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Purpose/objectives: To develop an instrument to measure staff nurse perceptions of the barriers to and benefits of addressing fertility preservation (FP) with patients newly diagnosed with cancer. 
., Design: A prospective, nonrandomized instrument development approach. 
., Setting: Harold C. Simmons Comprehensive Cancer Center at the University of Texas Southwestern Medical Center in Dallas. 
., Sample: 224 RNs who care for patients with cancer. 
., Methods: The instrument was developed with content experts and field-tested with oncology staff nurses. Responses to a web-based survey were used in exploratory factor analysis. After refining the instrument, the authors conducted a confirmatory factor analysis with 230 web-based survey responses. 
., Main Research Variables: Self-perceived barriers to providing FP options to patients newly diagnosed with cancer.
., Findings: The results supported a 15-item instrument with five domains., Conclusions: This instrument can be used to explore oncology nurses' attitudes toward FP in newly diagnosed people with cancer in their reproductive years. 
., Implications for Nursing: A more comprehensive understanding of attitudes and barriers related to FP will guide the building of optimal systems that support effective FP options, resources, and programs for individuals with cancer.

Purpose/objectives: To explore perceived exercise benefits and barriers in adults with acute leukemia who recently completed an inpatient exercise intervention during induction therapy.
., Research Approach: Descriptive, exploratory design using semistructured interviews.
., Setting: Inpatient hematology/oncology unit at North Carolina Cancer Hospital in Chapel Hill.
., Participants: 6 adults with acute leukemia aged 35-67 years.
., Methodologic Approach: Content analyses of semistructured interviews that were conducted with each participant prior to hospital discharge.
., Findings: Most participants were not meeting the recommended physical activity levels of 150 minutes of moderate-intensity exercise per week before their diagnosis. Patients were highly pleased with the exercise intervention and the overall program. Common barriers to exercise were anxiety and aches and pains.
., Interpretation: Overall, participants experienced physical and psychological benefits with the exercise intervention with no adverse events from exercising regularly during induction chemotherapy. Referrals for cancer rehabilitation management will lead to prolonged recovery benefits.
., Implications for Nursing: Findings inform the nurses' role in encouraging and supporting adults with acute leukemia to exercise and be physically active during their hospitalization. Nurses should also be responsible for assisting patients with physical function activities to increase mobility and enhance overall health-related quality of life.

Purpose/objectives: To explore the attitudes of nurses treating patients with cancer regarding the use of complementary and integrative medicine (CIM) therapies to reduce symptoms and improve quality of life (QOL). 
., Design: Prospective and descriptive.
 
., Setting: 12 hospital and community care settings in Israel. 
., Sample: 973 nurses working in oncology and non-oncology departments.
., Methods: A 26-item questionnaire was administered to a convenience sample of nurses treating patients with cancer. 
., Main Research Variables: Interest in CIM integration and training in supportive cancer care.
., Findings: Of the 973 nurses who completed the questionnaire, 934 expressed interest in integrating CIM into supportive cancer care. A logistic regression model indicated that nurses with a greater interest in integration tended to be older, believed that CIM improved patients' QOL, and had no structured postgraduate oncology training. Nurses who believed CIM to be beneficial for QOL-related outcomes were more likely to express interest in related training. The goals of such training include improving QOL-related outcomes, such as anxiety, insomnia, gastrointestinal symptoms, and pain. 
., Conclusions: Most nurses working with patients with cancer are interested in the integration of CIM into supportive cancer care. 
., Implications for Nursing: Most nurses would like to undergo training in CIM to supplement conventional care. CIM-trained integrative nurses can help promote the integration of patient-centered CIM therapies in supportive cancer care settings.

Problem Identification: To evaluate the effects of nurse-led telephone-based supportive interventions (NTSIs) for patients with cancer.
., Literature Search: Electronic databases, including EMBASE®, MEDLINE, Google Scholar, 
Cochrane Library CENTRAL, ProQuest Medical Library, and CINAHL®, were searched through February 2016.
., Data Evaluation: 239 studies were identified; 16 were suitable for meta-analysis. Cochrane's risk of bias tool and the Comprehensive Meta-Analysis software were used.
., Synthesis: The authors performed a meta-analysis of 16 trials that met eligibility criteria. Thirteen randomized, controlled trials (RCTs) and three non-RCTs examined a total of 2,912 patients with cancer. Patients who received NTSIs were compared with those who received attentional control or usual care (no intervention).
., Conclusions: Telephone interventions delivered by a nurse in an oncology care setting reduced cancer symptoms with a moderate effect size (ES) (-0.33) and emotional distress with a small ES (-0.12), and improved self-care with a large ES (0.64) and health-related quality of life (HRQOL) with a small ES (0.3). Subgroup analyses indicated that the significant effects of NTSIs on cancer symptoms, emotional distress, and HRQOL were larger for studies that combined an application of a theoretical framework, had a control group given usual care, and used an RTC design.
., Implications for Research: The findings suggest that an additional tiered evaluation that has a theoretical underpinning and high-quality methodology is required to confirm the efficacy of NTSI for adoption of specific care models.

