32^nd International Conference on Oncology Nursing and Cancer Care September 13-14, 2017 Singapore

Biography:

After completion of his postdoctoral training at University of Texas MD Anderson Cancer Center, Prof. Gautam Sethi joined Department of Pharmacology, Yong Loo Lin School of Medicine, National University of Singapore in 2008 as an Assistant Professor and was promoted to Associate Professor in 2015.  The focus of his research over the past few years has been to elucidate the mechanism (s) of activation of oncogenic transcription factors such as NF-kB/STAT3 by carcinogens and inflammatory agents and the identification of novel inhibitors of these proteins for prevention of and therapy for cancer. The findings of his research work have so far resulted in more than one hundred and fifty scientific publications in high impact factor peer reviewed journals and several international awards. He currently serves as an Academic Editor for PLOS, editorial board member of Scientific Reports, Pharmacological Research, BMC Cancer, Frontiers in Pharmacology, Frontiers in Oncology, and ad-hoc reviewer for several other international journals.          

Abstract:

Constitutive activation of diverse transcription factors including that of NF-kB and STAT3 has been frequently encountered in prostate cancer (PCa) and closely linked with its proliferation and metastasis. Hence identification of novel agents that can target these oncogenic transcription factors has an enormous potential for PCa treatment. We tested diosgenin, a steroidal saponin obtained from a variety of plants including fenugreek (Trigonella foenum graecum), roots of wild yam (Dioscorea villosa), Solanum incanum and Solanum xanthocarpum for its ability to suppress NF-kB /STAT3 activation cascade in PCa cells and its efficacy to suppress tumor growth in transgenic mouse model.  Overall, our data suggested that diosgenin exerted its anti-tumor and anti-metastatic effects through the suppression of diverse pro-inflammatory transcription factors in PCa.

Biography:

Professor Bettina Meiser is Head of the Psychosocial Research Group, Prince of Wales Clinical School. She holds a National Health and Medical Research Council (NHMRC) Senior Research Fellowship Level B as well as research grants from the NHMRC, Australian Research Council, Cancer Australia, NSW Cancer Council, Cancer Institute NSW and the APEX Foundation for Research into Intellectual Disabilities. With the input of many colleagues, Associate Professor Meiser has built a nationally and internationally recognised research program that assesses the psychosocial impact of genetic counselling and testing for hereditary disease; psychological adjustment of individuals at risk for hereditary disease; and the design and evaluation of interventions in the cancer genetic counselling setting, in particular decision aids as an innovative means of patient education.

Abstract:

Background: No communication skills training (CST) resources specifically targeting cultural competency in oncology healthcare are currently available. This project aimed to develop an online interactive CST program and assess its feasibility and potential efficacy in improving perceived competence of oncology health professionals (HPs) in communicating with people with cancer from minority backgrounds.

Methods: An online CST program providing strategies exemplified in vignettes-based professionally produced videos was developed through an iterative process with input from a large multidisciplinary team.  The CST program was tested with medical oncologists, radiation oncologists and oncology nurses. Participants were asked to complete self-report questionnaires at 3 time points-pre-CST program (baseline) and post-CST program, (a) 2 weeks after completion and (b) 3 months later. 

Results: To date 54 participants completed the first two questionnaires.  Preliminary analysis demonstrates that participants’ evaluations were overwhelmingly positive. Ninety-eight percent found the CST program was helpful in working with patients from minority backgrounds, and 84% stated that they have gained new skills in working with these patients. Ninety-one percent stated that they would recommend the program to their colleagues. Analyses of changes from baseline to the first follow up show that HPs felt more competent in communicating with patients from minority backgrounds (Z=-2.286, P=0.022) and they perceived the program will bring positive change in their practice and their readiness to communicate in a culturally competent manner (Z=-2.991, P=0.003).

Conclusion:  The program was judged highly acceptable by HPs, and initial results indicate that it may be effective in increasing perceived competence.

Biography:

Ms Audrey Saw currently practices as Deputy Director, Nursing at Khoo Teck Puat Hospital. Ms Audrey obtained her a Bachelor of Science (Nursing) from University of Sydney Australia, a Post Graduate Diploma in Clinical Nursing in the field of Critical Care from Curtin University of Technology Australia and a Master in Health Administration from University Of Sydney Australia. Ms Audrey was awarded Ministry of Health; Health Manpower Development Plan (HMDP) Nursing Award in the field of  Nursing Administration where she spend her attachment at Cleveland Clinic Ohio and Henry Ford Health System at Michigan USA.

Besides her administrative role, her portfolio include nursing leadership training, oversee Intensive Care Unit, Emergency Department, Cardiovascular Centre, and currently part of her role is to oversee the development of Nursing Informatics at Khoo Teck Puat Hospital.

Abstract:

With advances in medical care, more patients are now cared for in Intensive Care Unit (ICU). Besides patients, family members are equally or more stressful when their loved ones are admitted to ICU.  In view of these challenges, patients and families in the ICU require a comprehensive approach that includes attention to the physical, psychological, social, practical and spiritual aspects in the service of active coping and problem solving.

Death seems to be the only certainty in life. A good death has indeed a social dimension. A good death doesn’t come with accident, it takes planning and preparation in many aspect. It is important to have a conversation about this important journey. However due to cultural and taboo about the “death” topic, many find it difficult to have this conversation started. Introduction to Advance Care Planning (ACP) is a milestone for healthcare professionals trying to initiate the discussion about end of life journey. Besides medical aspect of health, there should be equal emphasis on social, emotional and psychological state of a person.

Understanding ‘Will”, “Lasting Power of Attorney”, “Advance Medical Directive” and “Advance Care Planning” will certainly contribute to better planning of this important journey in life.

Biography:

Abstract:

Family care givers experience psychosocial distress while caring for cancer patients. Usually terminally ill patients spend their end stages  of life at home  being cared for by without formal home care services (Emanuel, Fairclough, & Slutsman, 2000). The caregivers experience many barriers to manage the symptoms experienced by their beloved one who is suffering from cancers. Fear of addiction may be an important barrier to cancer pain management ( Valeberg, Miaskowski,Paul, & Rustøen, 2015).Depression among caregivers is mainly due to the fear of unemployment during caregiving, being the spouse of a patient, burden of caregiving and disturbance of personal life (Park, et al., 2013). Family caregiver’s experience Many difficulties and have increased       responsibilities during and after the treatment for cancer (Stenberg,  Ruland,&  Miaskowski, 2010). Caregiver’s sleep disturbances contribute to depression, anger, and anxiety ( Flaskerud, Carter, & Lee , 2000).   

