The construction and application of continuous nursing platform for the care of patients with wound or stoma

April 14th, 2022 in ICNN Articles, International News

Author: Yongyi Chen (RN, PhD), Hunan Cancer Hospital / the Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University

With the advent of an aging society, chronic wounds have become a global health problem. According to the statistics, there were an estimated 463 million adults living with diabetes all around worldwide(Sen, 2021).Globally, diabetic burden was highest in China (89.5 million) with India (67.8 million), United States (30.7 million), Indonesia (21.0 million), and Mexico (13.1 million) following behind(Sen, 2021).In the United States, 3% of the population older than 65 years have open wounds, and chronic wounds as a whole cost the medical system over US$25 billion per year(Han and Ceilley, 2017).In China, there were nearly 100 million diabetic patients, which is the country with the largest number of patients in the world(Wei and Yiying et al., 2018).and the lifetime incidence rate was 25% (Tchanque-Fossuo and Wishy et al., 2018).The incidence of malignant wounds of malignant tumor is 5%-10% in cancer patients (Xiaolong and Qixia, 2014). Once chronic wounds occur, the symptoms of massive exudation, smelly, easy bleeding, pain, and other symptoms seriously affect their quality of life of patients. At the same time, there were one million patients with stoma, with nearly 100 thousand patients increase every year (Yanming, 2017).Patients not only suffered from the inconvenience caused by the change of the normal excretion route of feces, but also, they suffered by the complications caused by improper stoma care, which seriously affected the quality of life of patients(Zelga and Kluska et al., 2021).However, the allocation of wound nursing staff in China is insufficient, and the distribution of medical and nursing resources in urban and rural areas is uneven, which cannot meet the needs of patients. Therefore, it is urgent to establish a continuous nursing platform for the care of patients with wound or stoma.

After literature search, qualitative interviews, group discussions, and expert consultation, we determined the content of the continuous nursing platform for the care of patients with wound or stoma, and in conjunction with information technology personnel, an Internet-based continuous nursing platform for the care of patients with wound or stoma has been developed. It contains two platforms, Healthcare portal and Patient portal respectively. Patients login in the system by entering their ID number/phone number and password. Healthcare workers login in the system by work account and password. The Internet-based continuous nursing platform connects the external network, internal network and client, breaking down information barriers. The platform includes four modules of Basic Information, Wound/Stoma Information, Healthcare-patient Interaction, and Health Education. The Basic Information’s content includes name, age, height, weight, diagnosis, place of residence, education, etc. The Wound Information Module includes date of wound formation, cause, size, base color, exudation, treatment, dressing selection, etc. The Stoma Information Module includes date of stoma operation, type of stoma, surrounding conditions of stoma, stoma complications, stoma home caregivers, use of stoma chassis and accessories, etc.

With respect to the application of the continuous nursing platform for the care of patients with wound or stoma, when a patient with wound or stoma seeks special advice in our clinic of wound and stoma for the first time, an archive will be established. Log in to the platform and add a new patient case with stoma or wound, then enter patient’s ID number, synchronize HIS system to get the patient’s information. Then complete new cases and establish detailed case archives of patient with stoma or wound and collect and input the patient’s information. The opportunity to establishing follow-up archives is as follows: regularly review of the patients’ wounds weekly. If the condition of wound changes within one week, the patient’s wound should also be reviewed, until the patient’s wound heal or die. The other is stoma patients need to establish archives every time when they come to the hospital for a follow-up visit. A total of 1,166 cases of wound stoma had been documented by the end of 2021.770 cases of wound and 396 cases of stoma have been established. Lots of patients have online consultation by healthcare workers, which have effectively promote comprehensive rehabilitation of patients.

The Internet-based continuous nursing platform for the care of patients with wound or stoma can manage patient’s data conveniently, and a lot of patients have online consultation by healthcare workers, which have effectively promote comprehensive rehabilitation of patients.

This study was presented at ICCN2022 virtual conference. Registration for ICCN2022 virtual library now open. For more information, please access https://www.iccn2022.com/registration/

References

Han, G. and R. Ceilley (2017). “Chronic Wound Healing: A Review of Current Management and Treatments.” Adv Ther 34 (3): 599-610.doi: 10.1007/s12325-017-0478-y. Epub 2017 Jan 21.

Sen, C. K. (2021). “Human Wound and Its Burden: Updated 2020 Compendium of Estimates.” Adv Wound Care (New Rochelle) 10 (5): 281-292.doi: 10.1089/wound.2021.0026.

