Totally implantable venous access devices (TIVADs) have been widely used for many years in the management of patients suffering from cancer. Thrombotic occlusion is the most common functional complication in the off-treatment period. This study aims to investigate the incidence of and risk factors for TIVADs-related thrombotic occlusion in patients with breast cancer. The clinical data of 1586 eligible patients with breast cancer with TIVADs at the Fourth Affiliated Hospital of Hebei Medical University from 1 January 2019 to 31 August 2021 were analysed. Thrombotic occlusion was confirmed by angiography with signs of partial or total occlusion. Thrombotic occlusion occurred in 96 (6.1%) cases. Multivariable logistic regression analysis showed that the insertion site of the catheter (P = 0.004), size of the catheter (P < 0.001), and indwelling time (P < 0.001) were significant factors for thrombotic occlusion. Insertion in the right internal jugular vein, smaller catheter size and shorter indwelling time can lower the incidence of thrombotic occlusion in breast cancer patients with TIVADs in the off-treatment period.
Background: Monitoring adverse Events (AEs) is a standard practice for clinician to assess the overall effect of anti-cancer treatment on patients. However, studies have found clinicians have difficulty in capturing nuance aspects of patient-centered AEs. We aimed to explore the differences between nurses and clinicians in term of subjective AEs assessment and discuss the nurses’ role in subjective AEs assessment.Methods: From April and July, 2020, a questionnaires based study was conducted in Day Chemotherapy ward of Breast Center in Hebei Cancer Hospital. Six common subjective AEs were assessed by nurses and clinicians utilizing Common Terminology Criteria for Adverse Events (CTCAE). Patients needed to self-report their own subject AEs by filling up a Simplified Chinese version of PRO-CTCAE containing the same AEs. Results from the three different pairs (Nurse/Patient, Nurse/ Clinician, and Clinician/Patient) were collected and analyzed. Chi-square test and kappa coefficient were utilized to analysis the differences and consistency among different pairs.Results: of 417 patients were asked to participate in the study, 384 pairs surveys were collected. Nurses detected more AEs than clinicians, and the differences were statistically significant (P<0.00). Nurse/patient pair scored the highest agreement in terms of reporting rate and toxicity grade for most of AEs except the toxicity grade for the frequency of vomiting and pain which were as consistent as nurse/clinician.Conclusions: The results of this study support nurses can be successfully enrolled in the assessment of subjective AEs because of the greater ability to elicit more patient-centered information than clinicians.
A cross-sectional study was performed at Hebei Medical University Fourth Affiliated Hospital from April to July 2020 to explore the difference and consistency between nurses and physicians in terms of symptomatic adverse event (AE) assessment. The Common Terminology Criteria for Adverse Events (CTCAE) was utilized by nurses and physicians to assess patients’ symptomatic AEs. Patients self-reported their AEs utilizing the Patient-Reported Outcomes Version of the Common Terminology Criteria for Adverse Events (PRO-CTCAE). Four nurses and three physicians were enrolled to assess patients’ symptomatic AEs. Given the same AEs, nurses tended to detect more AEs than physicians, and the differences were statistically significant (P < 0.001). The toxicity grade reported by nurses and physicians showed no difference for all AEs, except for fatigue (χ2 = 5.083, P = 0.024). The agreement between nurses and patients was highest compared to the agreement between nurses versus physicians and physicians versus patients. The differences in symptomatic AE assessment can lead to different symptom management. Thus, it is important to establish a collaborative approach between nurses and physicians to ensure continuity in care delivery.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.
hi@scite.ai
10624 S. Eastern Ave., Ste. A-614
Henderson, NV 89052, USA
Copyright © 2024 scite LLC. All rights reserved.
Made with 💙 for researchers
Part of the Research Solutions Family.