Late-Breaking Abstracts

doi:10.1188/25.ONF.E14

. 2025 Mar 1;52(2):1–65. doi: 10.1188/25.ONF.E14

Late-Breaking Abstracts

PMCID: PMC12404696

Footnotes

Each abstract has been indexed according to first author. Abstracts appear as they were submitted and have not undergone editing or the Oncology Nursing Forum’s review process. Only abstracts that will be presented appear here. For ONS Congress^® scheduling information, visit https://www.ons.org/education-hub/events/ons-congress.

Data published in abstracts presented at the 50th Annual ONS Congress are embargoed until the conclusion of the presentation. Coverage and/or distribution of an abstract, poster, or any of its supplemental material to or by the news media, any commercial entity, or individuals, including the authors of said abstract, is strictly prohibited until the embargo is lifted. Promotion of general topics and speakers is encouraged within these guidelines.

Oncology Nursing Forum. 2025 Mar 1;52(2):3.

User and Usability Testing of a Conversational Chatbot Supporting Cancer Genetic Education and Testing

Jinghua An ¹, Jinghua An ², Sherry Grumet ³, Scott Walters ⁴, Emily Heidt ⁵, Anita Kinney ⁶, Anita Kinney ⁷

Purpose

To expand access to cancer genetic education and testing, our multidisciplinary team developed a chatbot (i.e., a conversation-based digital platform), Alex, based on formative research and patient-centered care principles. The current study aimed to refine the chatbot through two phases of testing: user testing (content-focused) and usability testing (functionality-focused).

Significance

Identifying individuals with hereditary syndromes is crucial for the prevention and early detection of many cancers, including breast, ovarian, prostate, pancreatic, colon, and others. However, multilevel barriers hinder access to genetic counseling and germline testing (GT). Chatbots offer a promising solution by delivering interactive, multimedia pre-test education and increasing access to GT. Rigorous refinement is essential to ensure the tool’s utility and effectiveness.

Methods

Following user-centered design principles, we conducted user testing (n=8) and usability testing (n=6) with cancer patients through semi-structured interviews. During user testing, think-aloud techniques were employed to elicit patients’ preferences and expectations for Alex and to identify content and functional issues. In the usability testing phase, participants performed 22 tasks, such as account creation, watching pre-testing educational videos, requesting GT kit, and viewing GT results. Usability was measured with the Chatbot Usability Questionnaire (CUQ, possible range 0–100). Descriptive statistics were summarized for quantitative data. Framework analysis is conducted for qualitative data.

Findings and Interpretations

The CUQ score improved from 77.9 (Standard Deviation [SD] = 15.3) in user testing to 80.2 (SD = 10.1) in usability testing. Qualitative findings helped us identify functional issues requiring refinement (e.g., pedigree display, video sound quality), and enabled us to improve Alex’s content (e.g., expansion and reorganization of Frequently Asked Questions) and design (e.g., incorporating icons to guide users in uploading insurance card photos). Most tasks, such as ‘View menu’ and ‘Set user preferences,’ were completed within 0–15 seconds on the first attempt. ‘Create an account’ took 0.5–3 minutes, with one outlier taking 5 minutes due to difficulty locating the activation email. ‘Order a genetic testing kit’ took 1.5–3.5 minutes, with one exception of 8.8 minutes, where the participant did not press the ‘Send’ button until prompted.

Discussion

Cancer patients generally found that Alex was well-designed, engaging, appropriate, and informative. The two rounds of testing identified areas for improvement in design, content, and functions. These findings support the further efficacy testing of Alex in delivering genetics education and expanding equitable access to cancer genetics care.

Oncology Nursing Forum. 2025 Mar 1;52(2):3–4.

Group-Based Trajectory Modeling of Fatigue and its Genetic Associations During the First year of Breast Cancer Treatment

Katrina Carr ¹, Susan Sereika ², Catherine Bender ³, Yvette Conley ⁴, Sue Wesmiller ⁵

Purpose

Breast cancer (BC) patients identify cancer-related fatigue (CRF) as the most difficult persistent symptom with up to 30% of patients still reporting severe fatigue one year after diagnosis. Understanding who is at risk for severe fatigue and why will allow better treatment options to be developed for fatigue symptom management.

Significance

CRF has broad impacts impairing quality of life including social functioning, the ability to respond to work demands, and for some, the ability to hold a job. Current recommendations do help but are not sufficient for many patients who experience CRF.

Methods

This secondary analysis used longitudinal data collected in the prospective Treatment-Induced Nausea and Vomiting Study (R01/NR016695; RE43ONF; 5T32NR009759), that examined the genetic underpinnings of nausea and vomiting in early-stage BC patients. Participants provided informed consent before initial BC surgery. Saliva samples for genetic data were collected at the time of surgery. Participants completed the Patient-Reported Outcomes Measurement Information System (PROMIS®29) Questionnaire after hospital discharge, weekly during active treatment, and monthly otherwise. Group-based trajectory modeling (GBTM) was used to identify distinct fatigue patterns from baseline to twelve months after surgery. Single nucleotide polymorphisms (SNPs) from five inflammatory cytokine genes (IL6, IL8, IL10, TNFa, CRP) and three neurotransmitter genes (NKFB, NKFB2, BDNF) were examined individually through GBTM using multinomial logistic regression.

Findings and Interpretations

Participants had a mean age of 60.13 (SD=11.67) years. GBTM identified three distinct fatigue trajectories – mild and linearly decreasing (28.5%), mild and flat (55.6%), and moderate and flat (15.8%). Sufficient variability was found in 60 of the 130 SNPs across the eight genes considered for analysis. Of these SNPs, 14 were associated with fatigue trajectory group membership: NFKB (2), NFKB2 (1), BDNF (11). Having copies of the variant alleles for the SNPs in the NFKB and NFKB2 genes were associated with membership in the moderate and flat group compared to the mild and decreasing group (p<.05). Having copies of the variant alleles for SNPs in the BDNF gene were associated with membership in the mild and flat group compared to the mild and decreasing fatigue group (p<.05).

Discussion

We found three distinct fatigue trajectory groups, but one group had much lower fatigue levels over the year than expected. Notably, all significant associations were for SNPs in neurotransmitters genes suggesting a potential protective mechanism between these neurotransmitters against fatigue.

Oncology Nursing Forum. 2025 Mar 1;52(2):4.

The Multidimensional Impact of Social Determinants of Health on Symptoms in Breast Cancer Survivors

Zahra A Barandouzi ¹, Hannah Choi ², Yufen Lin ³, Deborah Bruner ⁴, Hongjin Li ⁵

Purpose

This study aimed to evaluate the multidimensional impact of social determinants of health (SDOH) on psychoneurological symptoms (PNS) burden in breast cancer survivors.

Significance

An estimated 24–68% of breast cancer survivors experience co-occurring psychoneurological symptoms (PNS), including pain, fatigue, sleep disturbances, depressive symptoms, and cognitive impairment, as lasting effects of cancer and its treatment. Social determinants of health (SDOH) significantly influence health outcomes in the cancer population. These determinants include individual factors (e.g., financial resource needs, transportation barriers, and social support) and community-level factors (e.g., neighborhood socioeconomic deprivation). Despite their recognized importance, limited research has systematically evaluated the multidimensional impact of SDOH on symptom burden in women with breast cancer.

Methods

In this secondary data analysis, multidimensional SDOH was assessed using an 11-item questionnaire that identifies needs across eight domains: alcohol consumption, financial resource needs, transportation needs, physical activity, stress, social connections, intimate partner violence, and depression. Neighborhood deprivation was measured using the Area Deprivation Index (ADI). Symptoms, including pain, fatigue, sleep disturbances, depressive symptoms, and cognitive impairment, were evaluated using the PROMIS 29 version 1.0 questionnaires. Additionally, a composite score of the PNS symptom cluster was calculated by averaging the PROMIS T score of each individual symptom. Linear regression models were conducted to determine the influence of SDOH on symptoms.

Findings and Interpretations

The analysis included 74 women with breast cancer with a mean age of 54 years and an average BMI of 31. The study population consisted of 53% Non-Hispanic Black, 28% Non-Hispanic White, and 19% Hispanic White/Non-White individuals. Most participants (65%) had early-stage breast cancer (stage 0–III). Among various SDOH, higher financial needs were significantly associated with more severe PNS (p=0.002), depressive symptoms (p=0.0006), and pain (p=0.015). Additionally, higher stress levels were significantly associated with more severe PNS (p<0.001), depressive symptoms (p=0.0003), anxiety (p<0.001), and sleep disturbance (p=0.003) after controlling for race-ethnicity, BMI, and marital status.

Discussion

Higher financial needs and stress levels were associated with increased severity of PNS symptoms in breast cancer survivors. These findings highlight the importance of addressing financial needs and stress as key SDOH influencing symptom severity, highlighting the need for targeted interventions that alleviate these challenges to improve symptom management and enhance the quality of life for women with breast cancer.

Oncology Nursing Forum. 2025 Mar 1;52(2):5.

A Nurse-Led Intervention to Enhance Quality of Life among Early Phase Cancer Clinical Trial Participants

Debra Lundquist ¹, Rachel Jimenez ², Nora Horick ³, Dejan Juric ⁴, Ryan Nipp ⁵, Betty Ferrell ⁶

Purpose

To determine the feasibility and acceptability of a nurse-led, quality of life (QOL) intervention among early phase cancer clinical trial (EP-CT) participants.

Significance

Efforts to address supportive care (SC) concerns among EP-CT participants are key for improving QOL and decreasing symptom burden, while facilitating access to new therapies. Clinical Research Nurses (CRNs) are uniquely positioned to address SC concerns among EP-CT participants.

Methods

We prospectively enrolled cancer patients, family caregivers, CRNs, and clinicians at an academic medical center from 7/2023–09/2024. The nurse-led intervention included educational sessions and implementation of bi-monthly interdisciplinary team (IDT) meetings. We assessed patients’ QOL (Functional Assessment of Cancer Therapy-General [FACT-G]), hope (Herth Hope Index [HHI]), symptom burden (Edmonton Symptom Assessment System-revised [ESAS-r]), and coping (Brief-Cope) at enrollment; nurse-patient relationship (Patients’ Perceptions of Nurse-Patient Relationship as Healing Transformations Scale [RELATE], higher scores indicate nurse-patient relationship as healing and transformative) at study completion. We assessed acceptability (Acceptability of Intervention Measure [AIM]; exit interviews to assess perceptions of usefulness, effectiveness, relevance), and feasibility (>60% enrollment of patients approached and >70% of enrolled participants complete >60% of surveys; Feasibility of Intervention Measure [FIM]).

Findings and Interpretations

Among 61 patients approached, we enrolled 50 (enrollment rate: 85%; median age: 58.7 years [IQR: 52.8–65.7 years], 60.0% female, 94.0% metastatic cancer, ECOG 0=38.0% and ECOG 1=62.0%). Most common cancer types were gastrointestinal (22.0%) and breast (7.0%). Overall, 88% (44/50) completed at least 60% of surveys; with baseline mean scores as follows: FACT-G: 77.7 (range=36.0–108.0), HHI: 32.0 (range=22.0–40.0), ESAS-r: 23.3 (range=0.0–57.4), and Brief-Cope (self-blame=2.6; acceptance=6.9, denial=2.5, support=6.9, active=6.5, disengage=2.2, religion=4.5). For the RELATE scale, 22 completed (44% completion), with mean of 92.9 (range=79–102). For caregivers, 25 participated (100% participation), with median age: 57.3 years (IQR=51.8–63.5 years), 72.0% female, 92.0% married, 88.0% employed. We had 10 CRNs and 10 clinicians participate (100% participation rates). Most CRNs (90%) and clinicians (90%) completed AIM (mean: 17.6 [range=4–20]), FIM (mean: 17.7 [range=4–20) and exit interviews (three themes identified: Patient-centric collaboration, Logistics, Unexpected outcomes).

Discussion

This pilot study utilized an innovative nurse-led intervention to address the unique SC concerns of the understudied EP-CT population. Feasibility and acceptability were high, which along with exit interviews, underscore the intervention’s potential usefulness, effectiveness, and relevance. Future research will build upon this work to test nurse-led interventions targeting SC concerns seeking to enhance QOL among EP-CT participants.

Oncology Nursing Forum. 2025 Mar 1;52(2):5–6.

Distinct Symptom Subgroups in Patients with Colorectal Cancer: Differences in Social Determinants of Health and Diet Quality

Youran Lee ¹, Qing Yang ², Donald Bailey Jr ³, Melissa Kay ⁴, Rosa Gonzalez-Guarda ⁵

Purpose

This study aimed to (a) identify distinct symptom severity subgroups among patients with colorectal cancer (CRC) and (b) examine the differences among characteristics in social determinants of health (SDOH) and diet quality across these subgroups.

Significance

CRC is a major cause of cancer mortality in the U.S., with many survivors facing ongoing physical and psychological symptoms. These symptom experiences are influenced by SDOH and diet quality, impacting treatment outcomes and quality of life. Therefore, understanding the relationships among SDOH, diet quality, and symptom subgroups is important for enhancing patient care.

Methods

A secondary analysis of the ColoCare Study dataset from the University of Utah Huntsman Cancer Institute was conducted, involving multiethnic CRC patients from six U.S. cancer centers. Latent class analysis was conducted to identify distinct symptom severity subgroups. Chi-square and AVONA were conducted to examine differences in SDOH and diet quality as measured by the Healthy Eating Index (HEI)-2020 among these subgroups.

Findings and Interpretations

A total of 256 patients with CRC (mean age: 59.17 ± 13.71; 54.55% male; 79.65% White; 57.58% non-Hispanic; 89.61% married; 64.94% college graduates; 45.67% with income < $70,000; 53.9% stage 3+ cancer; 75.32% received surgery) were included in this analysis. The average social support score was 25.76 ± 4.91, and the mean diet quality score was 60.57 ± 11.41. For Aim 1, three symptom severity subgroups were identified: low symptom severity (n=84), moderate symptom severity (n=123), mild symptom severity (n=49). For Aim 2, patients in the high symptom severity group were more likely to be younger (F = 4.48, p = 0.0122), identify as Hispanic (χ² = 9.10, p = 0.0106), report lower income levels (χ² = 12.92, p = 0.0117), and have received neoadjuvant treatment (χ² = 10.30, p = 0.0058). Additionally, this group demonstrated significantly lower scores for both total social support (F = 5.60, p = 0.0042) and diet quality (F = 9.58, p = 0.0001) compared to the moderate and low symptom severity groups.

Discussion

This study underscores the critical need for personalized dietary interventions and strong support systems to enhance symptom management in patients with CRC. The findings highlight the importance of implementing targeted strategies that address SDOH to optimize patient care and improve overall quality of life.

Oncology Nursing Forum. 2025 Mar 1;52(2):6–7.

A Primary Palliative Care Communication Intervention (Precursor) for the Patient-Caregiver-Provider Triad in the Setting of Incurable Cancer: Results of a Pilot Study

Kristin Levoy ¹, Kristin Levoy ², Alexia Torke ³, Alexia Torke ⁴, Krista Longtin ⁵, Marianne Matthias ⁶, Marianne Matthias ⁷, Susan Hickman ⁸, Susan Hickman ⁹

Purpose

This nonrandomized (10 usual care control, 10 intervention) pilot aimed to 1) evaluate the feasibility and acceptability of a primary palliative care (PPC) communication intervention, PRECURSOR, among patients with incurable gynecologic cancer, caregivers, and providers, 2) explore group differences in supportive care communication behaviors during outpatient oncology encounters and psychosocial outcomes following encounters, and 3) identify opportunities for intervention refinement.

