Outpatient Chemotherapy Clinic Research Articles

Awareness of Food, Supplement, and Drug Interactions among Oncology Patients on Oral Chemotherapy

Abstract Background Food-drug interactions (FDIs) are very common, but under-reported due to a lack of proper history or lack of knowledge and limited research. Our study highlights the knowledge gap among oncology patients treated with capecitabine regarding food-oral chemotherapy interactions. Method A cross-sectional study was conducted among 110 breast and colon cancer patients, purposively sampled from the chemotherapy outpatient clinic from June 2021 to December 2021. A structured questionnaire and interviews were used to collect data, we asked them about the information they had received from the doctor and the way they were taking the medicine. Data were analyzed using SPSS, and the p-value of p < 0.05 was considered significant. Results Regarding the sociodemographic and clinical data of participants, their ages widely ranged from 20-83 years old, and their mean age was 54.78±13.18. The majority of participants were females 81(73.6%), non-employed 86(78.2%), colon cancer 72(65.5%) and received ≤4 cycles 66 (60%). Still, there is poor awareness concerning FDI among oncology patients and most participants were unaware of the possible interactions of capecitabine with grapefruits, vitamins, herbs, and antioxidants, but the majority 92 (83.6%) were taking their medication correctly concerning meal recommendations and only 18(16.4% )were not taking capecitabine within 30 minutes of meals. The current study showed that patients’ knowledge was not associated with age, sex, education, marital status, or occupation. The main factors that affected knowledge in the current study were the cancer site and the number of treatment cycles, as colon cancer patients and those who have received four or fewer cycles had better doctor-patient communication. Conclusion There is a lack of awareness about interactions between oral chemotherapy and various nutrients and supplements among patients in the current study. Patient education and better doctor-patient communication are recommended to ensure optimal oral chemotherapy intake and patient safety.

Latent classes of health-promoting lifestyle in breast cancer patients undergoing chemotherapy in China: A cross-sectional survey.

To identify the latent classes of a health-promoting lifestyle and examine the associations of latent class profile with individual characteristics of breast cancer undergoing chemotherapy in China in order to provide some insights and recommendations for targeted and individualized health education of health-promoting lifestyle. A descriptive cross-sectional survey design was used for this work. A total of 197 patients with breast cancer undergoing chemotherapy recruited from the Breast Cancer Outpatient Chemotherapy Clinic of a Grade 3A hospital were surveyed. Health-promoting lifestyle was measured using the Health Promotion Lifestyle Profile-II: Chinese Version Short (HPLP-IICR). Latent class analysis was used to examine respondents' health-promoting lifestyle patterns. Associations between the latent class membership and individual characteristics were examined using multinomial logistic regression. Four latent classes were identified: Class 1-Good Nutrition and Poor Physical Activity, Class 2-Poor Health Responsibility and Nutrition, Class 3-Active Health-Promoting Lifestyle, and Class 4-Medium Spiritual Growth and Poor Other Dimensions. Younger respondents and respondents with a higher score in anxiety and depression were more likely to be classified in Class 4 rather than Class 1 or 3. Respondents with low exercise self-efficacy were more likely to be classified in Class 4 than the others. Respondents in Class 4 had more chemotherapy symptom severity and interference, and cases of menopause were fewer in Class 4 rather than Class 3. Those in Class 4 were more likely to have been diagnosed with cancer within 3 months than those in Class 1.

Outpatient versus inpatient delivery of intensive chemotherapy for patients with hematological neoplasms: A 5-year experience from a tertiary center.

