Cancer fatigue has been defined and described as an important problem. However, few studies have assessed the relative importance of fatigue compared with other patient symptoms and concerns. To explore this issue, the authors surveyed 534 patients and 91 physician experts from 5 NCCN member institutions and community support agencies. Specifically, they asked patients with advanced bladder, brain, breast, colorectal, head and neck, hepatobiliary/pancreatic, kidney, lung, ovarian, or prostate cancer or lymphoma about their "most important symptoms or concerns to monitor." Across the entire sample, and individually for patients with 9 cancer types, fatigue emerged as the top-ranked symptom. Fatigue was also ranked most important among patients with 10 of 11 cancer types when asked to rank lists of common concerns. Patient fatigue ratings were most strongly associated with malaise (r = 0.50) and difficulties with activities of daily living, pain, and quality of life. Expert ratings of how much fatigue is attributable to disease versus treatment mostly suggested that both play an important role, with disease-related factors predominant in hepatobiliary and lung cancer, and treatment-related factors playing a stronger role in head and neck cancer.

Background Growth of online education has increased the demand for satisfied educators with perceived self-efficacy in online teaching. Teaching self-efficacy is an indicator of the belief that one can make a difference in student learning outcomes. Purpose The aim of this study was to examine the level of teaching self-efficacy and satisfaction of online nursing faculty. Methods This study used a descriptive cross-sectional survey design. Faculty satisfaction was measured by the Online Instructor Satisfaction Measure, and self-efficacy for online teaching was measured by the Michigan Nurse Educator's Sense of Efficacy for Online Teaching instrument. Results The sample included 100 faculty in multiple schools of nursing who taught at least 1 online course in RN to BSN or graduate nursing programs. Overall, participants had relatively high levels of online teaching self-efficacy and satisfaction. Conclusions Teacher self-efficacy can be facilitated through faculty development and increased experience teaching online.

Background Minimal information exists about the educational environment that will foster learning and engage Generation Z students. Purpose The purposes of this study were to identify the teaching methods that Generation Z nursing students preferred and felt were the most engaging and effective for learning and to determine their engagement level in the classroom setting. Methods This study employed a descriptive, cross-sectional design. Results Lecture with audience response clickers was the most preferred/most engaging and effective method for helping Generation Z nursing students learn, whereas assigned reading was the least preferred method. Students preferred a traditional classroom model instead of a flipped classroom. Acquiring skills was the dimension of engagement rated the highest by this group of students. Conclusions Innovative lectures that incorporate applicable visual images and audience involvement combined with simulation, videos, and case studies may encompass a teaching formula that will engage and foster learning for Generation Z students.

OBJECTIVES To determine the work values of Generation Z nurses, a new generation in the current workforce. BACKGROUND A new generation of nurses is now part of the nursing workforce. Generation Z nurses, born in 1995 (aged ≤24 years), will bring new expectations and ideals about life and work into healthcare work settings. METHODS A descriptive, cross-sectional survey design was used to assess the work values of traditional baccalaureate Generation Z nursing students using the Lyons Work Values Survey. RESULTS The work value component ranked most important by participants was social/altruistic, followed by instrumental/extrinsic, cognitive/intrinsic, and prestige. CONCLUSION Helping people and having a job that is interesting and engaging while also offering job security and good benefits were the most important future Generation Z nurse work values.

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Recent guidance from the FDA discusses patient-reported outcomes as end points in clinical trials. Using methods consistent with this guidance, the authors developed symptom indexes for patients with advanced cancer. Input on the most important symptoms was obtained from 533 patients recruited from NCCN Member Institutions and 4 nonprofit social service organizations. Diagnoses included bladder, brain, breast, colorectal, head and neck, hepatobiliary/pancreatic, kidney, lung, ovarian, and prostate cancers and lymphoma. Physician experts in each of these diseases were also surveyed to differentiate symptoms that were predominantly disease-based from those that were predominantly treatment-induced. Results are evaluated alongside previously published indexes for 9 of these 11 advanced cancers that were created based on expert provider surveys, also Implemented at NCCN Member Institutions. Final results are 11 symptom indexes that reflect the highest priorities of people affected by these 11 advanced cancers and the experienced perspective of the people who provide their medical treatment. Beyond the clinical value of such indexes, they may also contribute significantly to satisfying regulatory requirements for a standardized tool to evaluate drug efficacy with respect to symptomatology.

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Bundling or grouping together evidence-based interventions to improve care for the mechanically ventilated patient was piloted by a 10-bed medical-surgical critical care unit of a hospital. The bundled care interventions included: (a) keeping the head of bed elevated at 30 degrees, (b) instituting daily interruption of continuous sedative infusion, (c) assessing readiness to wean using a rapid-wean assessment guide, (d) initiating deep venous thrombosis prophylaxis, and (e) implementing peptic ulcer disease prophylaxis. The interventions were implemented using a plan-do-check-act quality-improvement methodology. Results indicated that the use of bundled interventions for mechanically ventilated patients could decrease average ventilator times and average length of stay with no concomitant increase in reintubations. Average mortality rates and the number of adverse events per 100 patient days also were reduced.