Significance

Despite calls for integrating PPC into routine oncology care, this integration is nascent. PPC requires expert communication to address supportive care needs. Yet, oncology providers disproportionately focus communication on their clinical agendas, leaving little time for patients and caregivers to communicate their individualized supportive care needs—paving the way for adverse psychosocial outcomes following encounters.

Methods

PRECURSOR is rooted in a blended theoretical model, which posits that behaviors directly result from one’s intentions. PRECURSOR leveraged a listing exercise (Freelisting) to elicit communication intentions about supportive care needs independently (patient, caregiver, provider) before encounters. Participants were not instructed to endorse the Freelisting—leaving the decision to discuss elicited communication intentions up to individuals as the encounter naturally occurred. The primary outcomes were feasibility (25% of eligible enrolled; 1 triad/week) and acceptability (80% of participants will “agree” or “completely agree” to each acceptability item). Exploratory outcomes included supportive care communication behaviors during encounters (measured using transcriptions of the audio-recorded encounters) and psychosocial outcomes following encounters (measured using patient and caregiver post-encounter surveys and qualitative interviews).

Findings and Interpretations

Of 1,356 patients screened, 86 were eligible, and 20 (23%) enrolled in 38 weeks. Most patients (70%) and caregivers (78%) agreed to each acceptability item. Some exploratory outcomes suggested group differences in favor of the intervention—the intervention group’s distress (patients, M=3.5; caregivers, M=2.8) and anxiety (patients, M=5.1; caregivers, M=5.1) were lower on average than the control group’s distress (patients, M=4.1; caregivers, M=3.6) and anxiety (patients, M=7.1; caregivers, M=5.6). The remaining exploratory outcomes were not suggestive of group differences.

Discussion

This indicates that PRECURSOR approached feasibility and acceptability benchmarks. Exploratory outcomes suggest PRECURSOR can improve the psychosocial experiences of patients and caregivers through enhanced primary palliative communication in the outpatient setting. Yet, PRECURSOR’s impact on other communication behaviors and outcomes is indeterminate. Qualitative findings indicated the perceived value of PRECURSOR but desired intervention refinements through agenda-setting (visualization/review of Freelisting to establish conversational priorities) to increase its impact.

er level of care. Machine learning offers opportunities to predict outcomes in patients with cancer and was used in this study to develop a superior model to detect deterioration in patients undergoing HCT. This early detection occurs before clinicians can intuitively or quantitatively distinguish change, which has great potential to improve patient outcomes. This is the first model developed to predict deterioration in patients undergoing HCT. Additionally, while ML models are emerging in cancer care, none recommend implementation strategies. This study engaged frontline clinicians to garner qualitative perspectives about model implementation to explore strategies and barriers to successful implementation.

Oncology Nursing Forum. 2025 Mar 1;52(2):7.

I19. Innovative Strategies in the Care of a Patient with Paraplegia Requiring Radiation Isolation

Philip Bernaldez ¹, Mary Myers ², Assumpta Ude ³

Significance & Background

Radioactive iodine (RAI) is recommended as an adjunct therapy for patients with known extrathyroidal metastases after thyroidectomy to improve disease-specific and progression-free survival and reduce recurrence rates. Radiation safety programs managed by health physicists and nurses facilitate safe care of patients receiving RAI. The strict regulatory guidelines and monitoring following administration of ionizing radiopharmaceuticals, present challenges to nurses. Historically, our patients requiring radiation therapy were able to perform independent daily activities. We present a case study of a medical-surgical patient with paraplegia treated with Iodine-131 and requiring radiation isolation.

Purpose

To successfully integrate standard radiation safety guidelines in the care of a patient with paraplegia receiving RAI therapy and highlight innovative care adaptations to mitigate risk for radiation exposure.

Interventions

Before admission, nurses facilitated collaboration with multidisciplinary team to address treatment plan and anticipated care concerns. Based on these discussions, nurses designed a plan of care for a paraplegic patient receiving RAI therapy. Interventions to minimize radiation exposure risk included, mock care sessions, utilization of hospital’s historical data on radiation exposure levels, provision of enhanced personal protective equipment, utilization of assistive mobility devices, modification of nursing personnel workflow, strict enforcement of radiation level monitoring during exit and entry, and staggered scheduling to limit nurses’ exposure time.

Results

Care coordination provided opportunity for targeted and specialized care that contributed to a successful patient outcome. The results also demonstrated the intrinsic value of comprehensive planning, optimal use of resources, care adaptations, and collaborative effort in meeting radiation safety goals. Additionally, this experience highlighted the need for risk mitigation policy for standardized care of diverse patient population receiving RAI therapy, including patients with severe mobility deficits. These outcomes underscored the benefits of collaborative team spirit and the value of nurses’ receptivity to workflow changes in novel care adaptations.

Discussion

Care coordination provided opportunity for targeted and specialized care that contributed to a successful patient outcome. The results also demonstrated the intrinsic value of comprehensive planning, optimal use of resources, care adaptations, and collaborative effort in meeting radiation safety goals. This experience highlighted the need for risk mitigation policy for standardized care of diverse patient population receiving RAI therapy. These outcomes underscored the benefits of collaborative team spirit and the value of nurses’ receptivity to workflow changes in novel care adaptations.

Oncology Nursing Forum. 2025 Mar 1;52(2):7–8.

I20. Acuity Based Model to Advance Support of High-Risk Cancer Patients

Lindsay Boudinot ¹, Jessica Suarez ², Jenna Rush ³

Significance & Background

Iris is a virtual-first supportive care service for people living with cancer. Nurse navigators enable this service through comprehensive assessments, care plan development, on-demand symptom management, and ongoing proactive outreach. To tailor care to patients with the highest needs and utilize navigation resources effectively, we recognized the need for an acuity-based care model. The National Navigation Acuity Team defines oncology navigation acuity as a measure of patient distress and the medical and psychosocial barriers patients face. Acuity helps determine the optimal level of navigator support based on the patient’s illness complexity and social factors.

Purpose

The purpose of this study is to describe how we have applied a segmentation-based acuity model to manage our high-risk patients with cancer through outreach, personalized care plans, and appropriate referrals, aiming to improve outcomes.

Interventions

To assign a patient’s acuity level, we use claims data along with virtual screenings to determine relevant barriers to care. Nurse navigators evaluate patients in areas such as psychosocial, financial, and physical needs. This information is combined to arrive at the patient’s acuity level. The assigned acuity level guides our nurse navigators to create an appropriate care plan. Individuals with high acuity receive more frequent monitoring and referrals to appropriate supportive services.

Results

Since initiating the use of an acuity-based model to help drive patient support, we have seen a 27.5% increase in overall clinician visits with our high-risk patients. This suggests that patients are connected to the appropriate services at the right time.

Discussion

The use of our acuity-based model to drive the nurse care plan and has enabled our By providing them with tailored support based on acuity, we address the most pertinent physical and psychosocial issues by guiding them to the right level of clinician support. More research is required to determine the impact of the approach on outcomes.

Oncology Nursing Forum. 2025 Mar 1;52(2):8–9.

I22. Phase 3 Aquila study of Daratumumab Monotherapy Versus Active Monitoring in Patients with High-risk Smoldering Multiple Myeloma (SMM)

Andrew J Cowan ¹, Peter M Voorhees ², Meletios A Dimopoulos ³, Fredrik Schjesvold ⁴, Yael C Cohen ⁵, S Vincent Rajkumar ⁶

Significance & Background

SMM is an asymptomatic precursor condition to multiple myeloma (MM) without approved treatment options. Therapeutic intervention before onset of end-organ damage and MM diagnosis may benefit patients with high-risk SMM.

Purpose

The phase 3 AQUILA study (NCT03301220) evaluated whether daratumumab could delay progression to MM versus active monitoring in high-risk SMM.

Interventions

Adults with high-risk SMM for ≤5 years were randomized 1:1 to active monitoring or subcutaneous daratumumab monotherapy in 28-day cycles until 39 cycles, 36 months, or disease progression, whichever came first. The primary endpoint was progression-free survival (PFS), defined as progression to MM per independent review committee according to IMWG diagnostic criteria for MM (SLiM-CRAB) or death.

Results

390 patients were randomized to daratumumab (n=194) or active monitoring (n=196). Baseline characteristics were generally balanced between groups. Median daratumumab treatment duration was 38 cycles (35.0 months). At a median follow-up of 65.2 months, daratumumab significantly reduced the risk of progression to MM or death by 51% versus active monitoring (60-month rates: 63.1% vs 40.8%; HR, 0.49 [95%CI, 0.36–0.67]; P<0.0001), with a generally consistent PFS benefit across prespecified subgroups, including retrospective analysis of high-risk SMM per the Mayo 2018 definition. Overall response rate was 63.4% with daratumumab versus 2.0% with active monitoring (P<0.0001). As of the clinical cutoff, 33.2% of daratumumab patients and 53.6% of active monitoring patients had started first-line MM treatment. Median time to initiation of first-line MM treatment was not reached with daratumumab versus 50.2 months with active monitoring (HR, 0.46 [95%CI, 0.33–0.62]). Daratumumab also improved PFS2 including first-line MM treatment (60-month rates: 85.9% vs 78.0%; HR, 0.58 [95%CI, 0.35–0.96]) and overall survival (60-month rates: 93.0% vs 86.9%; HR, 0.52 [95%CI, 0.27–0.98]). Forty-one deaths were observed (daratumumab, n=15; active monitoring, n=26). Daratumumab demonstrated a favorable safety profile, with a low (5.7%) frequency of daratumumab discontinuations due to treatment-emergent adverse events (TEAEs). Grade 3/4 TEAEs occurred in 40.4% and 30.1% of patients in the daratumumab and active monitoring groups, respectively, with hypertension the most frequent event (5.7% vs 4.6%). In an expanded assessment of patient-reported outcomes, quality of life was maintained with daratumumab treatment across multiple measures/domains.

Discussion

Results strongly support early intervention with daratumumab monotherapy in patients with high-risk SMM, representing an opportunity to delay/prevent end-organ damage and progression to MM, while preserving quality of life and improving survival.

Oncology Nursing Forum. 2025 Mar 1;52(2):9.

I23. Incidence of Infection and Immune Recovery in the Cartitude-4 Trial of Ciltacabtagene Autoleucel Versus Standard of Care for Treatment of Multiple Myeloma

Jean Esselmann ¹, Anna Davis ², Sandy Kruyswijk ³, Erika Florendo ⁴, Vicki Plaks ⁵, Niels WCJ van de Donk ⁶

Significance & Background

Ciltacabtagene autoleucel (cilta-cel) significantly improved progression-free survival versus standard of care (SOC; hazard ratio [HR], 0.26; P<0.0001) in patients with lenalidomide-refractory multiple myeloma (MM) after 1–3 prior lines of therapy in the phase 3 CARTITUDE-4 trial (NCT04181827) at the 15.9-month median follow-up (MFU). At the 34-month MFU, cilta-cel exhibited increased overall survival versus SOC (HR, 0.55; P=0.0009). Nurses should become aware of increased risk of infection in patients with MM due to underlying immune dysregulation and potential treatment effects.

Purpose

To describe infections and immune recovery after the 21.5-month median follow-up in CARTITUDE-4.

Interventions

Patients were randomized to a single infusion of cilta-cel or SOC (daratumumab-pomalidomide-dexamethasone/pomalidomide-bortezomib-dexamethasone). Infection was assessed in patients who received any part of study treatment and those who received cilta-cel as study treatment.

Results

Overall, 128 of 208 cilta-cel–treated patients (61.5%) and 157 of 208 SOC-treated patients (75.5%) had treatment-emergent (TE) infections of any grade; grade ≥3 TE infections occurred in 57 patients (27.4%) and 56 patients (26.9%) in the cilta-cel versus SOC groups, respectively. Rates of grade ≥3 TE infections in the cilta-cel group were highest within the first 6 months and decreased thereafter (Figure). TE fatal infections occurred in 9 patients (4.3%) in the cilta-cel group and 6 patients (2.9%) in the SOC group; most infections in the cilta-cel group were due to COVID-19 pneumonia (cilta-cel, n=7; SOC, n=2). Among 176 patients who received cilta-cel as study treatment (ie, those without disease progression prior to infusion), 54 had grade ≥3 infections and 11 had fatal infections (TE or non-TE; 8 within 6 months), including the 7 COVID-19–related deaths (none were fully vaccinated; deaths occurred before implementation of COVID-19 mitigation protocols). Grade 3/4 neutropenia recovered to grade ≤2 by day 60 in 89.2% of cilta-cel–treated patients (Figure). By ~9 months after infusion, B cells and polyclonal plasma cells recovered to baseline levels in blood. TE hypogammaglobulinemia or post-baseline IgG <500 mg/dL occurred in 90.9% of the cilta-cel group and 71.6% of the SOC group; 68.3% and 15.9%, respectively, received intravenous immunoglobulin (IVIG).

Discussion

Patients who received cilta-cel and SOC were at risk of severe and fatal infections, particularly within the first few months after treatment. Nurses should play a critical role in monitoring, vaccination, COVID-19 mitigation, infection prophylaxis (eg, IVIG), and supportive care following infusion.

Oncology Nursing Forum. 2025 Mar 1;52(2):9–10.

I24. Multidisciplinary Consensus Recommendations on Proactive Management of Dermatologic Reactions Associated with Epidermal Growth Factor Receptor-Targeted Treatments for Lung Cancer

Lindsay Dougherty ¹, Joshua Sabari ², Jill Feldman ³, Rachel Sanborn ⁴, Whitney Lewis ⁵, Nicole R LeBoeuf ⁶

Significance & Background

Management of Epidermal Growth Factor Receptor (EGFR) inhibitor-related dermatologic reactions is often informed by the experiences of individual healthcare providers, which can lead to inconsistent and suboptimal care. Proactive dermatologic management for patients initiating EGFR inhibitors for lung cancer can reduce the occurrence and severity of side effects in the skin, hair, and nails. Advanced practice providers can play a pivotal role in the provision of proactive management, allowing patients to maintain quality of life without disruption of cancer treatment.

Purpose

The purpose of this study is to establish consensus on best practices for the proactive management of dermatologic reactions in patients treated with EGFR inhibitors for lung cancer.

Interventions

The study employed a modified Delphi methodology. A literature review and multidisciplinary steering group discussions were used to develop statements on proactive management. US dermatologists, medical oncologists, onco-dermatologists, oncology nurse practitioners, and oncology pharmacists were surveyed regarding their level of agreement with each statement (4-point Likert scale). The threshold for consensus was set a priori by the steering group at 75% agreement.

Results

Forty-five statements were developed by the steering group. In June–August 2024, 304 survey responses were received from onco-dermatologists(n=25), dermatologists(n=78), medical oncologists(n=100), oncology nurse practitioners(n=50), and oncology pharmacists(n=51). Consensus was achieved for 43 of 45 statements. Key statements across 4 domains included (1) identification and education of patients for proactive management: patients demonstrating concern regarding the potential impact of dermatologic toxicities on quality of life should receive proactive management (94% agreement); (2) recommendations for proactive management: patients receiving EGFR inhibitors with high skin toxicity risk should receive prophylactic oral antibiotics (76% agreement); (3) multidisciplinary optimization: referral to a dermatologist should be considered for patients with persistent and/or worsening rash after 2–4 weeks of topical steroid treatment (96% agreement); and (4) future guidelines and protocols: future guidelines should highlight the role of various healthcare professionals involved in care for dermatologic reactions associated with EGFR inhibitors (97%).

