Purpose: The aims of this study were to understand the experiences of oncology nurses caring for patients with solid-tumor bone metastases and provide a theoretical basis for oncology nurses to formulate a standardized training and management system for patients with bone metastases,so as to improve the ability of patients to care for their own bone health. Methods: A phenomenological, qualitative study design with objective sampling was used. Semi-structured interviews were conducted with 12 oncology nurses in a third-grade a cancer hospital in Hebei Province from March to June 2022. Data collection and analysis proceeded simultaneously until data saturation was reached. The Colaizzi seven-step method of data analysis was used to analyze the data and refine the themes. Results: The experiences of oncology nurses caring for patients with solid-tumor bone metastases could be summarized into five themes: the oncology nurses have insufficient knowledge of the diseases of patients with solid-tumor bone metastases; Oncology nurses have a sense of weakness in managing patients with solid-tumor bone metastases; oncology nurses only pay attention to the primary disease and individual symptoms of patients with solid-tumor bone metastasis; oncology nurses hope to acquire more knowledge related to bone metastasis; and the role of oncology nurses in managing patients with solid-tumor bone metastases is ambiguous. Conclusion: The experiences of oncology nurses caring for patients with solid-tumor bone metastases are multi-dimensional. The interview results suggest that nursing managers need to strengthen nurse training related to bone metastases, formulate comprehensive and standardized nursing protocols for patients with bone metastases, and provide evidence-based support for nurses of patients with bone metastases. These changes could improve the self-management ability of bone health, delay the occurrence of skeletal-related events, and improve patient’ quality life.
Background: Multiple myeloma (MM) extramedullary disease (EMD) is an invasive growth of-clonal plasma cells that, is characterized by myeloma cells escaping from the bone marrow microenvironment, entering the blood circulation and infiltrating and growing in other organs. Soft-tissue involvement was associated with significantly shorter progression-free survival and overall survival, with a poor prognosis and a median survival of 8.5 months. Among the sites involved in extramedullary lesions, the abdomen and back are rare. The prognosis of soft tissue masses located in extramedullary organs is the worst, and the treatment of soft tissue masses with enlargement of extramedullary lesions is still difficult because the poor effects of radio-chemotherapy. Case Presentation: We present an MM patient who experienced multiple skeletal-related events with EMD in the neck, chest, abdomen, and back after four surgical interventions, multiple cycles of chemotherapy and autologous peripheral blood stem cell transplantation, and surgical resection. Conclusions: MM with a large extramedullary plasma cell tumour often is not responsive to chemotherapy and radiotherapy. For continuously growing masses, surgical resection is recommended to reduce the tumour load, relieve pain, and relieve secondary vascular and nerve compression.
Purpose: To compare the effects of peripherally inserted central catheters (PICC) and totally implantable venous access devices (port) in terms of complications and shoulder function in patients with malignant bone and soft tissue tumors of the lower limbs. Patients and methods: We analyzed 65 cases of port and 65 cases of PICC at the orthopedic department of the Fourth Hospital of Hebei Medical University. The two groups were compared in terms of catheter indwelling time, catheter-related complications, Constant-Murley shoulder function score, and displacement of the position of the catheter end on the catheterization side. Results: Compared to the PICC group, at six months after catheterization the port group showed better outcomes for catheter indwelling time, catheter-related complications, and Constant-Murley score for the catheterization-side shoulder joint (p < 0.05). The port group also showed less displacement of the catheter end position after 180° abduction of the catheterization-side shoulder joint (p < 0.05). Conclusion: Compared with PICC, port can prolong catheter indwelling time, reduce catheter-related complications, and maintain shoulder joint function, which makes it an ideal venous-access approach when providing chemotherapy to patients with malignant bone and soft tissue tumors of the lower limbs.
Objective To understand the knowledge status, obstacle factors, and management confidence of oncology nurses on the bone health of cancer patients, and in addition to provide reference for establishing bone health knowledge training system for oncology nurses and guiding them to manage bone health of cancer patients. Methods A total of 602 nurses engaged in oncology nursing in 6 hospitals in Hebei Province were selected by cluster sampling, and an online anonymous survey was conducted by sending questionnaires to oncology nurses from the Hebei Cancer Prevention and Control Association. The questionnaire was developed by the study team. There are 4 parts, namely general information, nurses’ role and job responsibilities, knowledge of skeletal-related events (SREs) and cancer treatment–induced bone loss (CTIBL), and understanding and confidence in bone health management, for a total of 33 questions. Results Thirty-seven percent of oncology nurses received training on bone health and other related contents; 40.48% of oncology nurses used domestic and foreign guidelines when managing patients with bone metastases or CTIBL. Only approximately one-third of oncology nurses had confidence in managing the side effects of bone metastases and bone modification drugs and identifying patients at risk of CTIBL and fracture; only 33.04% of oncology nurses believed that weight-bearing exercise can prevent bone loss; less than 50% of oncology nurses believed that aromatase inhibitor therapy, ovarian suppression therapy, androgen deprivation therapy, and low body weight were risk factors for pathological fractures. The reasons that hindered oncology nurses from optimizing the management of patients with bone metastases and understanding the preventive measures and risk factors for bone loss mainly included lack of relevant knowledge training, lack of understanding of effective intervention measures, and lack of training and professionalism of specialized nurses, including insufficient development time and guidelines for clinical nursing practice. Conclusion Managers must continuously improve the training system of oncology nurses, enrich the content of training pertaining to bone health for cancer patients, formulate clinical nursing practice guidelines, and give oncology nurses more time for professional development.
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