Tchanque-Fossuo, C. N. and A. M. Wishy, et al. (2018). “Reclaiming Autologous Amputated Tissue for Limb Salvage of a Diabetic Foot Burn with Underlying Critical Limb Ischemia.” Adv Skin Wound Care 31 (1): 596-600.doi: 10.1097/01.ASW.0000526604.26748.3d.

Wei, W. and W. Yiying, et al. (2018). “Application progress of silver ion dressing in the treatment of diabetic foot.” Chinese Journal of Modern Nursing 24 (30): 3718-3720.doi: 10.3760/cma.j.issn.1674-2907.2018.30.032

Xiaolong, Q. and J. Qixia (2014). “Research progress on the assessment and management of odour in malignant fungating wounds.” Chinese Nursing Management 14 (04): 435-437. doi: 10.3969/j.issn.1672-1756.2014.04.033

Yanming, D. (2017). Ostomy Nursing. Beijing, People’s Health Publishing House.

Zelga, P. and P. Kluska, et al. (2021). “Patient-Related Factors Associated With Stoma and Peristomal Complications Following Fecal Ostomy Surgery: A Scoping Review.” J Wound Ostomy Continence Nurs 48 (5): 415-430.doi: 10.1097/WON.0000000000000796.

Brief motivational interviewing delivered via information communication technologies to promote regular physical activity in pediatric cancer survivors: A pilot randomized controlled trial

April 7th, 2022 in International News, Reflection

Author: Ankie Tan Cheung (RN, PhD), The Nethersole School of Nursing, Faculty of Medicine, The Chinese University of Hong Kong

Pediatric cancer is an emerging global child health priority as it is a leading cause of death in children and adolescents (Miller et al., 2020). Ongoing advances in early detection and cancer treatment contribute to a significant increase in the overall five-year survival rate of pediatric cancer, currently approaching 85% (Miller et al., 2020). Despite improved survival rate, an estimated two-thirds of pediatric cancer survivors develop at least one chronic health condition, including cardiopulmonary disease, endocrine and musculoskeletal disease, cancer-related fatigue, functional impairment, and psychological distress, all of which jeopardize their quality of life (QoL) throughout the survivorship trajectory (Oeffinger et al., 2006).

Physical activity (PA) has protective and beneficial effects in attenuating the late effects incurred by cancer and/or its treatment (Morales et al., 2021). However, many pediatric cancer survivors do not participate in adequate physical activity to confer the health benefits associated with PA. The problem of physical inactivity is particularly critical in Hong Kong Chinese pediatric cancer survivors, with approximately 92.2% of Chinese survivors (vs 52.1% Western counterparts) do not comply with the World Health Organization recommended PA guideline for children and adolescents (i.e., minimum of 60 min of moderate-to-vigorous PA daily) (Chung et al., 2014; Stolley et al., 2010).

Adopting an innovative and sustainable approach to promote regular PA in pediatric cancer survivors is therefore necessary. Growing evidence suggests the efficacy of using motivational interviewing (MI) with parents to promote health-enhancing behavior in children, such as eating habits and weight management (Norman et al., 2016; Wong & Cheng, 2013). Yet, empirical evidence is lacking for its feasibility in promoting PA among pediatric cancer survivors. Therefore, we conducted a two-group pre-/post-test pilot randomized controlled trial to examine the feasibility and preliminary effect of a brief MI to promote PA, improve cancer-related fatigue, muscular strength, peak expiratory flow rate and QoL in pediatric cancer survivors. A total of 30 pediatric cancer survivors aged between 9 and 16 years and their parents were recruited. These parent-child dyads were randomly allocated to the intervention (n=16; a 3-month brief MI delivered via instant messaging applications) and control groups (n=14; usual care). According to Cohen’s (1992) guidelines, small-to-medium effect sizes were found for the outcome variables. All parents were satisfied with the intervention and supported the use of mobile instant messaging applications (i.e., WhatsApp/WeChat) to deliver the brief MI intervention. Many parents described the approach was feasible and acceptable to motivate them to encourage their children to engage in regular PA. Most parents reported that the intervention enhanced their awareness of the significance of PA for their children and understanding of the specific health benefits thereof. It is worth noting that parents perceived that the intervention provided them personalized support that suited the needs of their families. Further, the parents appreciated the flexibility of the communication with the counselor, the continuous and timely professional advice throughout the intervention period. However, a larger-scale randomized controlled trial is warranted to ascertain the efficacy of such an intervention in promoting PA in pediatric cancer survivors.

Physical activity plays a vital role in the healthy development of pediatric cancer survivors, thus healthcare professionals should encourage survivors to engage in regular physical activity using different feasible and appropriate approaches, e.g., brief motivational interviewing.