Discussion

Advanced practice providers can play a critical role in preventing and controlling dermatologic reactions in lung cancer patients initiating EGFR inhibitors. This consensus study validates considerations and best practices for proactive management, including actions that nurses can take to identify patients for proactive management and to educate patients on risks, medications, lifestyle modifications, and the importance of early reporting of dermatologic reactions.

Oncology Nursing Forum. 2025 Mar 1;52(2):10–11.

I25. Thematic Analysis & Implications from a PhD-DNP Think Tank

Erica Fischer-Cartlidge ¹, Margaret Quinn Rosenzweig ²; the ONS Research Priority Team

Significance & Background

The Institute of Medicine emphasizes the need for meaningful collaboration between DNP and PhD-prepared nurses, yet progress in fostering such collaboration has been slow and inconsistent. Competition and lack of synergy are still prevalent in both academic and clinical practice settings. In oncology, where rapid advancements in treatment and care are occurring, the urgency to close this gap is present. In order to keep pace with medical innovations and ensure that research findings are efficiently developed and translated into clinical practice to improve patient outcomes.

Purpose

To define and address the contributing factors to lack of consistent collaboration between oncology PhDs and DNPs.

Interventions

A PhD/DNP Think Tank was held in April 2024. A convenience sample of participants who held either doctoral degree and were attending the annual 2024 ONS Congress were invited to participate. Abstraction laddering techniques for small group discussion was utilized to (1) identify barriers to collaboration, (2) benefits of collaboration, and (3) interventions that would promote and facilitate enhanced synergy between roles. Thematic analysis was done for findings in each phase of the program.

Results

Twenty-six oncology-specialized PhDs and DNPs, from 15 different states participated. Several themes emerged at each phase. Final presentation will discuss the detailed methodology and thematic findings for each phase of work. Practical short-term changes were identified and implemented within the first 6 months post Congress.

Discussion

The critical importance of generating new knowledge in oncology nursing through well-designed research and successfully translating that research into the practice setting are often not holistically considered. This PhD/DNP Think Tank identified current barriers to achieving this translation as well as highlighting the numerous benefits to shifting the status quo and exploring practical change. Addressing these issues at the individual, organizational and national level will change this dynamic and improve oncology nursing practice and patient care.

Oncology Nursing Forum. 2025 Mar 1;52(2):11.

I26. Confronting High-Resolution Anoscopy (HRA) Utilization in the Ambulatory Setting

Kim Gafford ¹, Jennifer Euton ², Kristi Schimberg ³

Significance & Background

High-resolution anoscopy (HRA) is an important procedure in the diagnosis and management of anal dysplasia in patients with abnormal anal pap smears. However, it can be intimidating for many patients, particularly for those who experience poor access to care or a shortage of healthcare providers. To address this, we developed a patient-centered approach, including education, procedure preparation, and emotional support before and after HRA. This removes barriers to care, addresses disparities in healthcare, and provides follow-up care for a lifetime.

Purpose

To optimize patient education and treatment adherence while addressing disparities in access to HRA pre- and post-procedure. In addition, working directly with PCPs to transition patients through their healthcare journey, following a positive anal pap smear. We encourage patients to become proactive and engaged, improve their outcomes, and receive comprehensive follow-up care.

Interventions

The program combines the knowledge of nursing staff with the support of a lay patient navigator. They support patients at every level of the HRA journey, creating a seamless experience. Nursing emphasizes individualized education, including mental and physical hurdles with new diagnoses. Education includes medication, preparation for procedures, and pre- and post-care instructions. The lay navigator helps address barriers to care, like scheduling conflicts or transportation problems, while providing support and encouragement. This teamwork helps patients leave the hospital with the information and support that will allow them to go home feeling empowered and ready to continue on their rehab journey.

Results

Since implementation, patients’ health has improved. With proactive patient engagement, no-show rates for HRA appointments have fallen significantly. Patients have a greater understanding of their diagnosis and treatment plan, are more compliant with procedural protocols, and are more likely to make regular follow-up visits. Advances have improved procedural success, patient outcomes, and satisfaction.

Discussion

Teamwork between nursing and a lay navigator redefined the patient experience in high-resolution anoscopy. A significant reason for this is the emphasis on education, which empowers patients to navigate their healthcare confidently. With clear and individualized instructions, alongside patient support, patients learn to manage their care better. This leads to better overall health, improved patient compliance and less anxiety. This creative, compassionate, accessible, effective program addresses HRA challenges by integrating nursing education with the navigational expertise of a lay navigator.

Oncology Nursing Forum. 2025 Mar 1;52(2):11–12.

I27. Enhancing the Onboarding Process for New Nursing Leaders: A Comprehensive Mentorship and Support Model

Jewell Hudson ¹, Erica Scott ²

Significance & Background

The transition into leadership roles in nursing units presents unique challenges, particularly for new managers. In many cases, inadequate orientation periods and the absence of ongoing support contribute to job dissatisfaction, high turnover rates, and inconsistent leadership development.

Purpose

The purpose if this project was to explore the common problems associated with onboarding new nurse managers, including insufficient orientation time and the lack of structured mentorship.

Interventions

To address gaps in onboarding and orientation for new leaders, there was a proposal for implementation of a comprehensive onboarding program that extends beyond the initial orientation period. Key elements of the program included assigning each new nurse manager a dedicated mentor for one year, providing a consistent point of contact for guidance and support. Weekly check-ins via phone, email, or virtual meetings allowed for continuous feedback and development, helping to alleviate feelings of isolation and uncertainty. Additional strategies, such as peer support groups and leadership workshops, will be considered to further strengthen leadership skills and build confidence.

Results

As a result of this enhanced orientation and onboarding, the two nurse managers who participated reported that they felt well prepared and supported to successfully lead their teams. The teams that these nurse managers supported showed an increase in employee and patient satisfaction over a 6 month time period. This increase in satisfaction is related to the nurse manager being well prepared and present to support their teams.

Discussion

By adopting a structured, long-term approach to onboarding, healthcare organizations can better equip new nursing leaders to succeed in their roles, ultimately improving team cohesion, patient care outcomes, and manager retention.

Oncology Nursing Forum. 2025 Mar 1;52(2):12.

I28. Effectiveness of Bridging Therapy Corresponds to Improved Outcomes after Receiving CAR-T Therapy: Phase 3 Cartitude-4 Study of Patients with Relapsed, Lenalidomide-Refractory Multiple Myeloma

Gina Lange ¹, Erika Florendo ², Tamar Lengil ³, Sébastien Anguille ⁴

Significance & Background

The phase 3 CARTITUDE-4 trial (NCT04181827) demonstrated improved progression-free survival (PFS) with ciltacabtagene autoleucel (cilta-cel) versus standard of care (SOC) in patients with lenalidomide-refractory multiple myeloma at a 16-month median follow-up (MFU; hazard ratio [HR], 0.26; P<0.0001). At a second analysis (34-month MFU), cilta-cel improved overall survival versus SOC (HR, 0.55; P=0.0009). Patients able to receive cilta-cel as study treatment (ie, those without disease progression prior to infusion) had high rates of response (99.4%) and 12-month PFS (89.7% from randomization), demonstrating the importance of pre-infusion disease control. Bridging therapy to reduce disease burden during CAR-T manufacturing may therefore improve post-infusion outcomes in cilta-cel–treated patients.

Purpose

To report the efficacy of cilta-cel by response to bridging therapy in patients who received cilta-cel as study treatment.

Interventions

In CARTITUDE-4, cilta-cel–treated patients underwent apheresis followed by bridging therapy and cilta-cel infusion 5 to 7 days after start of lymphodepletion. Bridging therapy included physician’s choice of either daratumumab, pomalidomide, and dexamethasone (DPd) or pomalidomide, bortezomib, and dexamethasone (PVd). To assess the impact of bridging therapy response on outcomes following cilta-cel infusion, PFS was evaluated in patients who experienced ≥25% reduction in tumor burden following bridging therapy versus those who did not (ie, increase, no change, or <25% reduction [<25% decrease group]). Biomarker correlates of response to bridging therapy and cilta-cel included effector-to-target (E:T) ratio, calculated as peak CAR-T cell expansion normalized to pre-infusion serum soluble BCMA levels.

Results

Of 176 patients who received cilta-cel as study treatment, 158 received DPd and 18 received PVd as bridging therapy. Most patients had ≥25% reduction in tumor burden in response to bridging therapy (Figure). At the 15.9-month median follow-up, median PFS (95% confidence interval) was not reached (not estimable [NE]-NE) in the ≥25% decrease group and 19.2 months (15.8 months-NE) in the <25% decrease group. Patients in the ≥25% decrease group with available biomarker data had a higher E:T ratio than those in the <25% decrease group, which also correlated with improved PFS.

Discussion

Cilta-cel–treated patients in CARTITUDE-4 who demonstrated ≥25% reduction in tumor burden following bridging therapy experienced longer PFS, which may be driven by a higher E:T ratio in those with lower disease burden prior to cilta-cel infusion. These results highlight the importance of optimizing bridging therapy to improve outcomes in patients receiving cilta-cel.

Oncology Nursing Forum. 2025 Mar 1;52(2):12–13.

I29. Long-Term Efficacy and Safety of Ciltacabtagene Autoleucel Versus Standard of Care for Treatment of Lenalidomide-Refractory Multiple Myeloma in the Cartitude-4 Trial

Jean Esselmann ¹, Theresa Latchford ², Gina Lange ³, Erika Florendo ⁴, Nikoletta Lendvai ⁵, Maria-Victoria Mateos ⁶

Significance & Background

Ciltacabtagene autoleucel (cilta-cel) is approved in the United States and European Union for treatment of patients with lenalidomide-refractory multiple myeloma (MM) after ≥1 line of therapy based on the phase 3 CARTITUDE-4 trial (NCT04181827). At the primary analysis (15.9-month median follow-up), cilta-cel significantly improved progression-free survival (PFS) versus standard of care (SOC; hazard ratio [HR], 0.26; P<0.0001).

Purpose

To report updated safety and efficacy from CARTITUDE-4, including prespecified analysis of overall survival (OS) and minimal residual disease (MRD) negativity (10-5), an important predictor of long-term treatment outcomes, at the 33.6-month median follow-up.

Interventions

Patients in CARTITUDE-4 were randomly assigned to a single infusion of cilta-cel or SOC (pomalidomide-bortezomib-dexamethasone [PVd]/daratumumab-pomalidomide-dexamethasone [DPd]).

Results

Overall, 419 patients were randomized (intent-to-treat population; cilta-cel, n=208; SOC, n=211). Median OS was not reached (NR) with cilta-cel or SOC (HR, 0.55 [protocol-specified weighted analysis]; 95% confidence interval, 0.39–0.79; P=0.0009); 30-month OS rates were 76% and 64%, respectively (Table). OS benefit was generally maintained across prespecified subgroups (eg, 1 vs 2–3 prior lines of therapy, cytogenetic high-risk disease, refractory status). At this longer-term follow-up, cilta-cel maintained improvements over SOC in treatment response (overall response rate, 85% vs 67% with cilta-cel vs SOC [complete response or better (≥CR), 77% vs 24%]), duration of response (NR vs 18.69 months), and PFS (NR vs 11.79 months; Table). At the 10-5 threshold, MRD-negativity rates were higher with cilta-cel versus SOC (62% vs 18%; P<0.0001); in the cilta-cel group, 48% achieved MRD negativity by day 56, increasing to 60% within 6 months after infusion. Sustained MRD-negativity rates were 40% in the cilta-cel group versus 6% in the SOC group (P<0.0001). Median PFS was >3 years in patients with MRD negativity and ≥CR at month 12, regardless of treatment. In the safety population (cilta-cel, n=208; SOC, n=208), there were 50 and 82 deaths in the cilta-cel and SOC arms, respectively, of which 21 and 51 were due to progressive disease (Table).

Discussion

At ~3 years of follow-up, cilta-cel reduced risk of death by 45% versus SOC, improved PFS, was associated with high rates of deep and sustained MRD negativity, and maintained a consistent safety profile. MRD-related outcomes are important in clinical trials given the increasing recognition of MRD negativity as a primary clinical endpoint in MM that is linked to improvements in PFS and OS.

Oncology Nursing Forum. 2025 Mar 1;52(2):13.

I30. Identifying Suicidal Ideation in Cancer Patients

Sabina Medjedovic ¹

Significance & Background

Cancer is a disease that has significant physical, emotional, social and financial consequences for sufferers and their families. In a large number of cases, the diagnosis of cancer is made before a period of progressive onset of non-specific symptoms or through routine screening. Many patients are relatively healthy before the onset of cancer and may therefore be encountering the healthcare system for the first time.

Purpose

The aim of the study was to determine the prevalence of suicidal ideation in outpatients with cancer, to investigate which patients are at highest risk and how demographic and health factors influence the risk of suicidal ideation and suicide. Interventions 972 adult patients with different types of cancer treated in an outpatient setting were included in the study. Data were collected using standardised questionnaires PHQ-9 and ASQ. Data were analysed using descriptive statistics and binomial logistic regression.

Results

The results of the PHQ-9 questionnaire showed that among all 972 patients, 27.7% reported suicidal ideation in the last 2 weeks. At the time of completing the questionnaire, 0.5% (n = 4.8) of patients had suicidal ideation. The results showed that 88.7% of the respondents had not received psychological help since they learned of their oncological diagnosis, but that 43.5% (n = 425) would have needed it. We found a weak association between gender and physical activity in relation to suicidal ideation. Statistically significant associations were found for patients who live alone, have a poorer prognosis, are in pain, are treated with systemic therapy, have symptoms of depression and anxiety. These patients are more likely to experience suicidal ideation.

Discussion

Our results showed that suicidal ideation is present in oncology patients, and it is necessary to introduce the use of validated screening tools in clinical practice and to organise educational workshops for patients. Emotional distress should be identified, monitored and documented as a sixth vital sign. This would reduce the negative thoughts experienced at the time of an oncological diagnosis and consequently improve patient care.

Oncology Nursing Forum. 2025 Mar 1;52(2):13–14.

I31. Phase 3 Auriga Study of Subcutaneous Daratumumab Plus Lenalidomide Versus Lenalidomide Alone as Maintenance Therapy in Newly Diagnosed Multiple Myeloma (NDMM) after Autologous Stem Cell Transplant (ASCT)

Todd Milliron ¹, Larry D Anderson Jr ², Alfred Chung ³, Peter M Voorhees ⁴, Ashraf Badros ⁵, Laahn Foster ⁶

Significance & Background

Standard treatment for transplant-eligible patients with NDMM includes induction/consolidation with ASCT and lenalidomide maintenance. Addition of daratumumab may improve outcomes; however, no randomized trials have directly compared daratumumab-based versus lenalidomide maintenance.

Purpose

The phase 3 AURIGA study (NCT03901963) evaluated daratumumab plus lenalidomide maintenance in anti-CD38–naïve, post-ASCT MRD-positive patients with NDMM.

Interventions

Patients were 18–79 years, anti-CD38 naïve, in very good partial response or better (≥VGPR) and MRD positive (10-5 threshold; via NGS) after ASCT, received ≥4 induction cycles, and enrolled ≤12 months from induction start and ≤6 months from ASCT. Patients were stratified by cytogenetic risk and randomized 1:1 to receive 28-day cycles of lenalidomide ± subcutaneous daratumumab for ≤36 cycles or until disease progression/unacceptable toxicity/withdrawal.