This article presents the collaborative effort of two complementary and integrative medicine (CIM) professionals caring for three patients with cancer. The challenges facing the integration of CIM in an oncology setting are addressed, and the collaboration between the two CIM practitioners is discussed. The effect of the combined approach was synergistic, empowering the patients and the CIM practitioners, reducing symptom burdens, and improving quality of life and function. 
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Background: Chronic and refractory cancer pain are significant issues and can increase patient suffering and compromise quality of life. A variety of evidence-based pharmacologic strategies can be used routinely to control cancer pain. 
., Objectives: The purpose of this study is to conduct a systematic review of the pharmacologic evidence in the management of chronic and refractory cancer pain. 
., Methods: The Oncology Nursing Society's Putting Evidence Into Practice pain team conducted a search of 184 systematic reviews, meta-analyses, research studies, and guidelines and classified the evidence into weight-of-evidence categories. 
., Findings: Opioids are the mainstay of cancer pain management, but evidence supports the use of coanalgesics and adjuvants to improve overall pain management. Complementary pharmacologic strategies, such as caffeine and herbal preparations, are under investigation, but additional research is needed to recommend these modalities.
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Background: When a loved one dies of cancer, complicated grief (CG) may occur because of the trauma associated with family caregivers' perceptions of their loved one's suffering, either from advanced cancer or from side effects of cancer treatment.
., Objectives: This article provides an overview of CG and existing interventions for family caregivers who may be at risk for CG following the loss of a loved one and the implications for oncology nurses who provide emotional support and guidance.
., Methods: Current evidence related to the treatment of CG and information to assist with identification of individuals at risk for CG are presented, as well as resources for oncology nurses who encounter individuals who are at high risk for, or who are experiencing, CG.
., Findings: Although therapy interventions for CG have been shown to be effective forms of treatment, these therapies are not widely available and often require an extended treatment period to yield results. Oncology nurses can provide early interventions, such as referrals to supportive care services and mental health professionals to facilitate effective treatment.

Background: Breakthrough cancer pain (BtCP), defined as a transient exacerbation of pain that occurs in conjunction with well-controlled background pain, is a common and burdensome problem in patients with cancer.
., Objectives: The aim of this systematic review is to identify evidence-based pharmacologic modalities for adequate management of BtCP. 
., Methods: PubMed and CINAHL® databases were searched to identify literature regarding pharmacologic strategies for BtCP published from January 2006 to June 2016. These studies were then synthesized by the Oncology Nursing Society Putting Evidence Into Practice pain team. 
., Findings: Forty-four studies provide evidence for the use of opioids for the management of BtCP. Transmucosal immediate-release fentanyl (TIRF) was found to have the most evidence for BtCP. Five studies and guidelines also suggest that oral opioids (not including TIRF products) be dosed proportionally to baseline opioids at 10%-20% of the 24-hour, around-the-clock dose.

Background: Patients treated for breast cancer often experience severe oral complications, such as mucositis, xerostomia, and infections, which can result in dose reductions and treatment delays, affecting treatment outcomes.
., Objectives: The purpose of this article is to explore oncology nurses' perceptions of their educational experiences, professional attitudes, and behavior related to providing oral healthcare education to patients with breast cancer.
., Methods: The Oncology Nursing Society sent an email to 5,000 nursing team members who cared for patients with breast cancer, requesting participation in a web-based survey; 194 responses were received, with 164 meeting study eligibility.
., Findings: More oral health-related education was received during clinical experiences than during formal or continuing education. Although patient-driven oral care and diagnostic efforts were frequent, actual behavior was less frequent. No major barriers to providing oral care were indicated. Increased oral health-related education and behavior correlated with the reported importance of increased oral health education for nurses.

Background: Patients with metastatic lung cancer experience high levels of distress related to their disease trajectory and treatment. Oncology nurses are experts in patient care and symptom management, giving them an opportunity to screen and treat patients' distress.
., Objectives: The objectives of this study were to screen patients for distress and manage their symptoms to positively affect their quality of life, treatment adherence, and clinical outcomes, and to reduce healthcare costs. 
., Methods: This quality improvement project was conducted to pilot the Distress Thermometer (DT) into the care of patients with thoracic cancer and to evaluate the effect of a multifaceted intervention, consisting of a patient education pamphlet and a nurse coaching call, on distress levels. 
., Findings: Severe distress was reported in more than half the patients. A paired-sample t test revealed a significant decrease in distress scores following the intervention.

Background: Cancer-related pain is a major health problem because of its magnitude, the subjective nature of the pain experience, and the complexity of the disease, making it difficult to assess and control. When assessment is not performed, poor pain control can result.
., Objectives: This article provides an overview of the components of a comprehensive cancer pain assessment.
., Methods: A review of the healthcare literature was performed.
., Findings: Nurses play a key role in pain assessment by establishing patient trust and rapport, which helps to break down barriers that may stand in the way of effective pain assessment and management.

