This study aimed to examine the symptom burden reported by survivors treated in survivorship clinics by describing the severity of symptoms and symptom interference with life activities, comparing symptom severity by sex, and identifying predictors of the three most prevalent moderate to severe symptoms. This secondary data analysis examined patient-reported symptom burden data using the MD Anderson Symptom Inventory collected for clinical purposes from January to December 2023. Sex differences in symptom burden were compared using t-tests. Multivariate logistic regressions identified predictors of the three most prevalent moderate to severe symptoms. Among 2550 survivors (mean age 61.9 ± 12.1 years; 69.9

BACKGROUND:"Opiophobia" lacks a clear definition and measurement, but it is commonly used by researchers and healthcare professionals in pain management to describe the underutilization of opioids by patients, caregivers, prescribers, and other healthcare professionals. This inconsistency complicates research and clinical interventions. OBJECTIVE:This systematic review aimed to comprehensively evaluate the conceptualization and operationalization of opiophobia across quantitative studies involving adult populations. METHODS:Peer-reviewed articles published before July 2024 were retrieved from four bibliographic databases (CINAHL, Embase, MEDLINE, and Scopus) and systematically reviewed. Included studies defined and/or measured opiophobia or opioid stigma among adult patients, family caregivers, and healthcare professionals. The review was conducted in two phases: the first phase provided a comprehensive understanding of study characteristics, while the second phase evaluated the conceptualization and measurement of opiophobia. RESULTS:Thirty-six articles met inclusion criteria. Studies focused on healthcare professionals (n = 23, 64%); adult patients (n = 13, 33%), including 7 studies involving patients with cancer (19%); healthcare professionals and patients (n = 2, 5%); and family caregivers (n = 1, 3%). Among the studies that defined opiophobia (n = 20, 67%), common definitions included fear, prejudice, reluctance, addiction, exaggeration, underutilization, and inappropriate attitudes/beliefs, respectively. Limitations included the predominance of observational designs (n = 32, 89%) and the use of investigator-developed instruments (n = 27, 73%). LINKING EVIDENCE TO ACTION:Instruments measuring opiophobia focused on opioid-related fears and behaviors. Instrument items that measured opiophobia primarily focused on fears and behaviors resulting from these fears. It remains unclear whether opiophobia is solely fear-based or also includes poor adherence to prescribed opioids. The wide variations in definitions and the use of mostly investigator-developed measures led to inconsistencies among studies. Further research is needed to design specific interventions and determine delivery times.

Older adults with diabetes are at risk for impairments in activities of daily living (ADL) performance. Home health (HH) services help patients regain their ability to perform ADLs following hospitalization, but there may be disparities in ADL improvement. We aimed to identify factors associated with change in ADL performance from the start of HH care to discharge in HH patients with diabetes age ≥65. This secondary analysis used Outcome and Assessment Information Set-D data collected by a HH agency. The sample (n = 1350) had a mean age of 76.3 (SD 7.3). Black/African American race and bowel incontinence/ostomy were associated with less ADL improvement. The following factors were associated with greater ADL improvement: having a caregiver who needed training/support, surgical wounds, pain that interfered with activity, confusion, and better scores in prior functioning. Overall, most patients improved their ADL performance while receiving HH care, but there are disparities that should be addressed.

The outbreak of SARS-CoV-2, which causes COVID-19, has significantly impacted the psychological and physical health of a wide range of individuals, including healthcare professionals (HCPs). This umbrella review aims provide a quantitative summary of meta-analyses that have investigated the prevalence of stress, anxiety, depression, and sleep disturbance among HCPs during the COVID-19 pandemic. An umbrella review of systematic reviews and meta-analyses reviews was conducted. The search was performed using the EMBASE, PubMed, CINAHL, MEDLINE, PsycINFO, and Google Scholar databases from 01st January 2020 to 15th January 2024. A random-effects model was then used to estimate prevalence with a 95% confidence interval. Subgroup analysis and sensitivity analyses were then conducted to explore the heterogeneity of the sample. Seventy-two meta-analyses involved 2,308 primary studies were included after a full-text review. The umbrella review revealed that the pooled prevalence of stress, anxiety, depression, and sleep disturbance among HCPs during the COVID-19 pandemic was 37% (95% CI 32.87-41.22), 31.8% (95% CI 29.2-34.61) 29.4% (95% CI 27.13-31.84) 36.9% (95% CI 33.78-40.05) respectively. In subgroup analyses the prevalence of anxiety and depression was higher among nurses than among physicians. Evidence from this umbrella review suggested that a significant proportion of HCPs experienced stress, anxiety, depression, and sleep disturbance during the COVID-19 pandemic. This information will support authorities when implementing specific interventions that address mental health problems among HCPs during future pandemics or any other health crises. Such interventions may include the provision of mental health support services, such as counseling and peer support programs, as well as the implementation of organizational strategies to reduce workplace stressors.