Results

200 patients were randomized to daratumumab/lenalidomide (n=99) or lenalidomide (n=101); median ages were 63 and 62 years; 25.3% and 23.5% had ISS stage III disease; 34.4% and 33.7% had high-risk cytogenetics (del[17p], t[4;14], t[14;16], t[14;20], and/or gain/amp[1q21]). At a median follow-up of 32.3 months, MRD-negative (10-5) conversion by 12 months from maintenance start (primary endpoint) favored daratumumab/lenalidomide (50.5%) versus lenalidomide (18.8%; OR, 4.51 [95%CI, 2.37–8.57]; P<0.0001), including in high-risk (43.8% vs 13.3%) and standard-risk (53.8% vs 22.6%) cytogenetic subgroups. MRD-negative (10-5) with complete response or better (≥CR) conversion rate by 12 months was 44.4% for daratumumab/lenalidomide versus 14.9% for lenalidomide. Daratumumab/lenalidomide also improved overall MRD-negative (10-5) conversion (60.6% vs 27.7%) and sustained MRD-negativity lasting ≥6 months (35.4% vs 13.9%). At the 10-6 threshold, daratumumab/lenalidomide improved MRD-negative conversion by 12 months (23.2% vs 5.0%) and overall (36.4% vs 12.9%). ≥CR rates were 75.8% for daratumumab/lenalidomide versus 61.4% for lenalidomide; among patients with VGPR at baseline, 66.2% and 45.1% improved to ≥CR. Progression-free survival favored daratumumab/lenalidomide versus lenalidomide (HR, 0.53 [95%CI, 0.29–0.97]; P=0.0361), irrespective of baseline response (<CR: HR, 0.60 [95%CI, 0.30–1.21]; ≥CR: HR, 0.49 [95%CI, 0.14–1.67]). Grade 3/4 treatment-emergent adverse events occurred in 74.0% of daratumumab/lenalidomide and 67.3% of lenalidomide patients; infections (18.8% and 13.3%) and neutropenia (46.9% and 41.8%) were most common and similar between race and age subgroups, except lower rates of grade 3/4 infections with lenalidomide in White and younger (<65 years) patients.

Discussion

AURIGA demonstrated a benefit of adding daratumumab to lenalidomide maintenance in transplant-eligible patients with NDMM, with improved MRD-negative conversion rates and no new safety concerns.

Oncology Nursing Forum. 2025 Mar 1;52(2):14–15.

I32. Real-World Head-to-Head Studies Evaluating Overall Survival with Apalutamide and Abiraterone Acetate or Enzalutamide in Patients with Metastatic Castration-Sensitive Prostate Cancer

Neal Shore ¹, Benjamin Lowntritt ², Ibrahim Khilfeh ³, Shawn Du ⁴, Lorie Ellis ⁵, Mehmet Bilen ⁶

Significance & Background

Androgen-receptor pathway inhibitors (ARPIs) are recognized as effective treatment options for patients with metastatic castration-sensitive prostate cancer (mCSPC). However, there are no head-to-head studies comparing overall survival (OS) outcomes between the different agents.

Purpose

These analyses compared OS for apalutamide vs enzalutamide, and apalutamide vs abiraterone acetate, at 24 months in ARPI-naïve patients with mCSPC.

Interventions

These retrospective analyses (apalutamide vs enzalutamide and apalutamide vs abiraterone acetate) were performed using two large, de-identified linked healthcare databases (PPS Analytics and Komodo). The index date was the first prescription date for apalutamide, enzalutamide, or abiraterone acetate. Exclusion criteria included castration resistance, prior use of an ARPI or other advanced prostate cancer treatments, or the presence of another primary cancer. OS was analyzed using weighted Cox proportional hazards models, with a 24-month observation period for the primary objective. Exploratory analyses considered all follow-up data.

Results

A total of 3,719 patients were included in the apalutamide (N=1,810) vs enzalutamide (N=1,909) analysis. Baseline characteristics were well balanced between groups; after applying inverse-probability of treatment weighting, the mean age at the index date was 73 years; ~72% had bone metastasis, ~49% had nodal metastasis, ~20% had visceral metastasis, and ~81% used androgen deprivation therapy. 3,952 patients were included in the apalutamide (N=1,879) vs abiraterone acetate (N=2,073) analysis. After applying inverse probability of treatment weighting, the mean age at the index date was 72 years; ~62% were White, ~18% Black, ~66% had bone metastasis, 53% had nodal metastasis, ~22% had visceral metastasis, and ~77% had prior androgen deprivation therapy. By 24-months, those on apalutamide exhibited a statistically significant 23% or 26% reduction in the risk of death compared to those on enzalutamide (hazard ratio [HR]: 0.77; 95% confidence interval [CI]: 0.62, 0.96; P=0.019) or abiraterone acetate (HR: 0.74; 95% CI: 0.59, 0.93; P=0.010), respectively. Consistent findings emerged when all follow-up data were analyzed (HR: 0.77; 95% CI: 0.64, 0.93; nominal P=0.008 and HR: 0.72; 95% CI: 0.59, 0.88; nominal P<0.001, respectively).

Discussion

These real-world retrospective head-to-head analyses indicate that initiating treatment with apalutamide in patients with mCSPC had a statistically significant reduction in the risk of death at 24 months compared to enzalutamide or abiraterone acetate, respectively. These findings highlight the potential advantage of apalutamide in managing this patient population.

Oncology Nursing Forum. 2025 Mar 1;52(2):15.

I34. Long-Term Effects of Ciltacabtagene Autoleucel on Patient-Reported Outcomes and Time to Next Anti-Myeloma Therapy vs Standard of Care in the CARTITUDE-4 Trial of Patients with Lenalidomide-Refractory Multiple Myeloma

Linh Tran ¹, Anna Davis ², Erika Florendo ³, Katharine Gries ⁴, Noffar Bar ⁵

Significance & Background

Ciltacabtagene autoleucel (cilta-cel) demonstrated superior progression-free survival compared to standard of care (SOC; hazard ratio [HR], 0.26; P<0.0001) after a median follow-up (MFU) of 15.9 months in patients with lenalidomide-refractory multiple myeloma (MM) after 1 to 3 prior lines of therapy in the phase 3 CARTITUDE-4 trial. In a longer-term analysis (MFU, 33.6 months), overall survival was significantly improved with cilta-cel versus SOC. In addition to these clinical benefits, improvements in patient-reported outcomes (PROs) were also evaluated for this long-term CARTITUDE-4 analysis.

Purpose

To evaluate PROs and time to next anti-myeloma therapy (TTNT) in CARTITUDE-4 with cilta-cel versus SOC at the ~3-year MFU.

Interventions

CARTITUDE-4 patients (N=419) were randomized to receive either cilta-cel (n=208) or SOC (n=211). PRO assessments included the Multiple Myeloma Symptom and Impact Questionnaire (MySIm-Q) and European Organization for Research and Treatment of Cancer Quality of Life Questionnaire Core 30 (EORTC QLQ-C30). Additional clinically important measures included time to worsening (TTW) of symptoms and impact and TTW of global health status/quality of life (GHS/QoL). TTNT was defined as time from randomization to next anti-myeloma therapy or death due to progressive disease. MySlm-Q assessed symptom (pain, fatigue, digestion, cognition) and impact (activity limitations, social functioning, emotional impact) domains, and EORTC QLQ-C30 assessed patient health-related QoL (HRQoL) across 1 global health status scale, 5 functional scales (physical, role, emotional, cognitive, social), and 3 symptom scales (pain, fatigue, nausea/vomiting).

Results

At the MFU of 34 months, cilta-cel was associated with significantly longer TTW of symptoms and impact on MySIm-Q versus SOC (Figure). By 30 months after randomization, 77% and 83% of cilta-cel–treated patients had not experienced worsening of symptoms or functional impacts, respectively, compared to 63% and 69% of the SOC group. Improvements from baseline in MySIm-Q symptom and impact scores were greater with cilta-cel versus SOC. Similarly, cilta-cel delayed TTW on EORTC QLQ-C30 GHS/QoL versus SOC (HR, 0.40; 95% confidence interval [CI], 0.25–0.64; P<0.0001). Median (95% CI) TTNT was not reached (38.4 months-not estimable) with cilta-cel versus 13.4 months (12.0–17.1 months) with SOC.

Discussion

Long-term clinically meaningful improvements in HRQoL, together with survival outcomes, demonstrate significant benefits of cilta-cel versus SOC. These data may enhance informed decision-making and aid in educating patients on the benefits of this treatment for MM, an important component of patient-centered care.

Oncology Nursing Forum. 2025 Mar 1;52(2):16.

I35. Phase 3 Cepheus Study of Bortezomib, Lenalidomide, and Dexamethasone with or Without Daratumumab in Transplant-Ineligible or Transplant-Deferred Patients with Newly Diagnosed Multiple Myeloma (NDMM)

Saad Z Usmani ¹, Thierry Facon ², Vania Hungria ³, Nizar J Bahlis ⁴, Christopher P Venner ⁵, Sonja Zweegman ⁶

Significance & Background

In the MAIA and PERSEUS studies, addition of daratumumab to standard-of-care therapy improved outcomes for transplant-ineligible and transplant-eligible patients with NDMM.

Purpose

The phase 3 CEPHEUS study (NCT03652064) evaluated the addition of subcutaneous daratumumab to bortezomib/lenalidomide/dexamethasone (VRd) versus VRd alone in patients with NDMM who are transplant ineligible or for whom transplant was not planned as initial therapy (transplant deferred).

Interventions

Patients were ≥18 years with transplant-ineligible or transplant-deferred NDMM. All patients received eight 21-day cycles of VRd followed by 28-day cycles of Rd until progressive disease. Patients randomized to D-VRd also received subcutaneous daratumumab (1800mg QW C1–2, Q3W C3–8, Q4W C9+) until progressive disease. The primary endpoint was minimal residual disease (MRD)-negativity rate (10–5 threshold) with complete response or better (≥CR).

Results

395 patients were randomized to D-VRd (n=197) or VRd (n=198). Median age was 70 years; 28.1% had ISS stage III disease; 13.2% had high-risk cytogenetics (del[17p], t[4;14], and/or t[14;16]). At a median follow-up of 58.7 months, MRD-negativity rate was significantly improved with D-VRd versus VRd at the 10-5 threshold (60.9% vs 39.4%; OR, 2.37 [95%CI, 1.58–3.55]; P<0.0001) and 10-6 threshold (46.2% vs 27.3%; OR, 2.24 [95%CI, 1.48–3.40]; P=0.0001), with a benefit across most prespecified subgroups. Rate of sustained MRD negativity (10-5) lasting ≥12 months was 49.2% for D-VRd versus 27.3% for VRd (P<0.0001). ≥CR rate was 81.2% with D-VRd versus 61.6% with VRd (P<0.0001). Progression-free survival (PFS) was significantly improved with D-VRd versus VRd (54-month rates: 68.1% vs 49.5%; HR, 0.57 [95%CI, 0.41–0.79]; P=0.0005), and the PFS benefit was generally consistent across prespecified subgroups. Overall survival also trended in favor of D-VRd (HR, 0.85 [95%CI, 0.58–1.24]); in a sensitivity analysis censoring COVID-19 deaths, the HR was 0.69 (95%CI, 0.45–1.05). Treatment-emergent adverse events (TEAEs) were consistent with known safety profiles for daratumumab and VRd. When adjusted for treatment exposure (median: D-VRd, 56.3 months; VRd, 34.3 months), grade 5 TEAE rates were comparable for D-VRd and VRd (0.39 vs 0.31 per 100 patient-months). Health-related quality of life (measured by EQ-5D-5L visual analog scale) improved comparably over time in both treatment groups.

Discussion

In transplant-ineligible or transplant-deferred patients with NDMM, D-VRd demonstrated a consistent benefit versus VRd. These data support the use of daratumumab quadruplet therapy in transplant-ineligible and transplant-deferred patients if the use of bortezomib is deemed appropriate.

Oncology Nursing Forum. 2025 Mar 1;52(2):16–17.

I36. Nursing Implications on the Impact of Treatment Suspension on Health-Related Quality of Life From Embark

Monique Williams ¹, Stephen J Freedland ², Stephen J Freedland ³, Ugo De Giorgi ⁴, Antti Rannikko ⁵, Fred Saad ⁶, Neal Shore ⁷

Significance & Background

Enzalutamide with and without leuprolide is approved for the treatment of patients with high-risk biochemically recurrent (hrBCR) prostate cancer based on the results of the EMBARK study (NCT02319837). EMBARK demonstrated that enzalutamide plus leuprolide (combination) and enzalutamide monotherapy improved metastasis-free survival compared with leuprolide alone while maintaining global health-related quality of life (HRQoL) in patients with hrBCR. Nurses play an important role guiding patients throughout their treatment and prostate cancer journey.

Purpose

To discuss the nursing implications of previously reported patient-reported outcome (PRO) data during treatment suspension of enzalutamide with and without leuprolide in patients with hrBCR.

Interventions

EMBARK is a randomized, phase 3 study of patients with hrBCR defined as prostate-specific antigen (PSA) doubling time ≤9 months and PSA ≥2 ng/mL above nadir post-radiotherapy or ≥1 ng/mL after radical prostatectomy ± postoperative radiotherapy. Treatment was suspended at week 37 if PSA was <0.2 ng/mL and reinitiated if PSA reached protocol-defined levels. Longitudinal changes in HRQoL from week 37 through subsequent assessments while on suspension until week 109 were assessed via mixed model repeated measures using separate models for each instrument among patients who suspended treatment. After week 109, data variability increased due to decreasing patient numbers.

Results

The results showed that treatment was suspended in 90.4% (321/355) of patients treated with enzalutamide combination, 85.6% (304/355) treated with enzalutamide monotherapy, and 67.0% (240/358) treated with leuprolide alone. After treatment suspension, hormonal treatment-related symptoms gradually improved in all treatment arms. No clinically meaningful mean changes were observed in the other PRO domains analyzed, reflecting minimal impact of treatment on global HRQoL.

Discussion

This post hoc analysis, along with the EMBARK clinical and PRO data, show that enzalutamide combination and monotherapy improve MFS compared with leuprolide alone, without affecting global HRQoL during treatment or after treatment suspension. Nurses oversee many aspects of patient care, often including evaluation of symptoms, adverse events, and lab results (including PSA levels) for signs of progressive disease, and are fundamental in educating patients throughout their prostate cancer journey. Nurses may help identify patients for whom treatment suspension may be appropriate based on PSA levels and help manage their HRQoL during treatment suspension emphasizing a whole-patient care plan that considers psychosocial well-being, exercise, diet, sleep hygiene, and non-pharmaceutical resources for pain and stress.

Oncology Nursing Forum. 2025 Mar 1;52(2):17.

I37. Effectiveness of an Educational Intervention for the Prevention and Reduction of Phlebitis in Patients Oncology

Adriana Zancheta Sousa Costa ¹, Renato Pinheiro Fernandes ², Denise Raquel Lima ³, Lara Arcipreti Boel Souza ⁴

Significance & Background

Intravenous administration of medications, fluids and blood products is one of the most common procedures in hospitals. The patient’s responsibility is to be aware of the catheter, its limitations, and to report symptoms that may indicate its malfunction. The use of peripheral venous catheter has been associated with complications, the most notable being phlebitis.To reduce the incidence of grade II or higher phlebitis by up to 0.35 in patients hospitalized in the oncology unit in 6 months.

Purpose

The study used the PDSA (Plan-Do-Study-Act) cycle to implement an educational intervention to reduce the incidence of phlebitis.