Result: Result shows that 216 (28.1%) of the participants were in the age group between 31 and 40 years, 454 (59.1%) were females and most of them 350 (45.6%) were spouses. With regard to the barriers, most i.e. 423 (55.1%) of the participants had less confidence on diseased patient to manage symptoms, 681 (88.6%) had lack of awareness about pain assessment and manageme nt, Majority i.e. 654 (85.1%) of them had financial problems in the family, 750 (97.7%) had lack of knowledge about the disease and 606 (78.9%) had reported that due to hospitalization caregivers could not continue their job/ education and 696 (90.6%) had reported that they were unable to carry out their routine work due to hospitalization of the patients.

Discussion: Similar findings reported by Valeberg, Miaskowski, Paul, & Rustøen, (2015), that concerns of both the patients and their family caregivers (FCGs) about pain and the use of analgesics may act as barriers to effective pain management.

Conclusion: The caregivers experience many barriers to the proper management of symptoms of cancer patients. The family caregivers need to be empowered on management of cancer care.

Biography:

Yolanda Godoy is a medical school professor in Quito. She is a family physician who has been working since 1999 on qualitative research in the area of sexual and reproductive health, trying to find different ways to improve the doctor-patient relationship and the biopsychosocial model. Her activity has been carried out in the frame of Primary Health Care research, according to two main subjects: phenomenological perspective on doctor–patient relationship and women´s participation as health care services users.

Abstract:

Cervical cancer is the second leading cause of cancer death in Ecuadorian women, only surpassed by stomach cancer. The incidence of this cancer varies widely from 19 to 32 / 100,000 inhabitants. Regarding breast cancer, this is the third leading cause of death from cancer and the incidence is increasing (30 / 100,000). Poor coverage of cancer screening programs in impoverished population and rural groups is mentioned as the main cause of this issue. 

Gynecological cancer screening programs in Ecuador are promoted by health authorities and are integrated into broader health programs such as Sexual and Reproductive care or elderly care.
Based on the concept of social representations, the evaluations, knowledge and experiences of gynecological cancer screening programs users were explored through focus groups and in-depth interviews. Research suggests participating women develop understanding of cancer screening programs based on messages provided by health professionals and other sources of information such as social media and close relatives’ experiences. Interviewed women were confused on the concepts of gynecological cancer screening programs provided by health system and their stories were associated with pain and discomfort. Research showed information provided by health professionals was perceived as normative, prescriptive, authoritarian and therefore discouraging. In contrast, social media campaigning were found to be a more effective tool because interviewed women easily associated those messages with their own lives.

Authors propound medical speech will be more effective when health care providers understand communication as an ethic and empathetic human meeting. Health care professionals should be nourished with theoretical proposals that conceive the world as a network of relationships, connections, patterns of behavior and cultural setting. The authors believe this holistic approach will allow a more integrated understanding of the complexity of problematic health.

Biography:

Supatcha Prasertcharoensuk has completed her surgical training at the age of 31 years from Khonkaen University and vascular and transplant surgery from Mahidol university.          
 

Abstract:

Background: Gastrointestinal stromal tumors (GISTs), which are mesenchymal neoplasms in the gastrointestinal (GI) tract account for 0.2% of all GI tumors. Several factors have been reported (mostly from studies conducted in Western countries) to be associated with survival in GISTs cases such as tumor site, staging, and tumor size. We conducted a pragmatic study, looking at a 10-year period, aimed at understanding the prognostic factors related to GISTs in a university hospital. The study population consisted of patients with large symptomatic GISTs. Methods: This was a retrospective study conducted at the Department of Surgery in the Khon Kaen University Hospital (Thailand). All patients diagnosed with GISTs that were treated between 2006 and 2015 were consecutively enrolled. The diagnosis of GISTs was made by examining the pathological section and immunohistochemistry results. The outcome of this study was the rate of survival after surgical treatment. Prognostic factors were determined using Cox regression analysis. Results: There were 124 GISTs patients treated at the university hospital during the 10-year period of the study. The median age of all patients was 54 years (range 24-83 years). Of those, 119 (95.9%) were symptomatic. Rectosigmoid GISTs accounted for 20.2% of all tumors. The median tumor size was 8 cm. A total of 68 patients (54.8%) died. The median survival time for all patients was 7.18 years (1st -3rd quartile range 6.48-7.89). There were three significant factors associated with death including male gender, liver metastasis, and peritoneal metastasis. Conclusion: Male gender, liver metastasis, and peritoneal metastasis were prognostic factors for large symptomatic GISTs 

Biography:

Belgüzar Kara is a Professor of Internal Medicine Nursing in the Faculty of Health Sciences at Yüksek Ä°htisas University in Ankara, Turkey. She has a focus on chronic disease management, nursing education and behavior change. As an experienced researcher and author, her research interests include self-care, adherence, coping, social support, sleep quality, health beliefs and health-related quality of life in patients with a variety of chronic illnesses, complementary and alternative medicine, and geriatrics and gerontology.

Abstract:

Palliative care is defined as “an approach that improves the quality of life of patients and their families facing the problem associated with life-threatening illness, through the prevention and relief of suffering by means of early identification and impeccable assessment and treatment of pain and other problems, physical, psychosocial and spiritual”. While music therapy has been used for over 30 years in palliative care, evidence-based practices are limited. There are a few studies regarding the effects of music therapy in palliative care in patients with cancer. In a randomized controlled trial in hospitalized adult patients with cancer, it was indicated that music interventions were effective for improving pain and depression. Similarly, a recent meta-analysis study reported that music therapy may be effective to reduce pain, emotional distress from pain, anesthetic use, opioid and non-opioid intake and improve vital signs. It is noted that music therapy may provide an effective complementary approach for the relief of pain in patients with cancer. On the other hand, some studies found no relationship between these two variables in palliative care settings. Further research is therefore needed to better understand the effect of music therapy on pain in this patient group. In this review, the scientific data regarding the effect of music therapy on pain in patients with cancer were discussed.