Background: Pain is a common issue for patients with cancer and can be challenging to manage effectively. Healthcare professionals need to be knowledgeable about evidence-based nonpharmacologic interventions.
., Objectives: This systematic review critically appraises the strength and quality of the empirical evidence for nonpharmacologic interventions in reducing chronic cancer pain.
., Methods: Intervention studies were critically appraised and summarized by an Oncology Nursing Society Putting Evidence Into Practice team of RNs, advanced practice nurses, and nurse scientists. A level of evidence and a practice recommendation was assigned to each intervention.
., Findings: Based on evidence, recommended interventions to reduce chronic cancer pain are celiac plexus block for pain related to pancreatic and abdominal cancers and radiation therapy for bone pain. Although psychoeducational interventions are considered likely to be effective, the effective components of these interventions and their dose and duration need to be determined through additional research.

Oncology nurses have worked within the three pillars of cancer care-surgery, chemotherapy, and radiation therapy -for decades. Now, immuno-oncologic (I-O) therapy agents are a new paradigm in cancer treatment. On March 28, 2017, an I-O think tank was held at the Oncology Nursing Society (ONS) in Pittsburgh, PA. This think tank was organized in response to the rapid changes in cancer treatment with the advent of I-O therapies. The think tank appraised the needs of patients receiving these agents and the oncology nurses and healthcare providers caring for them. Seventeen nurse experts from around the country joined seven ONS staff members to discuss the challenges faced by patients receiving these therapies and the nurses who administer the treatments and coordinate the care. 
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Nurses are individuals called to both care for patients and families and facilitate the healing process. Our profession fills a unique role in health care as oncology nurses combine medical science with the art of interpersonal relationships to provide both physical and emotional support for patients. Promoting healing and facilitating adjustment draws individuals to become exceptional nurses and is an innate quality of oncology nurses (American Nurses Association, 2016). It is a characteristic not easily separated from one's personality. Often, nurses become frustrated in their inability to do more for a patient or the family members. This feeling becomes particularly prevalent in life-limiting or life-threatening conditions, most notably cancer.
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Objective: To review effective methods of prevention that can be used to control the incidence of cervical cancer and detection strategies that can identify the precancerous lesions before they become true cancer., Data Sources: Current medical, scientific and nursing literature, and national and international guidelines of cervical cancer., Conclusion: Nearly all cervical cancers are caused by specific types of human papillomavirus (HPV). Prophylactic vaccination for HPV provides the most effective method of primary prevention against HPV-related diseases. The use of the Pap test and HPV test, according to published guidelines, provides the most effective means of screening for cervical cancer., Implications for Nursing Practice: Nurses are in a key position to provide health education with the goal of supporting vaccine uptake and screening guidelines., (Copyright © 2017 Elsevier Inc. All rights reserved.)

Compassion fatigue (CF), or vicarious traumatization, is a state of physical/emotional distress that results from caring for those experiencing pain. We sought to characterize levels of CF in intensive care unit (ICU) and oncology nursing populations with subanalyses comparing specific personal/professional demographic factors. The Professional Quality of Life (ProQOL) scale, a validated tool for assessing CF, burnout (BO), and compassion satisfaction (CS), was distributed to the ICU and oncology divisions of a community hospital. Demographic data and ProQOL scale scores were collected and compared within specialty and gender subgroups. Two-sample t tests and regression analyses were used to compare groups. Statistical significance was defined as p < .05. A total of 86 nurses submitted completed surveys able to be analyzed. Levels of CS were significantly lower (p = .023) and levels of BO were significantly higher (p = .029) in ICU nurses than in oncology nurses. Male nurses exhibited significantly higher CS (p = .001) and significantly lower BO (p = .021) and CF (p = .014) than female nurses. Intensive care unit nurses and female nurses from both ICU and oncology specialties may be at increased risk for developing a poorer overall ProQOL and CF.

Problem Identification: Oncology nurses are regularly exposed to high-stress situations that may lead to compassion fatigue, and many institutions have implemented interventions to reduce burnout in nurses, but knowledge on the feasiblity, effectiveness, and nurses' experience of interventions is lacking.
., Literature Search: Electronic search of literature published from 1992-2015 was performed to evaluate in-facility interventions to manage compassion fatigue in oncology nurses. Databases used included CINAHL®, PubMed, Web of Science, Google Scholar, and PsycINFO®. 
., Data Evaluation: The goal was to evaluate the effectiveness, feasibility, and nurses' experience of interventions to manage compassion fatigue. The study designs, methods, and limitations were independently screened by the authors. 
., Synthesis: Of 164 studies, 31 met eligibility criteria. 
., Conclusions: The majority of the studies were conducted in Western countries, which suggests the need for additional research in other settings to determine effective interventions that address compassion fatigue and stress cross-culturally. Quantitative and qualitative studies failed to gain high scores in terms of quality. Limited conclusions can be drawn from small studies that report on outcomes with many confounding variables, such as turnover rate or general health of nurses, from a single institution. 
., Implications for Research: Lack of empirical precision in evaluating the effectiveness, feasibility, and nurses' experiences of interventions indicates a need for future, more rigorously designed experimental studies. Because of the global increase in the number of patients being diagnosed and living with cancer, oncology nurses should be able to recognize and manage compassion fatigue.