Interventions

Identification of the problem and planning of the intervention. In this case, root cause analysis was performed using the Cause and Effect Diagram and audits. Evaluation of the results of the actions implemented, through the phlebitis incidence indicator, continuous adjustments and improvements based on the results obtained, interventions and implementation of the planned actions. Educational workshops were held with the healthcare team to address the identified causes and discuss phlebitis prevention strategies. During the care provided by nursing, patients were presented with a folder educating them about the degrees of phlebitis, so that could in fact, be a barrier to phlebitis prevention.

Results

The indicator demonstrated a significant reduction of 0.68 in the average incidence of phlebitis in the sector after the implementation of the educational intervention. This decrease reflects the effectiveness of the measures adopted, such as root cause analysis and educational workshops, and the main intervention, which was the educational folder for the patient. In addition, it is important to highlight that, in the 6 months following the intervention, the incidence of phlebitis remained consistently below the target established by the institution. Notably, in four of these months, there were no cases of phlebitis in the sector, demonstrating the sustainability of the improvements achieved and the positive impact of patients.

Discussion

The creation of the educational brochure about a major change in the educational process for the nursing team and the cancer patient. The nursing team provided feedback on barriers. These obstacles were removed and analyzed. The quality improvement principles were successfully adopted, reducing the number of phlebitis greater than or equal to grade II.

Oncology Nursing Forum. 2025 Mar 1;52(2):18.

RS56. Do Race and Ethnicity Impact the Prevalence and Quality of Clinical Trials Discussions Between Patients with Advanced Cancer and their Oncologists?

Maram Alhemairy ¹, Maram Alhemairy ², Siobhan Aaron ³

Purpose

To assess prevalence of discussions on clinical trials between oncologists and patients with advanced cancer and evaluate whether there are variations in communication quality based on the patient’s race and/or ethnicity.

Significance

Despite advancements in cancer treatment improving survival rates, racial and ethnic minorities continue to experience poorer outcomes due to delayed diagnoses and lower survival durations. Clinical trials could enhance treatment results, yet participation rates are disproportionately low—3–6% for Black Americans compared to 70–90% for Non-Hispanic Whites. Barriers include medical skepticism, lack of information, clinician bias, and limited access to resources. Effective clinician-patient communication is crucial for fostering trust and improving trial participation equity.

Methods

An analysis of secondary data from audio-recorded oncology post scans encounters, obtained from a longitudinal observational study conducted in New York City at the Mount Sinai Health System and the Duke Cancer Institute. The study involves 180 patients with advanced solid tumors along with their oncologists. A codebook will be developed with contributions from community partners to evaluate communication themes including trial eligibility, benefits of participation, and patient involvement. This codebook will assist in quantifying discussions about clinical trials. The audio recordings will be analyzed to assess the frequency and quality of clinical trial discussions, employing statistical models (such as linear mixed-effects models) to uncover differences among various racial and ethnic groups. Expected

Findings and Interpretations

This study will offer insights into the prevalence and quality of clinical trials discussions between clinician and patient. The results will investigate if variations occur among racial and ethnic groups in the discussion of clinical trials, the length and depth of these exchanges, and the level of patient involvement.

Discussion

Disparities related to race and ethnicity in participation in clinical trials continue to pose a major obstacle to achieving equitable cancer outcomes. Efficient communication between clinicians and patients is crucial for tackling these disparities, as it enhances trust, health literacy, and engagement levels. This research highlights the significance of approaches centered on community-informed resources and methods to reduce bias in clinical trial conversations. Enhancing communication quality and inclusivity can potentially improve minority representation in clinical trials and ultimately lessen disparities in cancer outcomes.

Oncology Nursing Forum. 2025 Mar 1;52(2):18–19.

RS57. Everyday Cognitive and Psychosocial Contributors to Sexual Satisfaction among Women Living with Metastatic Breast Cancer: An Ecological Momentary Assessment Study

Natalie Allen ¹, Ashley Henneghan ², Oscar Franco-Rocha ³

Purpose

The purpose of this study was to 1) examine differences in clinical, demographic, cognitive, and psychosocial factors among metastatic breast cancer survivors (MBCS) with lower levels of sexual satisfaction compared to higher, and 2) identify which cognitive and psychosocial factors predict sexual satisfaction.

Significance

Undergoing MBC treatment can alter one’s body, brain, and relationships, which may reduce sexual satisfaction. Little is known about what symptom-related factors contribute to sexual satisfaction in MBCS.

Methods

Secondary data analysis from a 28-day ecological momentary assessment (EMA) protocol to assess cognitive and psychosocial symptoms (once/day) among MBCS. Baseline data included self-reported clinical history (time since diagnosis; MBC type), sociodemographic factors (age, education, partner status), and sexual satisfaction (“I am satisfied with my sex life” item from the FACT-G). Sexual satisfaction was reassessed at follow-up. Participants were grouped into two groups based on levels of sexual satisfaction: “No satisfaction” (those who reported being “Not at all” satisfied) and “Some satisfaction” (those who reported being “A little bit,” “Somewhat,” “Quite a bit,” or “Very much” satisfied). Person-specific means were calculated across the 28-day EMA protocol for cognitive and psychosocial symptoms. Wilcoxon rank-sum tests or Chi-square tests were used to evaluate clinical, sociodemographic, cognitive, and psychosocial differences between groups. Factors that significantly differed between groups (p < 0.1) were included in a multivariable linear regression model to predict sexual satisfaction levels.

Findings and Interpretations

42 participants were included in the analysis (n= 21 per group). Clinical, demographic, and psychosocial characteristics of the participants are summarized in Table 1. Significant group differences were observed for years since diagnosis, sleep quality, cognitive impairment, engagement in daily activities, social satisfaction, and overall well-being. The final linear regression was statistically significant and explained 29.1% of the variance (F= 2.955, p= 0.02). Only cognitive impairment emerged as a significant predictor of sexual satisfaction (B = 0.348, t = 2.648, p = 0.01, See Figure 1).

Discussion

Half the sample (50%) experienced low sexual satisfaction. Surprisingly, those in the sample with higher CRCI scores reported greater levels of satisfaction. It is possible that those who were functioning at a higher level in their everyday lives also had greater sexual functioning/satisfaction, faced more cognitive challenges, and experienced more symptoms, but further research is needed. The data highlights the importance of assessing sexual satisfaction in MBCS.

Oncology Nursing Forum. 2025 Mar 1;52(2):19.

RS58. Survey of Oncology Nurses Attitudes and Perceptions of Nursing Research in the Post- Pandemic Era

Liz Arthur ¹, Peggy Campbell ², Laura Flora ³, Diana McMahon ⁴, Colleen O’Leary ⁵

Purpose

To assess nurses’ attitudes and perceptions regarding nursing research within a large NCI-CCC accredited hospital and compare them to our previous pre- COVID-19 pandemic study.

Significance

Oncology nursing research is imperative to generate evidence that improves care delivery and patient outcomes. Despite the significant clinical presence of nurses at our large academic institution, nurses’ participation in research is limited. Barriers to research participation include lack of time, knowledge, and support. Since the pandemic, nurses report additional challenges engaging in professional activities beyond direct patient care responsibilities.

Methods

We replicated a cross-sectional study of nurses’ attitudes from 2018 at our institution. All registered nurses in any role at our organization were invited to complete an electronic survey with standardized scales of 1) attitudes toward research, 2) perceptions of our institution’s research environment, and 3) personal experiences with research. Higher scores are more positive. Data analysis included descriptive statistics and t-tests comparing 2018 and 2024 survey results.

Findings and Interpretations

Mean age of participants (n=146) was 43.5 years old with over 17 years nursing experience on average. Most were White, female, employed full time, and worked day shift. Scale scores for attitudes about nursing research were generally positive and unchanged from 2018 [mean 3.8, standard deviation (SD) 0.5, range 1–5]. Perceptions of institutional support (range 1–4) decreased slightly across years for present state (2018 mean 2.5, SD 0.6; 2024 mean 2.3, SD 0.6; p<.01) and remained the same for future as it should be (mean 3.3, SD 0.7). Nurses’ involvement in research was generally unchanged for participation in the past (18% in 2018, 22% in 2024) and current participation (8% in 2018, 9% in 2024). However, planned research participation in the future increased from 14% in 2018 to 30% in 2024 (p<.01).

Discussion

Oncology nurses maintain a positive attitude towards research post-pandemic but suggest institutional support could be improved. Despite the challenges COVID-19 posed to professional nursing, twice the number of nurses in 2024 plan to be involved in research in the future compared to pre-pandemic rates. Oncology clinical and research leaders play a pivotal role in fostering nurses’ engagement in research by developing targeted strategies. Enhancing nurses’ involvement in research not only contributes to their professional growth and job satisfaction but also drives better clinical outcomes, ultimately improving the quality of care for oncology patients.

Oncology Nursing Forum. 2025 Mar 1;52(2):19–20.

RS59. The Use of Phytotherapy (Herbal Treatment) During Treatment among Patients Diagnosed with Cancer: A Sample of Turkiye

Aleyna Ozkan ¹, Canan Porucu ², Gulcan Bagcivan ³

Purpose

This study aims to determine the thoughts and practices of patients receiving cancer treatment regarding phytotherapy during treatment.

Significance

Patients diagnosed with cancer may consider using herbal products for purposes such as healing the tumor and managing the symptoms of the disease and treatment, but herbal products should be used with caution, significantly, as they may change the effectiveness of some drugs and cause side effects.

Methods

This descriptive study was conducted in two university hospitals in Türkiye between January 2022 and September 2023. The study population consisted of cancer patients who were receiving treatment. Patients who were 18 years or older, who knew their diagnosis, and who were receiving cancer-related treatment were included in this study. A total sample of 149 patients participated. Data were collected face to face using a Patient Information Form and a Herbal Product Form created by the authors. The SPSS 28.0 package program was used for data analyses. In statistical analysis, the level of significance was accepted as 0.05 (p-value).

Findings and Interpretations

The average age of participants was 55.64, and 53.7% were male; 44.3% had a university education or above. 12.1% of the participants stated that they use phytotherapy. Only 17.4% of the participants were evaluated by the oncology nurse or doctor regarding phytotherapy. 55.6% of those using phytotherapy consume the drug form, and 60% aim to increase immunity. Only 64.7% of them consulted a specialist before using herbal products. The most consulted specialist was the oncologist. Phytotherapy use did not vary by patients’ sociodemographic and medical characteristics.

Discussion

In this study examining the use of phytotherapy in people diagnosed with cancer, it was found that the use of phytotherapy was low and that the patients who used it mostly used it to increase immunity. In addition, it was found that the use of phytotherapy was not significantly different according to the patient’s sociodemographic and medical clinical characteristics. Healthcare professionals should provide patients with evidence-based information about phytotherapy, and unconscious product use should be prevented. Oncology nurses should evaluate their patients regarding phytotherapy product use and inform them as necessary.

Oncology Nursing Forum. 2025 Mar 1;52(2):20.

RS60. Improve Timeliness to Care within Radiation Oncology Department by Utilizing Nurse Navigator Role for Coordination of Care in Breast Cancer Patients

Doris Bailey ¹, Kari Gill ²

Purpose

Improve utilization of nurse navigator to decrease radiation treatment delays related to availability of patient data impacting timeliness to care.

Significance

Navigation collaborates with multiple service lines and providers to remove barriers to care and connect patients with various care providers1 . Navigation has the ability to ensure cancer patients receive treatment in a timely manner and decrease overall mortality2.

Methods

A pre- and post-design with convenience sampling was used to evaluate navigator collaboration and availability within radiation oncology department. Timeliness data was collected one month pre- and post-staff education and at introduction of patient facing navigation consults in radiation oncology department.

Findings and Interpretations

Navigator collaborated with molecular diagnostic company to obtain access to Provider Portal to detect and resolve delays in breast cancer molecular testing results. Timeliness of genomic testing results improved by 4.90 days (6.75 days vs. to 2.15 days) with utilization of nurse navigator. Four (4) month electronic medical record review pre- and post- nurse navigator utilization revealed improved timeliness in radiation treatment by 8.73 days (32.44 days vs. 24.71 days). A positive correlation was also seen in earlier surgical treatment intervention of 8.49 days (51.81 days vs. 43.32 days) with nurse navigator utilization.

Discussion

Early navigation involvement demonstrated improved timeliness to care by resolving delays in Oncotype Dx® test results and earlier radiation intervention. Additional studies are needed to explore navigation impact on cancer care in surgical and medical oncology settings. This research was supported (in whole or in part) by HCA Healthcare and/or an HCA Healthcare affiliated entity. The views expressed in this publication represent those of the author(s) and do not necessarily represent the official views of HCA Healthcare or any of its affiliated entities.”

Oncology Nursing Forum. 2025 Mar 1;52(2):20–21.

RS61. Preliminary Exploration Between Responsiveness and Fear of Prostate Cancer Recurrence in Couples

Donald Bailey Jr ¹, Cary Robertson ², Christian Noval ³, Anushka Palipana ⁴, Isaac Lipkus ⁵

Purpose

Determine how relationship responsiveness, that is, how individuals in relationships understand, validate and meet each other’s needs, relates to coping with stress, relationship closeness, and fear of cancer recurrence (FCR) for men with localized prostate cancer (PC) and their partner prior to and three months after treatment.

Significance

Among men treated for PC and their partners, FCR is common and negatively affects quality of life. Despite PC being a “we” disease, there is limited research examining interpersonal processes that influence FCR. Relationship responsiveness, a key process in interpersonal relationships, has not be examined in this context and could inform future interventions.

Methods

We recruited 55 early-stage PC survivors and their partners prior to treatment. Couples completed a four-item measure of responsiveness, a Venn diagram assessing dyadic closeness, the Dyadic Coping Inventory consists of three items capturing dyadic coping with stress, and a two-item measure evaluating dyadic coping. FCR was assessed using the four-item FCR4. Similar questions were repeated at three-month follow-up. As this was a pilot, a p<.15 was deemed statistically significant and reported.

Findings and Interpretations

Thirty-six (64%) couples completed baseline and follow-up. 20 patients underwent HIFU, 10 and 6 had open and robotic prostatectomy, respectively. FCR decreased across time for both survivors (M=8.7, SD=3.0 vs. M=7.2, SD=3.3) and partners (M=10.0, SD=4.4 vs. M=7.9, SD=3.6), with no significant correlation between survivors and partners. Among survivors, baseline responsiveness (M=6.4, SD=.85) correlated with greater partner FCR (rs=.41, p<.02); among partners, baseline responsiveness (M=5.8, SD=1.2) correlated with greater survivors’ FCR (rs=.38, p<.03). Baseline correlates of survivors’ responsiveness included feeling close to the partner (rs=.40, p<.02), more ways of coping with stress (rs=.39, p<.03) and satisfaction with dyadic coping with stress (rs=.55, p<.001); it was also correlated positively with partners’ use of more ways of coping with stress (rs=.28, p<.10). Baseline correlates of partners’ responsiveness were feeling close to the partner (rs=.59, p<.001), own reports of more ways of coping with stress (rs=.68, p<.001) and feeling satisfied with dyadic coping with stress (rs=.76, p<.001); partner responsiveness was related to survivors’ feeling close to their partner (rs=.36, p<.04) and more ways of coping with stress (rs=.48, p<.01). Partners who felt closer to survivors had greater FCR (rs=.34, p<.05).

Discussion

Preliminary findings indicate that responsiveness is an important construct warranting further investigation in the context of couple-based FCR.

Oncology Nursing Forum. 2025 Mar 1;52(2):21–22.

