needed to manage their illness(es). A qualitative descriptive design and inductive content analysis were used to explore the information needs of 24 CALD patients with chronic illnesses.

Exploring the Necessity of Routine Daily Chest X-rays for Mechanically Ventilated Patients in the Pediatric Intensive Care Unit: An Integrative Review.

Problem: In the PICU of a university teaching hospital, daily chest X-rays (CXR) are performed on all intubated and non-invasive ventilation-assisted patients, even when the patient is stable with no changes in clinical status. Inconsistent practice was identified with PICUs globally. This review aims to address the risk-benefit balance of clinical value, outcomes, cost, and radiation exposure when performing routine daily CXRs in the PICU.

The effect of culturally-adapted health education interventions among culturally and linguistically diverse (CALD) patients with a chronic illness: A meta-analysis and descriptive systematic review.

Objective: To review the effectiveness of health education interventions adapted for culturally and linguistically diverse (CALD) populations with a chronic illness.

Methods: A systematic review and meta-analysis were conducted. Eligible studies were identified across six databases.

Exploring Cancer Patients' Perceptions of Accessing and Experience with Using the Educational Material in the Opal Patient Portal.

Purpose: Opal is a new patient-centered mobile application that gives cancer patients access to their real time medical data in conjunction with disease- and treatment-specific patient education material. Few studies have focused on patients' experiences with such mobile applications. This study's objectives were to (1) explore cancer patients' perceptions of accessing the educational materials through Opal and (2) explore their experiences using these educational materials.

Does Hand Massage Have Sustained Effects on Pain Intensity and Pain-Related Interference in the Cardiac Surgery Critically Ill? A Randomized Controlled Trial.

Background: Despite the promising short-term pain relief effect of massage, little is known regarding its sustained effects on pain intensity and pain-related interference with functioning.

Aims: To evaluate the sustained effect of hand massage on the pain intensity and pain-related interference with functioning of cardiac surgery patients.

Design: A randomized controlled trial.

Developing education materials for caregivers of culturally and linguistically diverse patients: Insights from a qualitative analysis of caregivers' needs, access and understanding of information.

Objectives: To explore the information needs of caregivers of culturally and linguistically diverse (CALD) patients, and how they access and understand health information related to the management of their care person's chronic illness(es).

Background: Caregivers of CALD patients experience greater unmet needs compared to the general caregiver population. They experience many challenges in identifying resources and accessing formal supports to aid in self-management behaviours.

Effects of Massage in Reducing the Pain and Anxiety of the Cardiac Surgery Critically Ill-a Randomized Controlled Trial.

Objective: To evaluate the effectiveness of hand massage on the pain and anxiety of the cardiac surgery critically ill.

Design: A three-arm randomized controlled trial.

Setting: This study was conducted in a medical-surgical intensive care unit in Canada.

Experiences of Older Adult Trauma Patients Discharged Home From a Level I Trauma Center.

The number of patients 65 years and older has been rising steadily every year at our Level I trauma center. Our clinical experience demonstrated that once discharged, some of these patients were not managing well. Postdischarge portrait is difficult to ascertain because this information is not captured in the trauma registry database.

The Effectiveness of Hand Massage on Pain in Critically Ill Patients After Cardiac Surgery: A Randomized Controlled Trial Protocol.

Background: Postoperative pain is common in the intensive care unit despite the administration of analgesia. Some trials suggest that massage can be effective at reducing postoperative pain in acute care units; however, its effects on pain relief in the intensive care unit and when pain severity is highest remain unknown.

Objective: The objective is to evaluate the effectiveness of hand massage on the pain intensity (primary outcome), unpleasantness and interference, muscle tension, anxiety, and vital signs of critically ill patients after cardiac surgery.

Patient experiences of in-hospital preparations for follow-up care at home.

Aims And Objectives: To examine patient experiences of hospital-based discharge preparation for referral for follow-up home care services. To identify aspects of discharge preparation that will assist patients with their transition from hospital-based care to home-based follow-up care.

Background: To improve patients' transitions from hospital-based care to community-based home care, hospitals incorporate home care referral processes into discharge planning.

A psychosocial oncology program: perceptions of the telephone-triage assessment.

