![]() |
|
Volume 18, Issue 1, February 2008
|
Message From the Coordinator Stay Informed in the Ever-Changing Cancer Prevention Arena
Diane McElwain, RN, MEd, OCN® Happy winter, everyone! 2007 was a very positive year in cancer care, with reports of declining cancer rates. Those of us who have been working in cancer outreach for some time might be thinking, “Perhaps what I teach is making a difference.” Please make an effort to read the November 2007 issue of ONS Connect. Ellen Giarelli, EdD, RN, CRNP, ex officio of the Prevention and Early Detection SIG, and Suzanne Mahon, RN, DNSc, AOCN®, APNG, our current newsletter editor, are featured in the article, “Clearing the Air: An Update on the Progress of Tobacco Control.” We are most proud of our members who exemplify why we love our prevention actions. Because of my busy fall activities, I had quite a pile of literature to review recently. I was amazed by how many publications are highlighting the prevention of cancer as well as reducing cancer risks. Publications such as the Oncology Nursing Forum, Oncology Times, Nutrition Action, and CA: A Cancer Journal for Clinicians are offering information about current studies and results pertaining to cancer prevention and risk reduction. I eagerly read these articles because I have found that the “inquiring public” also reads the information and often asks questions. Furthermore, I am intrigued as to how often the information changes, challenging those of us in the field to stay informed. An article in the November 2007 issue of Reader’s Digest included interesting information about what vitamins not to take. Newspapers, news magazines, and television news programs are constantly announcing “new breakthroughs.” The American Institute for Cancer Research and the World Cancer Research Fund recently released the Second Expert Report on Food, Nutrition, Physical Activity, and the Prevention of Cancer: A Global Perspective. An excellent synopsis of the report can be found in the December 2007 issue of Nutrition Action Healthletter. The report was released by a panel of 21 international experts who reviewed 700 studies on 17 kinds of cancer and 61 types of exposures. The report has shifted the causes of cancer from poor food choices to body "fatness," emphasizing the importance of not gaining weight and engaging in moderate physical activity. Calorie-dense foods and sugary drinks that promote weight gain also are targeted. The recommendations to eat foods mostly of plant origin and to limit the intake of red and processed meats are still valid. Limited alcohol and salt intake are still recommended. Dietary supplements are discouraged. Breastfeeding is encouraged for at least six months. Cancer survivors are advised to follow recommendations for cancer prevention for diet, healthy weight, and physical activity. Teaching these principles may be as important as teaching the means of early detection of cancer. With the obesity epidemic and the lack of physical activity trend in our country, we have a lot to tackle. I am intrigued that diabetes educators, cardiac rehabilitation nurses, and others soon will have almost an identical message for disease prevention. In my quest to always present the latest and most accurate information, I am grateful for groups such as our SIG, my local oncology dietitian, and the variety of quick-reading journals and newsletters that are available. Patients, families, and the general public seek advice and information from nurses. With the ever-changing data, I am most grateful that resources are available to us! Please contact me with your ideas for making this newsletter a valuable resource to you. If you are able to review an article, please volunteer to send a synopsis to Editor Suzanne Mahon so that we can include it in a future issue. We would like to make this newsletter as helpful to you as possible. We continue to work on our Web site. Please e-mail me with your suggestions! The ONS Web master will be helping us with this activity. I look forward to meeting with you at the ONS 33rd Annual Congress, which will be held May 1518 in Philadelphia, PA. In the meantime, stay as informed as you can to be a valuable resource for the ever-changing cancer prevention arena. |
The Prevention/Early Detection SIG Newsletter is produced by members of the Prevention/Early Detection SIG and ONS staff and is not a peer-reviewed publication. |
Special Interest Group Newsletter February 2008 |
Sue Shultz, MA We previously looked at quick and easy PubMed searching using text words. But what can we do if the search nets too much information or the retrieval yields too many articles that are not exactly on point? To focus our search and eliminate unwanted citations or concepts, we can use MeSH terms. MeSH, which stands for medical subject headings, is the National Library of Medicine’s controlled vocabulary or dictionary of terms approved for indexing articles in MEDLINE. A standardized set of terms provides us with a consistent starting point to retrieve information. MeSH eliminates the need to think of all variations and spellings by assigning a single key term. Let’s look at some examples. Example 1 You would like to know if early detection of pancreatic cancer can make a significant difference in the mortality rate. You also need to know if and how an early diagnosis can be made. Begin by clicking “MeSH Database” on the left side of the PubMed home page; the menu on the screen will appear as follows.
