Sultan Kav

Effectiveness of peer education for breast cancer screening and health beliefs in eastern Turkey.

Background: The primary site of cancer in Turkish women is breast cancer. The incidence of breast cancer is increasing in Turkey. Objective: The aim of the research was to educate women 40 years and older to increase their awareness on early detection and diagnosis, to facilitate the use of the early diagnosis methods, to improve the womens beliefs in relation breast cancer, and to increase the use of Cancer Early Diagnosis and Screening Centers available in the city. Methods: The target population of the research was 5000 women. Forty selected women were educated as peer educators. Twenty-five of them were selected as principal peer educator. Each peer educator was expected to educate 200 women. Peer trainers educated their peer and also arranged for the mammography appointment of the women who decided to have theirs taken. Data were obtained before and after the training by Champions Health Belief Model Scale, questionnaire forms, and Cancer Early Diagnosis and Screening Centers data for mammography practice. Results: Breast cancer was detected in 8 women. Statistical analyses showed positive changes in womens health beliefs and breast self-examination knowledge. There were 20.4% of women (n = 1040) who did get mammograms, and 8% (n = 8) of women were found to have cancer in all of those screened. Conclusion: Peer education was found to be effective for increasing the knowledge, beliefs, and practice of women related to breast cancer. Implications for Practice: Peers can reinforce learning through ongoing contact. Peer education can be used to improve early diagnosis of breast cancer and breast cancer awareness in asymptomatic women.

The impact of supportive nursing care on the needs of men with prostate cancer: a study across seven European countries.

Background:Prostate cancer is for many men a chronic disease with a long life expectancy after treatment. The impact of prostate cancer therapy on men has been well defined, however, explanation of the consequences of cancer treatment has not been modelled against the wider variables of long-term health-care provision. The aim of this study was to explore the parameters of unmet supportive care needs in men with prostate cancer in relation to the experience of nursing care.Methods:A survey was conducted among a volunteer sample of 1001 men with prostate cancer living in seven European countries.Results:At the time of the survey, 81% of the men had some unmet supportive care needs including psychological, sexual and health system and information needs. Logistic regression indicated that lack of post-treatment nursing care significantly predicted unmet need. Critically, men’s contact with nurses and/or receipt of advice and support from nurses, for several different aspects of nursing care significantly had an impact on men’s outcomes.Conclusion:Unmet need is related not only to disease and treatment factors but is also associated with the supportive care men received. Imperative to improving men’s treatment outcomes is to also consider the access to nursing and the components of supportive care provided, especially after therapy.

Role of the nurse in patient education and follow-up of people receiving oral chemotherapy treatment: an International survey

PurposeThe aim of this study was to explore the nursing role in education and follow-up of patients who were taking oral chemotherapy (CT) and to identify the worldwide gap in patient education about oral CT.Materials and methodsMultinational Association of Supportive Care in Cancer members were invited to participate in a survey on oral CT. Nurse coordinators collected data via a 16-item questionnaire. Respondents totaled 1115 oncology nurses from 15 countries.ResultsFindings showed that about half of subjects work in outpatient/ambulatory clinics and had given at least two or more oral CT drugs. Although 52% had some type of guidelines/protocols, 47% reported not having received any education about oral CT drugs. While 64% report being involved in patient education, 58% of subjects indicated lack of patient education materials that are specific for oral CT agents. Only 27% stated that they gave all necessary information such as when and how to take the drugs, drug safety and storage, side effects, and symptom management. Reasons for not being involved in oral CT education and follow-up included beliefs that the physician plans the oral CT and gives patients necessary instructions (34%), that nurses only see patients who receive intravenous chemotherapy (16%), that nurses have lack of knowledge about oral agents (15%), and belief that physicians are responsible for patient follow-up. The nurses suggested better education and follow-up of patients to include the written patient education materials (33%) and professional education for nurses (30%).ConclusionsFindings revealed the need for professional education for nurses to ensure comprehensive, consistent patient education and development of written materials for patients receiving oral CT treatment.

