by Catherine Johnson, Calvary Mater Newcastle, Newcastle, Australia. ISNCC Finance and Audit Committee Member, ISNCC Corporate and Philanthropic Committee Member, ISNCC Knowledge Development and Dissemination Committee Member, ISNCC Communications Committee Member, ISNCC Member Development Committee Member.
Globally non-communicable diseases (NCDs) which include cancer, cardiovascular diseases, diabetes and chronic respiratory diseases make the largest contribution to mortality; approximately 60% (35 million) of all deaths and have the greatest impact in low and middle income countries (28 million deaths) (1). Most of these deaths are from preventable causes: tobacco use, unhealthy diets, alcohol consumption and physical inactivity. In 2010 the International Council of Nurses (ICN) identified that nurses are well positioned to lead NCD prevention, care and treatment. The ICN have developed a website (www.growyourwellness.com) that has a variety of tool and resources to help nurses lead wellness including prevention and health promotion tools, health assessments, policy and advocacy and also a section on nurses’ own health.
The International Society of Nurses in Cancer Care (ISNCC) has strong leaders in the prevention and control of NCDs. Stella Bialous, current ISNCC president, with her colleague Linda Sarna have been advocates of tobacco cessation and the important role of nurses in helping smokers quit. They highlight tobacco cessation is incredibly important as it can lead to all four of the NCDs and have actively pursued capacity building of nurses in tobacco control. Of note, the ISNCC updated tobacco position statement was released in July 2014 and can be found at http://www.isncc.org/?page=Position_Statements. The ISNCC tobacco taskforce has been hosted in Eastern Europe (2012) and in China (2014) to increase nurses’ delivery of tobacco dependence treatment.
In 2014, at the World Cancer Leaders’ Summit, Sanchia Aranda, Past ISNCC president and current president of the Union for International Cancer Control, advocated for prevention strategies including higher tobacco taxes; implementation of prevention packages to improve diets and increase physical activity; development of effective workplace health promotion programs; and widespread vaccination programs, particularly in low-resource settings where routine screening and treatment services may not be available. Professor Aranda also spoke of the need for solutions that are accessible and affordable that deliver a return on investments for governments, particularly low and middle income countries where the burden of disease is greater and health services are not as well developed or resourced.
Nurses can play key roles in prevention and control of NCDs through key areas of policy, advocacy, research, education and clinical practice.
Do you feel prepared to contribute the prevention and control of NCDs?
Do you have the knowledge and skills to help patients, carers and their families modify their unhealthy behaviours to reduce their risk of developing one of the four key NCDs?
Will you be part of the solution?
by Susan L. Beck, University of Utah, Salt Lake City, United States. ISNCC Knowledge Development and Dissemination Committee Chair, ISNCC Conference Management Committee Member.
The Board of Directors of ISNCC is committed to increasing access to informational and educational resources to our members. The Knowledge Development and Dissemination (KDD) Committee is actively engaged in identifying and sharing high quality resources with our members. In 2014 we were approached by one of ISNCC’s corporate partners about the possibility of making an innovative educational resource available to our members. inPractice® Oncology Nursing is a digital point-of-care reference and educational resource designed specifically for nurses who care for patients with cancer. The program, available by subscription offers:
- Comprehensive, current oncology nursing practice standards
- Continually updated evidence-based recommendations from our expert, world-renowned oncology nursing authors
- 52 clinical modules covering nursing care of the whole patient—physical, psychosocial, and spiritual
- Apple/Android apps so you can learn on the go
- More than 80 ANCC contact hours, plus study prep for certification and recertification (US)
In order to make the resource affordable for our broad membership, inPractice® is now being offered at a discounted rate, especially for nurses in low and middle income countries (see below).
An online survey of ISNCC members conducted December 2014 measured member interest in the inPractice Oncology Nursing product, including the value of both content and functionality. 1,027 ISNCC members were invited to take the survey and 299 across 63 countries participated for a response rate of 29.1%. . In general, respondents were well-educated and experienced, which is representative of ISNCC individual members.
Over 90% indicated the resource (inPractice) would be valuable or very valuable. Respondents were very positive about both the content and functional attributes. The ability to receive continuing education units from the US was least favorable but even that feature was values by 57% of the respondents. Respondents felt that all clinical topics surveyed were applicable to their clinical practice with symptom management being endorsed by most.
