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Theresa Mallick-Searle,1 Brett Snodgrass,2 Jeannine M Brant,3 1Pain Management Center, Stanford Health Care, Redwood City, CA, 2LifeLinc Pain Centers, Cordova, TN, 3Billings Clinic, Billings, MT, USA Abstract: Herpes zoster, also known as shingles, is a distinctive clinical condition caused by the reactivation of latent varicella zoster (chickenpox) virus following an initial infection. Approximately 1 million cases of herpes zoster occur annually in the US, and one in every three people develops herpes zoster during their lifetime. Postherpetic neuralgia is a neuropathic pain syndrome characterized by pain that persists for months to years after resolution of the herpes zoster rash. It stems from damage to peripheral and central neurons that may be a byproduct of the immune/inflammatory response accompanying varicella zoster virus reactivation. Patients with postherpetic neuralgia report decreased quality of life and interference with activities of daily living. Approaches to management of postherpetic neuralgia include preventing herpes zoster through vaccination and/or antiviral treatment, and administering specific medications to treat pain. Current guidelines recommend treatment of postherpetic neuralgia in a hierarchical manner, with calcium channel α2-δ ligands (gabapentin and pregabalin), tricyclic antidepressants (amitriptyline, nortriptyline, or desipramine), or topical lidocaine patches as first-line drugs. The safety and tolerability of pharmacologic therapies for pain are important issues to consider as postherpetic neuralgia affects primarily an older population. Patients should be educated on appropriate dosing, titration if applicable, the importance of adherence to treatment for optimal effectiveness, and possible side effects. Health-care professionals play a key role in helping to ameliorate the pain caused by postherpetic neuralgia through early recognition and diligent assessment of the problem; recommending evidence-based treatments; and monitoring treatment adherence, adverse events, responses, and expectations. Nurse practitioners are especially crucial in establishing communication with patients and encouraging the initiation of appropriate pain-relieving treatments. Keywords: postherpetic neuralgia, herpes zoster, shingles, gabapentin, pregabalin, tricyclic antidepressants

This study examined the psychometric properties of the Pain Care Quality (PainCQ) survey, a new instrument to measure the quality of nursing and interdisciplinary care related to pain management. Hospitalized medical/surgical oncology patients with pain from 3 states completed the 44-item version of the PainCQ survey following completion of a nursing shift. Interdisciplinary items were evaluated over the entire hospital stay; nursing care was evaluated during the previous shift. The sample included 109 patients ranging in age from 20 to 84 (mean = 53.09). The sample was 58.7% female, 88% non-Hispanic white. Principal Axis Factoring with an oblimin rotation was used as factors were correlated. Two scales resulted. The PainCQ-Interdisciplinary scale included 11 items representing 2 constructs and explaining 47.1% of shared item variance: partnership with the health care team (k = 6 items; [alpha] = .85) and comprehensive interdisciplinary pain care (k = 5 items; [alpha] = .76). The PainCQ-Nursing scale measured three constructs and explained 60.8% of shared item variance: being treated right (k = 15 items; [alpha] = .95), comprehensive nursing pain care (k = 3 items; [alpha] = .77), and efficacy of pain management (k =4 items; [alpha] = .87). Results supported the internal consistency reliability and structural validity of the PainCQ survey with 33 items. PERSPECTIVE: This article presents the psychometric properties of a new tool to measure interdisciplinary and nursing care quality related to pain management from the patient's perspective. This tool can be used for research and as a clinical performance measure to monitor and improve quality of care and patient outcomes. [ABSTRACT FROM AUTHOR]