Biography:

Manjusha Vagal has her proficiency in rehabilitating patients with musculoskeletal conditions and in lymphedema management. Her 23 years of professional experience made her create various innovative & award winning  orthotic and assistive devices and therapy protocol for functionally independent and productive living of physically challenged. Her exceptional patients service skills has fetched her professional excellence award.

Abstract:

Radiation therapy is commonly used treatment modality in gynecological cancers especially the cervical cancers in combination with other modes of treatment like surgery and chemotherapy.

Many women get cured with this treatment and many have excellent long term survival however, some women suffer various side effects, especially with radiotherapy, which has a lasting effect on their quality of life.

Vaginal stenosis is the most common complication of gynecological cancer management. Efforts are made to prevent and manage vaginal stenosis to enable adequate examination of the vaginal vault and the cervix during follow up period to detect treatable re-occurrence of the disease and to avoid sexual morbidity.

Vaginal dilation is advised for managing vaginal stenosis after the acute inflammatory response post radiation therapy has settled. As per the international guidelines on vaginal dilation after pelvic radiotherapy, vaginal dilators of variable sizes are prescribed as per the anatomy. According to various reviewed articles a 10 minutes of dilation per day is prescribed. Along with vaginal dilator, vaginal intercourse is encouraged in early post radiation therapy to avoid sexual morbidity.

Rehabilitation intervention post pelvic radiotherapy include teaching vaginal dilation exercises with the help of vaginal dilators, education on importance of dilation practice & sexual counseling and follow-up assessment of vaginal patency etc.

There is a strong need of well designed prospective randomized controlled trials establishing reliable evidence base to support the use of vaginal dilators in restoring vaginal patency following pelvic radiation therapy. There is need for standardized assessment techniques pertaining to dilation procedure. There is need of creating awareness amongst oncologists about vaginal dilation and sexual rehab in gynecological cancer survivors. Patients education on importance of vaginal patency and sexual health need serious attention. Also, there is need for detailed assessment of sexual quality of life in gynecological cancer survivors.

Biography:

Asrat Meleko has completed his Masters Degree in public health from Addis Ababa University and Bachelor Degree from Mada-Walabu University. She has been working in Mizan Tepi University as a lecturer, researcher and different project coordinator for more than 7 years. She has research articles published in different reputable journals.

Abstract:

Countries with narrow bases for legal abortion are vulnerable for burden of unsafe abortion and related mortality. Globally, 26% of populations live where abortion is prohibited or permitted on certain circumstances where majorities are in developing countries. In Ethiopia, one in seven women die from pregnancy-related causes, and of this unsafe abortion contribute for maternal deaths of more than half of the 20,000 that occur annually. It is fact that only setting Legal reforms alone in a given country cannot reduce abortion related deaths especially in Ethiopia. This study was aimed to fill the existing information gap in Mizan Aman town by assessing knowledge and attitudes of men and women towards legalization of induced abortion. Hence, community based cross-sectional study was conducted from October 2015 to June 2016. in Mizan Aman town, Bench Maji zone, south west Ethiopia. Data collection tool used was structured questionnaire. Data entry and analysis was done using EpiData V3.1 and SPSS V20. The result was displayed using tables and figures.  A total of 422 individuals were included in this study. Majority, 238 (56.4%), of them preferred legalization of induced abortion. Only, 24 (5.7%), respondents know current legal status of abortion. Knowledge about abortion complication and preference to terminate unwanted pregnancy has association with attitude towards legalization of abortion (P <0.005). Finally it was concluded that low number of respondents knows current legal status of abortion. Thus concerned bodies such as professionals, CBOs and other influential individuals should be involved to enhance community knowledge and perception towards legal aspects of abortion. 

Biography:

Will update soon

Abstract:

Backgroud: Quality of life (QOL) assessment is a relatively new concept in patients and care providers in India. Patients are generally not forthcoming for self-reporting of PROM (patient reported outcome measures). At Tata Medical Canter, dedicated clinical nurse specialists are involved in a QOL study in ovarian cancer (SOCQER-IND). 

Objectives: To assess whether pre and post-operative counselling and follow up by oncology specialist nurses lead to i. Increase patient participation in self reporting of PROM and increase uptake of other patient initiated methods of documenting QOL symptoms like telephone interview, postal and email services ii. Detection of early recurrence through symptom questionnaire by telephonic follow-up iii. Reduction of patient follow up appointments and distress by co-ordinating with other departments i.e., palliative care team and gynae/ medical oncology at same visit.

Materials and Methods: Prospective study. SPAQ (symptom palliation assessment questionnaire developed in house), OVO 28, CR 29, PR 25 and EORTC QLQ C-30 questionnaires were used to assess QOL pre and post op and during follow up visits after thorough counselling by a specialist nurse and social worker.

Results: Between June, 2016 to June, 2017 76 patients were assessed in preoperatively; 66 and 30 patients are assessed at 6 weeks and 6 months follow-up period. Compared to the pre-operative period, there was significant improvement in symptoms ( very much/ moderate to none; symptom score 3/4  to 1) including abdominal pain , bloating, frequent bowel movement and urinary urgency/frequency/ incontinence at 1 month and 6 month follow-up period. There was increase (score from 1 to 3 /4) in the following symptoms at 6 months due to chemotherapy: tingling sensation, numbness, weakness and muscle pain. Early referral to palliative care team was integrated in 25 out of 76 women. At follow up visits, women were comfortable in self reporting of symptoms to the nurse including sensitive issues like body image and sexuality even by non-face to face methods including telephone calls/ emails and postal mails. In 3 women, follow up appointments were preponed due to symptoms and have resulted in early detection of recurrences.

Conclusion: Counselling, education and building up of interpersonal relationship with specialist nurses can improve patient participation, satisfaction and follow up in resource poor conditions. This can help in early detection of recurrences and integrated palliation of symptoms.

