Assessing Patient Perspectives and the Health Equity of a Digital Cancer Symptom Remote Monitoring and Management System.

Purpose: People with cancer experience poorly controlled symptoms that persist between treatment visits. Automated digital technology can remotely monitor and facilitate symptom management at home. Essential to digital interventions is patient engagement, user satisfaction, and intervention benefits that are distributed across patient populations so as not to perpetuate inequities.

Pairing automated exercise coaching with patient-reported symptom monitoring: A way to nudge exercise uptake during cancer treatment?

Introduction: Symptoms during cancer treatment cause burden, diminished physical functioning, and poor quality of life. Exercise is recommended during treatment to mitigate symptoms; however, interventions are difficult to translate into clinical care due to the lack of patient uptake and clinical implementation barriers. We evaluated the uptake, acceptability, and impact of an automated ePRO exercise module triggered by three patient-reported symptoms: nausea/vomiting, fatigue, and anxiety, during chemotherapy.

Feasibility and Usability of EnergyPoints: A Mobile Health App to Guide Acupressure Use for Cancer Symptom Management.

Objective: To examine the feasibility and usability of EnergyPoints™, an innovative mobile health app that teaches and guides people with cancer to implement daily acupressure to self-manage their fatigue and sleep disturbances.

Methods And Intervention: The study used an integrated agile, human-centered approach. Adults (age 18 years and over) with cancer experiencing at least moderate fatigue, and living in the Greater New York City community, were recruited from social media, patient advocacy groups, and referrals.

An Audio-Recorded Hypnosis Intervention for Chronic Pain Management in Cancer Survivors: A Randomized Controlled Pilot Study.

This pilot study evaluated the feasibility, acceptability, and potential efficacy of a 4-week hypnosis audio-recording intervention in cancer survivors with chronic pain. Forty participants were randomly assigned to treatment ( = 21) or wait-list ( = 19) conditions. Pain intensity ratings were lower at Week 4 for both groups.

Online social support for cancer caregivers: alignment between requests and offers on CaringBridge.

Objectives: Exploring CaringBridge, we describe types of social support caregivers requested, types of social support offered, and the alignment between the two.

Research Approach: A retrospective, longitudinal, descriptive approach.

Sample: Twenty public CaringBridge sites.

Cross-Cultural Translation of the nChinese Version of Pain Care Quality Surveys (C-PainCQ).

Health disparities in pain care continue to exist among non-English-speaking Chinese-Americans. The Pain Care Quality?© (PainCQ) surveys, a valid instrument measuring the quality of pain care from the patient's perspective, is available only in English currently. This study generated a Chinese version of the PainCQ (C-PainCQ) following a cross-cultural translation approach to address health equity in pain care.

Psychometric Properties of the Chinese Version of the Evidence-Based Practice Questionnaire for Nurses.

Background And Purpose: The Evidence-Based Practice Questionnaire (EBPQ-English) has been used in various populations. However, it has not been validated in the Chinese nursing population. This study aimed to translate EBPQ-English into Chinese and evaluate its psychometric properties.

Trajectories of Depressed Mood and Anxiety During Chemotherapy for Breast Cancer.

Background: Women are at risk of mood disturbance during treatment for breast cancer.

Objective: The aims of this study were to identify classes of women experiencing similar trajectories of depressed mood and anxiety while receiving chemotherapy for breast cancer and to determine associated antecedents and outcomes. The specific aims were to (1) determine the distinct trajectory classes associated with severity of depressed mood and anxiety reported by women undergoing cycles 2 and 3 of chemotherapy for breast cancer, (2) determine if class membership is associated with various antecedent variables, and (3) determine if class membership is associated with days of missed work and hours spent lying down.

Design and Evaluation of the Electronic Patient-Generated Index.

Background: The patient-generated index (PGI) is an individualized measure of health-related quality of life. Previous work testing the PGI in the oncology setting identified threats to content validity due to navigational and computational completion errors using the paper format.