7 Background: There has been a shift towards the utilization of outpatient delivery of intensive chemotherapy due to potential improvements in quality of life measures and resource utilization. Herein, we aim to report the findings of a five-year quality improvement project comparing the outcomes and healthcare costs of outpatient and inpatient delivery of post-induction intensive chemotherapy amongst patients with hematological neoplasms. Methods: Using Plan-Do-Study-Act (PDSA) methodology, a multidisciplinary team was established to determine appropriate strategies for delivering outpatient intensive chemotherapy and improving healthcare resource utilization. Records of patients receiving inpatient chemotherapy from 2016-2017 were retrospectively reviewed. Process mapping was utilized to design interventions to facilitate the outpatient delivery of chemotherapy. The interventions included the initiation of an outpatient chemotherapy clinic, creating clinical pathways for chemotherapy protocols, developing educational materials for patients and healthcare staff, and facilitating access to emergency care services. During 2018-2022, patients were prospectively identified and enrolled to receive outpatient chemotherapy. Results: 288 patients were enrolled with 70 (24.3%) receiving inpatient chemotherapy and 218 (75.7%) receiving outpatient chemotherapy. The median age for the inpatient and outpatient chemotherapy groups was 34 and 38, respectively [P = 0.027]. Patients enrolled in this project had diagnoses of acute leukemia (53.2%), Hodgkin’s lymphoma 16.3%, and non-Hodgkin’s lymphoma (30.6%). Febrile neutropenia was observed in 64.3% of patients receiving inpatient chemotherapy and in 27.5% of patients receiving outpatient chemotherapy [P < 0.001]. Death during the course of the chemotherapy regimens was seen in 4% of patients receiving inpatient chemotherapy compared to 0.5% of outpatient chemotherapy patients [P = 0.003]. Outpatient chemotherapy resulted in a 53.4% reduction in total bed days occupied. The estimated total cost saving due to this intervention during the years of 2018-2022 was $2.88 million USD. Conclusions: Outpatient delivery of intensive chemotherapy for hematological malignancies is an effective approach which results in comparable safety outcomes and significant improvements in cost-effectiveness and resource utilization.

SYMPTOMS AND QUALITY OF LIFE OF PATIENTS WITH CANCER IN PRE-CHEMOTHERAPY

Cancer is a global public health problem, and chemotherapy treatment can cause side effects and physical symptoms that may compromise nutritional status and quality of life. The study objective was to identify the physical symptoms and quality of life of individuals with neoplasms before they started antineoplastic treatment. It is a cross-sectional study carried out with non-probabilistic sampling for convenience. Patients with neoplasms were recruited from the Chemotherapy Outpatient Clinic of the General Public Hospital of Palmas – TO in the day of their first appointment. A total of 38 patients met the inclusion criteria. A Socioeconomic Questionnaire, the Whoquol-Bref Questionnaire (1993) and the PG-SGA filled in by the patient were used for data collection. The most frequent physical symptoms presented before starting treatment were pain (55.3%) and fatigue (31.6%). In the results of the WHOQOL-bref referring to the perspective of quality of life, there was greater impairment in the physical domain. According to the PG-SGA, 65.8% of the patients were as well-nourished and 31.6% with suspected malnutrition or moderate malnutrition. This study showed an outline of nutritional status and quality of life of these patients with cancer before starting chemotherapy. It also brought useful data to promote future health strategies and better nutritional support during treatment.

The Effects of Spirituality on the Quality of Life Among Cancer Patients enrolled in the Out Patient Chemotherapy Clinic

Spirituality was defined as a way individuals seek and express meaning and purpose and the way they experience their connectedness to the moment. Studies showed that spiritual beliefs provided comfort to cancer patients and that different dimensions were related to the different aspects of health. The study aims to determine and correlate the effects of spirituality and the quality of life among patients enrolled in the outpatient chemotherapy clinic. An analytical cross-sectional study using a non-probability convenience sampling was done of which validated questionnaires on the Spirituality and Quality of Life were the research instruments of the study. Pearson’s correlation coefficient/Spearman rho computed on the relationship between the dimensions of spirituality and subscales of the quality of life among cancer patients. Chi-Square/Fisher’s test was used to determine the correlation between the types and stages of cancer with the quality of life and spirituality of the respondents. A total of 105 cancer patients participated in this study, This study revealed that most of the cancer patients enrolled in the outpatient chemotherapy clinic had a mean score of 3.56 +/- 0.35 indicating a moderate to high level of spirituality. It also showed a mean score of 5.41 +/- 0.53 indicating high QOLs. Dimensions of spirituality that were found to have a significant association with QOL domains (p-values < 0.05) were Mindfulness and Feeling of Security which were both found to have a positive correlation with Emotional Well-being and Social Status. Spiritual care should be included as one of the non-pharmacological modalities in the comprehensive management and palliative care for Filipino cancer patients to improve the overall well-being, healthcare outcomes, and quality of life of patients and their families. Keywords: Cancer Patients, Spirituality, Quality of Life