In the search box, type one of the concepts for your search. For our example, the main concept would be “pancreatic cancer.” When we have entered those terms and clicked go, a series of possible MeSH matches are displayed along with definitions of the terms. Pancreatic Neoplasms, the first choice, appears to be the best selection for our search.
Put a check mark in the box, and send the term to the “Search Box with AND” by using the pull-down window on the right.
The next term we might try is “early diagnosis.” MeSH does have a term for that, so we can add it to our search in the same way. First, put a check in the box and then send the term to the “Search Box with AND,” as shown above. Our search box now looks like this:
Other search terms can be added as indicated by the parameters we have established for our question. If we decide that all of the parts of the question are now represented in the search box, we instruct the database to run the search by clicking the “PubMed Search” button. On the day this search was completed (July 23, 2007), the strategy produced 25 articles, 16 of which are in English. The first citation from the retrieval is reproduced here.
Example 2 For this example, we will construct a simple search using a subheading attached to our main subject to refine our retrieval. We would like to know the availability of any current information concerning the prevention of pancreatic cancer. Begin the search as described above by clicking “MeSH Database” from the menu on the left side of the PubMed home page and type the main concept, “pancreatic cancer,” in the search box. Pancreatic Neoplasms is the closest match. To view the subheadings attached to this MeSH term, either double-click Pancreatic Neoplasms to reveal the subheading list or change the display pull-down menu to Full.
The screen then will expand to include all of the possible subheadings for this term. Each of these will be preceded by a check box so that one or more subheadings can be selected. For our example, the only subheading of the many offered that we will need is “prevention and control.” To select the term with the subheading, place a check mark in the box next to “prevention and control” and send to the “Search Box with AND” by using the pull-down window on the right.
Our search strategy will look like this:
To run the search, click the “PubMed Search” button. On the day this search was completed (July 23, 2007), the strategy produced 239 articles, 126 of which are in English. One of the citations from the retrieval is reproduced here:
Summary This is a simple explanation of a PubMed search using MeSH. For more information, consult the PubMed Tutorials by clicking the “Tutorials” link on the left side of the PubMed home page. Scroll down a short way to find the PubMed’s MeSH Database section, which includes the following tutorials.
|
||||||||||||
Special Interest Group Newsletter February 2008 |
Linda Lillington, RN, DNSc ONS has been exploring the role it can play in outcomes measurement and multisite research as part of the Outcomes and Multisite Research Strategic Plans. The Nursing-Sensitive Patient Outcomes White Paper (Given & Sherwood, 2005), published in the Oncology Nursing Forum as a result of the 2003 Outcomes Project Team, provided important background for the examination and evaluation of oncology patient outcomes impacted by nursing interventions. Simultaneously, the interest of ONS research members in identifying ONS’s role in facilitating the use of the same research plan across several sites and pooling data for interpretation and dissemination has led to the development of several initiatives. The outcomes and multisite research initiatives came together at the recent Multisite Research Core Data Set/Outcomes Consensus Conference held August 45, 2007. Several experts were invited to join the Core Data Set Project Team to share and present their expertise in defining outcomes, developing quality indicators, and collecting and storing large data sets. The presenters included Jacqueline Dunbar-Jacob, PhD, RN, FAAN, from the National Institutes of Health’s Patient-Reported Outcomes Measurement Information System (PROMIS) Initiative and the University of Pittsburgh Center for Research in Chronic Disorders; Kristen McNiff, MPH, from the American Society of Clinical Oncology Quality Oncology Practice Initiative; Lori Hoffman-Hogg, RN, MS, AOCN®, from the Veterans Affairs Nursing Outcomes Database; and Dianne M. Reeves, RN, MSN, from the National Cancer Institute’s Cancer Biomedical