by Myrna A. A. Doumit, Alice Ramez Chagoury School of Nursing, Beirut, Lebanon. ISNCC Conference Management Committee Member.
It gives me great pleasure to write about my experience at the ICCN conference this year in Vancouver. The conference was a breathtaking scientific meeting. Topics were diverse and rich which helped in meeting all attendees’ needs. The preconference workshops were very interesting and included hands on experience which made them more attractive and stimulating. I personally attended the mixed method design workshop and it was very useful and the moderators were very knowledgeable and able to convey the message properly and professionally. The plenary sessions were remarkable in terms of presenters and content.
The most exciting event that happened with me was that my poster won the people’s award. In reality I did not expect such a triumph. Not because I do not believe in what I am doing, on the contrary I did my poster with the aim of relying my results to the highest number of people in the most interesting and attractive method. But in view of the conditions of the competition which depend on the people’s choice and opinion with all honesty as Lebanese I did not expect to win thinking that people would vote for their friends or country mate, but again the objectivity of nurses won! And here I would like to thank all those who voted and all those who did not vote for my poster. Thank you for making this conference an unforgettable event in my professional life.
In conclusion I cannot forget the remarkable organization of the conference and the helpfulness of the all staff and organizing committee for making this scientific meeting a memorable event in the life of many attendees.
Myrna Doumit (right) receiving People’s Choice Poster Award from Linda Krebs (left) at ICCN 2015.
by Sandra L. Spoelstra, Michigan State University College of Nursing, East Lansing, United States.
Patients with cancer miss as much as one third of the prescribed doses of oral anti-cancer agents required for treatment of their disease. Even more disconcerting is that within the next three years, 25% of cancer treatment will be delivered in pill form. This shift in the treatment paradigm will result in increased care in the home, placing greater responsibility on patients. Barriers to oral agent adherence for patients include no or limited coverage for the medication, complex dosing regimens, difficulty obtaining the prescription, running out of the prescription, forgetting to take the pills, skipping or stopping because they believed the medication was not working or because it created symptoms from side effects, and not seeking help from others. Often, the more adherent patients are to oral chemotherapy agents, the more likely they are to experience symptoms. Patients prescribed oral agents have indicated titrating doses as they were unable to tolerate symptoms occurring as a side effect of the cancer treatment. Thus, prompt and aggressive management of symptoms becomes vital to managing adherence at home. Furthermore, pharmacy literature suggests a narrow therapeutic index for cancer therapy, increasing the importance of oral agent adherence, as non-adherence may affect time to disease progression and mortality. The therapeutic outcome for patients taking oral agents depends heavily on the ability of patients to adhere to the prescribed regimen. Healthcare research has not conclusively identified effective interventions to promote medication adherence. Chemotherapy classes are a common part of care for patients receiving IV treatment. However, training for patients on oral agents is underdeveloped, and needs to include adherence, monitoring and reporting of symptoms from side effects and toxicities, coordination of changes in dosing if altered or stopped, and management of insurance coverage and drug delivery. Oncology nurses must take the lead in structuring care settings that promote patient behavior to attain optimal adherence. Oncology nurses can help patients and their families understand what they are responsible for in many ways. The number of cancer patients who receive oral agents in pill form is increasing, and oncology nurses can lead the way enabling patients to adhere to and complete their cancer treatment.
Bassan, F., Peter, F., Houbre, B., Brennstuhl, M. J., Costantini, M., Speyer, E., & Tarquinio, C. (2014). Adherence to oral antineoplastic agents by cancer patients: Definition and literature review. European Journal of Cancer Care, 23, 22–35. doi:10.1111/ecc.12124
Lichtman, S. M., & Boparai, M. K. (2008). Anticancer drug therapy in the older cancer patient: pharmacology and polypharmacy. Current Treatment Options in Oncology, 9, 191–203. doi:10.1007/s11864-008-0060-6
Soria, J. C., Blay, J. Y., Spano, J. P., Pivot, X., Coscas, Y., & Khayat, D. (2011). Added value of molecular targeted agents in oncology. Annals of Oncology, 22, 1703–1716. doi: 10.1093/annonc/mdq675
Spoelstra, S. L., Given, B. A., Given, C. W., Grant, M., Sikorskii, A., You, M., & Decker, V. (2013a). An intervention to improve adherence and management of symptoms for patients prescribed oral chemotherapy agents: An exploratory study. Cancer Nursing, 36, 18–28.