Biography:

Dr B Srilatha has a PhD in Sexual Medicine from the National University of Singapore (NUS) and a post graduate medical degree from Madras University (India). Based in Singapore, she works as Clinical Sexologist & Senior Researcher under Psychosocial Support Services, Singapore Cancer Society. She is an active member of the International Society for Sexual Medicine (ISSM) representing the Communications Committee and is in the Executive Committee of the Asia Pacific Society for Sexual Medicine (APSSM). Her seminal contributions were awarded the prestigious Emil Tanagho Prize for Best Innovative Research in Sexual Medicine at the 12^th World Congress of Sexual Medicine in Cairo, Egypt (2006) and the Best of the Top 10 Basic Science Papers Prize at the Annual Fall Meeting of the Sexual Medicine Society for North America (2011). She has impactful publications in leading international referenced journals. She is a council member of Asia-Oceania Federation for Sexology (AOFS) and the Vice-President of Singapore’s Society for the Study of Andrology and Sexology (SSASS).

Abstract:

The diagnosis and clinical course of cancers have immediate as well as lasting impacts on the quality of relationship, intimacy, sexuality and overall life of patients and their partners. In spite of its rising awareness as an integral part of holistic health, sexual concerns in this isolated group are often neglected and underserved within the clinical care provision. Studies indicate that the sexual readjustment or rehabilitation is a major challenge for a collective prevalence of sexual disorders in about 30%–90% of this subpopulation. Clinically, a significant number of these patients may present with declines in the important domains of their sexual response cycle. In a vast majority, the issues can be further aggravated by negative psycho-emotional attitudes including stigma, low self-esteem and altered body image perceptions. Together with oncological advances in early detection and treatment, there is significant improvement in the long-term survival and post-treatment life expectancy of cancer patients. It is therefore imperative for the healthcare professionals to identify interventional measures that will succeed in recovering the sexual quality of life for their patients as well as partners. Identified modalities should incorporate a systematic assessment, intervention and follow-up for the sexual problems, psychosexual counseling and couple therapy and appropriate referral (if necessary), for a meaningful and lasting improvement on the overall symptoms and quality life care of their cancer patients and partners.

Biography:

Emi John Prince, Associate Professor, has completed her PhD in Nursing Science from Vinayaka Missions University, Tamil Nadu. She is nationally and internationally recognized in the areas of Maternity Nursing. Dr. Emi John Prince is the Course Coordinator for Postgraduate studies in Nursing at Institute of Health and Management, at NSW. As a Midwife, she works part time at Royal Brisbane Hospital, Brisbane. Her research and scholarly pursuits are in the areas of maternal health and women’s health. She has published her work widely and has written many articles. Dr. Emi John Prince is also actively involved in extended professional role as External Examiner (Adjudicator) for PhD thesis for many of the universities
 

Abstract:

It is difficult to measure and define the quality of life. Quality of life in patients with breast cancer is an important outcome. The quality of life data provided scientific evidence for clinical decision-making and conveyed helpful information concerning breast cancer patients' Although quality of life assessments have been employed successfully in descriptive and evaluative studies in oncology, their use in cancer clinical trials has, to date, been limited.As part of a study on quality of life in breast cancer patients, an extensive literature search was carried out using MEDLINE, EMBASE, the Science Citation Index (ISI), the Cumulative Index to Nursing and Allied Health Literature (CINAHL), the PsycINFO, the Allied and Complementary Medicine (AMED), and Global Health databases. The intention was to review all full publications that have been appeared in English language biomedical journals between 1974 and 20013.

The use of proxy raters of patients' quality of life has been suggested as a means of facilitating the factoring of quality-of-life considerations explicitly into the medical decision-making process and of resolving the problem of missing data in longitudinal quality-of-life investigations.

The paper also concluded that it is not only the study of quality of life in newly diagnosed breast cancer patients that is necessary; studying quality of life in long-term survivors is equally important

References

·         Husson O, Mols F, van de Poll-Franse LV. The relation between information provision and health-related quality of life, anxiety and depression among cancer survivors: a systematic review. Ann Oncol. 2011;22:761–72.Leap ,N., 2009. Woman-centered or women centered care: does it matter? British Journal of Midwifery 17(1), 12-16.

·         Cornish D, Holterhues C, van de Poll-Franse LV, Coebergh JW, Nijsten T. A systematic review of health-related quality of life in cutaneous melanoma. Ann Oncol. 2009;20(6):51–8..

Biography:

Prof. Dr. Karima Elshamy has a doctorate degree in nursing science from Cairo University, Egypt (DNSc). She is A. Prof. of Medical Surgical Nursing, Faculty of Nursing, Mansoura University, Egypt. She is AORTIC Vice President of North Africa. Prof. Karima is Vice President of International Federation of African Women for North Africa and chair of health committee. Prof. Karima is a member of Egypt Scholars Association Council.

Abstract:

End-of-life care presents many challenges both for clinicians, as well as for patients and their families. Moreover, the care of the dying patient must be considered within the context of the psychological, physical, and social experiences of a person's life. Foremost among those who require end-of-life care are cancer patients at the end of life. Unfortunately, clinicians who are responsible for the treatment of patients at the end of life commonly lack adequate training to help guide end-of-life decisions and to deliver bad news to patients and families. They must also face their own discomfort with discussions about death and deal with poor compensation for the time spent discussing end-of-life care with patients and families. Given the unique process of each person's death, strategies are often inadequate to guide patients, their families, and the clinicians who care for them through this complex and emotionally challenging process. It would stand the clinician in good stead to be aware of these challenges and have an approach toward dealing with such problems. In addition, organizations have a responsibility to ensure that systems are in place to minimize its occurrence and ensure that staff are supported through the process of resolving issues and conflicts that may arise.

Biography:

F.Estebsari  has completed his PhD  in health education and health promotion to Iran University of Medical Sciences.
Now, she is  faculty  member  of Nursing and Midwifery school   in Department of Community Health Nursing  of Shahid Beheshti  University of Medical science.   Interests  research  into lifestyle and cancer is. . She has published more than 29 papers in International  journals .
The following are some of the newest articles are published.