References

Chung, O. K., Li, H. C., Chiu, S. Y., Ho, K. Y., & Lopez, V. (2014). The impact of cancer and its treatment on physical activity levels and behavior in Hong Kong Chinese childhood cancer survivors. Cancer Nursing, 37(3), E43–E51. https://doi.org/10.1097/NCC.0b013e3182980255

Cohen, J. (1992). A power primer. Psychol Bull, 112(1), 155-159.
Morales, J. S., Valenzuela, P. L., Velázquez-Díaz, D., Castillo-García, A., Jiménez-Pavón, D., Lucia, A., & Fiuza-Luces, C. (2021). Exercise and Childhood Cancer-A Historical Review. Cancers, 14(1), 82. https://doi.org/10.3390/cancers14010082

Miller, K. D., Fidler-Benaoudia, M., Keegan, T. H., Hipp, H. S., Jemal, A., & Siegel, R. L. (2020). Cancer statistics for adolescents and young adults, 2020. CA: A Cancer Journal for Clinicians, 70(6), 443–459. https://doi.org/10.3322/caac.21637

Oeffinger, K. C., Mertens, A. C., Sklar, C. A., Kawashima, T., Hudson, M. M., Meadows, A. T., Friedman, D. L., Marina, N., Hobbie, W., Kadan-Lottick, N. S., Schwartz, C. L., Leisenring, W., Robison, L. L., & Childhood Cancer Survivor Study (2006). Chronic health conditions in adult survivors of childhood cancer. The New England Journal of Medicine, 355(15), 1572–1582. https://doi.org/10.1056/NEJMsa060185

Stolley, M. R., Restrepo, J., & Sharp, L. K. (2010). Diet and physical activity in childhood cancer survivors: a review of the literature. Annals of Behavioral Medicine : a publication of the Society of Behavioral Medicine, 39(3), 232–249. https://doi.org/10.1007/s12160-010-9192-6

International News: Support of Ukrainian Cancer Patients

March 28th, 2022 in Hot Topics, International News

Submitted by Scarlott K Mueller, MPH, RN, FAAN, ISNCC Board Member

As the world watches the challenges and suffering of the people of Ukraine, I want to share how the American Cancer Society, along with the American Society of Clinical Oncologists and the Sidney Kimmel Cancer Center-Jefferson Health, are partnering to assist the Ukrainian cancer patients and their families. With over 179,000 newly diagnosed cancer patients in Ukraine, displacement from their homes and lack of medical resources may lead to significant disruption in care and treatment and may negatively impact their cancer survival. This collaborative healthcare group is making available valuable cancer information in languages that include English, Ukrainian, Polish, and Russian and can be accessed at www.cancer.net/ukraine.

In addition, these partners are supporting the American Cancer Society Clinician Volunteer Corps comprised of oncologists and oncology nurses. These volunteer resource individuals will be available to answer inquiries from Ukrainian patients and families through connection with the American Cancer Society’s National Cancer Information Center at +1-800-227-2345 and can be reached  24 hours a day. Oncology nurses and physicians who are interested in participating in this humanitarian effort should complete a volunteer form online at www.cancer.org/ukrainevolunteer. Members of the American Society of Clinical Oncologists should use the website international@asco.org.

The American Cancer Society and these partners stand in solidarity to support Ukrainian cancer patients and their families. As global oncology nurses, our support can also have influence.

What can nurses do to meet the challenges of COVID-19?

January 26th, 2022 in Hot Topics, International News, Reflection

Author: Dion Smyth, Senior Lecturer (Cancer and Palliative care), Birmingham City University, Birmingham, UK

The global Covid-19 pandemic has profoundly disturbed and continues to disrupt, cancer care and management. Despite professionals and cancer services responding rapidly to the challenges posed by the pandemic with a range of changes to their service delivery, we know that delayed or decreased access to screening, early diagnosis, and treatment has been a typical finding across the globe.

For example, research into the impact of Covid-19 has recounted that breast cancer screening declined in communities of color and populations of income deprivation in the US (Feweda et al, 2021); whilst, in the UK, Cancer Research UK estimates 3 million fewer people were screened, compared to pre-pandemic levels of activity (CRUK, 2021). Englum et al (2021) found that there was a significant reduction in the number of cancer diagnostic procedures, such as colonoscopies or prostate biopsies undertaken. Waiting lists and times for treatment of cancer are at record levels in the UK (NHS England, 2021), all of which clearly impact the mental health and well-being of patients waiting and worried about their diagnosis and, potentially, treatment outcomes.

So, what can nurses do?