RS62. Feasibility and Preliminary Impact of a Personalized, Needs Navigation Intervention for Adolescents and young Adults with Cancer

Melissa Beauchemin ¹, Rhea Khurana ², Stephen Crespo ³, Sabrina Alvarado ⁴, Janet Patton ⁵, Dawn Hershman ⁶

Purpose

We evaluated the feasibility and preliminary impact of a patient-informed, needs navigation intervention among adolescents and young adults (AYAs) with self-reported financial toxicity (FT) or unmet health-related social needs (HRSN).

Significance

AYA cancer survivors are at high risk for FT, which is associated with poorer health outcomes. Financial toxicity may disproportionately affect AYAs with unmet HRSN (e.g., food, housing, transportation). Needs navigation may be an effective intervention to reduce FT and improve health outcomes. In a pilot study of AYA-NAV, a patient-informed, digital and community partnered, personalized needs navigation intervention, we report the feasibility and preliminary impact of AYA-NAV on FT and resilience scores.

Methods

Eligible AYAs were 18–39 years old, Spanish- or English-speaking, receiving initial treatment for cancer, and screened positive for FT (Comprehensive Score of Financial Toxicity [COST] < 22) or unmet HRSN (food, housing, transportation, utilities). Resilience was measured at baseline (CD-RISC). Participants received a money voucher ($100) at study entry and were referred to Patient Advocate Foundation (PAF) for individualized case management support. At month 1, participants were guided through findhelp.org, a digital platform of resources to facilitate resolution of unmet HRSN. Participants completed study measures again at 6-months, including COST, HRSN, CD-RISC, and satisfaction scales (scored 1–5). We calculated the mean change in COST and CD-RISC scores from baseline to 6-months.

Findings and Interpretations

Of 30 AYAs that completed screening, 24 met criteria for FT or unmet HRSN and 23 (96%) agreed to participate in the intervention; one participant withdrew due to feeling overwhelmed. The mean age of participants was 32.5y; 26% preferred Spanish, 52% identified as Hispanic, and 74% were female. For this interim analysis, 10 (43%) AYAs met the 6-month endpoint. AYAs reported high acceptability and appropriateness of the intervention (mean score 4.2, SD 0.67). Of these 10 AYAs, COST scores increased 4.7 points (95%CI: −2.1–11.5; p=0.15) and CD-RISC scores increased 0.35 points (95%CI: 0.09–0.62, p=0.01); increasing scores for each indicate improvement. The proportion of AYAs who met criteria for high FT at 6-months was 70%, compared with 100% at baseline.

Discussion

Preliminary data indicate the feasibility of delivering AYA-NAV to an ethnically diverse group of AYAs. Further, data suggest it is effective at improving FT scores; further studies should explore the role of resilience in mediating the effectiveness of navigation interventions.

Oncology Nursing Forum. 2025 Mar 1;52(2):22.

RS63. The Impact of Daily Self-Reiki Practice on Resilience among Oncology Nurses: A Mixed Methods Study

Lynne Bentley ¹, Wendy Haylett ², Sandy Priester ³

Purpose

This study examined whether Reiki training can enhance resilience in oncology nurses. It aimed to establish a daily self-Reiki practice to bolster long-term resilience, equipping nurses with an easy-to-use self-healing technique while offering oncology departments a low-cost way to support their nurses.

Significance

Addressing burnout among oncology nurses is critical, as many are leaving the profession. Implementing a self-care practice like Reiki could enhance nurse well-being and resilience, while also potentially improving patient care. Reiki is documented in published studies for its ability to reduce stress and anxiety while enhancing overall well-being. It is commonly employed as a self-care technique to promote relaxation and improve quality of life. Despite its widespread use, there is a notable lack of research on its application for personal use, particularly among oncology nurses.

Methods

This IRB-approved mixed methods study used a semi-crossover and repeated measures design. Fifteen oncology nurses who worked at a regional cancer center were randomly divided into Cohort 1 (n=6) and Cohort 2 (n=9). Cohort 1 received Reiki training, while Cohort 2 served as the real-time control. Cohort 2 began training once Cohort 1 was complete. Each cohort was trained over four months in First and Second Degree Reiki. Training included weekly online content, in-person attunements and practice sessions, and an expectation of 20-minute daily self-Reiki practice. Resilience was measured using the 100-point Connor-Davidson Resilience Scale and qualitative questions, with surveys conducted before, immediately after, and at three- and six-months post-training.

Findings and Interpretations

Notable improvements in resilience were reported between cohorts. Combined scores of both cohorts showed that resilience increased by an average 16.3% immediately post-training, 12.15% at three months, and 8.5% at six months. Participation in the surveys dropped to 9 nurses by six months, and based on comments, possibly affected the declining resilience scores over time. Qualitative findings revealed greater feelings of reflection and calm, though participants identified a need for more external structure to support their practice.

Discussion

Reiki training appears to positively affect oncology nurses’ resilience. However, long-term habits may be difficult to establish. Department support such as a wellness room and protected time may enhance this initiative. Recommendations for future research include employing an adequately powered sample size, incentives for survey completion, detailed questions about self-practice, and expecting a shorter commitment (ten minutes) for daily self-practice.

Oncology Nursing Forum. 2025 Mar 1;52(2):22–23.

RS64. Polycystic Ovary Syndrome (PCOS) Symptoms and Family Cancer History in Hispanic Adolescents Living in Texas

Rosaleen Bloom ¹, Rosalie Castaneda ², Joelle Sfeir ³, Christin Yoro ⁴, Erlinda Pena ⁵, Heidi Vanden Brink ⁶

Purpose

To explore the relationship between polycystic ovary syndrome (PCOS) symptoms and cancer family history in Hispanic adolescents.

Significance

PCOS is a prevalent, heterogeneous condition characterized by hyperandrogenemia and ovulatory dysfunction in women across the reproductive lifespan. Whereas living with PCOS is associated with uterine cancers, the generational relationship between cancer and PCOS remains undefined. Both PCOS and cancer share common pathogenic features and risk factors, such as chronic inflammation and metabolic dysfunction, which makes understanding the risks and relationships between these two diseases more complex.

Methods

Post-menarcheal Hispanic adolescents in south Texas were recruited into a cross-sectional study. Dried blood spots measuring reproductive hormones, fasting insulin, and HbA1c, reproductive and medical history, and basic anthropometry were collected from participants. PCOS was defined as the presence of irregular menstrual cycles and either clinical androgen excess or biochemical hyperandrogenism. Cancer family history obtained by parent/legal guardian and participant report was categorized by the degree relative (1st, 2nd, or 3rd). Differences in family cancer history with and without PCOS were evaluated qualitatively and via Fisher’s Exact tests.

Findings and Interpretations

We conducted a preliminary analysis of 52 Hispanic adolescents (10–18 years; M = 15 years), most (n=41; 79%) were of Mexican Origin. Seventeen percent of participants met both diagnostic criteria for PCOS; 52% presented with one diagnostic criteria for PCOS (30% menstrual irregularity; 21% isolated androgen excess) and 32% did not exhibit any criteria for PCOS. Any family cancer history was reported in 51.9% (n= 27), with 77.8% of those cancer diagnoses belonging to one or more second degree relative(s). When exploring cancer history and PCOS, participants with diagnostic features of PCOS (37.5%) and those with one diagnostic feature (41.7%) were more likely to have a second degree relative with a cancer diagnosis than those without any features of PCOS (33.3%, p=0.752). Breast cancer was the most common diagnosis, followed by cervical, colon, uterine and other cancers. However, this was not significant potentially due to the small sample size.

Discussion

Family history of cancer may be more prevalent in adolescents with symptoms of PCOS. Second-degree relatives with cancer were more common in this community population of Hispanic adolescents. Further research is needed in a larger sample to understand any shared generational risks between cancer and risk of PCOS and whether additional or earlier cancer screening is needed.

Oncology Nursing Forum. 2025 Mar 1;52(2):23–24.

RS65. Communication Skills Training for Interdisciplinary Adult Oncology Clinicians: Description and Outcomes of an NCI-Funded Train-The-Trainer Program

Haley Buller ¹, Betty Ferrell ², Judith Paice ³, Myra Glajchen ⁴, Trace Haythorn ⁵

Purpose

The purpose of this abstract is to describe the outcomes from an Interprofessional Communication Curriculum (ICC) project funded through an NCI R25 grant and its five national train-the-trainer courses for interdisciplinary adult oncology clinicians (N=388).

Significance

Communication is vital to providing exceptional cancer care. Communication skills training for the entire interdisciplinary team is identified as a necessity to improving cancer patients’ quality of life across the continuum of care. However, clinicians continue to report a lack of confidence in having difficult conversations and limited formal communication training programs exist that address communication skills throughout the cancer trajectory.

Methods

Organized by the 8 domains of the National Consensus Project (NCP) Guidelines for Quality Palliative Care, ICC was developed to provide communication skills training for interdisciplinary dyads of oncology clinicians with a focus on providing communication training to others. Five 3-day train-the-trainer ICC courses have been held since 2021. Courses included lectures, skills-building exercises, vignettes, and role play demonstrations, and interactive small-group discussions. Participants completed a pre-course survey identifying their effectiveness in communication across the 8 NCP domains (e.g., communication around physical, social, cultural, and psychological aspects of care). Evaluation of the courses included immediate post-course evaluation. Post-course surveys at 12-months tracked training efforts and evaluated participants’ communication effectiveness after course participation.

Findings and Interpretations

Three-hundred eighty-eight participants (192 nurses, 134 social workers, 56 chaplains and 6 others) representing 38 states & DC (69.8% White, 12.6% Black or African American, 8.5% Asian, 2.4% Native Hawaiian and 6.7% more than one race) attended an ICC course. Pre-course survey results, on a scale of 1 to 5 (1=lowest), revealed spiritual aspects of care (3.1) as participants’ least effective area of communication across the NCP Domains. Immediate post-course evaluation revealed the course met participant’s expectations (4.9). 12-month post-course survey results for cohorts 1–4 revealed participants effectiveness in communication for spiritual aspects of care increased (3.9) from pre-course. Results also showed participants have provided ICC training to 8,643 clinicians (5,203 nurses, 1,180 social workers, 526 chaplains, 894 physicians, and 840 others).

Discussion

ICC is an effective train-the-trainer program for improving communication skills in cancer settings. Results have demonstrated an increase in self-reported communication effectiveness. The 12-month follow-up evaluation for cohort 5 scheduled for August 2025.

Oncology Nursing Forum. 2025 Mar 1;52(2):24.

RS66. Understanding How Black Patients with Leukemia Navigate Cance Care

Nicole Caviness-Ashe ¹, Rita Masese ², Thomas LeBlanc ³, Nancy Crego ⁴, Angelo Moore ⁵, Ashley Leak Bryant ⁶

Purpose

To understand how Black patients with acute myeloid leukemia (AML) navigate cancer care systems.

Significance

AML is a rare blood cancer that reveals racial and economic disparities that impact quality of life and survivorship. Racial and ethnic minorities represent a disproportionate number of the low socioeconomic population in AML and are highly susceptible to financial distress, lower social economic status and experience higher cancer burden compared to White patients. Managing rigorous treatments and symptoms of disease is especially burdensome for Black patients and may result in desperate care. The cancer care system provides patients with preventative, treatment and survivorship cancer services within the larger healthcare system; however, little is known about the role of cancer care and how contributes to or mitigates disparities. This study addresses this gap by exploring barriers and facilitators to navigating cancer care among adult Black patients with AML.

Methods

This study used a qualitative descriptive design. Purposive and convenience sampling using multiple strategies was used to initiate recruitment during the 2020 global pandemic of COVID-19. The study included semi-structured interviews with 16 adult Black patients diagnosed with AML. Interviews were conducted in-person and via telephone.

Findings and Interpretations

Themes that emerged from the qualitative interviews included 1) the importance of social support 2) the privilege of good health care 3) representation matters 4) experiencing COVID-19 before COVID-19 and 5) the disadvantage of being Black with AML. Most reported that having social support (i.e.., spiritual, familial, etc.), access to knowledgeable clinicians who were attentive and willing to listen, and positive encounters with patients and clinicians who looked like them were facilitators to how well patients could navigate cancer care. They shared how poor communication with clinicians, not being heard in clinical settings, not having insurance were barriers to care. Additionally, they described how being Black with AML was a double-edged sword.

Discussion

This study provides evidence to support the need for clinical studies aimed at developing culturally tailored interventions to improve communication between Black patients and clinicians. Additionally, studies are needed to develop a blood cancer diagnosis pathway, which may provide a standardized way to escalate care for patients who present with signs and symptoms of blood cancers in primary and emergency care settings. These interventions mechanism may mitigate patients’ more negative encounters of feelings unheard, not believed and dismissed.

Oncology Nursing Forum. 2025 Mar 1;52(2):24–25.

RS67. Gut Microbiome and Symptom Burden in Obese and Non-Obese Women Receiving Chemotherapy for Breast Cancer

Catherine Cherwin ¹, Jemmie Hoang ², Emily Roberts ³, Ashutosh Mangalam ⁴

Purpose

The purpose of this work is to report symptom burden and GI microbiome composition between obese and non-obese women with breast cancer to identify potential microbial influences for symptom severity.

Significance

Obese women with breast cancer experience high symptom burden, poor quality of life, and increased mortality compared to non-obese women with breast cancer. Obesity-related changes to the bacteria of the gut, the GI microbiome, may be one such mechanism for these differences in outcomes.

Methods

59 women with breast cancer (26 obese, 33 non-obese) provided symptom reports using the Memorial Symptom Assessment Scale and stool samples for 16S analysis one week after receiving chemotherapy. Symptom reports were summarized and examined for differences based on obesity. Fecal microbiome analysis was compared between groups using alpha-diversity (Shannon index), beta-diversity (Principal Coordinate Analysis with weighted UniFrac distances), and LASSO analysis of abundance of bacterial species.

Findings and Interpretations

While symptom burden was high, it did not differ based on obesity status. Alpha- and beta-diversity did not find significant differences based on obesity, but LASSO analysis identified eight bacteria to be significantly enriched in obese participants: Collinsella aerofacien, Prevotella 7, Coprobacillus cateniformis, Ruminococcus torques group, Agathobacter, Frisingicoccus, Roseburia inulinivorans, and Monoglobus pectinilyticus.

Discussion

Identifying biologic mechanisms driving symptoms is necessary for the development of therapies to reduce cancer-related symptom burden. While obesity may alter the GI microbiome and influence symptom burden in women with breast cancer, these effects may be outweighed by the effects of chemotherapy on the gut.

Oncology Nursing Forum. 2025 Mar 1;52(2):25.

RS68. Associations of Genetic and Epigenetic Variation of BDNF with Cognitive Function and the Role of Aerobic Exercise in Postmenopausal Women with Breast Cancer

Myeong-ga Cho ¹, Susan Sereika ², Meredith Cummings ³, Kirk Erickson ⁴, Catherine Bender ⁵, Yvette Conley ⁶

Purpose

We aimed to investigate the associations of genetic and epigenetic variation of the BDNF gene with cognitive changes over 6 months and the role of aerobic exercise in women with breast cancer.

Significance

Women with breast cancer often experience cognitive decline. Aerobic exercise may improve cognitive function and the cognitive-protective effects of BDNF at the protein level is well-known but varies by rs6265 allele. However, the cognitive-benefits of aerobic exercise are inconsistent, and little is known about BDNF’s DNA methylation-regulation level and its associations with cognitive function.