Pain and Malnutrition in Elderly Cancer Patients: Examples of Southern Turkey

Objective: The prevalence of geriatric cancer disease is gradually increasing. Both the cancer diagnosis and many accompanying symptoms affect individuals bio-psycho-socially and impair the quality of life. This study was conducted to evaluate pain and nutritional status in geriatric cancer patients.
 Methods: This descriptive study was conducted with geriatric cancer patients receiving treatment in the ambulatory chemotherapy outpatient clinic of a university and oncology hospital. The population of the study consisted of cancer patients receiving treatment in the hospital and the sample consisted of 215 geriatric cancer patients who were voluntary to participate in the study. The data of the study were collected using a questionnaire, the Visual Analog Scale (VAS), and the Mini Nutritional Assessment.
 Results: The mean age of the patients was 69.3±4.7 years. Respiratory tract cancers ranked first (28.8%). 42.8% of the patients were at stage four and they frequently experienced symptoms such as fatigue, loss of appetite and poor nutrition. VAS mean score was 4.8±2.8, Mini nutritional assessment mean score was 9.2±3.0, and there was a negative significant correlation between the VAS and Mini nutritional assessment mean scores (p

2143. Contact Investigation after Exposure to Active Pulmonary Tuberculosis in the Pediatric Cancer Center

Abstract Background The prevalence of tuberculosis (TB) in Korean children has decreased due to universal BCG vaccination and the national TB elimination project. However, exposure to TB in children has been consistently reported. There have been few reports of TB exposure in the pediatric hematology-oncology ward. Methods A mother of a pediatric cancer patient was diagnosed with active TB with a cavity. Contact investigation was performed on patients, their parents, and healthcare workers who were exposed to the index case. The criteria for close contact were exposure in the same space with the index patient for more than 8 hours continuously or a total of 40 hours in case of multiple exposures. The initial assessment was performed as soon as the index case was identified. The second evaluation was conducted 8–10 weeks after the initial exposure. Both tuberculin skin test (TST), TB Specific Interferon-Gamma (T-SPOT) tests, and chest radiography were used in immunocompromised pediatric patients. For immunocompetent adults, the QuantiFERON-TB Gold (QFT-G) test and chest radiography were performed. Results Total 23 patients and 29 parents were exposed. The median exposure duration of patients was 3 days (1–8 days). The initial evaluation did not detect TB infection in pediatric patients. However, at the second evaluation, five patients (17.4%) were diagnosed with latent TB infection (LTBI, three with positive TST and two with positive T-SPOT), and two patients (8.7 %) were diagnosed with active TB infection (lymphadenitis and pulmonary TB). Among the 29 parents, 11 individuals (37.9%) were diagnosed with LTBI at the initial evaluation, which was considered as preexisting LTBI before this exposure. No additional case of TB infection was identified in the second evaluation. Among exposed 24 healthcare workers, two (9.1%) were eventually confirmed as newly diagnosed LTBI. Conclusion TB exposure in pediatric hematology-oncology ward and outpatient chemotherapy clinic caused active TB or LTBI cases with an attack rate of 26% in children. The high LTBI rate, up to 38% among parents even before this exposure, needs further intervention such as routine LTBI evaluation and treatment for families of pediatric cancer patients to prevent a similar event. Disclosures Joon-sik Choi, MD, MS, Ministry of Trade, industry and Energy, Republic of Korea: Grant/Research Support Yae-Jean Kim, MD, PhD, Janssen: Grant/Research Support|Korean Society of Pediatric Infectious Diseases: Grant/Research Support|Ministry of Trade, Industry and Energy: Grant/Research Support|MSD: Grant/Research Support.