Objective: The purpose of this pilot study was to refine and evaluate the usability and acceptability of an electronic PGI (ePGI) prototype in the outpatient radiation oncology setting.

Bundling Interventions to Enhance Pain Care Quality (BITE Pain) in Medical Surgical Patients.

Inadequate pain management and undertreatment remain a serious clinical issue among hospitalized adults, contributing to chronic pain syndromes and opioid dependency. Implementation of individual pain care interventions has been insufficient to improve pain care quality. The purpose of this interprofessional, patient-centered project was to implement a 6-component bundle of evidence-based pain management strategies to improve patients' perception of pain care quality and 24-hour pain experience outcomes.

Dissemination and Implementation of Patient-centered Indicators of Pain Care Quality and Outcomes.

Background: Previous approaches to measuring and improving nursing-sensitive, patient-centered metrics of pain quality and outcomes in hospitalized patients have been limited.

Methods: In this translational research study, we disseminated and implemented pain quality indicators in 1611 medical and/or surgical, step-down, rehabilitation, critical access, and obstetrical (postpartum) units from 326 US hospitals participating in the National Database of Nursing Quality Indicators. Eligible patients were English-speaking adults in pain.

Symptom Care at Home: A Comprehensive and Pragmatic PRO System Approach to Improve Cancer Symptom Care.

Introduction: There is growing recognition that systematically obtaining the patient's perspective on their health experience, using patient-reported outcomes (PRO), can be used to improve patient care in real time. Few PRO systems are designed to monitor and provide symptom management support between visits. Patients are instructed to contact providers between visits with their concerns, but they rarely do, leaving patients to cope with symptoms alone at home.

Symptom Trajectories Are Associated With Co-occurring Symptoms During Chemotherapy for Breast Cancer.

Context: Symptoms are reported to co-occur during treatment for breast cancer. We previously identified three patterns of fatigue and two patterns of disturbed sleep, depressed mood, and anxiety in women undergoing chemotherapy for breast cancer using a Latent Growth Mixture Model.

Objectives: The purpose of this study was to explore whether membership in symptom classes of fatigue, disturbed sleep, depressed mood, and anxiety is associated with other symptoms at moderate-to-severe levels.

Context Matters for Nurses Leading Pain Improvement in U.S. Hospitals.

Background: Pain continues to be a problem in hospitalized patients. Contextual factors contribute to the success of pain quality improvement efforts.

Aims: This paper describes nurse team leaders' perceptions of organizational context and factors perceived to help and hinder the process of leading a unit-based improvement effort focused on pain.

Chemotherapy-related neuropathic symptom management: a randomized trial of an automated symptom-monitoring system paired with nurse practitioner follow-up.

Purpose: The purpose of this study was to evaluate a new care model to reduce chemotherapy-induced neuropathic symptoms. Neuropathic symptom usual care was prospectively compared to an automated symptom-monitoring and coaching system, SymptomCare@Home (SCH), which included nurse practitioner follow-up triggered by moderate to severe symptoms.

Methods: Patients beginning chemotherapy were randomized to usual care (UC) or to the SCH intervention.

A Community-Based Approach to Assessing the Physical, Emotional, and Health Status of Hispanic Breast Cancer Survivors.

Introduction: Latina breast cancer survivors in the United States face disproportionate risk for poorer quality of life and physical health, as well as greater emotional distress.

Method: A cross-sectional survey was conducted to describe the physical, emotional, and general health status of 135 Latina breast cancer survivors served by a community-based program.

Results: Of the 135 surveys sent, 48 survivors responded.

Distinct Trajectories of Fatigue and Sleep Disturbance in Women Receiving Chemotherapy for Breast Cancer.

Purpose/objectives: To examine self-reported severity of fatigue and disturbed sleep experienced daily by women with breast cancer during multiple cycles of chemotherapy, exploring potential classes of women experiencing similar symptom trajectories.
.

Design: In a secondary analysis, classes of women experiencing similar patterns of fatigue and disturbed sleep were identified.

Magmatic evolution of a Cordilleran flare-up and its role in the creation of silicic crust.

