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نتیجه جستجو - Oncology

تعداد مقالات یافته شده: 23
ردیف عنوان نوع
1 A Nonrandomized Pretest Posttest Study on the Impact of an Educational Pain Management Program on Nurses’ Knowledge and Attitudes Regarding Pain in a Middle Eastern Country
یک مطالعه غیرتصادفی پیش آزمون پس آزمون در مورد تأثیر یک برنامه آموزشی مدیریت درد بر دانش و نگرش پرستاران در مورد درد در یک کشور خاورمیانه-2021
Background: Although nurse’s knowledge and attitudes regarding pain management has been sufficiently studied worldwide, the impact of an educational intervention program in improving such attitudes and knowledge has not been likewise researched, especially in Middle Eastern countries.
Aims: To examine nurses’ knowledge and attitudes regarding pain at a university hospital in Lebanon before and after the introduction of a pain management educational program. And to assess the relationship between the characteristic of nurses and their pain knowledge.
Methods: Design; A nonrandomized pretest posttest study design was used. Setting; A university hospital in Lebanon. Participants; Included 183 nurses using the Nurses’ Knowledge and Attitudes Survey Regarding Pain questionnaire. The pain educational intervention was based on the principles of Ajzen’s theory of planned behavior.
Results: A significant difference between the pre and post test scores was noted (p = .016). Questions answered correctly by 80% of participants were related to questions about pain, pain assessment and management, and questions related to medications, such as correct dosages and opioid side effects were not answered correctly by the majority of nurses. There were significant associations between test scores and the nurses’ educational level, their age, and their years of experience. Nurses who worked in critical care units, the emergency department and oncology had higher scores than nurses who worked on general units.
Conclusions: Despite the intensive pain education provided at our institution, the pain knowledge of nurses remains below that recommended level which indicates a dire need for more intensive and continuous education in order to provide a pain free environment.
مقاله انگلیسی
2 Time management: Improving the timing of post-prostatectomy radiotherapy, clinical trials, and knowledge translation
مدیریت زمان: بهبود زمان رادیوتراپی پس از پروستاتکتومی، آزمایشات بالینی و ترجمه دانش-2021
Background: Management of prostate cancer after surgery is controversial. Past studies on adjuvant radiotherapy (aRT) for higher-risk features have had conflicting results. Through the collaborative conversations of the global radiation oncology Twitter-based journal club (#RadOnc #JC), we explored this complex topic to share recent advances, better understand what the global radiation oncology community felt was important and inspire next steps. Methods: We selected the recent publication of a landmark international randomized controlled trial (RCT) comparing immediate and salvage radiotherapy for prostate cancer, RADICALS-RT, for discussion over the weekend of January 16 to 17, 2021. Coordination included open access to the article and an asynchronous portion to decrease barriers to participation, cooperation of study authors (CP, MS) who participated to share deeper insights including a live hour, and curation of related resources and tweet content through a blog post and Wakelet journal club summary. Discussion of Results: Our conversations created 2,370,104 impressions over 599 tweets with 51 participants spanning 11 countries and 5 continents. A quarter of the participants were from the US (13/51) followed by 10% from the UK (5/51). Clinical or Radiation Oncologists comprised 59% of active participants (16/27) with 62% (18/29) reporting giving aRT within the last 5 years. Discussion was interdisciplinary with three urologists (11%), three trainees (11%), and two physiotherapists (7%). Four months after the journal club its article Altmetric score had increased by 7% (214 to 229). Thematic analysis of tweet content suggested participants wanted clarification on definitions of adjuvant (aRT) and salvage radiotherapy (sRT) including indications, timing, and decision-making tools including guidelines; more interdisciplinary and cross-sectoral collaboration including with patients for study design including survivorship and meaningful outcomes; more effective knowledge translation including faster clinical trials; and more data including mature results of current trials, particular high-risk features (Gleason Group 4+, pT4b+, and margin-positive disease), implications of newer technologies such as PSMA-PET and genomic classifiers, and better explanations for practice pattern variations including underutilization of radiotherapy. This was further explored in the context of relevant literature. Conclusion: Together, this global collaborative review on the postoperative management of prostate cancer suggested a stronger signal for the uptake of early salvage radiation treatment with careful PSA monitoring, more sensitive PSA triggers, and expected access to radiotherapy. Questions still remain on potential exceptions and barriers to use. These require better decision-making tools for all practice settings, consideration of newer technologies, more pragmatic trials, and better use of social media for knowledge translation.