Operations planning in outpatient chemotherapy with hybrid simulation modelling

Outpatient chemotherapy clinics (OCCs) are a crucial medical units where cancer is diagnosed, and treatment is provided. However, they face planning and scheduling challenges. In this paper, two problems in OCCs are addressed: how to accurately compute the utilisation of the nurses, and the patient appointment scheduling problem. An agent-based simulation is used to simulate the nurse activities and thus the nurse utilisation is computed. A discrete event simulation model is developed to evaluate the performance of the current patient appointment practice. However, the resulted nurse utilisation could not be accurately computed. Therefore, a hybrid discrete event and agent-based simulation model is developed to simulate the whole system including the nurse activities. Moreover, the proposed simulation model is used to determine the best patient appointment scenario. The results can be used to accurately compute the nurse utilisation in the OCCs beside the other key performance indicators (KPIs) in OCCs.

Supportive cryotherapy nursing intervention toward diminishing oral mucositis and associated pain among patients with cancer

Background Oral mucositis is a common problem with chemotherapy treatment. Cryotherapy is supportive in oncology, by preventing chemotherapy-induced complications such as oral mucositis and its related pain, through placing ice chips in the mouth. Aim To evaluate the effect of supportive cryotherapy nursing intervention toward diminishing oral mucositis and associated pain among patients with cancer. Design A quasi-experimental design was used. Setting The study was carried out at the chemotherapy outpatient clinic affiliated to El-Nasr Health Insurance Hospital, Helwan. Sample A purposive sample of 60 patients was equally divided into two groups: cryotherapy and control. Tools Four tools were used: (a) structured interview questionnaire, which included patient demographic characteristic and medical history; (b) the WHO oral mucositis assessment scale; (c) the oral assessment guide; and (d) the visual analog pain scale. Results There was a statistically significant difference in incidence and severity of oral mucositis and pain between cryotherapy and control groups at 7, 14, and 21 days of chemotherapy. Moreover, there were highly statistically significant differences in mean scores of oral assessments between both groups throughout the study phases. Conclusion Supportive cryotherapy nursing intervention for patients with cancer receiving chemotherapy had a positive effect on diminishing oral mucositis and associated pain in the cryotherapy group compared with the control group. Recommendations Training courses should be conducted for oncology patients receiving chemotherapy drugs about applying oral cryotherapy. Moreover, further research studies are recommended on a wider scale to counsel patients with cancer about the effect of oral cryotherapy on oral mucositis with recent chemotherapy treatment.

Avaliação do nível de distress em pacientes oncológicos atendidos em um ambulatório de quimioterapia

The aim of this study was to describe the socio-economic, occupational and clinical characteristics of cancer patients undergoing outpatient chemotherapy treatment and to assess the level of distress during chemotherapy treatment, using the Distress Thermometer instrument. This was a descriptive, cross-sectional study with a quantitative approach, developed at the chemotherapy outpatient clinic of a University Hospital, with 30 cancer patients. The Distress Thermometer instrument was used, and the data were analyzed using Software R (4.0.0). As a result, it was identified that the majority were men, average age of 59.5 years, married, employed and monthly income between 1 and 5 minimum wages. The result of the Distress Thermometer observed a high degree of suffering (>4), with a mean of 6.3 and standard deviation of 2.54. Associations between explanatory variables and outcome were not statistically significant. It was concluded that the instrument evaluated the level of distress of patients, being an important tool in nursing consultations in chemotherapy, favoring the perception and monitoring of stressors.