Abstract:

Introduction & Aim: Death is a natural and frightening phenomenon which is inevitable. Previous studies on death which presented a negative and tedious image of this process are now being revised and directed towards acceptable death and good death. One of the proposed terms about death and dying is “good death” which encourages dealing with death positively and leading a lively and happy life until the last moment. Objectives: The present study aimed to explain the Iranians views about criteria of good death.

Methods: This qualitative study was performed by the thematic- framework analysis. In this study 8 patients, 3 their families, 3 physicians, 3 nurses, 3 psychologists and 3 clergymen were selected. A total of 25 people were interviewed. The sampling method was homogeneous in the process of qualitative research and the sample size was based on the data saturation. Data were collected by semi – Structured   interview. All interviews were transcribed in fewer than 24 hours. The thematic framework method was used to analyze qualitative data.  MAXQDA software was used for data management.

Results: 10 main themes include death at the right time, death without cost, death without bothering to others, death without dependency with control, death in peace, death without difficulty, not dying a loan dying at home and death near the family, inspired death, programmed death were recognized as participant’s views about good death criteria in this study.

Conclusion: paying attention to conditions and factors that make good death from health policy makers and provide quality service for cancer patients in the end stage of life may be helpful for patients to experience good death.

Keywords:  breast cancer patients; End Stage Life; Good Death, Qualitative Study.

Biography:

Dr. Reetoo Banarsee is a Visiting Professor at Imperial College London. He is an experienced senior management executive with a proven track record in a wide field of NHS including 20 successful years  providing  research, strategic and operational management within clinical services and educational establishments with a strong track record performance within primary care, research, public and mental health services.  Have worked extensively with industry to deliver commercial research and develop long-term partnerships and platforms for commercial trials. He has led over 30 research projects for the NHS including a study on palliative care on End of Life. Currently he leads an  International MPH programme for Africa.

Abstract:

Given the choice, people want to die in their own homes, supported by their family and friends, be in their own community and have access to effective services. However, it is acknowledged that a great deal more can be done. People are unable to access the care they need in the community setting of choice and family as the carers are being left with the burden of the care. Seventy percent of people express a desire to die in their own home yet less that 20% achieve this. This is a case study for a vision for a model of service  for end of life care, identifies the key issues and gaps in service delivery and articulates how services will commit to achieve this vision over the next four years. The model being developed in the  UK involves working with key providers to realign and better integrate services that are provided to support people towards the end of their life including terminal care. It maximises the dignity of the person at end of life as well as relieve as much as is possible the stress for them and their carer’s and/or family. It is co-produced with patients and carers

The project uses an Equality Impact Assessment tool to better understand how to carry out targeted engagement and ensure that a representative sample of patients and carers are given the opportunity to inform service design. Central to this is the ability to monitor via provider contracts patient and carers experiences of services and use data from experiences of services. Engagement and involvement is an on-going process and include, but not be limited to patient/resident groups. This strategy has been produced and refined by harnessing patient and carer views both nationally and locally. 

Biography:

Sevil Inal has completed his PhD at the age of 34 years from Istanbul University, Pediatric Nursing Department. She worked in pediatric oncology unit as nurse. She is the Assoc. Prof. Istanbul University, Faculty of Health Sciences, She has published more than 14 papers in sciences citation indexsed (sci-e) journals. 

Abstract:

Aim: In this study, it was aimed to qualitatively analyze the feelings, thoughts and meanings of the nurses who had experience in child hematology in the past.

Method: In this qualitative study, in-depth interviews were conducted with 15 nurses between 29 and 53 years of age who had previously worked in child hematology-oncology unit. Interviews were conducted with a semi-structured interview form. Each interview lasted 20-30 minute. Some of the questions are: What kind of experiences do you experience when you think about the periods you are working in hematology-oncology service? Do you explain the reason for living these feelings? The data were analyzed with QSR NVivo 7 software.

Results: From the perspective of the nurses who had experience working in the pediatric hematology-oncology service in the past, five main themes and sub-themes related to emotions and thoughts towards this experiment were identified in the study. 1) Positive and negative emotions: (a) fear and anxiety, (b) desperation, pity, guilt, (c) burnout, (d) longing; 2) Being coping 3) Professional implications 4) Meaning of life 5) Unmet needs and suggestions.

Conclusions: Working in hematology should be viewed as a multidimensional situation that affects the way nurses view their profession and life, leading to a wide range of emotional lives. Data obtained from this study can be used to strengthen hematologic nurses.

Keywords— cancer, child, care, hematology, nursing

Biography:

Will be updated soon

Abstract:

Background: The effect of second-hand smoking (SHS) on breast cancer etiology is controversial. Genetic variants of the enzyme N-Acetyl-transferase 2 (NAT2) which is involved in the metabolism of tobacco carcinogens, may modify the association between SHS and breast cancer. The aim of the current study was to evaluate the relationship between SHS and breast cancer risk by NAT2 variants in Arab women in Israel, a unique population with high exposure to SHS and low active smoking and alcohol consumption rates.

Methods – This is a population-based case-control study consisting of never-smoking Arab women aged 30-70 from Northern Israel: 137 prevalent (diagnosed in 2008-2013) breast cancer patients and 274 population- based controls. All participants were interviewed using a detailed questionnaire relating to past and current exposure to SHS and to socio-demographic, gynecological and obstetric characteristics. Each participant provided a buccal smear for NAT2 genotype analyses. Logistic regression models adjusted for potential confounders and stratified by NAT2 variants were used to assess the association between SHS and breast cancer.

Results – SHS was associated with breast cancer risk with an adjusted odds ratio (OR) of 2.14 (95% confidence interval, CI 1.21-3.78). Higher exposure to SHS was associated with higher risk of breast cancer compared to never exposed women, those exposed to SHS during childhood, adolescence and currently had an OR of 3.60 (95% CI 1.85-7.21) while those exposed during adolescence and currently but not during childhood had an OR of 1.73 (95%CI 1.05-2.86). NAT2 variants did not modify these associations.

Conclusions - SHS exposure in Arab women that never smoked is associated with increased risk for breast cancer. NAT2 genetic variation does  not seem to play a role in the association. Additional studies are needed in order to support these findings.

