Mina Singh

Addressing fear of cancer recurrence among women with cancer: a feasibility and preliminary outcome study.

BackgroundEvidence suggests that fear of cancer recurrence (FCR) is one of the most frequently cited unmet needs among cancer survivors and is associated with psychological distress, stress-response symptoms, and lower quality of life, as well as increased use of health care resources. Despite these factors, few manualized interventions exist to address FCR among cancer survivors.PurposeTo develop, manualize, and pilot test the feasibility and preliminary efficacy of a 6-week cognitive-existential (CE) group intervention designed to address FCR in women with breast or ovarian cancer.MethodsThis study was a single-arm multi-site study with pre-, post-, and 3-month follow-up measurement occasions.ResultsA total of 56 breast or ovarian cancer survivors enrolled in the study; 44 completed the CE group intervention. Following the intervention, women experienced a reduction in the primary study outcome measure of FCR and secondary study outcome measures of cancer-specific distress and uncertainty. They also reported improvements in secondary study outcome measures of quality of life and coping. The effect sizes of the observed changes were for the most part in the medium to large effect range; furthermore, almost all changes were sustained at 3-month follow-up.ConclusionThis brief intervention appears feasible and has shown promising results in addressing FCR and related secondary outcomes of cancer-specific distress, uncertainty, quality of life, and coping; however, it should be further tested using a randomized controlled study design to more definitively assess its efficacy.Implications for Cancer SurvivorsFCR is a near-universal worry for cancer survivors that, when left unaddressed, tends to remain stable over time. This study has important implications for all cancer survivors as it is the first published intervention that provides preliminary evidence of its efficacy in decreasing fear of cancer recurrence.

Charting the territory: symptoms and functional assessment in children with progressive, non-curable conditions

Background Children with progressive, non-curable genetic, metabolic, or neurological conditions require specialised care to enhance their quality of life. Prevention and relief of physical symptoms for these children needs to begin at diagnosis, yet, little is known about their patterns of symptoms and functional abilities. Aim To describe these childrens symptoms, as well as how the childrens condition affects them physically. Design Cross-sectional, baseline results from an observational, longitudinal study, Charting the Territory, that followed 275 children and their families. Setting/participants Seven tertiary care childrens hospitals in Canada, 2 in the USA. Families were eligible based on the childs condition. A total of 275 children from 258 families participated. Results The 3 most common symptoms in these children were pain, sleep problems, and feeding difficulties; on average, they had 3.2 symptoms of concern. There was a pattern of under-reporting of childrens symptoms for clinicians compared with parents. Regardless of use of associated medications, pain, feeding and constipation symptoms were often frequent and distressing. Children with a G/J tube had a higher total number of symptoms, and respiratory problems, pain, feeding difficulties and constipation were more likely to occur. They also tended to have frequent and distressing symptoms, and to need extensive mobility modifications which, in turn, were associated with higher numbers of symptoms. Conclusions These children experience multiple symptoms that have been previously documented individually, but not collectively. Effective interventions are needed to reduce their symptom burden. Future longitudinal analyses will examine which disease-modifying interventions improve, or do not improve, symptom burden.

Street Youth in Toronto, Canada: An Investigation of Demographic Predictors of HIV Status Among Street Youth Who Access Preventive Health and Social Services

Street youth are increasingly at risk for HIV infection due to high-risk sexual behaviors and injection drug use. The purpose of this study was to assess the extent to which demographic characteristics of street youth in Toronto were predictive of HIV status. Age, gender, and ethnicity, education, length of time street-involved, and income were measured among a cross-sectional sample of 18- to 30-year-old street youth (N = 140). Results revealed statistically significant relationships between Age and HIV status (β = 2.413, p < .001, OR = 11.169, 95.0% CI = 3.344–37.303), as well as Ethnicity and HIV status (β = 2.051, p = .005, OR = 7.773, 95.0% CI = 1.836–32.900). Findings suggest that HIV prevention intervention programs may need to be refined or extended appropriately to older street youth in those 26–30 years of age, especially to meet the cultural needs of Black, Aboriginal, and other ethnic homeless youth populations. Further investigation of the duration of street involvement relating to HIV-risk–taking behaviors is necessary.

Paradox of a graduate human science curriculum experienced online: a faculty perspective.

BACKGROUND Program evaluation contributes to evidence-based nursing education. Exploring graduate faculty experience with developing and teaching an online masters of science in nursing program contributes to building a science of nursing education. METHODS A multimodal methodology for conducting a program evaluation is participatory and demonstrates both formative (improve the quality of the program) and summative (determine the worth of the program) components. Faculty participated through questionnaires, journals, and focus groups. RESULTS In the context of a philosophy that values understanding lived experience as foundational for nursing, faculty are teaching in an environment that is disembodied, technology based, and at a distance. Faculty relationships with students reveal emerging curricular issues. CONCLUSIONS Research into the intersection of pedagogy and technology reveals similarities with contemporary literature and many lived paradoxes to be accounted for in evaluation of graduate nursing education.

Towards the validation of a new, blended theoretical model of fear of cancer recurrence

Fear of cancer recurrence (FCR) is defined as “fear, worry, or concern about cancer returning or progressing”. To date, only the seminal model proposed by Lee‐Jones and colleagues has been partially validated, so additional model testing is critical to inform intervention efforts. The purpose of this study is to examine the validity of a blended model of FCR that integrates Leventhals Common Sense Model, Mishels Uncertainty in Illness Theory, and cognitive theories of worry.

The psychological impact of the rapid diagnostic centres in cancer screening: A systematic review

The purpose of this review is to assess the state of the literature and identify implications for nursing practice and future research on the psychological impact of rapid diagnostic centres (RDC) for women related to breast cancer. A systematic literature review was conducted on the topic and six studies were identified for data extraction and analysis. There is evidence that RDCs decrease short-term anxiety in women undergoing further cancer tests after cancer screening, and who receive a benign diagnosis. There is limited available research on the impact of anxiety on women who receive a diagnosis of cancer in RDCs, but some evidence showed that this sub-group had higher depression in the long term. Nurses need to be aware of the different needs of women undergoing further cancer screening tests after a cancer diagnosis and receiving these results in the same day.