The effect of progressive relaxation exercises on treatment-related symptoms and self-efficacy in patients with lung cancer receiving chemotherapy

BackgroundPatients with lung cancer receiving chemotherapy experience many symptoms, simultaneously or separately, that limit their daily living activities. This study aimed to determine the effect of progressive relaxation exercises on treatment-related symptoms and self-efficacy in patients with lung cancer receiving chemotherapy. Materials and methodsThis randomized controlled experimental study was conducted in a university hospital chemotherapy outpatient clinic in Turkey. The study sample consisted of 84 patients, randomly allocated to an experimental group (n = 42) and a control group (n = 42). The experimental group received applied training in progressive relaxation exercises using an MP3 player. The control group received only standard nursing interventions in the chemotherapy unit. Data were collected from patients using a personal information form, a telephone counseling follow-up form, the Memorial Symptom Assessment Scale and the Strategies Used by People to Promote Health Scale. Data collection tools were administered at four different times (at first interview and three times on the seventh day of the end of the chemotherapy cycle) and weekly telephone follow-ups were performed. ResultsThe symptom scores (frequency, severity and level of distress) significantly decreased in the experimental group, compared with the control group (p = 0.0001). Similarly, self-efficacy scores significantly improved in the experimental group (p = 0.001). ConclusionProgressive relaxation exercises were potentially effective in promoting symptom management and improving the level of self-efficacy.

Improvement of the comfort perception scale in oral mucositis.

The study was conducted to develop a valid and reliable measurement tool for determining the comfort perceptions of patients with oral mucositis. The study was carried out methodologically between April 2017 and October 2019 in outpatient chemotherapy centers and clinics in which malignant patients were treated in a university hospital and educational-research hospital in Erzurum, Turkey of the study sample comprised 380 patients who developed oral mucositis after treatment. A 'Patient Identification Information Form,' draft 'Comfort Perception Scale in Oral Mucositis' and 'General Comfort Scale' were used to collect the study data. Validity and reliability analyses were used when evaluating the data. Percentage, mean, independent groups t-test, Mann-Whitney U test, Kruskal-Wallis test, variance analysis and advanced analyzes were also used. In this study, while the face validity of the scale was obtained, the content validity index was found to be 0.62 Kaiser-Meyer-Olkin value of the scale for explanatory factor analysis was 0.94, and Bartlett's test x2=9142.156 (P<0.05). For the confirmatory factor analysis, the corrected chi-square value was 3.54, the root-mean-square error was 0.082, and the scale structure was confirmed according to these results. As a result, the scale consisted of 31 items and 2 sub-scales. Item-total correlation values ranged from 0.83 to 0.33. As a result of similar scale validity, a significant negative correlation was found between the Comfort Perception Scale in Oral Mucositis and General Comfort Scale scores (P<0.05). The Comfort Perception Scale in Oral Mucositis is a reliable and valid scale. In this study, it was determined that patient comfort was affected according to some variables.

Anxiety, Insomnia and Pandemic Awareness of Cancer Patients Receiving Chemotherapy During the COVID-19 Pandemic Period

The emergence of COVID-19 pandemic caused a global public health problem. In this article, anxiety and insomnia rates of cancer patients who received chemotherapy during COVID-19 outbreak period were determined. In addition, patients' information and opinions about COVID-19 were discussed. The study included 218 cancer patients who apply to outpatient chemotherapy clinic between May-June 2020, aged 18 and over, who were receiving chemotherapy. Generalized Anxiety Disorder and Insomnia Severity Index questionnaire forms were given to fill the patients to evaluate their anxiety and insomnia levels. We also prepared 12 additional questions about the knowledge and perceptions of COVID-19. Seventy eight (35.8%) patients had anxiety and 106 (48.6%) had insomnia. The rate of whole patients with severe anxiety was 1.8% and with severe insomnia was 2.8%. There was a statistically significant relationship between tumor localization and anxiety (p=0.006). Anxiety scores also increased with the increase in insomnia scores (p< 0.001). Eighty three percent of our patients wore face masks in any environment where they were in contact with people, and 84.9% believed in the protection of the face mask. To the authors'knowledge, this is the first study to examine the anxiety and insomnia rates of the cancer patients receiving chemotherapy in COVID-19 pandemic. The uncertainty of the COVID-19 pandemic process can further increase anxiety and insomnia rates. Patients should be evaluated psychosocially both in the pandemic process and after. Correcting these misperception should be targe-ted in information campaigns, information by clinicians to their patients, and media coverage.

