Spirituality in Patients With Cancer: A Synthesis of a Program of Research.

Background: Spiritual care is a key domain of quality palliative care as defined by national palliative care guidelines.

Aims: The aim of this project was to synthesize data and research experience by the authors over 30 years related to spirituality in patients with cancer. The research objectives for this analysis were to: Describe spirituality in patients with cancer.

Research Synthesis Related to Oncology Family Caregiver Spirituality in Palliative Care.

Family caregivers are central to the delivery of serious illness care and also have needs related to their role and experience. One aspect of the family caregiver quality of life (QOL) that has received less attention is caregiver spirituality. The research objectives for this analysis were (1) Describe spirituality in oncology family caregivers.

Care Processes and Quality-of-Life Outcomes Affecting the Gynecologic Cancer Survivorship Experience.

Purpose: To describe and assess physical and psychosocial concerns and care processes related to cancer and treatment in gynecologic cancer survivors.

Participants & Setting: 44 survivors of gynecologic cancer at City of Hope National Medical Center in southern California were enrolled.

Methodologic Approach: A descriptive mixed-methods approach was used.

Palliative Care in the New Era of Lung Cancer Treatment.

Lung cancer remains the most common malignancy and is recognized as having significant impact on quality of life. Advances in lung cancer treatment over the past decade have been significant, with new agents extending life, even in late-stage disease. The purpose of this study was to evaluate palliative care needs and use of supportive care services in a randomly selected sample (N = 99) of patients with lung cancer.

Evaluation of Bebtelovimab for Treatment of Covid-19 During the SARS-CoV-2 Omicron Variant Era.

Background: Monoclonal antibody (mAb) treatment is associated with decreased risk of hospitalization and death in high-risk outpatients with mild to moderate coronavirus disease 2019 (COVID-19) caused by early severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) variants. Bebtelovimab exhibits in vitro activity against the Omicron variant and its sublineages; however, clinical data are lacking.

Methods: A retrospective cohort study was conducted comparing bebtelovimab-treated patients with propensity score-adjusted and matched nontreated control groups.

Family Caregiver Preparedness: Developing an Educational Intervention for Symptom Management.

Background: Family caregivers provide complex care for patients with cancer, including management of multiple symptoms associated with the disease and its treatment.

Objectives: The objective of this pilot project was to develop and conduct feasibility testing of a family caregiver educational intervention for symptom management.

Methods: The intervention was conducted with 23 family caregivers of patients with lung or gynecologic cancer to evaluate feasibility testing and assessment of caregiver preparedness, quality of life, and psychological distress at baseline and three and seven weeks postintervention.

Implementing quality improvement efforts in spiritual care: outcomes from the interprofessional spiritual care education curriculum.

The Interprofessional Spiritual Care Curriculum (ISPEC) was created to train interdisciplinary health care teams to recognize and address the spiritual needs of seriously or chronically ill patients. The curriculum, in a train-the-trainer format, employs didactic presentations, discussions, lab sessions, skill demonstrations, and video clips. In course applications, participants were required to submit goals to achieve and demonstrate institutional support.

A nurse-led intervention for fear of cancer progression in advanced cancer: A pilot feasibility study.

Purpose: To assess the feasibility, acceptability, and preliminary effects of a nurse-led intervention for managing fear of cancer progression in advanced cancer patients.

Methods: A single group mixed methods study was conducted in patients with stage III or IV gynecologic or lung cancer (n = 31) with dysfunctional levels of fear of progression or distress. The intervention consisted of seven videoconferencing sessions with skills practice.

Fear of Cancer Progression: Findings From Case Studies and a Nurse-Led Intervention.

Background: Fear of cancer recurrence or progression (FOP) is a significant concern for cancer survivors. With the advent of new targeted therapies and immunotherapy, many patients with advanced cancer are living longer while dealing with uncertainty and fears related to cancer progression. Although some level of FOP is normal and adaptive, high levels adversely affect quality of life and healthcare costs.

Integrating Palliative Care for Patients on Clinical Trials: Opportunities for Oncology Nurses.

The purpose of this article is to describe the lessons learned in the course of a 5-year research study on a palliative care intervention for persons on a Phase 1 clinical trial. Patients who are participating in Phase 1 trials and the families who care for them may be especially vulnerable and require special attention. The patients are generally experiencing the effects of advanced disease, and they also may soon experience unknown side effects, intense treatment regimens, and the emotional stress of an uncertain future as a result of clinical trial participation.

Spirituality in cancer patients on phase 1 clinical trials.

Objectives: Patients with cancer who are at a transition to Phase I investigational treatments have been identified as an underserved population with regard to palliative care. This disease transition is often accompanied by spiritual and existential concerns. The study objective was to conduct a secondary analysis of data from a larger study testing a palliative care intervention.

Clinical Trials: Understanding Patient Perspectives and Beliefs About Treatment.

Background: Understanding the experiences of patients with solid tumors who are in phase 1 clinical trials can help nurses to provide optimal care.

Objectives: The purpose of this article is to describe patient perspectives of participating in a phase 1 trial and understanding their disease status and treatment options. In addition, the authors describe the impact of the disease and clinical trial participation on quality of life.

A Support Intervention for Family Caregivers of Advanced Cancer Patients.

Family caregivers are the primary providers of care. Education and support are needed to prepare them for the complex physical, psychological, social, and spiritual effects of cancer. This randomized clinical trial tested a palliative care intervention with 240 family caregivers, focusing on family caregivers who reported financial strain from cancer and treatment.