Purpose: Cancer can be a significant source of distress for patients and family members, which led to the creation of psychosocial oncology (PSO) programs across Canada. To access the PSO program at this institution, individuals are first triaged over the telephone by a clinical nurse specialist (CNS) who also provides psychosocial support during the call. In our study, we explored the perceptions of cancer patients or family members about their psychosocial telephone-triage assessment conducted by a CNS for a PSO program.

Reasons for returning to the emergency department following discharge from an internal medicine unit: perspectives of patients and the liaison nurse clinician.

Aims And Objectives: To understand the patients' reasons for returning to the emergency department soon after their discharge from an internal medicine unit and to compare these reasons with the liaison nurse clinician's risk assessment tools used for discharge planning.

Background: Returns to the emergency departments soon after discharge from the hospital are a recurrent problem. Factors precipitating readmission to hospital have been analysed through the lens of health care providers, but few studies have explored the patients' perspectives on their reasons for returning to the emergency departments.

Mental health care professionals' experiences with the discharge planning process and transitioning patients attending outpatient clinics into community care.

Background: Health care reform promotes delivery of mental health care in the community. Outpatient mental healthcare professionals (HCPs) are pressured to discharge patients. This study's purpose: to understand the experience and perceptions of mental HCPs with discharge planning and transitioning patients into community care.

An exploration of knowledge, attitudes and beliefs toward organ and tissue donation among the adult Haitian population living in the Greater Montreal area.

Background: The decision to donate organs and tissues has the potential to save and improve the quality of life of the transplant recipient. Previous studies suggest lack of information, fears, and prejudices have prevented some cultural minorities from participating in organ and tissue donation (OTD). There is scarce information about the views of those who might be approached for potential donation in the Haitian community.

The experience of uncertainty in young adults with cancer.

The purpose of this qualitative descriptive study was to describe the experience of uncertainty in young adults with cancer. A purposeful sample of 6 young adults between the ages of 19 and 30 years undergoing chemotherapy treatment was recruited. Participants were interviewed twice using semistructured interviews.

Taking aim at fall injury adverse events: best practices and organizational change.

Fall injuries represent a huge healthcare, social and financial burden to the Canadian population. In 2004, the McGill University Health Centre (MUHC) was awarded recognition as a National Spotlight Organization for Implementation of the Registered Nurses Association of Ontario Best Practice Guidelines (BPGs). That same year, the author and co-leader of the Best Practice Guideline Program began the CHSRF Executive Training in Research Application (EXTRA) Program with the goal of reducing falls injuries, one of the most common adverse events in the MUHC and in acute care in Canada.

Clarifying "meaning" in the context of cancer research: a systematic literature review.

Objectives: This article synthesizes the published literature related to the construct of meaning in the adult cancer population.

Methods: The databases CancerLit, CINAHL, Medline, PsychINFO, and the Journal of Psychosocial Oncology and PsychoOncology were searched to identify all studies related to meaning. The methodological aspects of all studies are described and the conceptual aspects are summarized only from those studies that met criteria for methodological rigor and validity of findings.

Meaning-making and psychological adjustment to cancer: development of an intervention and pilot results.

Purpose/objectives: To develop an intervention that uniquely addresses the existential impact of cancer through meaning-making coping strategies and to explore the intervention's impact on psychological adjustment.

Design: Descriptive, qualitative approach to develop the intervention; one-group pre- and post-test design to pilot test the intervention.

Setting: Patients' homes or ambulatory oncology clinics affiliated with a university health center in eastern Canada.

Meaning-making intervention during breast or colorectal cancer treatment improves self-esteem, optimism, and self-efficacy.

Existential issues often accompany a diagnosis of cancer and remain one aspect of psychosocial oncology care for which there is a need for focused, empirically tested interventions. This study examined the efficacy of a novel psychological intervention specifically designed to address existential issues through the use of meaning-making coping strategies on psychological adjustment to cancer. Eighty-two breast or colorectal cancer patients were randomly chosen to receive routine care (control group) or up to four sessions that explored the meaning of the emotional responses and cognitive appraisals of each individual's cancer experience within the context of past life events and future goals (experimental group).