Keywords: Prostate radiotherapy | Adjuvant radiation | Salvage radiation | Journal club
مقاله انگلیسی
3 Student nurses knowledge about the management of chemotherapy-induced neutropenia: Multi-national survey
دانش پرستاران دانشجویی در مورد مدیریت نوتروپنی ناشی از شیمی درمانی: مرور چند ملیتی-2021
Background: Chemotherapy-induced neutropenia is a serious global health concern. It is essential that student nurses who are the future of healthcare are equipped with the right knowledge to care for the unique needs of patients with neutropenia.
Objective: The study assesses student nurses’ knowledge of neutropenia management and examines the difference in their knowledge with regard to their demographics. Design: A descriptive cross-sectional survey design was used. Settings: Participants for this survey were recruited from four nursing schools from three countries: Jordan, Oman, and Saudi Arabia.
Participants: The study sample comprised 230 student nurses representing all three countries. Methods: Online data collection was implemented. A message including the link to the study questionnaire was sent to students through their university portal. Demographic data and the neutropenia knowledge questionnaire were collected.
Results: The student nurses showed poor knowledge of neutropenia and its management (mean = 10.1 out of 30). The bridging students (M = 12.6, SD = 9.8) had significantly higher mean total knowledge scores than the regular students (M = 9.8, SD = 5.5) (t = 2.9, df = 38.9, p = 0.006). However, students who had received previous education about neutropenia management (M = 11.6, SD = 5.0) had significantly higher mean knowledge scores than those who had not (M = 9.5, SD = 5.6) (t = − 2.73, df = 134.8, p = 0.007).
Conclusions: The study findings underscore the overarching necessity to improve students’ knowledge of neutropenia and its management. However, addressing this concern is multifaceted and requires deliberate effort from various agencies. Developing innovative strategies to increase the coverage of oncology nursing in the curriculum, improving faculty expertise, enhancing staff nurses’ knowledge and skills, provision of funding, and adoption of oncology-related competencies in the nursing program need to be explored as key solutions.
keywords: دانش | نوتروپنی | نوتروپنی ناشی از شیمی درمانی | دانش آموزان: پرستاری | پرستاری انکولوژی | نئوپلاسم | Knowledge | Neutropenia | Chemotherapy-induced febrile neutropenia | Students: nursing | Oncology nursing | Neoplasm
مقاله انگلیسی
4 Improving breast cancer nurses’ management of challenging situations involving family carers: Pilot evaluation of a brief targeted online education module (TRIO-Conflict)
بهبود مدیریت پرستاران سرطان پستان در موقعیت های چالش برانگیز شامل مراقبان خانواده: ارزیابی آزمایشی یک ماژول آموزش آنلاین هدفمند کوتاه (TRIO-Conflict)-2021
Objective: Given the stressful and emotional nature of cancer, challenging interactions between nurses, patients, and family frequently occur. Nurses are rarely equipped with strategies to avoid or de-escalate stressful situations with carers, which can include displays of conflict, anger, or dominance. A brief online education module (TRIO-Conflict) was developed to provide nurses with management strategies to use in situations of conflict. This study aimed to assess the feasibility, acceptability, and potential efficacy of TRIOConflict.
Methods: Nurses were recruited through an Australian breast cancer organisation (McGrath Foundation). Participants completed pre/post module measures of attitudes towards carers, confidence in their skills to effectively navigate challenging interactions with carers, and applied knowledge of management strategies. Data were analysed using Wilcoxon signed-rank tests. Qualitative feedback was analysed using content analysis.
Results: 52 nurses completed pre-/post- measures, with 4 semi-structured interviews conducted. Significant improvements in attitudes towards carers (p = .010) and confidence in one’s own ability to manage challenging interactions with carers (p < .001) were found, but not knowledge of strategies. Most nurses found TRIO-Conflict very/extremely helpful (87%) and were satisfied with content (94%) and usability (93%).