Biography:

Rafael T Jomar is a Nurse, a Master in Nursing and a PhD in Epidemiology. He is currently an Assistant Professor at University of State of Rio de Janeiro (Brazil) where he teaches and researches clinical and oncological nursing in undergraduate and postgraduate courses. His most recent scientific publications have dealt with the diagnostic stage of the nursing process in different scenarios of the care of patients with cancer. More information at http://lattes.cnpq.br/1420764617102430.

Abstract:

Statement of the Problem: Knowing that cancer patients are frequently treated with antineoplastic outpatient chemotherapy, nurses working in oncology outpatient services should provide care with a focus on the individual’s needs, using the nursing diagnosis as a tool in the context of nursing process for selecting interventions with the goal of improving patients’ responses to the proposed antineoplastic treatment. Considering the lack of publications on nursing diagnosis in oncology and the fact that knowledge of common nursing diagnoses (NDs) in this area can strengthen the nursing process, in addition to providing oncology nurses with support for decision-making choosing the best interventions, and performing a quality clinical practice, the objective of this study was to search in the scientific literature for NDs identified in adults/seniors undergoing antineoplastic chemotherapy in an outpatient setting. Methodology & Theoretical Orientation: Review of studies published in Portuguese, English, or Spanish which were searched in five electronic databases in March 2016, using the descriptors nursing process, nursing diagnosis, neoplasms, drug therapy and hospital outpatient clinic. Findings: In the four studies selected for review, 40 NDs were identified, namely unbalanced nutrition, less than body requirements, risk for deficient fluid volume, diarrhoea, fatigue, impaired home maintenance, deficient knowledge, disturbed body image, interrupted family processes, ineffective sexuality pattern, anxiety, powerlessness, fear, readiness for enhanced religiosity, risk for infection, impaired dentition, risk for impaired skin integrity, acute pain, and nausea. Conclusion & Significance: Given the scarcity of publications on the diagnostic phase of the oncology nursing process, the 40 NDs identified by the present review point to the complexity of the care provided to patients undergoing chemotherapy in an outpatient setting. If used as a guide for the investigation of NDs among adult/elderly users of oncology outpatient services, the results of this review may contribute to the advancement and improvement of the nursing process.

Biography:

Heshmatolah Heydari has his expertise in community health nursing. His interest is delivery of home health care to chronic disease. Currently he is assistant professor in Lorestan University of Medical Sciences, Iran.

Abstract:

The increasing prevalence of chronic diseases throughout the world is an undeniable phenomenon, In fact, 13% of all deaths related to chronic diseases are caused by cancer and the majority of cancer patients expire in the intensive care units (ICU), whereas bed occupancy of ICUs is in crises. In this situation, firstly, a number of patients do not have access to the ICU beds, and secondly, because of the need to ICU beds, the admitted patients in ICU wards are discharged earlier. WHO introduced home-based palliative care to improve the quality of life, quality of care, quality of death and patient satisfaction; decrease burnout in staffing and mortality in hospitals; reduce the cost, accept end of life as live days; neither accelerate death nor prolong life; consider all dimensions of human; help the patients to be active until the time of death; help the patient’s family to cope with the disease and loss of patient; and release the beds in hospitals. Although hospital beds are considered for healing the patients not a hospice for them, the majority of cancer patients die in the hospital and on the ICU beds, and to the last moments of life, they receive specialized cure, and occupy ICU beds. Cancer patients in health system of Iran receive specific treatment and chemotherapy even to moment of death. To consider countless benefits of home care and the patients’ desire to receive services at home, if we can provide the conditions that at least 20% of end stage cancer patients in receive home based palliative care, 1000 deaths will occur at home yearly, and 1000 ICU beds will be released for use for other patients with better prognosis for survival. Therefore, health system authorities in Iran should considered home-based palliative care of cancer patients as a priority.

Biography:

Abstract:

Fatigue is very much common among cancer patients and it has bearing on their lives during disease and treatment.  Cancer-related fatigue (CRF) experience is personal (subjective) and has got different factors attributed to it.

Most of the recently diagnosed patients of breast cancer report severe fatigue. Fatigue is significantly associated with psychological symptoms like anxiety and depression.

Almost 77% of the people receiving external beam radiation therapy for breast cancer experience fatigue. For patients on external beam radiation therapy, fatigue increased gradually during the course of radiation treatment.

Many interventions are tried out for treating cancer related fatigue with varying results. Some of them are psycho-stimulants, erythropoietin, exercise, psychosocial interventions and Yoga.

Yoga is the union of the individual self (Jivatma) with the Universal self (Paramatma). The system was first collated and written down by Patanjali in his Yoga Sutras or Aphorisms. Yoga has been used as interventions for stress and coping, pain reduction, emotional well- being, anxiety and blood pressure etc.

Yoga has shown to alleviate the side effects of cancer treatment such as cancer related fatigue and to improve the quality of life. Yoga was found to be effective in reducing cancer related fatigue among patients and survivors as well.

Biography:

Mr. Syed Imran has completed post graduation in psychiatric nursing and presently pursuing doctoral degree from Yenepoya University, Karnataka, India. He is working as assistant professor in the department of psychiatric nursing in Yenepoya College of Nursing, Yenepoya University, Mangalore, Karnataka, India. He is done his additional courses like psot graduate diploma in clinical ethics and post certificate course in palliative care. He has published more than 10 papers in national and international journals and has been serving as a scientific committee member for international journal of nursing care, India.

Abstract:

Abstract

The word “cancer” brings up many ideas for the individual. Surprisingly, they are afraid, not so much of death, but for themselves, the fear of pain or the end of life as they know it, and for others, the fear of being a nuisance or even objectionable. The diagnosis of cancer means a change in the lifestyle of the person in whom the cancer is found. The degree and permanency of that change is, of course, dependent on the extent of the disease, the course of treatment undertaken, and the resultant disabilities, all of which place that individual and his family under tremendous stress.

