Next-Generation Testing for Cancer Risk: Perceptions, Experiences, and Needs Among Early Adopters in Community Healthcare Settings.

Background: Advances in next-generation sequencing (NGS) technologies are driving a shift from single-gene to multigene panel testing for clinical genetic cancer risk assessment (GCRA). This study explored perceptions, experiences, and challenges with NGS testing for GCRA among U.S.

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.

Effectiveness of an interdisciplinary palliative care intervention for family caregivers in lung cancer.

Background: Family caregivers (FCGs) experience significant deteriorations in quality of life while caring for patients with lung cancer. In this study, the authors tested the effectiveness of an interdisciplinary palliative care intervention for FCGs of patients diagnosed with stage I through IV nonsmall cell lung cancer.

Methods: FCGs who were identified by patients as their primary caregivers were enrolled in a prospective, quasi-experimental study in which the usual care group was accrued first followed by the intervention group.

Facilitating survivorship program development for health care providers and administrators.

Purpose: This manuscript will describe institutional changes observed through goal analysis that occurred following a multidisciplinary education project, aimed at preparing health care professionals to meet the needs of the growing numbers of cancer survivors.

Method: Postcourse evaluations consisted of quantitative questionnaires and follow-up on three goals created by each participating team, during the 3-day educational program. Evaluations were performed 6, 12, and 18 months postcourse for percent of goal achievement.

Feasibility of a palliative care intervention for cancer patients in Phase I clinical trials.

Background: Cancer patients with advanced disease who have exhausted most treatment options are often offered participation in Phase I clinical trials. To date, studies that assess the benefits of palliative care provided concurrently in Phase I clinical trial settings are lacking. The overall purpose of this study was to test the feasibility of a palliative care intervention administered concurrently to cancer patients receiving treatment in a Phase I clinical trial.

Family caregivers' distress levels related to quality of life, burden, and preparedness.

Objective: Family caregivers (FCGs) caring for loved ones with lung cancer are at risk for psychological distress and impaired quality of life (QOL). This study explores the relationship between FCGs' distress, per the distress thermometer (DT) and FCGs' QOL, burden, and preparedness. The purpose is to identify types of problems unique to FCGs in cancer care.

Interdisciplinary palliative care intervention in metastatic non-small-cell lung cancer.

Objective: Challenges and barriers continue to hinder the integration of palliative care models into comprehensive, ambulatory oncology care. This article aims to describe how symptoms, distress, and quality of life (QOL) data from the usual care phase of a National Cancer Institute-supported Program Project informed the development of an interdisciplinary, tailored palliative care intervention for patients with metastatic non-small-cell lung cancer (NSCLC).

Methods: Patients receiving usual care for metastatic NSCLC were recruited into this prospective longitudinal study over a 1-year period.

End-of-life care education in acute and critical care: the California ELNEC project.

Acute and critical care nurses care for an increasingly aging population in the last stages of life. Unfortunately, many of these nurses do not have adequate education to care for this population. The End-of-Life Nursing Education Consortium (ELNEC) developed a critical care course, and in 2007 the Archstone Foundation provided a grant to educate critical care nurses in California.

Impact of a bilingual education intervention on the quality of life of Latina breast cancer survivors.

Purpose/objectives: To test the effectiveness of a bilingual education intervention to improve the quality of life (QOL) of Latina breast cancer survivors (BCSs) after completing primary treatment for breast cancer.

Design: A two-group prospective, longitudinal, randomized, controlled trial.

Setting: An ambulatory-care setting of a designated comprehensive cancer center in southern California.

Longitudinal changes in function, symptom burden, and quality of life in patients with early-stage lung cancer.

Background: Emerging evidence supports the integration of palliative care concurrently with disease-focused care in patients with serious illnesses, such as lung cancer. This paper describes how longitudinal changes in physical function, symptom burden, and QOL of patients with early-stage non-small cell lung cancer (NSCLC) informed the development of an interdisciplinary, tailored palliative care intervention.

Methods: Patients with early stage (I-IIIB) NSCLC were accrued into the usual care phase (Phase 1) of an NCI-funded Program Project Grant.

Mindful movement program for older breast cancer survivors: a pilot study.

Background: Older breast cancer survivors (BCSs) are at risk for late and long-term treatment effects on quality of life (QOL), including lower physical functioning and fear of recurrence. Two promising approaches to address this include dance/movement therapy and mindfulness.

Objective: The purpose of this 2-group randomized controlled pilot feasibility study was to test short-term effects of a 12-week Mindful Movement Program (MMP) intervention combining mindfulness with self-directed movement on QOL and mindfulness in female BCSs 50 years or older and at 12 months or more following treatment.

Impact of web-based case conferencing on cancer genetics training outcomes for community-based clinicians.

Introduction: Technology and market forces are driving the demand for cancer risk assessment services in the community setting, where few clinicians are trained to order and interpret predictive genetic tests. City of Hope conducts a three-phase course in genetic cancer risk assessment (GCRA) for community-based clinicians, comprised of distance didactics, face-to-face workshops, and 12 months of professional development. As designed, the course cannot meet increasing demands for GCRA training.

Functional status and health-related quality of life among allogeneic transplant patients at hospital discharge: a comparison of sociodemographic, disease, and treatment characteristics.