Spoelstra, S. L., Given, B. A., Given, C. W., Grant, M., Sikorskii, A., You, M., & Decker, V. (2013b). Issues related to overadherence to oral chemotherapy or targeted agents. Clinical Journal of Oncology Nursing, 17, 604–609. doi:10.1188/13.CJON.17-06AP
Spoelstra, S. L., & Given, C. W. (2011). Assessment and measurement of adherence to oral antineoplastic agents. Seminars in Oncology Nursing, 27, 116–132. doi:10.1016/j.soncn.2011.02.004
Weingart, S. N., Brown, E., Bach, P. B., Eng, K., Johnson, S. A., Kuzel, T. M., . . . Walters, R. S. (2008). NCCN Task Force Report: Oral chemotherapy. Journal of the National Comprehensive Cancer Network: JNCCN, 6, S1–S14.
by Linda Krebs, University of Colorado Denver, Denver, United States. ISNCC Conference Management Committee Chair, ISNCC Finance and Audit Committee Member.
ISNCC’s 1st annual conference and 1st conference focused solely on cancer nursing research and evidence-based practice was a huge success! Held from July 8th to 11th at the Westin Bayshore Hotel in Vancouver, BC, Canada, ICCN 2015 was attended by almost 400 nurses from 41 countries. Nurses from across the globe came together to share their findings, discuss methodologies and form new collaborations, leading to additional and more rigorous oncology nursing research in the future.
For ICCN 2015, ISNCC modeled new collaborations at all levels. The Conference Management Committee (CMC) invited regional and international partners to take part in all aspects of conference planning. AONS, EONS, IPOS, and MASCC were our international partners while ONS was a regional partner. Each organization appointed a member to the CMC; these individuals, along with 5 ISNCC members and 2 ISNCC Board Members planned ICCN 2015 including identifying the keynote and plenary speakers, slotting abstracts and selecting posters after blind reviews and selecting symposium sessions. Symposia were new this year and a welcome addition to the program! Each 80 minute session included 1-3 speakers addressing a specific research topic, from symptom management to global nursing to advanced practice.
The meeting began on July 8th with a choice of 3 pre-conference workshops; workshop participation was included in the registration fee. Sessions included an ELNEC workshop, a Mixed Methods Workshop and a collaborative session between ISNCC and ONS on global nursing research. This was followed by our 1st ever “Meet the Experts” where Drs. Linda Sarna, Theresa Wiseman and Sanchia Aranda answered questions about their research careers posed by moderator Dr. Susan Beck and also provided advice to novice and seasoned researchers. The day concluded with the Opening Reception and Poster Session I in the Exhibit Hall. ISNCC was pleased to have a nice array of new and returning vendors who shared their products and information with attendees in a very collegial Exhibit Hall; attendees met vendors, sipped coffee and tea and reviewed posters all in one setting.
The conference theme, “Cancer Nursing Research: Global Strategies and Implications for Evidence Based Practice, was supported by all conference activities. The Opening Ceremony included a brief address by ISNCC President Dr. Stella Bialous, followed by the keynote address by Dr. Joan Bottorff on Gender-Sensitive Approaches to Cancer Prevention: Promising Directions for Promoting Health. The session concluded with a presentation by the Git Hayetsk Dancers, a Northwest Coast First Nations Mask-Dancing Group, a wonderful and multi-talented dance group who left the attendees spellbound, but ready to gain new knowledge!