Informatics Grid. Other invited members included Susie Beck, PhD, ARPN, AOCN®, Deborah Eldredge, PhD, RN, Barb Holmes-Gobel, MS, RN, AOCN®, and Lori A. Williams, RN, DSN, OCN®, AOCN®. The focus of the consensus conference was to identify a set of core data elements that are meaningful to oncology nurses, patients, and stakeholders and to devise a strategy for collection and use in clinical practice, research, and administration. The group came together to brainstorm, reach consensus on nursing-sensitive measures (core data elements, core data set, and outcomes), and generate ideas for strategies to facilitate implementation in various clinical and research settings. Discussion focused on considerations important in planning and implementing an oncology nursing outcomes measurement program, including the role that ONS can contribute as a professional society. ONS Putting Evidence Into Practice (PEP®) resources were considered as the basis for the selection of core data elements. A review of proposed core data elements, their related measures, and criteria for selection, prepared by Christopher Friese, PhD, RN, AOCN®, and Dorothy Dulko, PhD, RN, MS, NP, identified core data elements to be considered for use, including fatigue, pain, oral assessment, performance status, emotional distress, neurotoxicity, neutropenia, sleep, nausea and vomiting, constipation, and demographic characteristics. The consensus conference participants felt that ONS core data elements for common data collection should aim to provide consistency in nursing core measures across local, regional, and national settings. The consensus conference yielded many activities that are consistent with several national and international initiatives related to quality cancer care and quality nursing care. The work of the 2007 Core Data Set/Outcomes Consensus Conference Project Team is just beginning, as this will be a long-term initiative with several intermediate steps, ultimately leading to data that will demonstrate the impact of oncology nursing interventions on quality cancer care. ONS has the potential to be in a unique leadership role in this complex and important quality cancer care initiative. Reference Given, B.A., & Sherwood, P.R. (2005). Nursing sensitive patient outcomesA white paper. Oncology Nursing Forum, 32, 773-784.
|
Special Interest Group Newsletter February 2008 |
Suzanne Mahon, RN, DNSC, AOCN®, APNG I often use a cartoon with Ziggy in my presentations. It is an old but favorite one. It shows Ziggy at the candy counter of a movie theater, debating whether he should buy a gigantic soft drink. The quandary is that the supersized soft drink is the best buy, but he misses half of the movie because of restroom breaks. It is all in the perspective. That is so true of all that we do. You can look at the world with a glass half-full or a glass half-empty mentality, or somewhere in between. If your furnace goes out on a cold night, but you can get it repaired at a substantial cost, what is your perspective? Are you angered by the cost or grateful that you have a home, a furnace, and the capability to make a repair? When you speak with families about cancer prevention and early detection, what is your approach? Do you present the statistics of incidence (which can be frightening), or do you just discuss prevention and detection strategies (which may be too simplistic)? Cancer prevention and early detection is not black and white. Patients need to understand the magnitude of the particular cancer that they are concerned about (epidemiology), their likelihood of developing it (personal risk), the strengths and limitations of the proposed screening test(s) (specificity and sensitivity), and the potential consequences of choosing not to screen or engage in a prevention strategy. If your presentation is too positive, the patient may not understand the seriousness of the cancer or the need for screening. If your presentation is too negative, the patient may feel as if there is no hope even with screening. Perspective is important. You need to determine your patients’ perspective and help them to honestly understand the risks and benefits of a prevention or detection test so they can make decisions that are aligned with their value systems. You also can remind your patients about Ziggy—looking at the whole picture is important. Patients can look at screening as an irritating and time-consuming process, or they can be grateful that in many cases screening does actually change the course of disease. It is all in the perspective.
