The Social Construction of Cancer Chemotherapy Toxicity

Chen, Hai-Chiao; Allan, Helen; Lu, Zxy-Yann Jane

doi:10.1097/ncc.0b013e31826a7235

Cited by 6 publications

(6 citation statements)

References 16 publications

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“…Previously, conventional antimicrobial therapy adopted an ascending stepwise model, which has been shown to be effective in patients with mild infections. However, for severe infection cases, despite certain mitigation on the APACHE II score and inflammatory response [ 15 ], it is mostly substituted by cephalosporins with higher potency due to its suboptimal efficacy, which increases the risk of adverse effects and the development of drug-resistant bacteria [ 16 ]. As a result, “step-down treatment” was recommended as a sensible medication approach for antimicrobial drug usage in ICU patients with severe bacterial infections.…”

Section: Discussionmentioning

confidence: 99%

Antimicrobial Step-Down Therapy versus Conventional Antimicrobial Therapy in the Treatment of Patients with Sepsis

et al. 2022

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Objective. This study was to evaluate the efficacy of antimicrobial step-down therapy versus conventional antimicrobial therapy in the treatment of patients with sepsis. Methods. Between September 2020 and September 2021, 65 patients with sepsis treated in the intensive care unit (ICU) of our hospital were recruited and assigned at a ratio of 1 : 1 to receive either conventional antimicrobial therapy (sulbactam plus cefoperazone) (control group) or antimicrobial step-down therapy (imipenem/cilastatin) (observation group). The results of drug sensitivity tests and clinical effects were evaluated comprehensively after 3-5 d of treatment, downgraded, and upgraded, or maintenance treatment was administered for 10 d. Outcome measures included clinical and laboratory indices and treatment efficacy. Results. Antimicrobial step-down therapy resulted in a significantly higher efficacy and lower levels of white blood cell (WBC) count and C-reactive protein (CRP) versus conventional antimicrobial therapy ( P < 0.05 ). The patients given antimicrobial step-down therapy showed a significantly shorter duration of antimicrobial drug administration, temperature recovery, time of respiratory support, and ICU stays versus conventional antimicrobial therapy ( P < 0.05 ). Conclusion. Antimicrobial step-down therapy contributes to the mitigation of inflammatory responses in patients with sepsis and shortens the duration of antimicrobial drug use and ICU stay versus conventional antimicrobial therapy. The reliability of the conclusions can be further increased if multicenter and large sample clinical observations can be conducted, which is the direction of endeavor for future clinical studies.

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Section: Discussionmentioning

confidence: 99%

Antimicrobial Step-Down Therapy versus Conventional Antimicrobial Therapy in the Treatment of Patients with Sepsis

et al. 2022

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“…These adverse effects can compromise quality of life, increase financial costs, diminish adherence to treatment and cause medical complications [3,4]. In addition, the financial costs of managing side effects of chemotherapy and the demand for better health care are increasing, potentially compromising cancer treatment [5].…”

Section: Introductionmentioning

confidence: 99%

Use of Text Messaging (SMS) for the Management of Side Effects in Cancer Patients Undergoing Chemotherapy Treatment: a Randomized Controlled Trial

et al. 2020

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Cancer patients are often not sufficiently oriented to manage side effects at home. Sending text messages with self-care guidelines aimed managing side effects is the main objective of this randomized controlled trial. Patients who started outpatient chemotherapy treatment between March and December 2017 at a hospital in southern Brazil were invited to participate in this study and were allocated to the intervention or control group (ratio 1: 1). Each patient in the intervention group received a daily SMS (short message service) with some guidance on management or prevention of side effects. All text messages were sent to the intervention group patients in an automated and tailored way by our app called cHEmotHErApp. Side effects experienced by patients were verified using the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire Core-30 (EORTC QLQ-C30). Results showed intervention group patients experienced fewer side effects compared to the control group in cycle 1 (p < 0.05), in general. In addition, intervention group experienced less nausea in relation to the control group, in the cycle 1 and cycle 2 (p < 0.05). This study indicate text messaging may be a tool for supporting side effect management in patients receiving chemotherapy. This study was enrolled in ClinicalTrials.gov with the identification number NCT03087422. This research was performed in accordance with the Declaration of Helsinki.

