Background. No comprehensive systematic review has been published since 1998 about the frequency with which cancer patients use complementary and alternative medicine (CAM). Methods. MEDLINE, AMED, and Embase databases were searched for surveys published until January 2009. Surveys conducted in Australia, Canada, Europe, New Zealand, and the United States with at least 100 adult cancer patients were included. Detailed information on methods and results was independently extracted by 2 reviewers. Methodological quality was assessed using a criteria list developed according to the STROBE guideline. Exploratory random effects metaanalysis and metaregression were applied. Results. Studies from 18 countries (152; >65 000 cancer patients) were included. Heterogeneity of CAM use was high and to some extent explained by differences in survey methods. The combined prevalence for “current use” of CAM across all studies was 40%. The highest was in the United States and the lowest in Italy and the Netherlands. Metaanalysis suggested an increase in CAM use from an estimated 25% in the 1970s and 1980s to more than 32% in the 1990s and to 49% after 2000. Conclusions. The overall prevalence of CAM use found was lower than often claimed. However, there was some evidence that the use has increased considerably over the past years. Therefore, the health care systems ought to implement clear strategies of how to deal with this. To improve the validity and reporting of future surveys, the authors suggest criteria for methodological quality that should be fulfilled and reporting standards that should be required.

https://journals.sagepub.com/doi/pdf/10.1177/1534735411423920

How Many Cancer Patients Use Complementary and Alternative Medicine: A Systematic Review and Metaanalysis

Background:Moral distress is one of intensive care unit nurses’ major problems, which may happen due to various reasons, and has several consequences. Due to various moral distress outcomes in intensive care unit nurses, and their impact on nurses’ personal and professional practice, recognizing moral distress is very important.Research objective:The aim of this study was to determine correlation between moral distress with burnout and anticipated turnover in intensive care unit nurses.Research design:This study is a descriptive-correlation research.Participants and research context:A total of 159 intensive care unit nurses were selected from medical sciences universities in Iran. Data collection instruments included “demographic questionnaire,” “ICU Nurses’ Moral Distress Scale,” “Copenhagen Burnout Inventory” and “Hinshaw and Atwood Turnover Scale.” Data analysis was done by using SPSS19.Ethical considerations:Informed consent from samples and research approval was obtained from Shahid Beheshti Medical ...

Relationship between ICU nurses’ moral distress with burnout and anticipated turnover

Objective To gain a holistic and deep understanding about how mastectomy effects the body image of women who have breast cancer. Materials and methods The sample of this qualitative descriptive study consisted of twenty patients who underwent mastectomy procedures. Semi-structured interviews were conducted during the second week after mastectomy. Each interview was transcribed verbatim, and a thematic analysis was performed. Results After the mastectomy, the findings related to the women's body image and their experiences were specified as four main themes and seven sub-themes. The main themes were: meaning of the breast, mastectomy and me, my body image and body image changes, and social life. Most of the participants in this study stated that the breast meant femininity, beauty, and motherhood. It was found that the meaning of mastectomy varied according to individuals. Women used quite negative statements about their appearances. The participants also said that they felt that half themselves was missing, as individuals and women. The women stated that they preferred clothes that hid their lack of breast. Some of the participants mentioned that relations with their husbands were not like before, and they abstained from social interaction. Conclusion Our findings suggest that mastectomy as a surgical treatment for breast cancer may negatively affect a woman's body image and her self-image.

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Body Image of Women with Breast Cancer After Mastectomy: A Qualitative Research.

Increased work complexity and financial strain in the health care sector have led to higher demands on staff to handle ethical issues. These demands can elicit stress reactions, that is, moral distress. One way to support professionals in handling ethical dilemmas is education and training in ethics. This article reports on a controlled prospective study evaluating a structured education and training program in ethics concerning its effects on moral distress. The results show that the participants were positive about the training program. Moral distress did not change significantly. This could be interpreted as competence development, with no effects on moral distress. Alternatively, the result could be attributed to shortcomings of the training program, or that it was too short, or it could be due to the evaluation instrument used. Organizational factors such as management involvement are also crucial. There is a need to design and evaluate ethics competence programs concerning their efficacy.

Developing Ethical Competence in Health Care Organizations

Researchers have identified the phenomena of moral distress through many studies in Western countries. This research reports the first study of moral distress in Iran. Because of the differences in cultural values and nursing education, nurses working in intensive care units may experience moral distress differently than reported in previous studies. This research used a qualitative method involving semistructured and in-depth interviews of a purposive sample of 31 (28 clinical nurses and 3 nurse educators) individuals to identify the types of moral distress among clinical nurses and nurse educators working in 12 cities in Iran. A content analysis of the data produced four themes to describe the nurses' moral distress. The four themes were as follows: (a) institutional barriers and constraints; (b) communication problems; (c) futile actions, malpractice, and medical/care errors; (d) inappropriate responsibilities, resources, and competencies. The results demonstrate that moral distress for intensive care unit nurses is different and that the nursing leaders must reduce moral distress among nursing in intensive care.