The role of magmatic processes as a significant mechanism for the generation of voluminous silicic crust and the development of Cordilleran plateaus remains a lingering question in part because of the inherent difficulty in quantifying plutonic volumes. Despite this difficulty, a growing body of independently measured plutonic-to-volcanic ratios suggests the volume of plutonic material in the crust related to Cordilleran magmatic systems is much larger than is previously expected. To better examine the role of crustal magmatic processes and its relationship to erupted material in Cordilleran systems, we present a continuous high-resolution crustal seismic velocity model for an ~800 km section of the active South American Cordillera (Puna Plateau).

SymptomCare@Home: Developing an Integrated Symptom Monitoring and Management System for Outpatients Receiving Chemotherapy.

SymptomCare@Home, an integrated symptom monitoring and management system, was designed as part of randomized clinical trials to help patients with cancer who receive chemotherapy in ambulatory clinics and often experience significant symptoms at home. An iterative design process was informed by chronic disease management theory and features of assessment and clinical decision support systems used in other diseases. Key stakeholders participated in the design process: nurse scientists, clinical experts, bioinformatics experts, and computer programmers.

Recommendations to Support Nurses and Improve the Delivery of Oncology and Palliative Care in India.

Context: Nurses in India often practice in resource-constrained settings and care for cancer patients with high symptom burden yet receive little oncology or palliative care training.

Aim: The aim of this study is to explore challenges encountered by nurses in India and offer recommendations to improve the delivery of oncology and palliative care.

Methods: Qualitative ethnography.

Automated home monitoring and management of patient-reported symptoms during chemotherapy: results of the symptom care at home RCT.

Technology-aided remote interventions for poorly controlled symptoms may improve cancer symptom outcomes. In a randomized controlled trial, the efficacy of an automated symptom management system was tested to determine if it reduced chemotherapy-related symptoms. Prospectively, 358 patients beginning chemotherapy were randomized to the Symptom Care at Home (SCH) intervention (n = 180) or enhanced usual care (UC) (n = 178).

Surface uplift in the Central Andes driven by growth of the Altiplano Puna Magma Body.

The Altiplano-Puna Magma Body (APMB) in the Central Andes is the largest imaged magma reservoir on Earth, and is located within the second highest orogenic plateau on Earth, the Altiplano-Puna. Although the APMB is a first-order geologic feature similar to the Sierra Nevada batholith, its role in the surface uplift history of the Central Andes remains uncertain. Here we show that a long-wavelength topographic dome overlies the seismically measured extent of the APMB, and gravity data suggest that the uplift is isostatically compensated.

Addressing Disparities: The Alliance Breast Cancer Community-Based Program for Hispanic Women.

Background: The Alliance Breast Cancer (ABC) program is a community-based initiative developed and implemented to address the needs of Hispanic women faced with a cancer diagnosis or cancer survivorship issues.

Objectives: This article evaluates the effectiveness of a community effort to address breast cancer-related disparities among Hispanic women.

Methods: Nurse scientists collaborated with program staff to conduct a systematic five-year program evaluation.

Me & My Wishes: Lessons Learned From Prototyping Resident Centered Videos About Care Preferences.

Me & My Wishes are facilitated, resident-centered video-recorded conversations to communicate current and end-of-life care preferences. We describe the video production process of two prototypes in the long-term care (LTC) setting and discuss lessons learned around developing this type of intervention. Partnering with an LTC community allowed us to create videos on-site, document staff time, handle any barriers with video production, and evaluate the process.

The Association of Chemotherapy-Induced Peripheral Neuropathy Symptoms and the Risk of Falling.

Importance: Chemotherapy-induced peripheral neuropathy (CIPN) is a common adverse effect of neurotoxic chemotherapy resulting in pain, sensory loss, and decreased quality of life. Few studies have prospectively examined the relationship between sensory neuropathy symptoms, falls, and fall-related injuries for patients receiving neurotoxic chemotherapy.

Objective: To determine the association between the symptoms of CIPN and the risk of falls for patients receiving neurotoxic chemotherapy.