Conclusion: TRIO-Conflict utilised evidence-based learning techniques (provision of example phrases, video vignettes, reflective exercises) to improve nurses attitudes and confidence. Practice Implications: TRIO-Conflict is a brief, targeted, clinically relevant, and easily accessible online training programme which could be widely disseminated to oncology nurses.
مقاله انگلیسی
5 Implementation of a standardized voiding management protocol to reduce unnecessary re-catheterization - A quality improvement project
اجرای یک پروتکل استاندارد مدیریت تخلیه برای کاهش دوباره کاتتریزاسیون غیر ضروری - یک پروژه بهبود کیفیت-2020
Objective. To design and implement a standardized postoperative voiding management protocol that accurately identifies patients with urinary retention and reduces unnecessary re-catheterization. Methods. A postoperative voiding management protocol was designed and implemented in patients undergoing major, inpatient, non-radical abdominal surgery with a gynecologic oncologist. No patients had epidural catheters. The implemented quality improvement (QI) protocol included: 1) Foley removal at six hours postoperatively; 2) universal bladder scan after the first void; and 3) limiting re-catheterization to patientswith bladder scan volumes N150 ml. A total of 96 patients post-protocol implementation were compared to 52 patients preprotocol. Along with baseline demographic data and timing of catheter removal,we recorded the presence or absence of urinary retention and/or unnecessary re-catheterization and postoperative urinary tract infection rates. Fishers exact test and students t-tests were performed for comparisons. Results. The overall rate of postoperative urinary retention was 21.6% (32/148). The new voiding management protocol reduced the rate of unnecessary re-catheterization by 90% (13.5% vs 2.1%, p = 0.01), without overlooking true urinary retention (23.1% vs 20.8%, p = 0.83). Additionally, there was a significant increase in hospital-defined early discharge prior to 11:00 AM (4.0% vs 22.0%, p = 0.022). There was no difference in the postoperative urinary tract infection rate between the groups (p=1.00). Risk factors associatedwith urinary retention included older age (p b 0.01), use of medications with anticholinergic properties (p b 0.01), and preexisting urinary dysfunction (p b 0.01). Conclusions. Implementation of this new voiding management protocol reduced unnecessary recatheterization, captured and treated true urinary retention, and facilitated early hospital discharge
Keywords: Quality improvement | Bladder voiding | Urinary retention | Postoperative management | Gynecologic Oncology surgery | Urinary tract infection
مقاله انگلیسی
6 اجرای یک پروتکل استاندارد مدیریت خالی سازی جهت کاهش میله گذاری دوباره غیرضروری – یک پروژه بهبود کیفیت
سال انتشار: 2020 - تعداد صفحات فایل pdf انگلیسی: 7 - تعداد صفحات فایل doc فارسی: 19
هدف: طراحی و اجرای یک پروتکل استاندارد مدیریت پساعملی خالی سازی که بیمارانی با نگه داشتن ادرار را به صورت دقیق شناسایی می کند و میله گذاری ضروری دوباره را کاهش می دهد. روشها: یک پروتکل پساعملی مدیریت خالی سازی در بیمارانی که عمل جراحی شدید، بستری شدن و وریدهای شکمی غیر ریشه ای را تحمل می کنند با یک تومورشناس زنان طراحی و اجرا شد. هیچ بیماری میله اپیدورالی نداشت. پروتکل بهبود کیفیت اجرا شده شامل موارد زیر بود: 1) حذف صدا در شش ساعت به صورت پساعملی؛ 2) اسکن عمومی مثانه پس از اولین خالی سازی؛ و 3) کاهش میله گذاری دوباره برای بیمارانی با حجم اسکن مثانه ای بیشتر از 150 میلی لیتر. درکل اجرای پساپروتکل 96 بیمار با پیش- پروتکل 52 بیمار مقایسه شد. درکنار داده های جمعیتی مبنا و زمان سنجی حذف میله گذاری، ما حضور یا عدم حضور نگه داشتن ادرار یا میله گذاری دوباره غیرضروری و نرخ عفونت پساعملیاتی دسته تارهای ادراری را ثبت کردیم. آزمایش واقعی فیشر و آزمایش های t دانشجویی برای مقایسه ها انجام شد. نتایج: نرخ کلی نگه داشتن ادرار پس از عمل جراحی برابر با 6/21% (148/32) بود. پروتکل جدید مدیریت خالی سازی، نرخ میله گذاری دوباره غیرضروری را تا 90 درصد (5/13 درصد دربرابر ½ درصد، 01/0 = p)، بدون چشم پوشی از نگه داشتن واقعی ادرار (1/23% دربرابر 8/20%، 83/0 = p) کاهش داد. به علاوه، افزایش قابل توجهی در ترخیص زودتر از زمان تعریف شده توسط بیمارستان قبل از ساعت 11 قبل از ظهر وجود داشت (40% دربرابر 22%، 022/0 = p). هیچ تفاوتی در نرخ عفونت تارهای ادراری پسا از عمل بین گروهها وجود نداشت (1 = p). عوامل خطر درکنار نگه داشتن ادرار شامل سن بالا (01/0>p)، استفاده از داروهایی با ویژگی های استیل کولین (01/0>p) و عملکرد غیرمعمول ادرارِ ازقبل موجود می شود. نتیجه گیری ها: اجرای این پروتکل مدیریتی جدید خالی سازی، میله گذاری دوباره غیرضروری را کاهش داد، نگه داشتن ادرار واقعی را به دست داد و ترخیص بیمارستانی پیشین را تسهیل کرد.