The Role of the Pharmacist in Clinical Settings (8): Efforts to Support Prescribing by Board-certified Pharmacists Attending Examinations in Outpatient Cancer Chemotherapy Clinics and Associated Problems

The Role of the Pharmacist in Clinical Settings (8): Efforts to Support Prescribing by Board-certified Pharmacists Attending Examinations in Outpatient Cancer Chemotherapy Clinics and Associated Problems

Solving operational problems in outpatient chemotherapy clinics using mathematical programming and simulation

Increasing number of cancer survivors besides effective medications increase the demand for cancer care services. Therefore, managers have to investigate new ways to enhance the operational performance of the outpatient chemotherapy clinics (OCCs). However, the management process is complex due to significant variability in treatment times as a result of the different cancer types and accordingly different chemotherapy protocols and scarce resources such as nurses, chemotherapy chairs/beds, and pharmacists. In this paper, we address two problems in OCCs. First, in the planning problem, the objective is assigning the optimum first day to start the treatment for a set of new patients, and computing the required number of nurses and pharmacists given the limited resources. Second, the operational problem of scheduling the patients’ appointments. In this problem, the objective is to set the best appointment schedules for all patients, new and existing to improve the operational performance of the clinic. As the two problems are highly interrelated, we propose a two-phase solution approach starting by a mixed integer programming model that assigns the starting day of treatment for new patients and finds the optimum number of needed nurses and pharmacists to fulfill two objectives. Then, in the second phase, a discrete event simulation model is used to generate patient appointment schedules that minimise the treatment delay for patients and the total completion times of treatments in each day under resources availability constraints, including two new constraints covering the drug availability and pharmacists working-hours. Finally, the proposed simulation model is applied for evaluating the operations performance of a current case study and finding the best scheduling rule for patient appointment times to achieve a minimum wait time in the OCC.

Perception of women with breast cancer undergoing chemotherapy: a comprehensive analysis.

To comprehensively analyze the perception of women with breast cancer on the experience of undergoing chemotherapy. This was a qualitative, descriptive, phenomenological study, supported by the Merleau-Ponty philosophy. It was conducted in a chemotherapy outpatient clinic with 20 participants who completed a phenomenological interview. The phenomenological data analysis demonstrated that the perception of women about the experience of chemotherapy is about change, not only of the physical body, but of their identity, and that it considers existential aspects. Three categories emerged from the experience of alopecia, fatigue, and spirituality, respectively: the body itself, the current and habitual body, and transcendence. Bodily changes, and the existential implications perceived by the women in this study, analyzed from the Merleau-Ponty perspective, makes it possible to consider body concept, and provides support for humanized care based on singularity and the socio-cultural context.

Avaliação da Qualidade de Vida de Portadores de Leucemia Mieloide Crônica em João Pessoa-PB no período de 2015 a 2016

Objetivo: Avaliar a qualidade de vida do paciente com Leucemia Mieloide Crônica (LMC) submetido à quimioterapia oral. Métodos: Para coleta de dados utilizou-se pesquisa quantitativa a partir da aplicação de dois instrumentos: o de dados sócio-demográficos, clínicos e terapêuticos; e o contendo o questionário World Health Organization Quality of Life (WHOQOL-bref), para avaliação da qualidade de vida. A amostra foi constituída por 105 pacientes atendidos no ambulatório de quimioterapia de um hospital de João Pessoa-PB, no período de setembro de 2015 a setembro de 2016. Resultados: Foi evidenciada a prevalência do sexo masculino e a média de idade dos pacientes foi de 31 a 40 anos. De acordo com os resultados encontrados, pode-se verificar que os domínios físicos e psicológicos foram os mais afetados, com diferença estatisticamente significativa para o domínio físico em relação a todos os domínios. É visto que a neoplasia hematológica causa mudanças na vida do paciente, demonstrando que as reações adversas ao tratamento influenciam negativamente na qualidade de vida dos mesmos. Conclusão: Assim sendo, verifica-se a necessidade do cuidado dos profissionais da saúde no impacto que o tratamento provoca nesse processo do paciente com LMC, levando em consideração os domínios de qualidade de vida afetados.