The stress begins before the person even enters hospital and is compounded by the events which follow the individual’s transformation into the hospital patient. A sick person is taken out of his or her natural environment and placed in the strange and often overwhelming atmosphere of a hospital, which, by its very nature, strips the patient of his or her individualism. It is, therefore, very important for the hospital worker, who is so familiar with this environment, not only to be aware of this anxiety-producing process, but to cope with it herself and to alleviate it for the patient as much as possible. The person who is diagnosed as having a cancer is anxious over many things in addition to being hospitalized.

Music is considered to be effective stress burner and also helps in decreasing anxiety in patients undergoing various treatment modalities. There is a growing body of research documenting the effects of many alternative treatment modalities in cancer care, one among which is the music therapy. Research has proved that engaging in the music listening or music composing activities will reduce the overall health ailments which will arise due to the treatment part and increases the quality of life in terms of comfort, relaxation in patients with cancer.

Thus the aim of this study was to examine the effects of relaxing music on the biophysiological (salivary amylase, Pain, blood pressure, heart rate) and psychological (anxiety) parameters of patients undergoing chemotherapy.

Material and methods

This study used quasi experimental time series control group design. A non probability convenience sampling was adopted to select the sample. The study participants (40) were recruited based on the inclusion criteria. The pre-test was done on the 1^st day by assessing the bio-physiological parameters such as collection of saliva, assessment of Blood pressure, heart rate, temperature and pain level by using the proper methods and protocols and psychological  outcomes (anxiety) using the standardized tools ( state anxiety inventory). A music preference questionnaire was administered to the experimental group before administration of music therapy. Music was administered to the experimental group by following the protocol for 3 hours of duration. The post tests were done on the day 1 i.e. soon after the intervention for the experimental group and after three hours of chemotherapy for the control group. Post tests were also done on day 2, day 3, day 4 and day 5. The control group had normal routine care during the chemotherapy session.

Results

The study showed the significant changes in the biophysiological and psychological outcomes in experimental group listened to the music during chemotherapy compared the control group who had normal routine care during the chemotherapy. So use of music as therapeutic approach in the oncology setting is helpful for the patients undergoing different treatment modalities.

Biography:

Ms. Sun Lingshan has completed her Bachelor of Science (Nursing) with Honours (Merit) in 2016 from National University of Singapore. She currently works as a Staff Nurse in KK Women’s and Children’s Hospital Singapore, specialising in gynecological-oncology nursing. 

Abstract:

Mastectomy is the most common surgical intervention for women diagnosed with breast cancer. The woman’s breast represents their identity of womanhood, femininity and even motherhood. The removal of breast is generally depicted as an awful encounter with negative impact among studies explored on women’s perceptions post-mastectomy. However, little attention was given to the positive impact experienced by the women after losing the breast and a meta-synthesis on the perceptions of both the negative and positive impact of losing the breast among women with breast cancer is lacking. The objective of the paper is to summarize qualitative studies exploring the impact of losing the breast in women breast cancer survivors. A total of 12 qualitative studies from year 2000 to 2015 were identified and appraised. Quality appraisal of the studies were conducted and data were synthesized using Sandelowski and Barroso. Four themes were identified: (1) Disfigurement; (2) Loss of identity; (3) Increase sense of security; and (4) Living life with a new wholeness. The findings showed that women breast cancer survivors experienced two opposing negative and positive impact of losing the breast, however, both impacts are bridged by “Living with the Discrepancy”. The perceptions of losing the breast were filled with contradictions, tensions and uncertainties while negotiating the discrepancy between the “self and body” and the societal expectations of femininity and womanhood. The results highlighted the need to identify the stage at which how the individuals are coping after losing their breast in order to develop personalised care plan for women who are going for mastectomy.

Biography:

Gonzalo Spera is a practicing medical oncologist mostly dedicated to translational research. He has the position of Clinical Research Physician and Study Manager in Translational Research in Oncology (TRIO), an academic CRO fully dedicated to design and run clinical trials in patients with cancer. Gonzalo owns a Master in Basic Sciences of Medicine (UDELAR, Uruguay) and in Molecular Oncology (CNIO, Madrid). He is now pursuing a PhD degree within TRIO with his project “Beta-blockers:  promissory anti-cancer agents in breast cancer ”. 

Abstract:

Stress is usually considered among the numerous factors involved in the complex process of cancer carcinogenesis. However, how stressors or stress response impact on the natural history of this disease is still unknown. The adrenergic pathway is involved in stress responses in daily life being epinephrine and norepinephrine its key mediators. These hormones have been previously described as potent mitogens in normal and malignant cells. The blockage of this pathway by beta-adrenergic antagonists (BBs) has proven to disrupt cell proliferation and migration in malignant cell models. In the clinical setting, BBs have also been linked to improved cancer control rates in patients with localized and advanced breast cancer. Inconsistent results from different retrospective studies have encouraged the conduction of distinct meta-analyses from which, as of today, no clear conclusions can be made. Recently our team has shown significantly improved outcomes in patients with advanced triple negative breast cancer who received BBs for other comorbidities. We hypothesize that the discordance observed in the available evidence could be a consequence of methodological limitations and tumor heterogeneity. Consequently, we are now conducting a back-translational project in order to search consistent signals now in breast cancer pre-clinical models exposed to BBs, with the objective to improve the understanding of their mechanism of action. In addition to this, confirming the value of adding BB to standard therapies in a prospectively designed clinical trial is needed. Because BBs are inexpensive and well-established agents with an excellent safety profile, prospective controlled studies in this context are feasible.  

Biography:

Sakda has completed Master of Science (Mental Health) from Chulalongkorn University and PhD (Development  Science) from Khonkaen University,Thailand. He had experts in psychiatric nursing  more than 25 years and stand with the great position of  instructor of  school of psychiatric nursing, institue of  nursing, Suranaree  University of Technology, Nakhon Ratchasima, Thailand. He has expertise in  mental health and psychiatry, sex education, counseling, depression as well as suicide, field. Not only  work  with  academic position, but  he also  work on  a collaborative action research in community setting  related to  psychiatric problems.