Development of the MASCC teaching tool for patients receiving oral agents for cancer

BackgroundOral agents for cancer treatment commonly are prescribed throughout the world. Since oral agents usually are self-administered or administered by lay caregivers, patient education is vital to help ensure that the oral agents are being stored, handled, and taken correctly. When oral agents are taken as prescribed and patients are well informed about signs and symptoms to report, patient outcomes are optimized. Patient education varies globally; consequently, there is a need for a consistent and comprehensive approach to educate patients about oral cancer treatment.Goal of workTo create a teaching tool to be used with patients receiving oral cancer agents for worldwide use.Materials and methodsSix oncology nurse experts conducted a literature review and convened as an expert panel to draft a teaching tool for patients receiving oral cancer agents. The tool includes key assessment questions, generic education discussion points, drug-specific education, and evaluation questions to help ensure that patients/caregivers understand the information provided. Eighteen healthcare providers from 15 countries reviewed the tool for clarity and usefulness in practice by scoring each item in the teaching tool on a 0–10 scale (“0 = not at all to “10” = most clear/useful”). Items that scored 5 or below required comments. At the Multinational Association for Supportive Care in Cancer (MASCC) Symposium in 2008, the healthcare providers who reviewed the teaching tool met with the oncology nurse experts who had developed the tool to review the item scores and revise the tool as necessary.ResultsAll items on the teaching tool received high scores, with the exception of items on refilling prescriptions and insurance issues, which vary from country to country. There was consensus that the MASCC Teaching Tool for Patients Receiving Oral Agents for Cancer was ready to be used and further evaluated in clinical practice.ConclusionsThe MASCC Teaching Tool for Patients Receiving Oral Agents for Cancer is an available resource to assist healthcare providers assess and teach patients about oral cancer treatment.

Attitudes and experiences of nurses toward death and caring for dying patients in Turkey.

Background: Caring of the dying patients and facing the death can be a stressful and difficult experience for nurses. Besides personal and professional experiences, nurses’ own attitudes toward death may affect the care given to dying individuals. Objective: The aim of this study was to examine Turkish nurses’ attitudes toward and experiences with death and caring for dying patients. Methods: A descriptive, cross-sectional study was conducted at 2 university hospitals and 1 state hospital located in Ankara, Turkey. Data were collected via sociodemographics form, the Death Attitude Profile–Revised, and Frommelt’s Attitude Toward Caring for Dying Patients. Results: The attitudes of Turkish nurses toward death and caring for dying patients are less positive than the reported attitudes of nurses in other studies. Significant relationships were found among level of education, willingness to care for dying patients, and scores on Frommelt’s Attitude Toward Caring for Dying Patients and on Death Attitude Profile–Revised subscales (P < .05). Although the majority of nurses (85%) stated that they had received education on end of life, most of them (82%) were not comfortable talking about death. Conclusions: A lack of education and experience may contribute to the negative attitudes. Providing a reflective narrative environment in which nurses can express their personal feelings about death and dying could be a potentially effective approach. Implications for Practice: This study highlights the need for further educational research and development of better educational programs to help nurses to explore and understand their attitudes toward death, overcome fears, increase communication skills, and enhance coping strategies.

Needs of Lay Caregivers of Bone Marrow Transplant Patients in Turkey: A Multicenter Study

The purpose of this research was to identify the needs of lay caregivers of bone marrow transplant (BMT) patients throughout the BMT trajectory. The sample consisted of 58 lay caregivers of BMT patients (5 of which were inpatients) from the 4 BMT units in Ankara, Turkey. Data were collected through a demographic data form and the Psychological and Social Needs Scale. Data analysis was performed using SPSS 10.0 for Windows. Among the descriptive statistics, frequencies and percentages were used to define the characteristics of lay caregivers and responses related to information. Mean values, standard deviations, and the Pearson correlation coefficients were also calculated for the results of the subscales. Most of the lay caregivers were spouses. The rest were other family members: brother/sister, mother, son/daughter, or father. Only one lay caregiver was a friend. The most common type of BMT was autologous. Most of the surveys were completed by the lay caregivers whose patients had been out of the hospital for 100+ days after BMT. The lay caregivers were educated on the BMT process by various sources, and 67.24% of them expressed satisfaction with the information that they were given. A majority of them preferred face-to-face communication with a healthcare professional. The categories of the information provided were diagnosis and treatment, homecare after discharge, follow-ups and laboratory tests, and nutrition. They indicated a need for more information, particularly regarding homecare after discharge and diagnosis. Fear was the highest scoring psychological needs/problems of lay caregivers, whereas leisure activity deficit was highest among the social needs/problems. The information gathered from this study led us to reevaluate our healthcare services for both patients and lay caregivers to improve physical, psychological, and social aspects of the nursing care as a whole.

