BackgroundTreatment of breast cancer entails surgery, often followed by chemotherapy. Alopecia is a major, intractable side effect with potentially profound impacts on appearance. We developed a nurse‐facilitated program targeting appearance‐related symptoms.AimsThis study explored the effects of the appearance care program on quality of life (QOL). The program was delivered across three sessions, each involving personal reflections on appearance concerns, short lectures on skincare and makeover techniques, and small group discussions.Method and ResultsSeventy‐two women who attended the appearance care program were invited to participate. We employed a mixed‐method design combining quantitative and qualitative methods. QOL instruments were used to measure effects of the program at the first and final sessions and at a one‐month follow‐up. The qualitative data were collected as open‐ended notes regarding participants' perception of the program at the final session and at a one‐month follow‐up. Fifty‐seven women completed all three sessions. Of them, 55 participated in this study. Their mean age was 46.4 years; 39 (70.9%) had partners, and 34 (61.8%) had children. Most participants experienced hair loss at one‐month post‐program; however, cancer‐specific QOL improved after attending the program. Patients' experience of fatigue and weakness may explain observations of decreased physical well‐being. Emotional well‐being continued to increase 1 month following the program, while social and functional well‐being was consistent. Participants felt empowered by the information on skincare and cosmetic techniques and valued the intimate support from the group members facing similar circumstances.ConclusionsThis study showed that the appearance care program increased or maintained the well‐being of participants. Findings suggest the appearance care program which promoted group sharing experiences empowered participants and may have enhanced their coping strategies.
9629 Background: Fosaprepitant is effective in the prevention of chemotherapy-induced nausea and vomiting. In January 2012, we started using fosaprepitant in anthracycline- and cisplatin-based regimens and observed a tendency for an increase in dermal and vascular adverse events (AEs) at local infusion sites, particularly in the anthracycline group. In this study, we tested the hypothesis that fosaprepitant use is associated with dermal and vascular AEs differentially between anthracycline- and cisplatin-based regimens. Methods: We conducted a retrospective cohort study consisting of all patients who were administered anthracycline- or cisplatin- based regimens in 2011 and 2012 at St. Luke’s International Hospital, Tokyo. Aprepitant was used in 2011 and fosaprepitant was used in 2012. All other factors including pre- and post-hydration, premedication, and injection schedule were the same. Dermal and vascular AEs was defined as any grade pain or skin changes at local infusion sites or infusion veins. Factors we considered include fosaprepitant use, chemotherapy regimen, age, number of prior regimens, and body mass index. Interaction analysis using multivariate logistic regression was used to evaluate the association between treatment regimen, fosaprepitant, and risk of AEs. Results: A total of 268 patients (aged 54.3±12.3) were included, of which 120 (44.8%) used fosaprepitant. Among fosaprepitant users, 50 patients (41.7%) developed dermal and vascular AEs, whereas only 16 patients (10.8%) experienced AEs among non-users (P< .001). When stratified by regimen, fosaprepitant was associated with a statistically significant increased risk of AEs (OR 12.10; 95% CI 5.45-26.93) in the anthracycline group. In contrast, no association was observed in the cisplatin group (OR 1.04; 95% CI 0.29-3.75). Statistically significant evidence of interaction was found (P< .001) between regimen and fosaprepitant in the risk of AEs. Conclusions: Our results support the finding that using fosaprepitant in anthracycline-based regimens increases dermal and vascular AEs. In response, we discourage the use of fosaprepitant in anthracycline-based regimens through peripheral lines.
Aims: Research the process of organizational change to understand how interventions such as appearance care can be integrated into daily practice. Background: Typical treatment of breast cancer is surgery, often followed by chemotherapy. Associated aesthetic ramifications, including hair loss, frequently cause patient distress. Methods: We conducted face-to-face semi-structured hour-long recorded interviews with three nurses. We then analyzed the developmental process according to the core competencies for interprofessional collaborative practice using the thematic content analysis. Results: Nurses worked with interdisciplinary team members with mutual respect and shared values such as concern for patients' quality of life. Nurses used knowledge of appearance-related side effects combined with beautician-provided coping skills. Intervention involved responsible communication with other health professionals and patients in a team approach. Nurses promoted the developmental process and became program facilitators. Conclusion: This group-intervention program, facilitated by nurses, was integrated into daily practice. Implications for nursing management: Research partnerships between academics, clinical nurses, nurse managers, and beauticians can improve the integration of interventions in routine practice and increase awareness of patients' needs.
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