The primary cause of bleeding in patients with cancer is thrombocytopenia and it commonly is attributed to myelosuppressive chemotherapy, radiation therapy, or bone marrow infiltration of the malignancy. Oncology nurses have a critical role to play in the prevention and management of bleeding in patients with cancer. As part of an Oncology Nursing Society Putting Evidence Into Practice (PEP) project team, the authors of this article reviewed the current literature to identify effective interventions in the prevention and management of bleeding in patients with cancer. The authors evaluated research studies conducted since 1991, current clinical practice guidelines, and systematic reviews. The literature was reviewed, synthesized, and developed into evidence tables that were ultimately published in a PEP card. All data were reviewed by experts in the field of thrombocytopenia. The Prevention of Bleeding PEP card was unveiled at the 8th Annual Institutes of Learning in November 2007. [ABSTRACT FROM AUTHOR]

When a parent dies from cancer, each surviving child faces unique grief and loss issues. Nurses play a major role in caring for the child whose parent has died or is expected to die from cancer. The nurse's responsibility begins with assessing the child's coping strategies, family environment, and community resources. All three components affect the child's ability to progress through the grief process. Early assessment may identify problematic grief reactions and facilitate a positive outcome. Interventions that facilitate the grieving process include involving the child and family in grief groups, providing individual counseling, providing adequate information, assisting the child in the creation of memory keepsakes, and encouraging normalcy within the family. [ABSTRACT FROM AUTHOR]

Support and solutions for this devastating consequence of chemotherapy. [ABSTRACT FROM AUTHOR]

Objectives: Provide an overview of how pain impacts mobility in patients with cancer., Methods: A literature search was conducted in PubMed and on Google Scholar using search terms, cancer pain with mobility, acute and chronic pain syndromes, enhanced recovery after surgery, nursing care, and rehabilitation. Peer-reviewed research studies, review articles, and pain guidelines and position papers were reviewed to provide an overview on cancer pain, its impact on mobility, and the nurse's role in managing pain and optimizing mobility and functional outcomes., Results: Firty-two references were included in this overview. This body of literature is replete with studies on the management of pain; however, the tie between pain and mobility has not been well described aside from the breakthrough pain literature. This manuscript weaves these two important concepts together to better inform nurses and other clinicians regarding the importance of managing pain to even begin mobilizing patients, especially following surgery and for other painful conditions., Conclusions: Oncology nurses play an integral role in assessing and managing cancer pain. It is important for nurses to recognize how their pain management interventions lead to improved mobility and functioning in patients with cancer., Implications for Nursing Practice: Nurses comprise the largest workforce around the globe and are well-equipped to assess and manage cancer pain in all cancer care settings. As leaders within the healthcare team, making recommendations to better control pain and communicating with other team members regarding the pain plan is essential in improving mobility in patients with cancer., Competing Interests: Declaration of competing interest The authors declare no potential conflicts of interest., (Copyright © 2024 Elsevier Inc. All rights reserved.)

Background: Transitioning into oncology practice can be challenging for new graduate RNs. High patient acuity, a steep learning curve, psychosocial challenges, and frequent patient deaths can be overwhelming., Objectives: The purpose of this program was to provide resilience training for new graduate oncology nurses as part of an existing nurse residency program. Building resilience among oncology nurses was a primary goal during the COVID-19 pandemic and continues to be an important goal., Methods: Resilience training in this program consisted of didactic lectures, personalized goal setting, one-on-one mentoring, and a follow-up support group. Various measurement scales were used at baseline, 6 months, and 12 months to assess resilience, professional quality of life, and new graduate experience measures, including communication and organizational skills., Findings: Resilience significantly declined from baseline to six months; professional quality of life and new graduate experience measures also worsened. Some improvements in organizational skills and communication emerged at 12 months. Results indicate an ongoing need to consider extending nurse residency programs, resilience training, and support beyond the traditional one-year period.