مقاله ترجمه شده
7 Artificial intelligence (AI) and big data in cancer and precision oncology
هوش مصنوعی و داده های بزرگ در سرطان و انکولوژی دقیق -2020
Artificial intelligence (AI) and machine learning have significantly influenced many facets of the healthcare sector. Advancement in technology has paved the way for analysis of big datasets in a cost- and time-effective manner. Clinical oncology and research are reaping the benefits of AI. The burden of cancer is a global phenomenon. Efforts to reduce mortality rates requires early diagnosis for effective therapeutic interventions. However, metastatic and recurrent cancers evolve and acquire drug resistance. It is imperative to detect novel biomarkers that induce drug resistance and identify therapeutic targets to enhance treatment regimes. The introduction of the next generation sequencing (NGS) platforms address these demands, has revolutionised the future of precision oncology. NGS offers several clinical applications that are important for risk predictor, early detection of disease, diagnosis by sequencing and medical imaging, accurate prognosis, biomarker identification and identification of therapeutic targets for novel drug discovery. NGS generates large datasets that demand specialised bioinformatics resources to analyse the data that is relevant and clinically significant. Through these applications of AI, cancer diagnostics and prognostic prediction are enhanced with NGS and medical imaging that delivers high resolution images. Regardless of the improvements in technology, AI has some challenges and limitations, and the clinical application of NGS remains to be validated. By continuing to enhance the progression of innovation and technology, the future of AI and precision oncology show great promise.
Keywords: Artificial intelligence | Machine learning | Deep learning | Big datasets | Precision oncology | NGS and bioinformatics | Medical imaging | Digital pathology | Diagnosis | Treatment | Prognosis and drug discovery
مقاله انگلیسی
8 A systematic quality assurance framework for the upgrade of radiation oncology information systems
یک چارچوب تضمین کیفیت سیستماتیک برای ارتقاء سیستم های اطلاعاتی آنکولوژی پرتونگاری-2020
In spite of its importance, no systematic and comprehensive quality assurance (QA) program for radiation oncology information systems (ROIS) to verify clinical and treatment data integrity and mitigate against data errors/corruption and/or data loss risks is available. Based on data organization, format and purpose, data in ROISs falls into five different categories: (1) the ROIS relational database and associated files; (2) the ROIS DICOM data stream; (3) treatment machine beam data and machine configuration data; (4) electronic medical record (EMR) documents; and (5) user-generated clinical and treatment reports from the ROIS. For each data category, this framework proposes a corresponding data QA strategy to very data integrity. This approach verified every bit of data in the ROIS, including billions of data records in the ROIS SQL database, tens of millions of ROIS database-associated files, tens of thousands of DICOM data files for a group of selected patients, almost half a million EMR documents, and tens of thousands of machine configuration files and beam data files. The framework has been validated through intentional modifications with test patient data. Despite the ‘big data’ nature of ROIS, the multiprocess and multithread nature of our QA tools enabled the whole ROIS data QA process to be completed within hours without clinical interruptions. The QA framework suggested in this study proved to be robust, efficient and comprehensive without labor-intensive manual checks and has been implemented for our routine ROIS QA and ROIS upgrades.