|
Special Interest Group Newsletter February 2008 |
The Institute of Medicine (IOM) convened a special committee to look at the delivery of psychosocial services to patients with cancer and their families and identify ways to improve the provision of care. The results, which were released in November 2007, are published in Cancer Care for the Whole Patient: Meeting Psychosocial Health Needs. The findings state that many patients with cancer have psychosocial needs. Although the supply of services is insufficient to address all patient needs, untapped resources exist, frequently at no additional cost. Patients, however, often are unaware of these resources. The committee proposed that all components of the healthcare system incorporate attention to patient psychosocial needs into their practice. This new standard of care recommends that all cancer care should ensure the provision of appropriate psychosocial services by
Links patients with needed psychosocial services
|
Special Interest Group Newsletter February 2008 |
All oncology nurses spend hours every day navigating patients through the bewildering maze of the medical system. Why not also take time to navigate through your SIG’s virtual community (VC)? It can serve as a library for all kinds of information, professional support, and resources for you and your patients.
Now you can check out all that your SIG’s VC has to offer. You do not need to log in to look through the page. At the top of the page, you will see a tool bar with tabs on it. The tabs include My SIG Page, About Us, News, Scrapbook, Calendar, Discussion, Find a SIG, and ONS National Announcements. Let’s look at some of the key sections of select tabs. SIG Home
About Us
News
Calendar
Discussion
ONS National Announcements
|
Special Interest Group Newsletter February 2008 |
Please welcome the following members to the Prevention and Early Detection SIG.
|
Special Interest Group Newsletter February 2008 |
Your Vote Counts! Oncology Nurse Practitioner Competencies Available This important guide was developed by a multi-organizational national panel convened by ONS that used a nationally vetted process to develop, review, and revise the document. The competencies then were reviewed and critiqued by 127 ONPs as well as 20 members of a national validation panel comprised of representatives of nursing organizations and National Cancer Institute-designated comprehensive cancer centers. To learn more, click here. 2007 Congress Session Webcasts Available Take Advantage of ONS Partner Products and Services Oncology Nursing Forum Addresses Poverty and Human Development ONS Web Site Offers Smoking Cessation Resources New ONS PEP® Card Volume Now Available Bring the 2007 Institutes of Learning and APN Conference Home! New Handbook Highlights Role of Oncology Nurse Practitioner Step Up and Become a Diversity Champion Updated 20052009 ONS Research Agenda Now Available for Review ONS Offers Online Tools for Nurse Researchers
|
Special Interest Group Newsletter February 2008 |
Put your knowledge and expertise to work by becoming a reviewer for the Clinical Journal of Oncology Nursing (CJON). For more information, click here. |
Special Interest Group Newsletter February 2008 |
Check out the Oncology Nursing Forum (ONF) for interesting articles about prevention and early detection.
For access to the full-text versions of these and other ONF, visit the Publications area of the ONS Web site.
|
| Special Interest Group Newsletter February 2008 |
|
Membership Information SIG Membership Benefits
Join a Virtual Community A great way to stay connected to your SIG is to join its Virtual Community. It’s easy to do so. All you will need to do is
Subscribe to Your SIG’s Virtual Community Discussion Forum All members are encouraged to participate in their SIG’s discussion forum. This area affords the opportunity for exchange of information between members and nonmembers on topics specific to all oncology subspecialties. Once you have your log-in credentials, you are ready to subscribe to your SIG’s Virtual Community discussion forum. To do so,
Participate in Your SIG’s Virtual Community Discussion Forum
Sign Up to Receive Your SIG’s Virtual Community Announcements As an added feature, members also are able to register to receive their SIG’s announcements by e-mail.
|
| Special Interest Group Newsletter February 2008 |
|
Prevention/Early Detection SIG Officers
Know someone who would like to receive a print copy of this newsletter? To view past newsletters, click here. ONS Membership/Leadership Team Contact Information Angie Stengel, MS, CAE, Director of Membership/Leadership Diane Scheuring, MBA, CMP, Manager of Member Services Carol DeMarco, Membership/Leadership Administrative Assistant The Oncology Nursing Society (ONS) does not assume responsibility for the opinions expressed and information provided by authors or by Special Interest Groups (SIGs). Acceptance of advertising or corporate support does not indicate or imply endorsement of the company or its products by ONS or the SIG. Web sites listed in the SIG newsletters are provided for information only. Hosts are responsible for their own content and availability. Oncology Nursing Society
|