Objectives: Provide an overview of navigation in three disparate populations: rural, Native American/Alaska Native, and low- to middle-income countries. Discuss gaps in care and opportunities to improve cancer care., Methods: A literature search was conducted in PubMed and on Google Scholar using search terms, nurse navigation, cancer, disparit*, low- to middle-income countries, Native American, American Indian, and rural. Peer-reviewed research studies, review articles, databases and websites of professional organizations, and historical books were reviewed to provide an overview of oncology nurse navigation in underserved communities. Experiences in working with these populations over the past 30 years were also provided to support current literature., Results: Forty references were included in this overview of nurse navigation in underserved communities. Nurse navigation in these disparate areas is in its infancy. While some programs exist and outcomes have been positive, their dissemination is sparse. A need exists to expand nurse navigation into these areas to provide care for these underserved communities., Conclusion: Oncology nursing navigation for each of these underserved communities requires a culturally sensitive approach. Many of these approaches are universal to cultural competency and can be applied to most disparate populations., Implications for Nursing Practice: Nurses comprise the largest workforce around the globe and are well-equipped to develop navigation programs in some of the most disparate communities around the world. To do so, it is important to use a foundation of building trust, embracing individual differences, providing culturally sensitive education and resources for growth, and good communication., Competing Interests: Declaration of competing interest The author declares that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 Elsevier Inc. All rights reserved.)

Background: Perianal injuries in adults with hematologic malignancies can result in sepsis or death. Patients on a 36-bed acute care oncology unit experienced increased perianal injuries from 2018 to 2021 based on a chart review, which revealed that 24 patients with leukemia, all of whom had received cytarabine, developed perianal injuries., Objectives: This study examined whether a nurse-led educational intervention would decrease perianal injuries., Methods: A survey examined baseline nurse knowledge on perianal injuries. Nurses received a 10-minute in-service education session about perianal injuries, their predisposing factors, and prevention strategies followed by a survey to test their knowledge. Twenty nurses completed the pre- and postintervention surveys., Findings: After the intervention, staff knowledge increased by 33%. One year postintervention, perianal injuries had decreased by more than 50%. Nurse and patient education are vital to decrease perianal injuries in patients with leukemia.

Background: Low back pain (LBP) is a significant source of disability and decreased quality of life. The Self-Natural Posture Exercise (SNPE) intervention can be used effectively in many cases, but feasibility and impact has not been fully explored., Objective: The current study explores the feasibility and efficacy of face-to-face (FtF) and virtual (Vir) SNPE programs on chronic low back pain., Methods: This is a randomized single-blinded waitlist control study with 10 participants in the FtF group (age 45.8 ± 2.89) and 9 in the Vir group (age 52.2 ± 2.3). Participants had low to moderate low back pain for > 3 months. Those who would eventually become the Vir group served initially as a waitlist control (Con) group. The FtF group received 12 weeks of in-person exercise training sessions conducted and the Vir group received weekly recorded training videos created by and featuring the same instructor. Measured outcomes included feasibility assessed by rate of retention and rate of attendance, level of low back pain (Oswestry Disability Index, Visual Analogue Scale), quality of life (36-Item Short Form Health Survey 1.0), muscular pressure pain threshold, and muscle tone. Analysis was done via repeated measures ANOVA and Wilcoxon tests., Results: Rates of retention were 80% in the FtF group and 78% in the Vir group. Attendance rates were 88% in the FtF group and 60% in the Vir group. ODI, VAS, and some SF-36 domains improved in both the FtF and Vir groups. Overall, the FtF group improved in more domains and by a larger degree than the Vir group and both groups improved relative to Con., Conclusion: A 12-week SNPE program, done virtually or in person, shows promise in improving ODI, VAS, and some SF-36 domains. FtF appears to be more effective. Future studies would benefit from sampling a larger and more diverse population.

Patients with cancer who are immunocompromised are at risk for catheter-associated urinary tract infections (CAUTIs). Many recommendations are available for healthcare organizations to use to reduce CAUTIs. Implementing vario.