Keywords: Quality assurance | Radiation oncology information system | Clinical data integrity and safety | Radiation oncology data management | Integrated oncology system
مقاله انگلیسی
9 Distributed learning on 20 000+ lung cancer patients – The Personal Health Train
یادگیری توزیع شده بر روی 20 000+ بیمار مبتلا به سرطان ریه - آموزش بهداشت شخصی-2020
Background and purpose: Access to healthcare data is indispensable for scientific progress and innovation. Sharing healthcare data is time-consuming and notoriously difficult due to privacy and regulatory concerns. The Personal Health Train (PHT) provides a privacy-by-design infrastructure connecting FAIR (Findable, Accessible, Interoperable, Reusable) data sources and allows distributed data analysis and machine learning. Patient data never leaves a healthcare institute. Materials and methods: Lung cancer patient-specific databases (tumor staging and post-treatment survival information) of oncology departments were translated according to a FAIR data model and stored locally in a graph database. Software was installed locally to enable deployment of distributed machine learning algorithms via a central server. Algorithms (MATLAB, code and documentation publicly available) are patient privacy-preserving as only summary statistics and regression coefficients are exchanged with the central server. A logistic regression model to predict post-treatment two-year survival was trained and evaluated by receiver operating characteristic curves (ROC), root mean square prediction error (RMSE) and calibration plots. Results: In 4 months, we connected databases with 23 203 patient cases across 8 healthcare institutes in 5 countries (Amsterdam, Cardiff, Maastricht, Manchester, Nijmegen, Rome, Rotterdam, Shanghai) using the PHT. Summary statistics were computed across databases. A distributed logistic regression model predicting post-treatment two-year survival was trained on 14 810 patients treated between 1978 and 2011 and validated on 8 393 patients treated between 2012 and 2015. Conclusion: The PHT infrastructure demonstrably overcomes patient privacy barriers to healthcare data sharing and enables fast data analyses across multiple institutes from different countries with different regulatory regimens. This infrastructure promotes global evidence-based medicine while prioritizing patient privacy.
Keywords: Lung cancer | Big data | Distributed learning | Federated learning | Machine learning | Survival analysis | Prediction modeling | FAIR data
مقاله انگلیسی
10 تعداد مورنیاز برای توئیت کردن: شبکه های اجتماعی و تاثیر آن روی علم جراحی
سال انتشار: 2019 - تعداد صفحات فایل pdf انگلیسی: 4 - تعداد صفحات فایل doc فارسی: 12
پزشکان جراح با استفاده از فیسبوک، توئیتر، لینکدین و اینستاگرام هم برای اهداف فردی و هم اهداف حرفه ای وارد شبکه های اجتماعی می شوند. در یک عصر دسترسی جهانی به هرچیز، خطر سرریز شدن اطلاعات وجود دارد و بنابراین نیاز به مقابله و همیاری داریم. هشتگ ها به صورت ویروسی تاثیر عظیم اجتماعی داشته اند مثلا" هشتگ #ILookLikeASurgeon. SoMe تبدیل به یک ابزاری برای برقراری ارتباط، به اشتراک گذاری و راهنمایی و آموزش شده است. این یک ابزاری برای آموزش نسل بعدی جراحان می باشد. برای محققان و مجلات، این سوال باقی مانده است که آیا ورودی مورد نیاز برای وارد شدن به بستر SoMe با یک بهره مشابه در خروجی، مثل شهرت و درمعرض دید قرار گرفتن جبران می شود یا خیر. اطلاعات خلاصه شده در چکیده های بصری می تواند به انتشار نتایج مطالعه برای طیف گسترده ای از مخاطبان کمک کند اما تاثیر یک هشتگ #visualabstract می تواند خاص و تخصصی باشد. درحال حاضر، اطلاعات و دانش اندکی درباره "تعداد موردنیاز برای توئیت کردن" به منظور اثرگذاشتن روی مواردی مثل دانلودها، ارجاع دهی ها و نهایتا" ضریب تاثیر وجود دارد.
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