Objectives: To review current evidence about cancer screening challenges that lead to cancer health disparities in minority populations., Data Sources: Research reports, published journal articles, web sites, and clinical practice observations., Conclusion: There are significant disparities that exist in cancer screening practices among racial and ethnic minority and underrepresented populations, resulting in disproportionately higher cancer mortality rates in these populations., Implications for Nursing Practice: Nurses are positioned to lead in educating, promoting, and bringing awareness to cancer screening recommendationsand current cancer prevention guidelines for at-risk individuals, and help them to implement these guidelines to reduce incidence and mortality., (Copyright © 2017 Elsevier Inc. All rights reserved.)

Objective: To synthesize relevant issues in cancer screening for older people for nursing practice., Data Sources: Published scientific literature, clinical literature, and published cancer screening guidelines from the United States and Canada., Conclusion: Nurses are caring for increasing numbers of older patients and, with this demographic shift, face increasing demands to address cancer screening and detection in both primary and specialty practice., Implications for Nursing Practice: Ageism, self-stereotyping, cancer fear and fatalism, and cancer survivorship experiences influence cancer screening and generate the need for improved awareness of these issues to advance nursing practice., (Copyright © 2017 Elsevier Inc. All rights reserved.)

Objective: To present an overview of current practices in the screening and early detection of gastrointestinal cancers., Data Sources: Literature reviews., Conclusion: Screening for gastrointestinal cancers is less than desirable, particularly in underserved populations. There are inadequate methods of screening for early detection of esophageal and gastric cancers., Implications for Nursing Practice: Education of patients is needed to reinforce the importance of screening for gastrointestinal cancers., (Copyright © 2017 Elsevier Inc. All rights reserved.)

Objective: To review the current state of prostate cancer screening and future directions., Data Sources: Nursing, medical and scientific literature related to prostate cancer screening, and national and international professional recommendations., Conclusion: Prostate cancer screening has been a topic of robust discussion for a number of years. Research continues to examine novel options for prostate cancer screening to either replace or compliment the prostate specific antigen test, but require additional validation before they will be widely accepted into clinical practice., Implications for Nursing Practice: As new data emerges and professional organizations update their recommendations, it is important for oncology nurses to keep abreast of the latest developments to educate patients., (Copyright © 2017 Elsevier Inc. All rights reserved.)

Objective: To review the history, current status, and future trends related to breast cancer screening., Data Sources: Peer-reviewed articles, web sites, and textbooks., Conclusion: Breast cancer remains a complex, heterogeneous disease. Serial screening with mammography is the most effective method to detect early stage disease and decrease mortality. Although politics and economics may inhibit organized mammography screening programs in many countries, the judicious use of proficient clinical and self-breast examination can also identify small tumors leading to reduced morbidity., Implications for Nursing Practice: Oncology nurses have exciting opportunities to lead, facilitate, and advocate for delivery of high-quality screening services targeting individuals and communities. A practical approach is needed to translate the complexities and controversies surrounding breast cancer screening into improved care outcomes., (Copyright © 2017 Elsevier Inc. All rights reserved.)

Symptom burden and poor adherence to oral anticancer agents remain significant clinical problems. This study examined feasibility, preliminary efficacy, and satisfaction with ADHERE, a nurse practitioner intervention that promotes symptom management and adherence among patients prescribed oral agents. The intervention group (which received one semistructured, face-to-face session followed by three weekly telephone sessions using motivational interviewing, brief cognitive-behavioral therapy, and a toolkit to promote self-management) had significantly lower symptom severity postintervention. Self-reported adherence was high and did not differ by group. Patients reported being highly satisfied with the ADHERE intervention.
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"What would you do?" I have heard this question numerous times throughout my nursing career by patients and families affected by cancer. As a pediatric blood and marrow transplantation nurse, I have often seen patients and their families wrestle with difficult treatment decisions. I have witnessed parents struggle between beginning end-of-life care for their child, or pursuing a risky but potentially life-saving clinical trial. With science driving advances in cancer treatments and patients playing more active roles in their care, uncertainty around cancer treatment decisions will only become more complicated. For me, being a good nurse meant helping these patients navigate this uncertainty. I was compelled to pursue research to understand the process patients experience as they make treatment decisions, who they choose to involve in decision making, and what role the unique nurse-
patient relationship could play in facilitating patient-centered decisions.
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Purpose: The aim of this study was to develop an in-depth understanding of the rationale, experiences, evaluation and outcomes of using Cancer Information and Support (CIS) services in Australia, the UK and USA., Methods: Semi-structured interviews were used to gather data between November 2015 and January 2016. Telephone interviews were recorded, de-identified, transcribed and thematically analysed. Ten users from each of three international CIS services (n = 30 in total) were recruited. Participants were eligible for inclusion if they had utilised the CIS in 2015 via telephone contact with a cancer nurse and identified as a patient or cancer survivor, or friend or family member of such a person., Results: Four major themes were derived and included a total of 25 sub-themes. Key themes included (i) drivers for access, (ii) experience of the service, (iii) impact and (iv) an adjunct to cancer treatment services., Conclusions: Cancer Information and Support nurses internationally act as expert navigators, educators and compassionate communicators who 'listen between the lines' to enable callers to better understand and contextualise their situation and discuss it with their healthcare team and family and friends. Use of the service can result in reduced worry, extend support repertoires and enable use of new knowledge and language as a tool to getting the most from the healthcare team. The positioning of CIS alongside cancer treatment services aids fuller integration of supportive care, benefiting both patients and clinicians.