Objective: Holographic Memory Resolution® (HMR®), a mind-based therapy, has been used for decades as a nonpharmacologic intervention for trauma imprinting to alleviate depression, anxiety, pain, and post-traumatic stress disorder (PTSD). No clinical studies were found examining the use of HMR®. This study examined the feasibility and preliminary efficacy of administering HMR® to individuals experiencing chronic pain and related biopsychosocial symptoms., Methods: A feasibility, mixed-methods study was conducted between October 2021 and July 2022 and included four HMR® sessions over 1-12 weeks. A convenience sample was comprised of 60 adults suffering from chronic physical or emotional pain of 4+ (0-10 scale) over 6+ months at two clinics in the U.S. Baseline and subsequent surveys after sessions 2, 3, and 4 assessed symptom response. Symptoms were longitudinally measured via self-report of depression, anxiety, somatic symptom burden, PTSD, and vitality., Results: 73% completed all four sessions, demonstrating feasibility. Ages ranged from 19 to 80 years, 85% were female, and 87% were Caucasian. 52% reported high risk for toxic stress. Four symptoms decreased significantly: depression ( p  = 0.05), anxiety ( p  = 0.03), symptom burden ( p  < 0.01) and PTSD symptoms ( p  = 0.01); vitality improved., Conclusions: HMR® may be a feasible intervention to address chronic pain and accompanying biopsychosocial symptoms; a randomized controlled trial is the next step to measure efficacy. Unlike other mind-based therapies, HMR® participants use their own internal language for identification and resolution of the pain. The trauma imprinting can then be gently addressed, and the memory-based components of pain resolved or reduced, which empowers participants to improve their well-being., Trial Registration: ClinicalTrials.gov Identifier: NCT05001399., (© 2023 The Authors. Psychiatric Research and Clinical Practice published by Wiley Periodicals LLC on behalf of American Psychiatric Association.)

Purpose: The purpose of this mixed-methods psychometric study was to translate and adapt the Arabic Pain Care Quality (APainCQ) Survey to Arabic and to measure the quality of pain care provided to Arab patients., Patients and Methods: This study used an iterative, mixed-methods approach that employed cognitive interviews, expert content analysis, and factor analysis to develop the APainCQ Survey. The study was conducted at Dubai Hospital, Dubai Health Authority, United Arab Emirates. Arabic-speaking patients admitted to the oncology/hematology inpatient units with a minimum 24-hour stay were eligible for the study., Results: The sample consisted of 155 patients. The iterative exploratory factor analysis process resulted in the sequential removal of three items. The results of the significant Bartlett test ( P < .001) of sphericity and Kaiser-Meyer-Olkin test of 0.93 for both the health care team scale and the nurse scale. The total variance explained was 76.17% for the health care team scale and 60.91% for the nurse scale, which explained 56.51% for factor 1 with 14 items and 4.40% for factor 2. Regarding internal consistency reliability, Cronbach's alpha and McDonald's omega for the health care team scale and nurse scale were high; both values were .95. Internal consistency reliability of pain assessment and pain management subscales of nurse scales were also high, with values of 0.96 and 0.79, respectively. Moreover, there was a moderate correlation ( r = 0.66; P < .001) between the two subscales in the nurse scale., Conclusion: This study provides evidence that the APainCQ is a reliable and valid measure of pain dimensions, including pain management and monitoring. This APainCQ scale can potentially expand research and clinical assessment in the Arab world.

Background: Although existing trauma nurse courses provide basic education, advanced courses with simulation experiences that enhance team leadership, communication, and workflows are lacking., Objective: To design and implement the Advanced Trauma Team Application Course (ATTAC) to promote advanced skills for nurses and respiratory therapists with varied experience and skill levels., Methods: Trauma nurses and respiratory therapists were selected to participate based on years of experience and the novice to expert nurse model. Two nurses from each level (excluding novice) participated, ensuring a diverse cohort to promote development and mentorship. The 11-module course was presented over 12 months. A five-question survey was employed at the end of each module to self-evaluate assessment skills, communication skills, and comfort for trauma patient care. Participants rated skills and comfort on a "0-10" scale, with 0 being "not at all" to 10 being "extensively.", Results: The pilot course was conducted from May 2019 to May 2020 at a Level II trauma center in the Northwest United States. Nurses reported ATTAC improved assessment skills, team communication, and comfort in caring for trauma patients (mean = 9.4; 95% CI [9.0, 9.8]; scale of 0-10). Participants indicated scenarios closely mimicked real-world situations; concept application commenced directly following each session., Conclusion: This novel approach to advanced trauma education promotes development of advanced skills that enable nurses to anticipate needs rather than being reactive, engage in critical thinking, and adapt to rapidly changing patient conditions., Competing Interests: Jeannine M. Brant reports serving on the Speakers' Bureau for Daiichi Sankyo/Astra Zeneca. The other authors have no conflicts of interest or funding to declare., (Copyright © 2023 Society of Trauma Nurses.)