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“…Within the health and illness sector, social constructionism has been used to examine meaning-making processes of the everyday subjective experiences of individuals with cancer through treatment and survivorship (Conrad & Barker, 2010). Within research with people with cancer specifically, past research has looked at how knowledge around cancer and chemotherapy are shaped by different cultural contexts and how these shape peoples' constructions of identity and access to healthcare (Chen et al, 2013;Gibson et al, 2022). For example, Chen et al (2013) and Gibson et al (2022) found that prevalent cultural norms and values played a significant role in shaping an individual's meaning making and experience regarding cancer and cancer treatment.…”

Section: Cancer Research Using Social Constructionismmentioning

confidence: 99%

“…Within research with people with cancer specifically, past research has looked at how knowledge around cancer and chemotherapy are shaped by different cultural contexts and how these shape peoples' constructions of identity and access to healthcare (Chen et al, 2013;Gibson et al, 2022). For example, Chen et al (2013) and Gibson et al (2022) found that prevalent cultural norms and values played a significant role in shaping an individual's meaning making and experience regarding cancer and cancer treatment. In cultures with a positive view on chemotherapy (such as western cultures), there was more acceptance towards undergoing treatment (Chen et al, 2013).…”

Section: Cancer Research Using Social Constructionismmentioning

confidence: 99%

“…For example, Chen et al (2013) and Gibson et al (2022) found that prevalent cultural norms and values played a significant role in shaping an individual's meaning making and experience regarding cancer and cancer treatment. In cultures with a positive view on chemotherapy (such as western cultures), there was more acceptance towards undergoing treatment (Chen et al, 2013). Whereas in cultures that were sceptical of cancer treatment (such as traditional Chinese culture), the findings identified a resistance to treatment and a need to explore alternative options (Chen et al, 2013).…”

Section: Cancer Research Using Social Constructionismmentioning

confidence: 99%

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Cancer carers’ constructions of caregiving during the COVID-19 pandemic: A study on Aotearoa- New Zealand

Vindamuri

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Background. Cancer is an illness that not only affects people who are diagnosed but also informal cancer carers. The COVID-19 pandemic has been found to decrease carers’ access to formal supports, such as healthcare services, and informal supports, such as family and friends. In turn, decreased supports due to COVID-19 regulations has also been associated with an increased engagement in care provision tasks by carers, such as hygiene management and at home cancer treatments, side effect management and recovery. This increase in care tasks has also been related to carer’s increased psychological distress and caregiver burden as well as decreased quality of life. The current body of research on cancer caring during COVID-19 is predominantly quantitative based, with limited qualitative studies. Furthermore, there is no research in Aotearoa-New Zealand that explores how carers make meaning of their experiences as cancer carers post-COVID-19.Aims. This study aimed to explore how cancer carers in Aotearoa-New Zealand constructed their caregiving amidst COVID-19. It also aimed to explore how carers negotiated supports for themselves and how these changed across the COVID-19 pandemic.Methods. This qualitative study adopted a social constructionist epistemology and used positioning theory as the theoretical standpoint. For cancer carers to be eligible for this study: carers and person with cancer must be above 18 years of age, self-identify as a cancer carer, and the cancer diagnosis or treatment must have begun or occurred after March 2020. Semi-structured interviews were conducted with eight participants who were recruited through community cancer organisations and social media. The data was analysed using thematic analysis.Results. Four carer subject positions across the cancer narratives were identified: The Advocate, The Intimate Carer, The Social carer, and The Focused Carer. The advocate found that carers were actively involved in interactions with healthcare professionals and often had to push for their person with cancer to receive adequate support. This was attributed by carers to the healthcare system being stretched thin due to COVID-19 related demands. The Intimate Carer identity was constructed around carers positioning themselves as being the main source of physical and emotional support in private settings such as homes and social settings. This identity was intensified due to COVID-19 isolating carers from accessing support from healthcare professionals, family members and friends. This included taking on supporting the person with cancer’s re-integration into society, increasing hygiene maintenance at home and monitoring medical management. In The Social Carer, there were two constructions. The dominant construction revolved around carers feeling invisible in their social interactions. The second construction revolved around the positive impact of a few social interactions that acknowledged the carer. The Focused Carer revolved around the impact of the caring experience being constructed around the person with 2 cancer. It also explored the carers construction of the relationship with the carer being stronger and the influence this relationship had the construction of the carer’s self-identity.Conclusion. Throughout the course of the cancer journey amidst the COVID-19 pandemic, cancer carers took on multiple identities, which were fluid within their accounts, with different identities being taken on at different stages of the cancer caring journey. The findings from this study have implications for healthcare professionals and community care organisations as it highlights the way in which cancer caring has been affected by COVID-19.

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The Social Construction of Cancer Chemotherapy Toxicity

Abstract: The disparity of perceptions between healthcare professionals and patients regarding chemotherapy toxicity needs to be thoroughly assessed. Thus, culturally specific nursing care models may be developed.

Cited by 6 publications

References 16 publications

Antimicrobial Step-Down Therapy versus Conventional Antimicrobial Therapy in the Treatment of Patients with Sepsis

Antimicrobial Step-Down Therapy versus Conventional Antimicrobial Therapy in the Treatment of Patients with Sepsis

Use of Text Messaging (SMS) for the Management of Side Effects in Cancer Patients Undergoing Chemotherapy Treatment: a Randomized Controlled Trial

Cancer carers’ constructions of caregiving during the COVID-19 pandemic: A study on Aotearoa- New Zealand

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