Background: Neutropenia-associated infections can prolong hospitalization, increase re-admission, mortality and morbidity rates., Aim: To determine nurses' knowledge and infection control care practices in neutropenic patients., Design: This descriptive study was conducted between January 2012 and May 2012, at oncology adult inpatient units of a university hospital in Turkey. Sample consisted of 51 staff nurses., Methods: Data were collected by a form included sociodemographic characteristics, neutropenia knowledge questions, and infection control care practices. Each nurse was observed by researcher three times for infection control care practices., Results: The mean score of nurses' knowledge was 21.3 ± 2.4 (min. 17; max. 27). For all three observations hand hygiene adherence was found low both in medication preparation, administration and vital signs assessment. Sterility disrupted in almost all preparation of parenteral medications., Conclusions: Even nurses' knowledge related with neutropenia and care of neutropenic patient was found above average their infection control care practices were found insufficient.

In the ambulatory care setting, chemotherapy regimens have become increasingly complex with the combination of induction treatments and oral medications. Nurses at one cancer center implemented an oral adherence tracking documentation system in the electronic health record (EHR). Oncology nurses assessed and monitored adherence to oral chemotherapy at each clinical encounter and during telephone calls and then documented findings in the EHR. After implementing this new standardized approach, adherence rates were captured as a metric for the organization.

Background: Problematic communication among providers, patients, and their family members can affect the quality of patient care, causing stress to all parties involved and decreased opportunities for collaborative decision making.
., Objectives: The purpose of this article is to present one case from a pilot study of a family caregiver intervention focused on communication. 
., Methods: The nurse-delivered communication intervention includes a written communication guide for family caregivers, as well as a one-time nurse communication coaching call. The call is aimed at identifying caregiver communication concerns, providing communication education, and role playing problematic communication.
., Findings: Psychological distress and caregiver confidence in communication were improved for the caregiver. Data presented from the case study demonstrate the need for family caregiver communication support and training and the potential benefits of such training.

Objective: This study explored the experiences and nursing support needs of women undergoing out-patient breast cancer chemotherapy in two teaching hospitals in Southeastern Nigeria., Methods: Using a qualitative descriptive design, based on grounded theory approach and focus group discussion (FGD) methodology, 20 histological confirmed breast cancer patients at different stages of combination chemotherapy (cyclophosphamide, doxorubicin, and fluorouracil ) were purposively selected and engaged in FGDs at two surgical oncology clinics. Data saturation was reached at the fourth FGD. The audio-taped and transcribed data were content analyzed using thematic approach., Results: Participants were all christians of the Igbo-speaking ethnic group, and aged between 36 and 66 years. Most were married and had at least primary education. Five themes emerged from the FGDs: inadequate preparation for chemotherapy; chemotherapy scary, distressful, and financially demanding; hope, faith and courage sustained treatment; self-care actions initiated to 'weather the storm'; and nursing assistance desired to foster hope and enhance patients' acceptance of, adjustment and adherence to breast cancer chemotherapy in Nigeria. Culture influenced their chemotherapy perspectives and coping., Conclusion: Women with breast cancer in southeastern Nigeria desired but were inadequately prepared to cope with chemotherapy distress they experienced. Nurses could help patients to accept and navigate through chemotherapy by initiating and supporting effective and efficient self-care actions that are culturally congruent.Copyright © 2015 John Wiley & Sons, Ltd., (Copyright © 2015 John Wiley & Sons, Ltd.)