Development of active tuberculosis during treatment of head and neck carcinoma: a case series

BackgroundPatients with head and neck carcinoma are considered to be at high risk of developing tuberculosis, since the risk of morbidity due to tuberculosis in these patients is 2.86 to 16 times the risk in the general population.Case presentationThis case series describes an 83-year-old Japanese man, a 60-year-old Japanese man, and a 69-year-old Japanese man who developed active pulmonary tuberculosis while being treated for head and neck carcinoma. Two had previously developed tuberculosis and were treated for more than 50 years, but no symptoms or imaging findings suggested tuberculosis onset in the patients at initiation of treatment for head and neck carcinoma. Initially, local radiotherapy was performed for all three patients. Chemotherapy was continued for two patients who had pulmonary metastasis since initial consultation. For the other patient, surgery was performed for recurrence. In all three cases, active tuberculosis infection was observed during maintenance chemotherapy or immediately following surgery.ConclusionsDue to the high risk of developing tuberculosis, the possibility of prophylactic administration of anti-tuberculosis agents to patients with head and neck carcinoma should be investigated, although prophylactic administration is not a cost-effective option for all patients with head and neck carcinoma. However, if tuberculosis onset occurs, it leads to various problems; it has a major impact on not only patients with cancer but also various people in the social environment. In the future, it is essential to consider prophylactic administration in patients requiring long-term maintenance drug therapy, especially in those who are treated at out-patient chemotherapy clinics, where there are several patients with cancer with low disease resistance.

Construction and validation of an instrument for nursing consultation in outpatient chemotherapy.

Construct and validate instrument content for nursing consultation in an adult chemotherapy outpatient clinic. Methodological study composed of two stages: elaboration of the instrument and validation of content. A literary review of the dimensions of customer care was carried out in the light of Theory of Basic Human Needs Theory, culminating in two instruments: one for admission consultation and other for follow-up. The content was validated by the evaluation of listed experts based on the adapted Fehring's Validation Model. In the first round, two items of the admission instrument and three items of follow-up required reformulation. In the second round, there was an increase in agreement rate: 11% in the instrument of admission and 10% in follow-up. The instrument represents a guideline for the Nursing Process and future research, but it cannot be seen as a substitute for nurses' knowledge and clinical reasoning.

Avaliação dos Registros de Enfermagem Acerca das Manifestações Clínicas de Cardiotoxicidade

Esta pesquisa objetivou avaliar os registros de enfermagem em um ambulatório de quimioterapia, acerca das manifestações clínicas de cardiotoxicidade e apresentar uma proposta de roteiro de informações direcionada aos registros dos cuidados nessa clientela. Trata-se de uma pesquisa documental, retrospectiva por análise do prontuário e avaliação quantitativa. Os dados foram coletados em formulário próprio contendo 4 variáveis direcionadas às características da população e 15 variáveis relacionadas às possíveis manifestações clínicas de cardiotoxicidade, obedecendo as normas éticas e analisados por meio da estatística descritiva. A proposta de um roteiro de informações foi descrita a partir de um quadro contendo variáveis sociodemográficas e de elementos específicos do tratamento, elaboradas a partir da revisão de literatura desta pesquisa. Apesar da potencial toxicidade do tratamento quimioterápico, não houve registro do medicamento quimioterápico utilizado em 12 (50%) prontuários avaliados e não foi encontrado nenhum registro de enfermagem sobre possíveis sinais de cardiotoxicidade. Conclui-se que a quimioterapia pode desenvolver reações tóxicas, como por exemplo, a cardiotoxicidade. O conhecimento sobre os possíveis sinais e sintomas de toxidade cardíaca, bem como dos fatores de risco e adequado registro dessas informações pela enfermagem, tornam-se importantes para o alcance de uma documentação clínica com qualidade.&#x0D; Palavras-chaves: Cardiotoxicidade; Quimioterápicos; Registro de enfermagem.