Background: Adoption of evidence remains slow, leading to variations in practices and quality of care. Examining evidence-based interventions implemented within oncology settings can guide knowledge translation efforts., Objective: This integrative review aimed to (1) identify topics implemented for oncology-related evidence-based practice (EBP) change; (2) describe frameworks, guidelines, and implementation strategies used to guide change; and (3) evaluate project quality., Methods: PubMed and CINAHL were searched to identify published practice change projects. PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-analyses) guidelines were followed. Fifty articles met the inclusion criteria. Data were extracted; content analysis was conducted. The Quality Improvement Minimum Quality Criteria Set guided quality assessment., Results: Topics included infection control/prevention (n = 18), pain/palliative care (n = 13), psychosocial assessment (n = 11), and medication adherence (n = 8). Among the projects, Plan, Do, Study, Act (n = 8) and Lean Six Sigma (n = 6) frameworks were used most. Thirty-six projects identified guidelines that directed interventions. Multiple implementation strategies were reported in all articles with planning, education, and restructuring the most common. Reach, sustainability, and ability to be replicated were identified as quality gaps across projects., Conclusion: The EBP topics that emerged are consistent with the oncology nursing priorities, including facilitating integration of EBP into practice. The studies identified used national guidelines and implementation strategies to move evidence into practice. Heterogeneity in measurement made synthesis of findings difficult across studies, although individual studies showed improvement in patient outcomes., Implications for Practice: Development of an interprofessional oncology consortium could facilitate a standardized approach to implementation of high-priority topics that target improved patient outcomes, harmonize measures, and accelerate translation of evidence into practice., Competing Interests: The authors have no funding or conflicts of interest to disclose., (Copyright © 2022 Wolters Kluwer Health, Inc. All rights reserved.)

Background Nurse residency programs (NRPs) have been proposed to meet the educational needs of new graduate nurses and facilitate the transition into practice. Although most studies indicate the benefits of NRPs to assist nurses during transition into practice, only one study compared an NRP with a control group. This study examined whether nurses in an NRP transitioned into practice more successfully than nurses in a traditional orientation program. Method This study enrolled 106 newly employed graduate nurses into study arms by unit: a nurse residency intervention group or a control group of standard nursing orientation. Casey-Fink Readiness for Practice, Nurse Retention, and Nurse Job Satisfaction surveys measured group outcomes. Results Readiness for practice improved significantly for nurse residents, as did nurse retention perceptions, indicating that nurse residents were more likely to be retained at the organization. The 1- and 2-year nurse retention rates during the 3 years of the study showed marked improvement. Conclusion The NRP resulted in improved readiness for practice, improved nurse retention, and higher job satisfaction compared with standard orientation. [ J Contin Educ Nurs . 2023;54(1):32-39.] .