Abstract Background Understanding the impact of a digital health coaching (DHC) program on patient-reported outcomes in women with breast cancer is imperative as web-based platforms and mobile phone applications to address health care needs flood the marketplace. This study evaluated the effect of a DHC program on patient-reported outcomes, including global health (primary outcome), symptom burden, quality of life, healthcare utilization, and financial toxicity among women undergoing active treatment for breast cancer. Methods English-speaking adult women undergoing active treatment for breast cancer were randomized to receive usual care or a 6-month DHC program, consisting of weekly telephone calls from a Health Advisor, unlimited patient-initiated communication via phone, text, or email, and digital delivery of additional health-behavior content. Patient-reported outcomes (PROs) were collected using validated measures at baseline, and 1, 3, and 6 months. Summary statistics were used to describe participant characteristics. Linear mixed models were used to assess the effect of the intervention on outcomes. Results Participants (n=254, planned enrollment=440) were enrolled from August 2019 to December 2022 and randomized equally to the control and intervention groups (n=127 each). Demographic data are presented in Table 1. Participants had a mean age of 48 (SD =10.15) years; 74% were White; 19.7% were Hispanic. In both groups, several PRO scores changed over time with some improving (quality of life and symptom severity) and others worsening (symptom interference and financial toxicity) compared to baseline (time effects). Of those enrolled in the intervention group 69% were retained in the DHC program, with an overall average of 4.6 months of engagement for all participants. There were no significant group (intervention versus control) effects or group by time interaction effects observed. Trends within and between groups are presented in Table 2. Though not statistically significant, there were fewer ER visits in the intervention group at each timepoint. Conclusions: While differential improvements in the DHC group were not observed, interesting trends in PROs over the 6-month enrollment period were observed in both groups. Participants reported improvements in quality of life and worsening of financial toxicity. Interestingly, slight improvements in symptom severity over time were observed in both groups while symptom interference worsened. Potential reasons for failure to detect a treatment effect for DHC may include ineffectiveness of DHC on the selected outcomes, the intervention not being strong enough as currently delivered to detect a treatment effect, varying uptake of DHC in the intervention group, heterogeneity of the sample, or the study being underpowered due to COVID restrictions affecting enrollment. Table 1. Demographic and clinical characteristics of the study population (n = 254) Table 2. Trends in Patient Reported Outcomes and Healthcare Utilization Citation Format: Meagan Whisenant, Eileen Hacker, Loretta Williams, Joyce Dains, Bryan Fellman, Trinity Isaac, Valerie Shelton, Austin Barr, Carolyn Harty, Mazi Rasulnia, Kelly Brassil. The Effect of a Digital Health Coaching Program on Patient Reported Outcomes of Women with Breast Cancer [abstract]. In: Proceedings of the 2023 San Antonio Breast Cancer Symposium; 2023 Dec 5-9; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2024;84(9 Suppl):Abstract nr PS02-08.

Background To advance oncology nursing science and clinical practice, researchers and clinicians must understand the important real-world concerns of nurses who provide direct care to people with cancer or manage processes that support patient care. Objective This study developed a comprehensive compendium of real-world concerns among oncology nurses and built consensus regarding their importance. Methods Using Delphi survey methodology, this prospective, descriptive study was performed in 3 phases: (1) identification of experts, defined as registered nurses (RNs) employed within a comprehensive cancer center; (2) qualitative content analysis of 353 responses from 267 RNs who responded to the question, “What do you see as nursing research concerns, problems, and/or issues on your unit or in your work environment that needs to be studied?”; and (3) rating the importance of 62 research themes identified from the qualitative content analysis (n = 247 RNs). Results The top research priority was patient safety followed by patient education, oncologic emergencies, patient expectations and adherence with care, team communication, patient psychosocial needs, patient-reported outcomes and quality of life, healthcare team burnout, workload, and nurse burnout. Conclusions The findings support the nursing discipline’s fundamental focus on patient safety, the top-rated nursing research priority, along with other patient-related and work environment issues. Implications for Practice Oncology nursing is complex and complicated. This study identified and prioritized the real-world concerns, issues, and problems of oncology RNs who provide direct care or manage the processes that support care, supporting the need to focus on patient-related and work environment research.

This study reports the development and psychometric testing of the Kidney Transplant Self-Management Scale (KT-SMS). The instrument development phase included the following: (a) conceptual definition, item generation, and framework; (b) face validity assessment; and (c) content validity assessment. The psychometric testing phase included the following: (a) construct validity testing; (b) internal consistency reliability testing; (c) convergent validity testing; and (d) predictive power of the KT-SMS using a cross-sectional sample of kidney transplant recipients (N = 153). Factor analysis results supported the 16-item KT-SMS as multidimensional with five domains (medication adherence, cardiovascular risk reduction, protecting kidney, ownership, and skin cancer prevention). Internal consistency reliability for the total scale and five subscales was adequate. Convergent validity was supported as the intercorrelations of the KT-SMS total score with the five subscales were significant. The KT-SMS total score and five subscales were significantly correlated with self-efficacy for managing chronic disease, patient activation, and health-related quality of life.