Methods

This study was a secondary analysis of the EPICC randomized controlled trial dataset, a study which examined whether, compared to usual-care, a 6-month aerobic-exercise intervention improves cognitive function in postmenopausal women with early-stage breast cancer receiving endocrine therapy. We included participants with DNA methylation data collected from peripheral blood at either pre-randomization or post-intervention. Data included 1) M-values of individual CpG sites (higher positive M-values=greater DNA methylation), 2) genotype at rs6265 (CC/CT/TT), and 3) cognitive composite scores in seven domains (higher scores=better cognitive function). We used a generalized linear mixed-effect modeling and adjusted for group assignment, age, education, and body mass index.

Findings and Interpretations

Women (N=117) were on average 62.6 years old (SD=7.84) with 92.3 days (SD=187.90) on endocrine therapy at pre-randomization. The majority were white (89.7%), with stage I disease (61.5%), and did not receive chemotherapy (83.8%). At cg20340655, an intervention effect on M-value was observed (F= 5.721, p= .018), with a significant decrease in the usual-care group and no changes detected in the aerobic-exercise group. Changes in M-values at specific CpG sites were linked to changes in specific cognitive function domain: cg24650785 with learning and memory (b= 0.165; 95%CI: 0.008, 0.322), cg08362738 (b= −0.201; 95%CI: −0.383, −0.019) and cg01546433 (b= −0.382; 95%CI: −0.688, −0.077) with verbal memory, cg17882499 (b= −0.233; 95%CI: −0.464, −0.001), cg15914769 (b= −0.217; 95%CI: −0.423, −0.010), cg26840770 (b= −0.269; 95%CI: −0.502, −0.036), and cg02527472 (b= −0.421; 95%CI: −0.832, −0.010) with executive function. No differences were observed in cognitive function changes or M-value changes across genotypes.

Discussion

These findings underscore the potential of CpG-specific methylation as potential biomarkers of cognitive changes and highlight the insights into the role of aerobic exercise in mitigating cognitive decline via epigenetic mechanisms. Exploring genetic-epigenetic interactions could further clarify pathways influencing cognitive function, informing precision interventions.

Oncology Nursing Forum. 2025 Mar 1;52(2):25–26.

RS69. Factors Associated with Acupuncture Expectancy among Breast Cancer Survivors

Hannah Choi ¹, Ardith Z Doorenbos ², Ardith Z Doorenbos ³, Zhengjia Chen ⁴, Judith M Schlaeger ⁵, Crystal L Patil ⁶, Hongjin Li ⁷, Hongjin Li ⁸

Purpose

This study aimed to identify factors influencing acupuncture expectancy among breast cancer survivors.

Significance

Acupuncture has shown promise in alleviating symptoms among breast cancer survivors, including pain, fatigue, and anxiety. Patient expectancy—the belief that a treatment will be effective—is an important driver of treatment effectiveness and adherence. Understanding the factors shaping expectancy and perceptions regarding acupuncture is essential for addressing its under-utilization and improving treatment outcomes and access.

Methods

This secondary analysis examined baseline data from 74 women with breast cancer who participated in two acupuncture trials involving a 5-week, 10-session intervention. Our primary outcome was acupuncture expectancy, measured using a sum score from a 4-item subscale of the validated Attitudes and Beliefs about Complementary and Alternative Medicine Questionnaire, with higher scores indicating greater expectancy. Other measures include the 11-item Social Determinants of Health (SDOH) Questionnaire, assessing 8 domains of SDOH needs (e.g., financial resource, transportation, and social connections), and the PROMIS-29 v1.0, evaluating 7 physical and emotional health domains using 4-item sum scores for each domain. Bivariate and multivariate linear regression analyses were conducted to identify significant factors influencing acupuncture expectancy.

Findings and Interpretations

Participants were on average 54 years old; 49% identified as Black, and 45% as White. Most (82%) had some college education or higher, and 65% were single. The majority (88%) were diagnosed with stage 0, I, or II breast cancer. Multivariate regression analysis identified factors positively associated with acupuncture expectancy: 1) identifying as White (compared to non-White; β=0.56, p=0.009), 2) higher education levels (some college or above: β=1.07, p<0.001; graduate school: β=0.96, p=0.002; reference: high school or below), 3) greater financial difficulty paying for basic living needs (β=0.32, p=0.004), and 4) experiencing arm pain (β=0.47, p=0.023).

Discussion

Despite financial difficulties, participants exhibited high acupuncture expectancy, reflecting a strong desire for holistic and affordable symptom management. However, out-of-pocket costs and limited insurance coverage may still hinder access to acupuncture, especially for underserved populations. Targeted research is needed to address these access issues and other socioeconomic challenges. Understanding individual factors affecting acupuncture expectancy can inform interventions to improve care for these populations, supporting healthcare providers in integrating acupuncture into oncology care to enhance symptom management and quality of life for breast cancer survivors.

Oncology Nursing Forum. 2025 Mar 1;52(2):26–27.

RS70. Non-Pharmacologic Interventions for Anxiety and Pain Reduction During Bone Marrow Biopsies in the Adult Ambulatory Oncology Setting

Melissa Cochran ¹, Megan Corbett ², Cynthia Arcieri ³, Terri Jabaley ⁴

Purpose

To assess the feasibility and effectiveness of non-pharmacologic interventions in reducing anxiety and pain during bone marrow biopsies.

Significance

Clinical experience and current literature demonstrate that patients experience anxiety and pain before, during, and after bone marrow biopsies. Despite this, standard of practice for this procedure has remained unchanged since the 1970s, often focusing on a practitioner centric approach rather than a patient centered approach. Non-pharmacologic interventions to reduce anxiety and pain are evidence-based practices. Our institution lacked specific guidelines for providing non-pharmacologic interventions to improve the patient experience during a bone marrow biopsy procedure.

Methods

Patients scheduled for a bone marrow biopsy procedure were offered items from a comfort cart including music, a meditation app, face cradles, stress balls, and weighted blankets. Patients chose as few or as many items for use during their procedure as desired. Patients completed surveys regarding anxiety, pain, usability, and effectiveness pre and post procedure. Staff completed a survey about feasibility of use.

Findings and Interpretations

Thirty-eight patients and 11 clinicians completed surveys. In patients who used comfort cart items, moderate or extreme anxiety decreased from 78% before the procedure to 1% after the procedure. All patients choosing music agreed or strongly agreed that music helped with comfort during the procedure. Eighty-eight percent of patients choosing stress balls agreed or strongly agreed that the stress ball helped with comfort during the procedure. Only 50% of patients choosing the face cradle agreed or strongly agreed that it helped with comfort. Fifty-three percent of patients reported they would use comfort cart items again in the future. No notable difference in mean pain scores pre- to post- procedure were observed.

All 11 clinicians surveyed reported the comfort cart was feasible to use and did not interfere with patient care.

Discussion

The use of non-pharmacologic interventions can be feasibly implemented to improve patients’ bone marrow biopsy experiences, most notably to improve comfort and reduce anxiety associated with the procedure. Stress balls and then music were the items selected most often. Implementation of a comfort cart with a variety of non-pharmacological options can enhance the patient experience and should be considered a valuable addition by healthcare organizations.

Oncology Nursing Forum. 2025 Mar 1;52(2):27.

RS71. Quality of Life Factors for Older Adults (≥60) With Acute Myeloid Leukemia, Myelodysplastic Syndromes, and their Care Partners: A Prospective Longitudinal Study

Victoria Crowder ¹, Danielle Steele Anderson ², Todd Schwartz ³, Lorinda A Coombs ⁴, Daniel Richardson ⁵, Ashley Leak Bryant ⁶

Purpose

To describe and explore relationships of nutrition, eating, and QOL during Cycles 1 and 2 of chemotherapy with hypomethylating agents and Venetoclax (HMA+VEN) for older adults with AML, MDS, and their care partners. Background and

Significance

For older adults (≥60) with acute myeloid leukemia (AML) and myelodysplastic syndromes (MDS), disease symptoms and treatment side effects may present challenges and impact their quality of life (QOL). Family and friend care partners can play a vital role in caring for patients and may face their own challenges. There is limited research to understand nutrition and eating over time for this population, and its role in QOL.

Methods

A quantitative, prospective longitudinal study was conducted with 12 patients and 9 care partners. Assessments were performed for QOL, nutritional status, sarcopenia, eating, and related factors every 1–2 weeks during Cycles 1 and 2 HMA+VEN treatment. QOL for patients was the primary outcome. Multiple linear regression was conducted to explore the relationships between nutritional status and sarcopenia on QOL for patients. Pearson correlation coefficients were computed to analyze the factors related to QOL. Descriptive statistics described changes for patients and care partners over time.

Findings and Interpretations

We identified three key findings: 1) Patients experienced notable challenges persisting through Cycles 1 and 2 of HMA+VEN treatment, including gastrointestinal symptoms, increased nutritional risk, significant weight loss, and the potential for impaired QOL; 2) Patients’ risk of malnutrition at baseline was suggested to be associated with QOL (r=−0.62, p=0.04); and 3) Care partners experienced challenges themselves which were suggested to be correlated with aspects of the patients’ QOL, including care partner nutritional risk (r=−0.71, p=0.03), appetite loss (r=−0.68, p=0.04), and impairments to QOL (r=−0.73, p=0.03).

Discussion and Innovation

Findings revealed that patients experience notable gastrointestinal symptoms and challenges with nutrition, including a higher risk of malnutrition and the presence of sarcopenia than in prior studies. Most patients experienced these challenges at one time during Cycles 1 and 2 of chemotherapy, demonstrating the importance of continued assessments by clinicians and nursing staff. Care partners faced significant challenges similar to patients and it was suggested to be associated with patient health and QOL. An understanding of these experiences is critical to the recognition and management and may inform the timing and content of interventions to address nutrition, eating, and QOL.

Oncology Nursing Forum. 2025 Mar 1;52(2):27–28.

RS72. Trajectories of Severe Oral Symptoms of Patients Receiving Treatment for Head and Neck Cancer and their Predictors

Meredith Cummings ¹, Susan Sereika ², Myeong-ga Cho ³, Catherine Bender ⁴, Marci Nilsen ⁵, Marci Nilsen ⁶

Purpose

The purpose of this secondary analysis was to identify the groups of patients with similar oral symptom severities during radiation using group-based trajectory modeling (GBTM) and identify predictors of severity group membership.

Significance

Patients with head and neck cancer (HNC) experience significant oral symptoms associated with treatment that can affect long-term patient outcomes and quality of life. Less is known about the experiences during treatment for HNC and specific patient- and disease-characteristics associated with individuals who experience more severe oral symptoms.

Methods

This prospective, repeated measures study recruited patients with squamous cell HNC from the UPMC HNC survivorship clinic. Participants were enrolled prior to radiation therapy initiation through 3-months post-treatment. Symptoms were measured using the MD Anderson Symptom Inventory Head and Neck Module and averaged weekly. Weeks 0–7 were included in this analysis. GBTM was used to identify groups of patients with similar taste, mucus, and dry mouth severities. We then evaluated univariate predictors of group membership at p <0.05.

Findings and Interpretations

Patients (N=221) were predominantly white (87.1%), male (72.8%), with a mean age of 61±10.6 years, and tumors primarily in the oropharynx (48.9%), oral cavity (20.8%), or larynx/hypopharynx (19.0%); 51.6% had advanced-stage (III–IV) disease. For taste severity, a three-group model emerged: low stable (31%), low increasing to severe (43.3%), and low rapidly increasing to severe (25.7%). Higher odds of severe taste group membership were associated with oropharyngeal, HPV- tumors, and higher Charlson Comorbidity Index (CCI). Similar models emerged for mucus severity (low stable: 48.4%, low increasing: 28.9%, high increasing: 22.7%) and dry mouth severity (low stable: 35.6%, low increasing: 44.1%, high increasing: 20.3%), with baseline insomnia and higher CCI associated with higher odds of membership in more severe mucus groups. No univariate predictors were identified for severe dry mouth groups.

Discussion

We demonstrated that different groups of oral symptom severity trajectories exist for patients receiving radiation for HNC. This work points to possible differences between patients who may experience more severe symptoms, which may allow for more personalized symptom management. Understanding and eventually anticipating which patients are at higher risk for more severe symptoms could improve patient outcomes and quality of life. Future work should include a multivariate approach to better understand the possible characteristics associated with membership in more severe symptom trajectories.

Oncology Nursing Forum. 2025 Mar 1;52(2):28–29.

RS74. Trajectories and Predictors of Resilience among Neuro-Oncology Caregivers

Sondos Eqylan ¹, Susan Sereika ², Elizabeth Crago ³, Paula Sherwood ⁴, Heidi Donovan ⁵

Purpose

We examined the temporal patterns (i.e., trajectories) of psychological outcomes associated with resilience (anxiety and depressive symptoms) over 10 months in neuro-oncology caregivers and identified predictors of trajectory group membership.

Significance

Resilience refers to individuals’ abilities to maintain or regain well-being following a major stressor such as providing care to a loved one with a primary malignant brain tumor. Anxiety and depressive symptoms are common psychological outcomes used to evaluate resilience. Yet, few studies have explored the temporal variability of these symptoms or the individual factors that may predict their trajectories during the first year of caregiving. Early identification of caregivers at risk for poor resilience may provide a promising avenue for designing tailored interventions to support neuro-oncology caregivers.

Methods

A secondary analysis was completed with longitudinal data from a randomized controlled trial (R01NR013170) conducted at two NCI-designated Comprehensive Cancer Centers. Neuro-oncology caregivers (n=104) were randomly assigned to the SmartCare intervention (n=66; 63.5%) or enhanced care as usual (n=38; 36.5%). Caregivers’ baseline sociodemographic characteristics, personality [neuroticism, optimism (LOT-R)], mastery (Mastery Scale), and intervention group assignment were assessed as possible predictors. Anxiety (POMS) and depressive symptoms (CES-D) were measured at five time points over 10 months. Group-based trajectory modeling was used to examine distinct anxiety and depressive symptoms trajectories and their associated individual factors.

Findings and Interpretations

Neuro-oncology caregivers (mean age 53±11.25, 67.3% female, 82.7% spouse) exhibited three distinct trajectories for anxiety and depressive symptoms (low, moderate, high). Caregivers with moderate or high anxiety and depressive symptoms trajectories were significantly (p<0.05) associated with lower baseline optimism and mastery and higher neuroticism. Additionally, caregivers lacking health insurance were more likely to display high anxiety trajectories (p<0.05). SmartCare intervention participants showed a reduced odds of following moderate or high depressive symptoms trajectories (p<0.05). Other individual factors (i.e., age, gender, race, education, marital status, employment status, and the caregiver-care recipient relationship) were not associated with trajectory group membership.

Discussion

These findings suggest that distinct subpopulations may exist within neuro-oncology caregivers based on anxiety and depressive symptoms trajectories. Additionally, caregivers’ personality, and their mastery levels may predict these resilience patterns. Preliminary insights indicate that psychoeducational interventions, like SmartCare, might be associated with changes in caregiver’s depressive symptoms, warranting further exploration. Future research should explore additional modifiable predictors of these trajectories to inform the design of tailored, resilience-focused caregiver interventions.

Oncology Nursing Forum. 2025 Mar 1;52(2):29.

RS75. Effective Use of Buprenorphine for Long Acting Pain Relief in Combination with Short Acting Full Agonist Opioids in Cancer Patients

Matthew Farren ¹

Purpose

To investigate if buprenorphine can be given safely with a full agonist opioid (FAO) for cancer related pain. Buprenorphine, a partial agonist at mu-receptor, carries the risk of precipitated opioid withdrawal when used in combination with FAOs. The study participants will be recruited from patients of the Supportive Oncology and Palliative Care Program at our institution.