Background: Modern cancer care requires the development of clinical pathways to enhance coordination, but there are few descriptive studies about the content of coordination activities. More specifically, little is known about hospital discharge coordination, although this is seen as a sensitive phase of clinical pathway., Purpose: The purpose of this study was to identify and quantify the categories of activities performed by nurse navigators for hospital discharge coordination., Methods: Patients supported within the Coordinating Outpatient Care department (COC) at Gustave Roussy (Villejuif, France). Study conducted over two consecutive phases (Feb-September 2014): (1) a qualitative phase to identify the categories of coordination activities (interviews with patients plus, focus groups with nurse navigators-NNs); (2) a quantitative phase to quantify the relative share of each category. The calls received through the telephone platform of COC (made by both patients and primary care providers) were systematically reported (caller; reason for the call; procedure performed) and then analyzed., Results: Qualitative phase: 17 interviews with patients, plus 2 focus groups with NNs. Quantitative phase: 543 calls analyzed. The callers were patients or their relatives (38 %), private nurses (35 %), medical device providers (20 %), and other primary care providers (e.g., pharmacists, family physicians) (7 %). Five categories of coordination activities identified: (F1) Patient monitoring (29 %); (F2) Helping to navigate (24 %); (F3) Managing technical problems (17 %); (F4) Explaining care protocols (16 %); (F5) Collecting and transmitting the patient medical record information (14 %)., Conclusions: The majority of requirements are related to organizational issues (e.g., navigation, lack of information, appointments). Nurse navigators' training and qualification must therefore combine both clinical and managerial skills., Competing Interests: The authors declare that they have no conflict of interest.

Purpose/objectives: To obtain consensus on priorities for oncology nursing research in the United Kingdom.
., Design: A three-round online Delphi survey.
., Setting: Oncology nurses were invited via the United Kingdom Oncology Nursing Society (UKONS) database. Patient participation was invited through patient organizations.
., Sample: 50 oncology nurses and 18 patients.
., Methods: Eligible and consenting individuals reported five priorities for oncology nursing research (round 1), rated their level of agreement with them (round 2), and restated and revised their responses in light of the group's responses (round 3). Consensus was defined as 80% agreement.
., Main Research Variables: Research priorities for oncology nursing as reported by oncology nurses and patients. 
., Findings: Consensus was reached on 50 of 107 research priorities. These priorities reflected the entire cancer pathway, from diagnosis to palliative care. Highest agreement was reached within and across groups on the need for research relating to prevention, screening, early diagnosis, and psychological care across the cancer trajectory. Little consensus was reached regarding symptoms and side effects. Some evident divergence existed., Conclusions: Oncology nurses and patients do not necessarily prioritize the same research areas. Prevention, screening, and early diagnosis are of the highest priority for future research among oncology nurses and patients. 
., Implications for Nursing: Patients usually play little part in priority setting for research. This study provided the opportunity for meaningful patient and nurse involvement in setting a research agenda for oncology nursing that is relevant and beneficial to oncology nurses and patients.

Lung cancer is the leading cause of cancer death worldwide. Tobacco use remains the single most important preventable cause of cancer and is responsible for 80% of all cases of lung cancer. Implementation of tobacco control measures, including preventing initiation and treating dependence, are pivotal to address the lung cancer epidemic. New evidence continues to emerge on the significant positive impact of incorporating tobacco dependence treatment within all lung cancer treatment protocols. Evidence and guidelines on how to implement these strategies exist and present an opportunity for nurses to make a difference in reducing suffering and preventing deaths from lung cancer., (Copyright © 2016 Elsevier Inc. All rights reserved.)

Purpose/objectives: To identify nursing staff reactions to and perceptions of electronic portal use in a cancer setting.
., Research Approach: Qualitative.
., Setting: Outpatient clinic at the Harold C. Simmons Comprehensive Cancer Center of the University of Texas Southwestern Medical Center in Dallas.
., Participants: 13 nurses with a range of credentials and experience, representing infusion, medical oncology, and bone marrow transplantation clinics.
., Methodologic Approach: Two focus groups were conducted. Theoretical thematic content analysis of data was performed.
., Findings: Key themes that emerged for consideration of electronic portals included work volume and flow, patient expectations and safety, variation in use of communication technologies, and education and management.
., Interpretation: The current study provides insight into the implications of electronic portals by identifying nursing staff reactions to this technology. These reactions are predominantly related to the impact on clinical workload and patient safety and expectations.
., Implications for Nursing: As clinical cancer facilities incorporate electronic portal technology into their operations, attention to the impact on staff workload, division of labor, patient safety, and patient expectations should be considered.

Providing holistic care is acknowledged as central to providing quality care for patients with cancer, but providing competent nursing care consistent with these approaches remains a challenge for nurses in Vietnam. Obstacles for Vietnamese oncology nurses include their low status, the limited scope of nursing practice, work overload in a hierarchical system, and cultural beliefs that view death and dying as taboo. Additional research to support oncology nurses in Vietnam must acknowledge the merits of improving nursing education as an important strategy for enhancing nursing autonomy, quality of care, and outcomes for the increasing number of patients with cancer in low- and middle-income countries.