Throughout the conference, abstract sessions focused on research topics ranging from cancer survivorship, to symptom management, to innovative practice and workforce issues. Participants were able to hear over 130 presentations and view more than 100 posters on the latest nursing research from across the globe. During each of the 2 poster sessions, conference participants were invited to vote on the Peoples’ Choice Poster Award, while a team of poster judges selected the top poster(s) for each session based on initial abstract scores. Peoples’ Choice Poster Award winners included Isabelle Brault, Myrna Doumit and Mary Glavassevich, while poster judges chose Tingyu Chiang and Myungsun Yi. Lunch and dinner tutorials and symposia rounded out the educational aspects of the conference, providing lunch/dinner and learning opportunities for all attendees. The Closing Ceremony brought us back together to reflect on all that had been taught and learned throughout the 3 ½ day conference. The final presentation and celebration was again by the Git Hayetsk Dancers who provided a wonderful ending to a fabulous conference!
We are now beginning to plan for ICCN2016 in Hong Kong, to be held from September 4-8, 2016 at the Sheraton Hong Kong Hotel. While still having nursing research and evidence-based practice at its core, ICCN 2016 will also include administration, education and practice as foci. There will be plenary, abstract, poster and symposia sessions as well as strategies to increase networking and interactions between attendees. Please plan to submit an abstract (or 2) and join us in Hong Kong for ICCN 2016!
by Marlon Garzo Saria, University of California San Diego Health System, La Jolla, United States. ISNCC Member Development Committee Member.
Hope is one of the most paradoxical concepts in cancer care. As nurses, there is a collective emphasis within the profession on actualizing our role as advocates for our patients, and with that, the expectation that we will always support and uphold our patient’s best interests. However, there are times when conflicts arise in our relationships with our patients, which sometimes happen with other healthcare professionals, including our fellow nurses. Many of us can recall an encounter where the patient’s family demanded extraordinary measures to extend the life of their loved one against the recommendation of the treating team. Conversely, many of us can also remember a story where one physician would pursue tumor response by offering one more agent, trying one more regimen, or enrolling the patient in one more clinical trial, even when the patient and the family have accepted that they are fighting a losing battle.
Our view of hope is influenced by our experiences, which are colored by the culture that defines us. From a country dominated by expatriates with a diverse ethnic and racial composition, to one that has maintained ethnic homogeneity albeit influenced by dominant cultures through media and the world wide web, the meaning of hope for each individual will not always be the same.
At a workshop hosted by the Oncology Nursing Society during the 2014 United Arab Emirates Cancer Congress, one course participant shared his intention to leave the oncology specialty primarily because of his constant struggle with oncology specialists proving false hope. False hope is one of the most commonly cited sources of moral distress, a phenomenon that occurs when an individual knows the ethically correct decision but is constrained from making it (Epstein & Delgado, 2010). During the discourse, workshop participants asked these provocative questions:
- Are there situations where we can all agree that there is truly no hope?
- Would we allow our patients and their families to cling on to false hope?
- How do we provide hope in a seemingly hopeless situation?
These conversations generated a lot of interest and the facilitators remained flexible around the agenda and allowed for more time to topics that were important to the workshop participants. However, this very important and highly controversial topic presented itself towards the end of the day when there was just not enough time to proceed with a thoughtful and meaningful discussion.
One of the facilitators summed up the topic by stating that as nurses, we should not take hope away from our patients. Even in dying, there is hope. Hope that we have a pain-free death, hope that we are surrounded by family when death comes to take us home, hope that the family will find the strength to carry on with life after their loss.
What are your thoughts on hope? What does hope mean to you?
Epstein, E.G., Delgado, S., (Sept 30, 2010) “Understanding and Addressing Moral Distress” OJIN: The Online Journal of Issues in Nursing Vol. 15, No. 3, Manuscript 1.