Pain and Suffering.

Objective: To review literature on the relationship of pain, spirituality, and suffering as it relates to the patient with cancer who is experiencing pain.

Data Sources: Peer-reviewed articles, textbooks, internet.

Conclusion: Pain and suffering are distinct and yet closely related in patients with cancer.

Translation and Evaluation of a Lung Cancer, Palliative Care Intervention for Community Practice.

Context: A notable gap in the evidence base for palliative care (PC) for cancer is that most trials were conducted in specialized centers with limited translation and further evaluation in "real-world" settings. Health systems are desperate for guidance on effective, scalable models.

Objectives: The objective of this study was to determine the effects of a nurse-led PC intervention for patients with non-small-cell lung cancer and their family caregivers (FCGs) in a community-based setting.

Family Caregivers: A Qualitative Study to Better Understand the Quality-of-Life Concerns and Needs of This Population.

Background: While providing physical, psychological, and spiritual care to their loved ones with cancer, family caregivers (FCGs) are physically and emotionally vulnerable to the tolls of caregiving. Patients and FCGs experience the uncertainty that comes with illness and treatment, its side effects, the lack of control, the emotional upheaval, the spiritual doubt, and the helplessness of advancing disease.

Objectives: This study was conducted to better understand the quality-of-life needs of the FCG population, particularly those who encounter financial strain related to patients' cancer and treatment.

Understanding Family Caregiver Communication to Provide Family-Centered Cancer Care.

Objectives: To describe a family caregiver communication typology and demonstrate identifiable communication challenges among four caregiver types: Manager, Carrier, Partner, and Lone.

Data Sources: Case studies based on interviews with oncology family caregivers.

Conclusion: Each caregiver type demonstrates unique communication challenges that can be identified.

Integration of a Palliative Care Intervention into Community Practice for Lung Cancer: A Study Protocol and Lessons Learned with Implementation.

Background: A notable gap in the evidence base for outpatient palliative care (PC) for cancer is that most trials were conducted in specialized oncology or academic centers with limited translation and further evaluation in "real-world" settings. Health systems are desperate for guidance regarding the most effective and sustainable PC service models.

Objective: Describe the study protocol to evaluate the dissemination of a previously tested nurse-led PC intervention (PCI) for patients with lung cancer and their family caregiver in community-based settings, lessons learned in adapting and implementing the PCI, and implications for future dissemination-translational efforts Design: Two-group, prospective sequential, quasi-experimental design with Phase 1 (Usual care) followed by Phase 2 (Intervention) setting/subjects.

Cancer Communication and Family Caregiver Quality of Life.

Family caregivers have enormous communication responsibilities tied to caregiving, such as sharing the patient's medical history with providers, relaying diagnosis and prognosis to other family members, and making decisions about care with the patient. While caregiver stress and burden has been widely documented in the caregiving literature, little is known about how communication burden, real or perceived communication challenges, impacts caregiver quality of life. In family caregiving, the City of Hope (COH) Quality of Life model proposes that the caregiving experience is reciprocal to the patient experience, impacting physical, social, psychological, and spiritual quality of life.

Support for Patients and Family Caregivers in Lung Cancer: Educational Components of an Interdisciplinary Palliative Care Intervention.

Consistent with the recommendations of the Institute of Medicine Report on quality cancer care, attention to symptom management and quality of life concerns of patients with lung cancer should be addressed throughout the disease trajectory. As part of a NCI-funded Program Project grant, this paper reports on the patient and family caregiver education component of a nurse-lead, tailored palliative care intervention for patients with early (I-III, n=130) and late (IV, n=142) stage lung cancer. Patients and family caregivers received 4 separate educational sessions organized around the Quality of Life model domains (physical, psychological, social, and spiritual well-being).

Palliative care and spiritual well-being in lung cancer patients and family caregivers.

Background: Spiritual well-being is an important dimension of quality of life (QOL) and is a core component of quality oncology and palliative care. In this analysis, we aimed to describe spiritual well-being outcomes in a National Cancer Institute (NCI)-supported Program Project that tested the effectiveness of an interdisciplinary palliative care intervention in lung cancer patients and their family caregivers (FCGs).

Methods: Patients undergoing treatments for NSCLC and their FCGs were enrolled in a prospective, quasi-experimental study.

Spiritual Assessment in a Patient With Lung Cancer.

CASE STUDY  Mr. G., an 82-year-old retired European man, was diagnosed with stage 4 non-small cell lung cancer (NSCLC) and recently enrolled on a phase II clinical trial.

Interdisciplinary Palliative Care for Patients With Lung Cancer.

Context: Palliative care, including symptom management and attention to quality of life (QOL) concerns, should be addressed throughout the trajectory of a serious illness such as lung cancer.

Objectives: This study tested the effectiveness of an interdisciplinary palliative care intervention for patients with Stage I-IV non-small cell lung cancer (NSCLC).

Methods: Patients undergoing treatments for NSCLC were enrolled in a prospective, quasi-experimental study whereby the usual care group was accrued first followed by the intervention group.

Direct optimization of signal-to-noise ratio of CPMG-like sequences in inhomogeneous fields.

The performance of the standard CPMG sequence in inhomogeneous fields can be improved with the use of broadband excitation and refocusing pulses. In previous work we have developed short composite broadband refocusing pulses together with practical excitation pulses to realize such performance gains, and quantified them using the ratio of signal to noise power (SNR). In this work we systematically explore the performance of refocusing pulses as a function of the overall pulse length up to ten times the length of the regular 180° pulse.