Purpose/objectives: To describe the physical activity (PA) promotion practices, beliefs, and barriers of Australasian oncology nurses and gain preliminary insight into how PA promotion practices may be affected by the demographics of the nurses.
., Design: Cross-sectional survey.
., Setting: Australia and New Zealand.
., Sample: 119 registered oncology nurses.
., Methods: Self-reported online survey completed once per participant.
., Main Research Variables: Questions assessed the PA promotion beliefs (e.g., primary healthcare professionals responsible for PA promotion, treatment stage), PA benefits (e.g., primary benefits, evidence base), and PA promotion barriers of oncology nurses.
., Findings: Oncology nurses believed they were the major providers of PA advice to their patients. They promoted PA prior to, during, and post-treatment. The three most commonly cited benefits of PA for their patients were improved quality of life, mental health, and activities of daily living. Lack of time, lack of adequate support structures, and risk to patient were the most common barriers to PA promotion. Relatively few significant differences in the oncology nurses' PA promotion practices, beliefs, and barriers were observed based on hospital location or years of experience.
., Conclusions: Despite numerous barriers, Australasian oncology nurses wish to promote PA to their patients with cancer across multiple treatment stages because they believe PA is beneficial for their patients.
., Implications for Nursing: Hospitals may need to better support oncology nurses in promoting PA to their patients and provide better referral pathways to exercise physiologists and physiotherapists.

Purpose/objectives: To explore gender differences in bladder cancer treatment decision making.
., Research Approach: Secondary qualitative analysis of interview transcripts.
., Setting: One multidisciplinary genitourinary oncology clinic (Dana-Farber Cancer Institute) and two urology clinics (Brigham and Women's Hospital and Beth Israel Deaconess Medical Center) in Boston, MA.
., Participants: As part of the original study, 45 men and 15 women with bladder cancer participated in individual interviews. Participants were primarily Caucasian, and most had at least some college education.
., Methodologic Approach: Word frequency reports were used to identify thematic differences between the men's and women's statements. Line-by-line coding of constructs prevalent among women was then performed on all participants in NVivo 9. Coding results were compared between genders using matrix coding queries.
., Findings: The role of family in the decision-making process was found to be a dominant theme for women but not for men. Women primarily described family members as facilitators of bladder cancer treatment-related decisions, but men were more likely to describe family in a nonsupportive role.
., Conclusions: The results suggest that influences on the decision-making process are different for men and women with bladder cancer. Family may play a particularly important role for women faced with bladder cancer treatment-related decisions.
., Interpretation: Clinical nurses who care for individuals with bladder cancer should routinely assess patients' support systems and desired level of family participation in decision making. For some people with bladder cancer, family may serve as a stressor. Nurses should support the decision-making processes of all patients and be familiar with resources that can provide support to patients who do not receive it from family.

Hospitalisation forces patients with glioblastoma and their family to face a new life made up of numerous constraints and uncertainties. In this context of anxiety, nursing care is based on global support which combines technical, organisational and relational skills., (Copyright © 2016 Elsevier Masson SAS. All rights reserved.)

Nurses in neurosurgical departments play a critical role as they are involved in the first stages of the care pathway of patients with glioblastoma. Indeed, surgery enables a definitive histopathological diagnosis to be established and the size of the tumour to be significantly reduced, thereby improving the prognosis., (Copyright © 2016 Elsevier Masson SAS. All rights reserved.)

Objectives: To describe psychosocial concerns associated with the postoperative cancer patient and to discuss current psychosocial evidence-based approaches to manage these psychosocial concerns., Data Sources: Published peer-reviewed literature., Conclusion: The postoperative phase of cancer care may be associated with a range of overlapping acute and chronic psychosocial concerns related to the surgery itself, the cancer diagnosis, and the need for ongoing cancer treatments. The postoperative period of cancer care represents an essential time to detect unmet psychosocial concerns and begin timely interventions for these concerns., Implications for Nursing Practice: Nurses are in a key position to detect, triage, refer, or manage psychosocial concerns in the postoperative patient with cancer. Current psychosocial evidence-based approaches may be used by surgical oncology nurses or other nurses who care for cancer patients during postoperative recovery., (Copyright © 2016. Published by Elsevier Inc.)

Objective: To review essential nursing implications in the care of postoperative esophagectomy patients., Data Sources: Peer-reviewed literature, institutional experience, journal articles., Conclusion: Utilizing a system-based approach to assess the post-esophagectomy patient will assist the nurse in ensuring safe and comprehensive care., Implications for Nursing Practice: Nursing care measures to reduce perioperative esophagectomy morbidity includes aggressive fluid management, pain management, use of epidural analgesia, and early ambulation. Therefore, nurses play a significant role in improving the outcomes for the esophagectomy patient., (Copyright © 2016 Elsevier Inc. All rights reserved.)

Objectives: To review oncology nurses role of informational continuity in regards to nutrition and hydration to ensure continuity of care from one care center to another., Data Sources: Peer-reviewed literature, PubMed, CINAHL, EMBASE, and web-based resources., Conclusion: Optimal nutrition and hydration during cancer treatment and survivorship requires assessment and preplanning of needs. Oncology nurses play a vital role in preparing patients and caregivers for optimal nutrition during the surgical treatment trajectory., Implications for Nursing Practice: Oncology nurses should emphasize nutrition planning during the surgical treatment trajectory to enhance survivorship and quality of life of the cancer patient. Educational resources exist for both nursing and cancer patients., (Copyright © 2016 Elsevier Inc. All rights reserved.)