Evaluating Palliative Care Needs in Middle Eastern Countries

BACKGROUND Cancer incidence in Middle Eastern countries, most categorized as low- and middle-income, is predicted to double in the next 10 years, greater than in any other part of the world. While progress has been made in cancer diagnosis/treatment, much remains to be done to improve palliative care for the majority of patients with cancer who present with advanced disease. OBJECTIVE To determine knowledge, beliefs, barriers, and resources regarding palliative care services in Middle Eastern countries and use findings to inform future educational and training activities. DESIGN Descriptive survey. SETTING/SUBJECTS Fifteen Middle Eastern countries; convenience sample of 776 nurses (44.3%), physicians (38.3%) and psychosocial, academic, and other health care professionals (17.4%) employed in varied settings. MEASUREMENTS Palliative care needs assessment. RESULTS Improved pain management services are key facilitators. Top barriers include lack of designated palliative care beds/services, community awareness, staff training, access to hospice services, and personnel/time. The nonexistence of functioning home-based and hospice services leaves families/providers unable to honor patient wishes. Respondents were least satisfied with discussions around advance directives and wish to learn more about palliative care focusing on communication techniques. Populations requiring special consideration comprise: patients with ethnic diversity, language barriers, and low literacy; pediatric and young adults; and the elderly. CONCLUSIONS The majority of Middle Eastern patients with cancer are treated in outlying regions; the community is pivotal and must be incorporated into future plans for developing palliative care services. Promoting palliative care education and certification for physicians and nurses is crucial; home-based and hospice services must be sustained.

Role of the nurse in patient education and follow-up of people receiving oral chemotherapy treatment in Turkey

IntroductionThe goal of this study was to identify the nursing role in providing education and follow-ups of patients who were taking oral chemotherapy (CT) treatment in oncology clinics in Turkey. This study arises from the fact that an increasing number of oral CT agents are being developed and used in clinical practice.MethodsOne hundred and two nurses from various centers completed a 16-item questionnaire.ResultsNearly half of the nurses work in outpatient/ambulatory clinics (46.1%); the most commonly used oral CT agents were etoposide, capecitabine, methotrexate, hydroxyurea, melphalan, and uracil plus tegafur; 86.3% of the nurses had not received any education on the oral drugs; 72.6% of the nurses stated there was no guideline/protocol for oral CT administration in their unit; and 91.2% of the subjects reported the lack of educational materials specifically for oral CT agents. Half of the subjects reported providing some patient education, mostly giving information about “timing,” among them 42.3% reported not giving any information on drug safety, side effects, or symptom management. The reasons for the nurses not being involved in oral CT education and follow-ups were because the physicians plan oral CT and follow-ups of the patients and because of a lack of knowledge.ConclusionsNurses and physicians describe the role of the nurse as “giving intravenous CT.” Given that the number of oral CT agents is on the rise, nurses must begin to take an active role in patient education and follow-up.

Oncology nurses awareness of drug interactions

Objective: The aim of this study was to determine oncology nurses awareness of drug interactions. Methods: This descriptive study was conducted with nurses working in the oncology clinics who are a member of Oncology Nursing Association of Turkey. A total of 115 nurses (response rate %20) were responded to the online survey that consists of 28 questions. Results: The mean age of the nurses was 33 ± 6.8. The majority of nurses work in university hospital (60%) as a clinical nurse (62.6%) and have a Bachelor Degree in Nursing (63.5%). The mean working years in oncology was 4 years. Half of them stated receiving information on drug interactions mostly through in-service education and courses/congresses in last 5 years. The majority of them (84.3%) indicated that they are considering the possibility of drug interactions when they are scheduling the medication administration time. More than half of the responders (59.1%) encountered drug interactions; however, few explored drug interactions with food, drinks, and nutritional supplements. Their practices to assess possibility of drug interactions were reviewing the drug prospectus (78.3%); consulting with their colleagues (58.3%) and searching on the available website (42.6%) and looking at the drug interaction (39.1%). More than half (65.2%) stated lack of any system to identify drug interactions in their workplace. Nearly half of them indicated to including the drug interaction into patient education mostly for food-drug (73.9%) and drug-drug (63.5%) interactions. Conclusions: Almost all indicated the needs for further education on drug interactions and suggested to have guideline/packet guide.

Symptom management in hematological patients

Signs and symptoms are among the most common reasons that patients seek healthcare. Being able to identify and distinguish what constitutes a sign or symptom in practice is an important part of nurses’ clinical expertise. Symptoms are multidimensional, complex and subjective phenomena that ‘‘reflect changes in biopsychosocial functioning, sensations, or cognition of an individual.’’ In contrast, signs are the objective abnormalities that indicate a disease or condition that are detectable by the individual or by others. Both signs and symtoms are important cues that bring problems to the attention of patients and clinicians. Signs and symptoms are also important because they impact the functional abilities and quality of life of patient with hematological diseases [4,7,10].