Obviously, the various government and population and individual responses vary, and so practitioners will work within the political and practical frameworks of their nation-states; however, there is still much that can be done. For example, we might lobby for more resources, whether that is local or a broader societal issue.

Nurses can advise, inform or advocate for the vaccination program so that the impact of incidence in a population can be mitigated, just as the vaccination against oncogenic viruses, such as HPV is known to lessen the burden of cervical cancer.

We might also look at how we can share our experiences, examples of good practice, and practice development so that our colleagues across the globe can gain insights into new ways of working. To that end, writing a blog piece for the ISNCC site is a good and commendable place to start.

References

CRUK (2021) Our research into the impact of COVID-19 on cancer Available at: https://www.cancerresearchuk.org/health-professional/our-research-into-the-impact-of-covid-19-on-cancer

NHS England (2021) Caner Waiting Times available at:  https://view.officeapps.live.com/op/view.aspx?src=https%3A%2F%2Fwww.england.nhs.uk%2Fstatistics%2Fwp-content%2Fuploads%2Fsites%2F2%2F2021%2F12%2FCancer-Waiting-Times-National-Time-Series-Oct-2009-Oct-2021-with-Revisions.xlsx&wdOrigin=BROWSELINK

Englum, BR et al (2021) Impact of the COVID-19 pandemic on diagnosis of new cancers: A national multicenter study of the Veterans Affairs Healthcare SystemCancer https://acsjournals.onlinelibrary.wiley.com/doi/10.1002/cncr.34011

Fedewa, SA et al (2021) Changes in breast cancer screening rates among 32 community health centers during the COVID-19 pandemicCancer 127(23): 4512-4515 https://acsjournals.onlinelibrary.wiley.com/doi/10.1002/cncr.33859

Experiences at the Asian Oncology Nursing Society (AONS) Conference 2021

December 7th, 2021 in International News, Reflection

Author: Ariesta Milanti, BSN, RN, MHC, The Nethersole School of Nursing, The Chinese University of Hong Kong; ISNCC Policy and Advocacy Committee member

It was a great pleasure to attend the 5th AONS Conference on the 18th-19th November 2021 among more than 500 delegates from 17 countries. This conference was held on a virtual platform in respect of the pandemic control. It was held by the Taiwan Oncology Nursing Society (TONS) of China.

In the opening ceremony, it was an honour to see Dr Ching-Te Lai giving the welcome address. All the welcome remarks gave the tone of the conference’s theme: “Innovations of Science and Art in Oncology Nursing”. After the opening remarks, there was a keynote speech by Professor Chien-Jen Chen, addressing the achievements and challenges of the national cancer prevention programmes in Taiwan of China. Another keynote speech was delivered by Professor Patsy Yates from Australia. She underlined that the era of precision cancer care brings the implications for nurses to understand more about the influences of patient experience, to deliver tailored intervention, and to support self-management of the patients. Meanwhile, the second day keynote speaker, Professor Winnie So, emphasised that the cancer health disparities which may occur in the disadvantaged populations should be addressed by using innovations to promote their access to cancer care.

The invited speakers and their speeches are inspirational. They are prominent leaders and scholars who have made a huge number of significant contributions in cancer nursing. Their presentations brought important lessons about the trends and current situation of innovation in cancer science and how cancer nurses can be the innovators to improve nursing practice.

In the oral presentation sessions, I was able to learn from a wide range of research topics from psychosocial care and survivorship to the hospice palliative care. This learning opportunity has widened my horizon and increase my knowledge about what is happening in cancer nursing studies, especially in Asia. In the poster presentation sessions, hundreds of recorded posters were played in marathon. Some of the presenters used text-to-speech application to present, which echoed the technology innovation to address the language barrier. In these sessions, I was also struck by a great number of cancer nurses who have made a difference in their clinical or educational settings to improve quality of care.

Lastly, I was very grateful to receive the scholarship award from AONS and to have an opportunity to present my study in a special award session. This session also invited the winners of excellence awards – cancer nurses with major contribution in research and practice. It was a great honour to be in one stage with the stellar nurses from different countries in Asia. Overall, this AONS conference 2021 was a rewarding and enlightening learning experience to increase my knowledge in cancer nursing.

Patsy Yates presenting to AONS conference 2021
Presentation of Patsy Yates – President, International Society of Nurses in Cancer Care (ISNCC)
Virtual award presentation at AONS 2021 conference
Special award presentation session (clockwise direction: Eunyoung Suh, AONS president; Winnie So, AONS past president, ISNCC president-elect; Sarita Chhetri (India); In Gak Kwon (South Korea); Eun Young Park (South Korea).