Symptom clusters in patients receiving chemotherapy: A systematic review

Background and purposeSince 2001, symptom cluster research has grown considerably. However, because multiple methodological considerations remain, ongoing synthesis of the literature is needed to identify gaps in this area of symptom science. This systematic review evaluated the progress in symptom clusters research in adults receiving primary or adjuvant chemotherapy since 2016.MethodsEligible studies were published in English between 1 January 2017 and 17 May 2021; evaluated for and identified symptom clusters ‘de novo;’ and included only adults being treated with primary or adjuvant chemotherapy. Studies were excluded if patients had advanced cancer or were receiving palliative chemotherapy; symptoms were measured after treatment; symptom clusters were pre-specified or a patient-centred analytic approach was used. For each study, symptom instrument(s); statistical methods and symptom dimension(s) used to create the clusters; whether symptoms were allowed to load on more than one factor; method used to assess for stability of symptom clusters and associations with secondary outcomes and biomarkers were extracted.ResultsTwenty-three studies were included. Memorial Symptom Assessment Scale was the most common instrument and exploratory factor analysis was the most common statistical method used to identify symptom clusters. Psychological, gastrointestinal, and nutritional clusters were the most commonly identified clusters. Only the psychological cluster remained relatively stable over time. Only five studies evaluated for secondary outcomes.DiscussionWhile symptom cluster research has evolved, clear criteria to evaluate the stability of symptom clusters and standardised nomenclature for naming clusters are needed. Additional research is needed to evaluate the biological mechanism(s) for symptom clusters.PROSPERO registration numberCRD42021240216.

The Effect of Educational Intervention on Care Dependency and Symptom Management After Hematopoietic Stem Cell Transplantation: A Theory-Based Randomized Controlled Study

The objective of the research was to determine the effect of educational intervention based on Bandura’s Social Cognitive Learning Theory on care dependency and symptom management after hematopoietic stem cell transplantation. Methods. This randomized controlled trial was conducted between January 2019 and February 2020 at the Hematopoietic Stem Cell Transplantation Center. All the patients were randomly divided into two groups: 53 individuals in the intervention group and 53 individuals in the control group. The sociodemographic data collection form, the Edmonton Symptom Assessment Scale and the Care Dependency Scale were used for data collection. Data were collected from the patients one day after hematopoietic stem cell transplantation and 12 weeks later. Results. There were no statistically significant differences between the groups regarding the mean scores of the Edmonton Symptom Assessment Scale and the Care Dependency Scale at baseline. Twelve weeks after intervention, there were statistically significant differences between the groups regarding the mean scores of the Edmonton Symptom Assessment Scale and the Care Dependency Scale. Conclusions. Educational intervention along with telephone counseling based on Bandura’s theory was found to be an effective way to reduce symptom severity and care dependency in patients who underwent hematopoietic stem cell transplantation and is recommended for all patients after hematopoietic stem cell transplantation.

Efficacy of Cognitive Behaviour Therapy in Gambling Disorder (A Case study)

Context: Gambling disorder is a mental health condition in which a person repeatedly engages in gambling behaviour despite various negative consequences. The condition is also known as gambling addiction, pathological gambling or compulsive gambling. Recent studies have demonstrated the efficacy of Cognitive Behaviour Therapy in treating gambling disorder. Aim: In the present study, the efficacy of cognitive behaviour therapy in treatment of an adult patient with gambling disorder was examined. Settings and Designs: A single case design with pre- and post-assessments on clinician-rated scales were adopted. Materials and Methods: Fourteen bi-weekly sessions of Cognitive Behaviour Therapy were conducted on an inpatient basis. Assessments were carried out on Gambling Symptom Assessment Scale and Hamilton Anxiety Rating Scale, at pre- and post-therapy points. Analysis: Pre- and post-therapy changes were examined using the method of clinical significance. Results: A significant decline was seen on the Gambling Symptom Assessment Scale, and Hamilton Anxiety Rating Scale Conclusion: Application of CBT was effective in treating the anxiety, and gambling symptoms in the patient with Gambling Disorder

Symptoms and symptom clusters in adolescents with cancer

Clinical specialists have suggested that adolescents with cancer experience multiple problems including physical, psychological, and emotional symptoms. This study aimed to identify symptoms and symptoms clusters among adolescent inpatients and outpatients receiving cancer treatment. The study’s sample consisted of 26 adolescents who were selected with the purposeful sampling method in a paediatric oncology unit in Edirne, Turkey. Data were collected using the Memorial Symptom Assessment Scale (MSAS). From the results of the research, in terms of symptoms, outpatients reported a greater lack of concentration than inpatients did. Inpatients reported more hair loss and weight loss symptoms than outpatients. Adolescent inpatients and outpatients experienced the most symptoms during the treatment. Inpatient adolescents experienced more acute treatment-related symptoms than did outpatients. The study recommends regular monitoring and screening for nurses to identify symptom and symptom clusters. Keywords: Adolescent; nursing; symptom cluster; symptom assessment; cancer;

Coping with a narcissistic partner during lockdown - A qualitative research

This work is a phenomenological analysis that investigates how the lockdown was perceived by dysfunctional families, namely, narcissistic families. The literature indicates serious disorders in the family life of the narcissist, hostility, tension, conflict, instability (Campbell, Foster, 2002; Kohut, 1972), so, we are interested in describing how narcissistic partners perceive their relationship, and how they describe the period spent during the pandemic restrictions. Two case studies were conducted, which were selected so as to be relevant to the research objectives. We were also interested in the psychological symptoms of the two subjects investigated shortly after the restrictions were lifted. In this regard, the Revised 90 symptom assessment scale (Marian, M.I., 2008) was also applied. The results of this study confirm the negative effects on mental health that a relationship with a narcissistic partner holds during lockdown and encompasses surprising coping strategies that make living with a narcissistic partner possible. Keywords: lockdown, narcissistic family, stress, mental health, coping

Comfort Level in Caregivers of Palliative Care Patients and Affecting Factors: What Should We Know?

Caregivers are an important source of support for patients in palliative care. Comfort is an important concept in nursing care for both patients and their families, and nurses aim to increase comfort. The aim of the study was to determine the comfort level and influencing factors in caregivers of palliative care patients. The research sample consisted of 102 caregivers related to palliative care patients. The data were obtained with an Individual Information Form, the Edmonton Symptom Assessment Scale (ESAS) and the End of Life Comfort Scale (Caregiver/Family). The study was conducted in the palliative care clinic of Aksaray University Training and Research Hospital between October 2018 and April 2019. There was a significant relationship between the total comfort score of the caregivers and the patient's performance status, the caregivers' age, their economic situation, the length of the caregiving period and receiving help in care (social support) ( p < 0.05). Providing comfort is an important function and challenge for holistic nursing care, as comfort is a lifelong need in health and disease. Caregivers in the risk group should be aware of this issue and necessary precautions should be taken.