One said “I feel it may be useful to me and my patients. I will be able to provide better care and the outcome of the care also would be better. I can utilize this to teach my students and colleagues as well.” Not surprisingly, there were some who expressed that even at a reduced rate the resource might be too expensive.
We concluded from the survey that there is strong interest in the oncology nursing online resource (inPractice), with strong purchase intent across both higher and lower resource regions. According to the survey, the US-based nature of the resource was only perceived to have a slight limit on its value to our members. The product is appealing for several uses encompassing: professional development, staff training, clinical reference, and other applications.
We are therefore excited to launch this new resource. As an ISNCC corporate partner, inPractice is pleased to offer ISNCC members special, discounted pricing! Please click here to log in to your ISNCC member profile to view the discounted subscription rates and how to subscribe.
We look forward to evaluating this resource and hearing from you about how it is being used.
Clinical Care Options ISNCC Survey. December 2014. Data on file.
Clinical Care Options ISNCC Survey. December 2014. Data on file.
by Ayda Nambayan, Makati Medical Center, Manila, Philippines. ISNCC Knowledge Development and Dissemination Committee Member.
The theme of “Feel no pain” predominates the 6th Congress of the Association of South-East Asia Pain Societies (ASEAPS), held in Manila, Philippines on March 14-17, 2015. ASEAPS represent the 11 countries of South East Asia, with most member countries categorized as either developing or underdeveloped. Although the scientific program comprehensively covered new developments in the etiology and management of both acute and chronic pain, this blog limits itself to pain as it relates to cancer and palliative care.
In 2012, the Asian Oncology Summit issued a consensus that for the countries where cancer mortality consistently remains high (>%50%), palliative care should be offered as an integral part of cancer care. From the very beginning, ASEAPS have always embraced the notion that pain and palliative care form one entity and in this congress, palliative care has been included with emphasis on multidisciplinary approach to care.
This is the second time that ASEAPS Congress has been held in the Philippines, the first one was in 2006. During the faculty social, the dinner discussion centers on changes in the essential pain medicine consumption within the represented countries between 2006 and 2015. Sad to say, the region follows the global trend in opiod use, where countries with limited resources consume the least opiod to manage pain. Dr. Jim Cleary quoted the most recent International Narcotic Control Board (INCB) report that 92% of pain medications are consumed by well-developed and developed countries, leaving about 85% of the world’s population with minimal or no adequate access to pain medications for control. Because of this disparity, many cancer patients are suffering and dying in pain.
Asians are often believed to be of stoic nature, especially when it comes to complaints of pain. Cultural factors are often cited as one of the main reasons but during this conference, preliminary studies in pharmacogenomics show some evidence in the role of genetics in opiod responses that could possibly explain Asian pain response. These studies are promising especially in its implications to the challenges of access, availability and other problems with opiods in the region.
Relative to palliative care, the multidisciplinary session focused on palliative care provision in Southeast (SE) Asia. It has been reported that only 20 out of 234 countries have integrated palliative care into the health care system and 75 countries do not provide palliative care services at all. In SE Asia, only one country (Singapore) has a well-integrated palliative/end-of-life program in mainstream health care. However, Malaysia and Thailand are fast coming into the arena, having just recently adopted palliative care as a governmental initiative.
Geographical differences between urban and rural areas, historical and political developments and culture pose resource and implementation challenges for the Southeast Asian countries. Many palliative care services are working in relative isolation and provision of such services can be patchy. Challenges include lack of education, both in palliative care and pain/symptom control; it was also reported that in some countries, health care workers are unaware that pain should be assessed and are unaware of the WHO pain ladder for pain management.
One of the questions was whether the western hospice model of care fit into the Asian health care environment. Issues about disclosure, autonomy, family relationships and roles, dying rituals and other factors will influence how hospice care should be shaped and delivered in the Southeast Asia region. Many Asians do not want to talk about death, and lest prepare for it. Asians have a pervasive belief that someone may have bad luck if they talk about death and dying. This belief influences greatly the need to embrace the new paradigm of palliative care, where palliative care is introduced early on in cases where disease modification (or even cure) is the goal. To this end, there was a sure bet statistic mentioned during the congress, that human mortality rates have not changed at all – it is still and remains at 100%.