Oncology Nursing Forum

Objectives: To explore burden and its related factors among primary caregivers of patients with cancer.

Sample & Setting: This study was conducted in an oncology ward at a medical center in southern Taiwan. A total of 137 dyads of patients with cancer and their primary caregivers were recruited.

Methods & Variables: This cross-sectional correlational study used a structured questionnaire to assess the burden of primary caregivers. Data on patients’ basic characteristics and disease profiles were extracted from medical records from January to June 2019. Linear regression analysis was used to identify factors associated with the burden of primary caregivers.

Results: The majority of primary caregivers were female (70%) and aged younger than 65 years (85%). Overall, the mean primary caregiver burden score was 38.83 (SD = 12.86), with spiritual burden ranking highest among the four domains assessed. Factors related to overall primary caregiver burden included psychiatric symptoms, daily care hours, patient age, and the lack of rotational support.

Implications for Nursing: Hospice and oncology nurses can actively identify psychiatric symptoms in primary caregivers, targeting high-risk groups to provide timely resources or psychiatric referrals, aiming to alleviate future caregiver burden.

Objectives: To identify barriers to surveillance mammography adherence in Korean breast cancer survivors (BCSs), which is crucial for early detection of recurrence and new cancers.

Sample & Setting: 195 BCSs were recruited from a breast cancer clinic and its support groups at a South Korean hospital.

Methods & Variables: This descriptive study used a cross-sectional design. Participants completed a self-administered multi-instrument survey based on a comprehensive framework for adherence, including individual characteristics, symptoms, quality of life, cognitive appraisal, social support, and healthcare system factors.

Results: Having had a mammogram within the past year was considered adherent (n = 177), and no mammography within the past year was considered nonadherent (n = 18). Logistic regression revealed that longer time since diagnosis (p < 0.001), greater depression (p = 0.024), and higher health services utilization (p < 0.001) were predictors of lower mammography adherence (chi square = 76.618, p < 0.001, R² = 58%).

Implications for Nursing: This is the first study to identify depression as a barrier to surveillance mammography in BCSs, suggesting that depression screening and treatment may be important for increasing adherence.

Objectives: To explore the incidence of adverse childhood experiences (ACEs) in breast cancer survivors and potential associations with long-term treatment-related sequelae.

Sample & Setting: English-speaking breast cancer survivors three or more years from diagnosis with complete treatment response (N = 120) were recruited prior to scheduled survivorship clinic visits.

Methods & Variables: Participants in this cross-sectional observational feasibility study rated anxiety, depression, fatigue, sleep disturbance, cognitive issues, resilience, and ACEs (experienced prior to age 18 years). Blood samples were analyzed for inflammatory and epigenetic biomarkers.

Results: ACEs assessment was feasible. Higher ACE scores correlated with greater fatigue, anxiety, and depression, and with lower cognitive function (p < 0.05). Resilience was positively associated with cognitive function and negatively associated with fatigue, anxiety, and depression.

Implications for Nursing: There is evidence for the impact of ACEs on long-term treatment-related sequelae in women with breast cancer. Oncology nurses should consider incorporating ACEs assessment into the workflow for women receiving survivorship care.