Purpose: The purpose of this paper is to report the findings of a study of hematopoietic cell transplant patients, describing the needs of allogeneic transplant patients at the time of discharge in regard to their functional status, quality of life (QOL), and caregiver information and comparing these needs across a number of sociodemographic, disease, and treatment characteristics. The findings of this study are part of a larger mixed-methods study, representing one data time point of the larger study.

Methods: This paper will discuss the baseline data collected at the time of discharge for 282 allogeneic transplant patients, which include sociodemographic data combined with disease, treatment, functional status, and QOL data to present a comprehensive portrait of the transplant patient at discharge.

A qualitative analysis of cancer-related fatigue in ambulatory oncology.

The purpose of this study was to describe patients' perceptions of the causes, relief, related symptoms, meaning, and suffering secondary to cancer-related fatigue (CRF). In total, 252 patients with breast, lung, colon, and prostate cancers were enrolled in a quasiexperimental study to test the effects of a clinical intervention on reducing barriers to symptom management in ambulatory care. Analysis of data reported in this article was derived from the Piper Fatigue Scale-Revised.

Educating health care professionals to provide institutional changes in cancer survivorship care.

The Institute of Medicine (IOM) 2006 report, From Cancer Patient to Cancer Survivor: Lost in Transition (In M. Hewitt, S. Greenfield and E.

The enduring need for the pain resource nurse (PRN) training program.

Nurses play a pivotal role in pain management but academic nursing curricula remain lacking in basic pain management principles. The purpose of this study was to evaluate the long-term impact of the City of Hope Pain Resource Nurse (PRN) Training Course on nursing pain management practice. An online survey, comparing RNs' pre- and post-training practice, assessed the long-term impact of the course on content application and dissemination.

Quality of life and barriers to symptom management in colon cancer.

Purpose Of The Research: Pain and fatigue are recognized as critical symptoms that impact QOL for patients with colon cancer. Barriers to optimum pain and fatigue relief include patient-related beliefs and attitudes about the treatment of cancer-related symptoms. The overall objective of this paper was to describe quality of life (QOL) and barriers to pain and fatigue management in patients with colon cancer.

Personalized cancer genetics training for personalized medicine: improving community-based healthcare through a genetically literate workforce.

Purpose: To assess the impact of a multimodal interdisciplinary course on genetic cancer risk assessment and research collaboration for community-based clinicians. Clinicians are increasingly requested to conduct genetic cancer risk assessment, but many are inadequately prepared to provide these services.

Methods: A prospective analysis of 131 participants (48 physicians, 41 advanced-practice nurses, and 42 genetic counselors) from community settings across the United States.

Effectiveness of a clinical intervention to eliminate barriers to pain and fatigue management in oncology.

Background: Pain and fatigue are recognized as critical symptoms that impact quality of life (QOL) in cancer, particularly in palliative care settings. Barriers to pain and fatigue relief have been classified into three categories: patient, professional, and system barriers. The overall objective of this study was to test the effects of a clinical intervention on reducing barriers to pain and fatigue management in oncology.

Reducing patient barriers to pain and fatigue management.

Context: Pain and fatigue are recognized as critical symptoms that impact the quality of life of cancer patients. The barriers to pain and fatigue relief have been classified into three categories: patient, professional, and system barriers.

Objectives: The overall objective of this trial as to test the effects of the "Passport to Comfort" intervention on reducing barriers to pain and fatigue management for ambulatory care cancer patients.

An overview of the ACE Project-advocating for clinical excellence: transdisciplinary palliative care education.

Background: Excellence in palliative care demands attention to the multidimensional aspects of patient and family suffering, yet too few psycho-oncology professionals report adequate preparation in this vital area.

Methods: A total of 148 competitively selected psychologists, social workers, and spiritual care professionals participated in intensive educational courses to enhance their palliative care delivery, leadership, and advocacy skills. Extensive process and outcome evaluations measured the effectiveness of this educational program.

Influence of genetic discrimination perceptions and knowledge on cancer genetics referral practice among clinicians.

Purpose: To describe nongenetics clinicians' perceptions and knowledge of cancer genetics and laws prohibiting genetic discrimination, attitudes toward the use of cancer genetic testing, and referral practices.

Methods: Invitations to participate were sent to a random stratified sample of California Medical Association members and to all members of California Association of Nurse Practitioners and California Latino Medical Association. Responders in active practice were eligible and completed a 47-item survey.

Cancer-related fatigue: role of oncology nurses in translating National Comprehensive Cancer Network assessment guidelines into practice.

This article reviews the National Comprehensive Cancer Network's (NCCN's) guidelines for cancer-related fatigue (CRF) assessment and discusses many of the common barriers that hinder the translation of the CRF guidelines into practice settings. Current assessment and measurement scales validated in patients with cancer are highlighted, and case studies reflect the vital roles that oncology nurses can play in managing patients with CRF. Oncology nurses must remember to assess the "gang of 7" (i.

Impact of fever on outcome in patients with stroke and neurologic injury: a comprehensive meta-analysis.

Background And Purpose: Many studies associate fever with poor outcome in patients with neurological injury, but this relationship is blurred by divergence in populations and outcome measures. We sought to incorporate all recent scholarship addressing fever in brain-injured patients into a comprehensive meta-analysis to evaluate disparate clinical findings.

Methods: We conducted a Medline search for articles since January 1, 1995 (in English with abstracts, in humans) and hand searches of references in bibliographies and review articles.