Abstract:

This  phenomenological  research  aim  to  explain the experiences of  breast cancer patients in being reaction to illness, adaptation, and coping with post illness. In-depth interviews were used to collect data from  thirty participants  who had breast cancer and  lived in  Nakhon Ratchasima. Data were analyzed by modified Colaizzi's method.   The results found that the participants reflected  experiences  three  theme : 1. Reaction to illness  (1) Phase of screening and waiting period ;  most of  them were worry ,frightened and fear that they would have cancer. (2) Phase to know the results; they had different reactions to cancer such as denied, separated, angered, bargained, depressed and accepted. (3) Phase to live with the disease ; they sought more knowledge and decreased stress and anxiety.  2. Adaptation  (1) Lifestyle changing post illness ; they worked less and more concern more themselves. (2)  Thoughts or beliefs about suicide ; most of  them did not think of suicide because they feared of sin.  (3) Reasons for living of  them  were  loving and caring for them family. (4) Sense of self  before and after illness ; they felt their life were precious so they must took care themselves more.  (5) Feelings of the daily lifestyle ; most of them though that they were valuable, advantage, accepted and fought to the disease. 3. Coping with post illness; they consulted and asked for support from their families  and  tried  to  cope  by themselves. Finding of this study will be beneficial for psychosocial care, promote mental health and  adaptation for further breast cancer patients. 

Biography:

Tzu-Hsuan Lin is currently a postgraduate student at the Nursing, Chung Shan Medical University She has been working more than 20 years at the Department of Nursing Hsinchu MacKay Memorial Hospital, Taiwan. Moreover, she has experience in Oncology Nursing education.

Hui-Shan Shen Graduated from Taipei University nursing master's degree and have been working at the medical ward of Mackay Memorial Hospital, Hsinchu. Also, she is a head nurse of nursing department.

Abstract:

Background:

Oral mucositis is one of the most common symptoms of head and neck cancer patients receiving concurrent chemoradiotherapy (CCRT), patients could have a high incidence of oral mucositis side effects of 80-90%. If medical staff is not given prophylactic oral mucosal care measures, this may result in severe oral mucositis grade 3 or more. Glutamine can help tissue mucosal repair, insufficient glutamine can lead to serious mucosal damage or even interrupt treatment.

Objective:

    This study aimed to survey whether early use of glutamine could decrease the severity of oral mucositis in patients with head and neck cancer received concurrent chemoradiotherapy.

Methodology:

A total of 44 patients with head and neck cancer has undergone CCRT were randomly divided into 22 patients oral Glutamine (G group), and 22 patients in the control group (R group), a glutamine dose of 10 g 3 times a day a week before CCRT, the control group (R group) are in accordance with the general routine oral care. An Oral mucositis evaluation was performed using NCI-CTCAE V3.0 until the end of the CCRT course (period 1-9 weeks).

Result:

The patients Mucositis G4 developed in all patients group G (0%) and group R (27%). Glutamine significantly decreased average grade of mucositis (group G, 2.41±0.5; 95% CI:2.19 to 2.63; group R, 3.23±0.5; 95% CI:2.99 to 3.46; p=. 002). Glutamine significantly decreased body weight loss (group G, 10.4±1.2kg; 95% CI:9.8 to10. 9; group R 12.5±1.4kg ; 95% CI:11.9 to 13.2; P=. 023).

Conclusion:

    Glutamine can prevent severe oral mucositis, to avoid interruption of treatment and affect the cure of the disease. Expected results of this study can provide the patient determine the most appropriate medical decision-making therefore, patients can have a better quality of care disease.

Biography:

Pei-Ju Lien graduated from a nursing university in Taiwan. She is a resisted nurse and works at the comprehensive breast health canter in Taipei Veterans General Hospital in Taipei. Her job provides the education about pre-, during, and post treatment for patient with breast cancer.

Abstract:

Biography:

Will be updated soon

Abstract:

What is a woman? This is part of the question and I suggest, motivation that currently has some women enduring lengthy reconstructive procedures post mastectomy. Nurses, play an important role in women’s health, and have an opportunity to explore, within this population of women, ideas about beauty, femininity, sexuality and being a woman, as well as the meaning they attach to their breasts and how these might be embodied post-mastectomy.

In this presentation, will provide an overview of how the female breast has been conceptualized in the West, followed by sections on how aesthetics, beauty and appearance are fundamental to reconstructive practices for women post mastectomy in contemporary society. Current reconstructive options for women post mastectomy will be discussed, emphasizing the invasiveness that women are willing to endure, in order to attain or maintain, that which is considered ‘normal’ or ‘ideal’ by society’s heteronormative standards. Lastly, the concepts of body image, femininity and sexual identity will be explored, contemplating alternative options such as choosing to adorn the mastectomy site with a tattoo. Threaded throughout, are some personal reflections and experiences I have had as a woman treated for breast cancer.

Biography:

I am a student of Faculty of Biology, Universitas Gadjah Mada Yogyakarta. I am 21 years old. I was fifth semester. I have a research about melignant melanoma with my friends Bening Larasati, Dea Febiansi, and Dhela aprilyandha Roshitafandi. We made an ointment that potentially  treatment malignant melanoma. 

Abstract:

Malignant melanoma (MM) is the abnormality of the melanocyte cells in long period will be skin cancer to death. MM has indication same as mole that cause people can not difference both of them. Chayote in society is believed can decrease risk of MM. Secondary metabolit, flavonoid and saponin, can prevent proliferation of cancer cells. Ointment is made of chayote extract that safe for sensitive skin. Sampel of chayote based on age that can see from size of chayote, ,1 month (small), 3 month (medium), 5 month (big). Method of research are etanolic extraction, phytochemical test consist of qualitative test, TLC, and  Spectrophotometry, and  then antiproliferation test using fibroblast cell HDFa in-vitro. The extract is made to be ointment with base PEG 400 and PEG 4000. The result of the research in three kind of extract sampel positive offlavonoid and saponin, and the highest concentration of flavonoid is extract sample 5 month (0,87%), the highest concentration of saponin is extract sample 1 month (12,74%). The concentration of flavonoid is lower than saponin concentration. An antiproliferation test given a sample extract 1 month can inhibit cell growth better. At 90% confidence level between the variation of sample concentration and viability is significantly different, whereas in the sample extract 3-month was not significantly different. Publications conducted in electronic media and print media are also scientific publications in Majalah Obat Tradisional.