Gail Abernethy

Effectiveness and Acceptability of a Moisturizing Cream and a Barrier Cream During Radiation Therapy for Breast Cancer in the Tropics: A Randomized Controlled Trial.

Background: Inconsistent evidence about product effectiveness to prevent moist desquamation during radiation treatment and minimal research about the acceptability to patients of recommended products prompted this study. Objective: This randomized controlled trial compared the effectiveness of 2 creams at minimizing the incidence of moist desquamation in a tropical setting and explored which product was most acceptable to patients receiving radiation treatment. Methods: Participants (n = 255) were stratified according to breast or chest wall radiation treatment and randomly allocated to use a moisturizing or barrier cream. Nurses assessed radiation skin reactions weekly with a standardized grading system, and patients were telephoned 1 month after completing treatment for a final skin assessment. Participants completed an Acceptability Survey at similar times. Results: At treatment completion, 15% of participants had moist desquamation. An additional 26% self-reported this at follow-up. Risk factors for moist desquamation included increased breast cup size and body mass index. The barrier cream significantly reduced the incidence of moist desquamation during treatment in patients receiving radiation to the chest wall (&khgr;2 = 3.93, P = .047). Participants preferred the barrier cream over the moisturizer (&khgr;2 = 5.81, P = .02) during treatment. Conclusions: This study identified a relatively high incidence of moist desquamation in patients receiving radiation therapy for breast cancer. Future patients will have information about product effectiveness in minimizing moist desquamation when choosing skin care products. Implications for Practice: Structured discharge planning and patient education need to include information about factors that contribute to the likelihood of developing moist desquamation.

Family-centred care in cystic fibrosis: a pilot study in North Queensland, Australia

The aims were to: (i) examine perceptions of family‐centred care of parents of children with cystic fibrosis and healthcare professionals who care for them; (ii) test design and tools in a regional population.

269 Living with cystic fibrosis in a remote or rural area

Australia is a vast country, its capital cities sited around its coastline where all primary cystic fibrosis (CF) treatment centres are located. However, many families with a child with CF live in rural or remote areas, often thousands of kilometres away. Little is known of the impact on their daily lives of living far from their main health resource. Objectives To improve the delivery of family centred care (FCC) to children with CF and their families who live distant from main treatment centres, and to understand what such distances mean to the care they are able to access. Method Semi-structured interviews (n = 15) were conducted with parents of a child with CF who live in the Townsville Health Service region, Queensland. Results Thematic analysis revealed parents seeking certainty and continuity in the uncertain realm of CF, their issues not unlike those of their city counterparts, but exacerbated by their sense of distance and isolation. So for example, while change of care-team is difficult anywhere, the impact is magnified when stretched over distance. Parents discussed having to establish rapport, build trust and tell their story again. especially when seeking to feel part of the visiting outreach team from the tertiary centre. Participants conveyed strategies and strong resolve, such as choosing to drive fifty minutes to a known medical centre to avoid a local one, which might be seen as insufficiently trustworthy or knowledgeable by parents who, by contrast, clearly are. Conclusion Insight into this unique milieu from a parental perspective is required so that care can accommodate the challenging environment and be planned around the whole family.