Background: Black patients are diagnosed with melanoma at a later stage, as compared with their white counterparts. It is unknown if Medicaid expansion might ameliorate this disparity., Methods: Using data from the 2016 National Cancer Database, we conducted a retrospective cohort study. The primary objective was to evaluate whether being diagnosed with melanoma at a Medicaid Expansion State (MES) and black race are associated with a late diagnosis of melanoma.  Main exposure: Being diagnosed in a MES. Secondary exposure: Race. Main outcome: Odds of Stage IV vs Stages 0-III at diagnosis. Univariate, multivariate logistic regression, and propensity score analyses were conducted to evaluate the potential associations. Sub-group analysis was conducted according to age < 65 or ≥ 65 years., Results: A total of 216,604 patients were included, 40-90 years of age, [Formula: see text] 64 years [SD 12.47]. In univariate analysis, patients diagnosed in MES were 15% less likely (95% CI, 0.81-0.88) to be diagnosed with Stage IV melanoma. Black race (vs white) had 3.04 increased odds (95% CI, 2.56-3.60) of late diagnosis. In multivariate analysis, adjusting for socio-economic confounders, patients < 65 years of age were 13% less likely (95% CI, 0.82-0.92) to be diagnosed with Stage IV melanoma. By propensity score analysis, the strength of the associations remained. Black race (vs white) was associated with higher odds (95% CI, 1.91-3.08) of being diagnosed with Stage IV disease. For black patients < 65 years, being diagnosed in a state without Medicaid expansion had 2.55 higher odds (95% CI, 1.93-3.38) of being diagnosed with Stage IV melanoma, which decreased to 2.11 odds (95% CI, 1.34-3.33) in MES. The interaction between race and MES was statistically significant (P = 0.008)., Conclusions: This study suggests that patients are less likely to be diagnosed with Stage IV melanoma in MES. This beneficial effect is more pronounced among Black minorities., (© 2021. W. Montague Cobb-NMA Health Institute.)

Background: Pancreatic cancer disparities have been described. However, it is unknown if they contribute to a late diagnosis and survival of patients with metastatic disease. Identifying their role is important as it will open the door for interventions. We hypothesize that social determinants of health (SDH) such as income, education, race, and insurance status impact (I) stage of diagnosis of PC (Stage IV vs. other stages), and (II) overall survival (OS) in Stage IV patients., Methods: Using the National Cancer Database, we evaluated a primary outcome of diagnosis of Stage IV PC and a secondary outcome of OS. Primary predictors included race, income, education, and insurance. Covariates included age, sex and Charlson-Deyo comorbidity score. Univariate, multivariable logistic regression models evaluated risk of a late diagnosis. Univariate, multivariable Cox proportional hazards model examined OS. 95% confidence intervals were used., Results: 230,877 patients were included, median age of 68 years (SD 12.1). In univariate analysis, a better education, higher income, and insurance decreased the odds of Stage IV PC, while Black race increased it. In multivariable analysis, education [>93% high-school completion (HSC) vs. <82.4%, OR 0.96 (0.93-0.99)] and insurance [private vs. no, OR 0.72 (0.67-0.74)] significantly decreased the risk of a late diagnosis, whereas Black race increased the odds [ vs. White, OR 1.09 (1.07-1.12)]. In univariate Cox analysis, having a higher income, insurance and better education improved OS, while Black race worsened it. In multivariable Cox, higher income [>$63,333 ( vs. <$40,277), HR 0.87 (0.85-0.89)] and insurance [private vs. no, HR 0.77 (0.74-0.79)] improved OS., Conclusions: SDH impacted the continuum of care for patients with advanced pancreatic cancer, including stage at diagnosis and overall survival., Competing Interests: Conflicts of Interest: All authors have completed the ICMJE uniform disclosure form (available at https://jgo.amegroups.com/article/view/10.21037/jgo-21-788/coif). JMB discloses serving on the Speakers’ Bureau for Daiichi Sankyo and Aztra-Zeneca. JCF discloses institutional research support from: BMS, Merck, Astra Zeneca, Likely, Bayer, Ipsen, GSK, Astellas Pharma, Genentech, and BioMed Valley Discoveries. TJG discloses consulting fees from Tempus and Pfizer, and Research support (Institution): BMS, Merck, Astra Zeneca, Likely, Bayer, Ipsten, GSK, Astellas Pharma, Genetech, BioMed Valley Discoveries. The other authors have no conflicts of interest to declare., (2022 Journal of Gastrointestinal Oncology. All rights reserved.)