Iranian intensive care unit nurses’ moral distress A content analysis

The use of complementary and alternative (non-conventional) medicine in cancer patients in Turkey

In this qualitative study, we aimed to identify and compare the ethical problems perceived by physicians and nurses in intensive care units at Baskent University hospitals in Turkey. A total of 21 physicians and 22 nurses were asked to describe ethical problems that they frequently encounter in their practice. The data were analyzed using an interactive model. The core problem for both physicians and nurses was end-of-life decisions (first level). In this category, physicians were most frequently concerned with euthanasia while nurses were more concerned with do-not-resuscitate orders (second level). At the third level, we saw that almost all of the participants' responses related to negative perceptions about euthanasia. Communication and hierarchical problems were the second most reported main category. Nurses were more likely to cite problems with hierarchy than physicians. At the third level, a large percentage of nurses described communication problems with authority and hierarchical problems with physicians. In the same category, physicians were most often concerned with communication problems with patients' relatives. The ethical problems were reported at different frequencies by physicians and nurses. We asked the participants about ethical decision-making styles. The results show that nurses and physicians do not follow a systematic pattern of ethical decision making.

A Qualitative Analysis of Ethical Problems Experienced by Physicians and Nurses in Intensive Care Units in Turkey

The purpose of this descriptive study was to identify the nurses’ approach to sexuality-related issues of oncology patients in Turkey. Seventy seven nurses from three universities and one state hospital in Ankara, who take care of the cancer patients, were involved. Data were collected via 13 item-questionnaire, five items were scaled (alwaysoften-occasionally-never) to evaluate the nurses’ approach to sexual concerns of cancer patients. Only 20.8% of them took education on sexuality; 46.8% of them “never” explain to male patient and their partner about birth control methods and “never” explore patients about the effects of the treatments on sexual desire. Only 18.2% of nurses stated that they “always” explore female patients who are in their fertility ages about the early menopause risk. Body image changes and their effects on sexuality were “occasionally” (45.5%) or “never” (33.8%) explored in patients. Possible effects of chemotherapy on fertility also were “occasionally” (31.2%) or “never” (39.0%) explored in patients. The reasons about not to give any information to patients were; “patients don’t tell any problems about this issues” and “not have knowledge base on this subject”. Nurses should be suggested to get education on sexual problems in cancer patients, how to communicate and counsel to the patients and their partners. The results of this study give us a perspective on nurses’ approach to sexuality-related issues in patients receiving cancer treatments and shows education needs of nurses. [Turk J Cancer 2008;38(3):135-141]

http://www.turkjcancer.org/pdf/pdf_TJC_491.pdf

Nurses' approach to sexuality-related issues in patients receiving cancer treatments

Amac: Konfor kavrami; âbireyin gereksinimleri ile ilgili yardim, huzur saglama ve sorunlarin ustesinden gelebilmeye iliskin fiziksel, psikolojik, sosyal ve cevresel butunluk icerisinde kompleks yapiya sahip beklenen bir sonucâ olarak tanimlamaktadir. Bu calisma, annelerin dogum sonu konforu ve etkileyen faktorlerin belirlenmesi amaciyla planlandi. Gerec ve Yontem: Calisma, kesitsel ve tanimlayici olarak planlanmistir. Arastirmanin evrenini 30.07.2008 ve 31.12.2008 tarihleri arasinda Baskent Universitesi Ankara Hastanesi Dogum Servisine basvuran anneler olusturmustur (n=150). Verilerin toplanmasinda anket formu ve dogum sonu konfor olcegi kullanilmistir. Bulgular: Annelerin yas ortalamasi 26.4 ± 3.5 yil olup, cogunlugunu lise mezunu (%68.7) ve multipar (%66.0) kadinlar olusturmaktaydi. Annelerin dogum sonu donemde halsizlik, agri, ayaga kalkmada gucluk, kisisel hijyenini yerine getirememe, bebek bakimina yonelik bilgi eksikligi ve deneyimsizlik gibi konularda sorun yasadiklari belirlendi. Normal dogum yapan annelerin konfor puanlarinin sezaryen olanlara gore daha yuksek oldugu goruldu (p

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Lale Algier

Papers

The use of complementary and alternative (non-conventional) medicine in cancer patients in Turkey

A Qualitative Analysis of Ethical Problems Experienced by Physicians and Nurses in Intensive Care Units in Turkey

Nurses' approach to sexuality-related issues in patients receiving cancer treatments

Annelerin doğum sonu konforunu etkileyen faktörler

Türkiyede kanserli hastalarda tamamlayıcı ve alternatif tedavi yöntemlerinin kullanımı: Literatür taraması