Background: Multiple treatment options, combined with disease heterogeneity, have created nursing challenges in the management of adverse events (AEs) during antilymphoma therapy. Testing has revealed that less than half of participating nurses correctly graded peripheral neuropathy and neutropenia related to antilymphoma regimens., Objectives: This article identifies nursing challenges in the management of AEs associated with therapy for lymphomas and describes how strategies in critical thinking can help meet those challenges., Methods: A comprehensive literature search in oncology nursing, nursing education, and critical thinking was conducted; participant responses to pre- and post-tests at nursing education programs were evaluated; and a roundtable meeting of authors was convened., Findings: Oncology nurses can cultivate critical thinking skills, practice thinking critically in relation to team members and patients, leverage information from the Patient-Reported Outcomes Common Terminology Criteria for Adverse Events, and manage workflow to allow more opportunity for critical thinking.

Objectives: To review postoperative symptoms experienced by patients following surgery for cancer and discuss focused, evidenced-based methods to teach the patient acute pain and symptom management to include both pharmacological and non-pharmacological strategies., Data Sources: Peer reviewed articles and national guidelines., Conclusion: Although significant advances have been made in providing effective acute pain control, pain remains a serious consequence after cancer surgery. Most patients go home after surgery (often the day of their surgery) not taking their pain medications or with inadequate pain medication. Postoperative symptoms such as nausea, constipation, and fatigue, and complications such as blood clots and infection, may present barriers to post-surgical recovery that can affect initiation of adjuvant therapy., Implications for Nursing Practice: Nurses who are equipped with successful strategies to support self-management of postoperative symptoms will ensure that patients have a positive surgical experience., (Copyright © 2016 Elsevier Inc. All rights reserved.)

Purpose: Oncology health professionals (HPs) are increasingly required to care for patients from minority backgrounds. Yet many HPs have not had formal training in how to communicate effectively in culturally diverse settings. More information is needed about the challenges that oncology HPs face in communicating with minority patients to inform the content of formal training programs. This qualitative study aimed to identify oncology nurses' and oncologists' individual experiences and challenges in communicating with patients from minority backgrounds., Method: Thirty-eight oncology HPs (21 oncology nurses, 12 medical oncologists, and 5 radiation oncologists) were interviewed individually or in focus groups about their experiences communicating with patients from minority backgrounds. The interviews were audio taped and analysed thematically., Results: The majority of participants (82%) reported varying degrees of uncertainty and discomfort regarding working with minority patients, with many barriers to communication encountered. Participants perceived that minority patients received less emotional support than majority group patients. They experienced challenges in balancing beliefs about patient autonomy with cultural differences regarding the role of the family. Strategies employed by participants to facilitate interactions included: modifying speech, taking more time in consultations, rapport building, and using nonverbal techniques., Conclusions: Oncology HPs encounter many linguistic and cultural barriers when communicating with minority patients. They need formal training tailored to developing culturally competent communication. Oncology nurses and oncologists could benefit from formal communication skills training focused upon cultural competence during their career development programs., (Copyright © 2016 Elsevier Ltd. All rights reserved.)

Objectives: To review the current evidence on the impact of minimally invasive, robotic-assisted cancer surgery (thoracic, gastrointestinal, gynecologic, genitourinary) on surgical outcomes and quality of life., Data Sources: Journal articles, research reports, state of the science papers, and clinical guidelines., Conclusion: Minimally invasive cancer surgery is an important and integral component of the comprehensive care of cancer patients. Current evidence suggests that minimally invasive procedures confer equivalent and potentially superior advantage in select surgical outcomes without compromising oncologic outcomes. There is a paucity of evidence for the impact of minimally invasive procedures on functional outcomes and quality of life., Implications for Nursing Practice: Perioperative nursing care in minimally invasive cancer surgery should focus on preparing patients and families for shorter hospital stay, with continued support for postoperative recovery following discharge., (Copyright © 2016 Elsevier Inc. All rights reserved.)

Objective: To review the psychosocial aspects experienced by children with cancer undergoing surgical and procedural treatments., Data Sources: CINAHL, PubMed, and PsycINFO resources., Conclusion: The diagnosis of cancer is a threatening experience for the pediatric patient with cancer leading to anxiety and distress, which is elevated with a surgical or procedural approach to treatment. Assessing the child's developmental level and previous experiences are fundamental in identifying the appropriate interventions to reduce anxiety and distress to support effective coping., Implications for Nursing Practice: Nurses are instrumental in assessing the child's level of anxiety related to surgical procedures. Suggested evidence-based interventions for anxiety and distress include therapeutic play, structured educational preparation, and art-based programs (ie, Hope Bead program)., (Copyright © 2016 Elsevier Inc. All rights reserved.)

The U.S. Pharmacopeial Convention's "Chapter <800> Hazardous Drugs-Handling in Healthcare Settings" is a new part of the National Formulary that describes standards-expectations for practice-for all aspects of handling and administering hazardous drugs (HDs). Some of the standards will require changes in policies, procedures, and practices for nurses. This article provides an overview of the new standards and the impact they will have on nurses who prepare and administer chemotherapy and other HDs.
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