Significance

Buprenorphine is often mostly known and used as treatment of opioid use disorder (OUD). However, it was developed as an analgesic and has been approved for the treatment of chronic pain. Studies have shown that buprenorphine is a safe option for the treatment of pain and is associated with lower rates of side effects than traditional opioids (such as morphine or oxycodone). It may also be more effective in neuropathic pain syndromes.

Methods

Pain will be monitored using the Numeric Rating Scale (NRS)/Brief Pain Inventory Scale (BPI). Signs of opioid withdrawal will be monitored using a modified Clinical Opioid Withdrawal Scale (COWS). Patients will track/monitor medication usage by smartphone application; Continuous Precision Medicine (CPM; Research Triangle Park, NC). The palliative program will complete baseline assessments using NRS/BPI/modified COWS assessments throughout the duration of the study (approximately 3 months).

Findings and Interpretations

A total of 35 patients have consented for the study so far (with expected accrual of 50 patients in total), 2 are currently enrolled, 27 have completed the study, and 6 were ineligible due to missed appointments. Results so far showed that buprenorphine may be effective for cancer pain and can be safely used in combination with FAO.

Discussion

Buprenorphine is increasingly recognized as a safe and effective option for the treatment of cancer pain. Given its unique pharmacologic characteristics, it may become a preferred option for some patients. In our practice, at NCI designated Comprehensive Cancer Center, buprenorphine is successfully used for many patients. We need further studies to examine its effectiveness and best ways to incorporate buprenorphine into analgesic regimens for patients with cancer pain.

Oncology Nursing Forum. 2025 Mar 1;52(2):29–30.

RS76. Behavioral Economic Strategies to Improve Patient-Reported Outcomes Adherence: A Nurse-Driven Cancer Care Symptom Monitoring Pilot

Melissa Fritz ¹, Daniel Blumenthal ², Peter Gabriel ³, E Paul Wileyto ⁴, Robert Schnoll ⁵, Samuel Takvorian ⁶

Purpose

In this trial, we evaluated the effect of nurse- and patient-directed implementation strategies on patient-reported outcome (PRO) questionnaire completion rates and clinical engagement.

Significance

Routine PRO monitoring improves quality of life (QoL) and overall survival for patients with cancer. Nevertheless, adoption of this evidence-based practice remains low with suboptimal PRO completion rates and clinical use.

Methods

Patients initiating a new line of systemic anticancer therapy were randomized to one of three arms: (1) visit-based PRO monitoring (usual care), (2) visit-based PRO monitoring with patient-directed reminders before appointments and nurse-directed alerts for severe/escalating symptoms, and (3) weekly remote PRO monitoring with patient reminders and nurse alerts. The PRO questionnaire was adapted from validated instruments assessing symptoms, QoL, and performance status, and prompted patients to identify symptoms for which they sought assistance. The primary outcome was patient-level PRO completion, defined as the number of weekly questionnaire completions divided by expected completions. Secondary outcomes included clinical team documentation of PROs and hospitalization rates. Primary analytic comparisons were prespecified as between Arms 1 and 2; Arm 3 was exploratory. Clinicians were encouraged to engage with PROs using newly-developed electronic health record dashboards, pre-populate responses in visit notes, and address symptoms during in-person visits. Triage nurses responded to alerts as they deemed appropriate and documented responses in a new structured form, promoting timely, systematic communication.

Findings and Interpretations

From December 2023 to February 2024, 476 patients (median age 65.4 years, 37.6% female, 22.5% Black) were enrolled across one academic (n=399, 83.8%) and one community (n=77, 16.2%) site. Overall, 54.5% (744 of 1366) of weekly questionnaires were completed, with increased patient completion (58.6% vs 51.0%) and clinical documentation (56.9% vs 39.2%) in Arm 2 vs Arm 1. PRO completion rates in Arm 3 were low (35.3%), likely due to patients having more reporting opportunities during the study (mean 11.6 in Arm 3 vs 4.6 and 4.5 in Arms 1 and 2). Rates of reported severe symptoms, triggered escalations, emergency department utilization, and hospitalization were comparable across arms.

Discussion

Patient- and nurse-directed implementation strategies modestly increased PRO completion rates and clinical engagement versus usual care. However, clinical outcomes were similar and overall rates of PRO completion and clinical use remained suboptimal. To build off this pilot, we are exploring strategies to scale patient and nurse alerts and remote PRO monitoring.

Oncology Nursing Forum. 2025 Mar 1;52(2):30–31.

RS77. Using Meta-Data to Measure Participant Engagement with a Cancer Symptom Self-Management Mobile App

Stephanie Gilbertson-White ¹, Marvin Nukunu-Attachey ², W Nick Street ³, Heath Davis ⁴, Chris Ortman ⁵, Nayung Youn ⁶

Purpose

Effective symptom self-management includes access to patient education materials, developing self-monitoring skills, and/or receipt of social support. The purposes of this study are to describe how we mapped each component of a cancer symptom self-management mobile app to the theoretical underpinning of the intervention and to describe results from our pilot study to designed to measure participant engagement with each app component.

Significance

Mobile apps provide an opportunity to provide just in time, tailored cancer symptom self-management support to people regardless of where they live and/or receive care. However, it is not how to best maintain engagement with mobile app interventions, the optimal length of use of mobile app intervention, or the active ingredient(s) needed in multi-modal symptom self-management mobile app to receive benefit. OASIS, a symptom self-management mobile app, was developed with intentional mapping of each app components to specific elements of the theoretical framework. Information about the date and time of use of each app component provides an opportunity to quantify frequency and periodicity of engagement with each component.

Methods

A sample of n=75 people with a cancer diagnosis receiving treatment (e.g., radiation, chemotherapy, immunotherapy, and/or hormonal therapy) recruited to participate in the study for a period of six weeks. Participate engagement with each component of the mobile (i.e., education, self-monitoring, and social support) was summed for both the entire study period and by week. Cluster analyses were conducted to identify engagement-based subgroups of participants.

Findings and Interpretations

The sample had a mean age of 57.9(+/−12.8) years, 65.8% female gender, 96% white, 64% had a bachelor’s degree or higher, and 51% reported an annual income of >$75,000. Participants logged in an average of 9.3 times (range 2–36) over 6 weeks or approximately 1.5 times per week, recorded self-monitoring an average of 105 times (range 1–684), social support an average of 3 times (range 1–25), and read educational materials an average of 6.4 times (range 1–83). Two engagement-based clusters were identified. Active/higher app engagement cluster consisted of older and low-income participants (n=21) whereas the less engagement cluster included healthier, younger, high income, participants (n=54).

Discussion

The ability to capture use of specific components of multi-modal symptom self-management mobile app interventions provides the analytic structure needed to address critical questions about “active ingredients” and optimal length of participation needed to achieve effective symptom management.

Oncology Nursing Forum. 2025 Mar 1;52(2):31.

RS78. Predictive and Convergent Validity of the Morse Fall Scale and Cleveland Clinic-Capone Albert Fall Risk Assessment Tool for Hospitalized Oncology Patients

Celestine Gochett ¹, Justus Randolph ²

Purpose

While the Morse Falls Scale (MFS) is widely adopted nationally as a fall risk prediction tool for hospitalized patients, it does not capture risk factors associated with oncology patients like the Cleveland Clinic-Capone Albert (CC-CA) Fall Risk Assessment Tool. The purpose of this study is to compare the predictive and convergent validity of these fall risk tools among hospitalized oncology patients.

Significance

Falls and fall-related injuries among hospitalized oncology patients account for some of the highest fall rates when compared to hospitalized patients without an oncology diagnosis. Researchers have provided evidence that an actual cancer diagnosis, metastatic disease spread and/or cancer treatments themselves contribute to oncology patient falls. The MFS has not consistently classified patients at risk of falling across diverse clinical settings and patient populations. In addition, prior comparison of these two scales, due to limited existing CC-CA Fall Risk Assessment Tool measurement research, has yielded contradictory results. Additional research is needed to determine which tool is more befitting for use among oncology patients.

Methods

A prospective, nonexperimental study was conducted enrolling 78 oncology patients. We examined convergent validity through correlational analysis of the MFS and CC-CA Fall Risk Assessment Tool and predictive validity through an analysis of scores for those who experienced fall events (n=2).

Findings and Interpretations

In terms of predictive validity, two of 78 cases experienced fall events, however, their scores on both scales did not indicate a high probability of a fall event. In terms of convergent validity, there was evidence of a moderate, but highly nonnormal, correlation (Spearman’s p (78) = .45, p < .001) between the two scales. Our conclusion is that the scales had questionable predictive validity and moderate convergent validity for this sample and setting.

Discussion

Findings from this study suggest that while these scales are related, one scale is not necessarily a better predictor over the other for oncology patients. Findings should be interpreted with caution as the total number of enrolled patients, especially the analysis of only 2 fall events, is a major study limitation. More measurement studies are needed to support key decisions for fall risk tool selection for oncology patients and to optimize the patient’s safety.

Oncology Nursing Forum. 2025 Mar 1;52(2):31–32.

RS79. Identifying Breast Cancer Staging Trends in South Carolina

Jessica Gonzalez ¹, Jessica Gonzalez ², Swann Arp Adams ³, Robin Dawson ⁴

Purpose

To examine South Carolina Community Assessment Network (SCAN) databases compare the breast cancer staging differences among Black women compared to white women to understand and interpret trends to identify disparities and identify opportunities for targeted interventions.

Significance

According to SCDHEC black women are nearly 40 percent more likely to die from breast cancer compared to white women. Black women make up a large percentage of the population in South Carolina and rural areas, which demonstrates a heightened need to identify breast cancer trends and promote effective preventative measures specific to this population when significant differences are identified.

Methods

Assessment and analysis of the most recent data available in SCAN 2015–2019 were used to examine early vs. late-stage definitions across subpopulations to understand stage progression and how it differentiates between subpopulations. SCAN data staging contained the following groups in situ, local, regional, distant staging and were compared in three distinct ways to assess increased incidence rates. Definitions of early and late stage were defined and assessed as follows early (in situ and local) vs late stage (regional and distant); non-invasive (in situ) vs. invasive (local, regional, distant); and early invasive (local) compared with late invasive (regional and distant) tumor incidence which were compared across Black and white women in SC. Data was input into an excel file and descriptive statistics were calculated. Chi-square probabilities were calculated using socscistatistics (social science statistics online calculator).

Findings and Interpretations

Black women in SC were 3% more likely to have a non-invasive breast cancer tumor type compared to white women (p-value <0.01). However Black women were 6% more likely to have late-stage breast cancer than white women (p-value <0.01). Furthermore, Black women were 9% more likely to have a late-stage invasive breast cancer subtype compared to white women (p-value <0.01). Despite Black women being less likely to have an invasive breast cancer compared with than white women, they are more likely to have a late invasive breast cancer stage at diagnosis.

Discussion

Defining early compared with late staging is important to assess trends among populations and identify future intervention opportunities. Future research should aim to understand the underlying mechanisms between staging and mortality, with a special focus on the invasive subtypes compared to noninvasive subtypes and trends compared across these subpopulations and breast cancer mortality.

Oncology Nursing Forum. 2025 Mar 1;52(2):32.

RS80. Comparison of Four Measures of Painful Chemotherapy-Induced Peripheral Neuropathy (CIPN)

Hiboombe Haamankuli ¹, Chisom Odii ², Sarah Khalidi ³, Jodelle Carlee ⁴, Ellen Lavoie Smith ⁵

Purpose

Evaluate CIPN-associated NP characteristics using the: 1) European Organization for Research and Treatment of Cancer Quality of Life Questionnaire–Chemotherapy-Induced Peripheral Neuropathy 20-Item Scale (CIPN20), 2) Neuropathic Pain Scale-Chemotherapy Induced Neuropathy (NPS-CIN), 3) Functional Assessment of Cancer Therapy-Gynecologic Oncology Group-Neurotoxicity (FACT-GOG-NTX), and 4) Douleur Neuropathique en 4 Questions (DN4). The study aims were to 1) describe CIPN-associated NP characteristics and score patterns from baseline to three months post the end of oxaliplatin treatment; and 2) describe the measures’ responsiveness.

Significance

Approximately 40% of patients develop CIPN-associated neuropathic pain (NP), characterized by painful numbness, tingling, and electric shock-like sensations in the upper and lower extremities. There are no gold standard CIPN-associated NP instruments to inform timely and effective interventions.

Methods

Eligible participants received oxaliplatin at a university teaching hospital in the Southeastern US to treat cancer. NP scores were collected at two time points (baseline and 3 months [3M] post-treatment completion) using 4 measures (scale=0–4, high score=worse pain). Descriptive statistics (frequency, range, mean, standard deviation, Cohen’s d) were used to describe score patterns, NP characteristics, and responsiveness.

Findings and Interpretations

Study participants (N=41) were mainly male (56.1%) and had colorectal cancer (70.7%). Although all measures demonstrated that NP severity worsened over time and was most severe at 3M, NP severity was low (mean range 0.51–2.19). NP item scores from the two most comprehensively validated CIPN patient-reported outcome measures (CIPN20, FACT-GOG-NTX) were similar, but the CIPN20 items that assess burning/shooting pain captured NP characteristics better than the FACT-GOG-NTX which measures general discomfort. The NPS-CIN assesses the severity of NP characteristics (sharp, deep, numb, and tingly pain); numb (mean=1.25, 95% CI: 0.81–1.67) and tingly (mean=1.25, 95% CI: 0.80–1.69) pain were the most severe. The DN4-assessed NP characteristic (tingling, numbness, burning, itching) frequencies at 3M ranged from 0–58.3%; numb (58.3%) and tingly (50%) pain were the most common. Cohen’s d values ranged from −0.196 to 0.028.

Discussion

CIPN-associated NP was not severe but progressively worsened at 3M post-completion of oxaliplatin. The most common NP characteristics were numb and tingly pain. While the measures were not responsive to change, low overall pain severity made it challenging to assess responsiveness. Future research is needed to identify responsive measures that will help oncology nurses monitor NP progression and the need for intervention.

Oncology Nursing Forum. 2025 Mar 1;52(2):32–33.

RS81. Perturbations in Neuroendocrine Pathways are Associated with High Symptom Burden in Patients Receiving Chemotherapy

Carolyn Harris ¹, Kord Kober ², Bruce Cooper ³, Steven Paul ⁴, Yvette Conley ⁵, Christine Miaskowski ⁶

Purpose

Evaluate for perturbed biological signaling pathways involved in neuroendocrine processes across two independent samples of patients receiving chemotherapy with a Low versus a High symptom burden.

Significance

Approximately 20% of oncology patients receiving chemotherapy experience a high symptom burden (i.e., experience of ≥16 concurrent symptoms). While common, the mechanisms underlying a higher symptom burden are understudied. A growing body of pre-clinical and clinical research suggest that neurological, immune, and endocrine systems are highly interconnected and may contribute to symptom burden. Prior research supports the role of inflammatory mechanisms in a higher symptom burden; however, the contribution of neuroendocrine processes remains unknown.

Methods

Prior to their second or third cycle of chemotherapy, outpatients with breast, gastrointestinal, gynecological, or lung cancers reported the occurrence of 38 symptoms using the Memorial Symptom Assessment Scale and provided a peripheral blood sample. Based on findings from a previous symptom cutpoint analysis, patients with Low (0–8 symptoms) versus High (16–38 symptoms) symptom burden were evaluated. Transcriptome-wide gene expression was quantified using RNA-sequencing (n=213) or microarray (n=207) technologies. Pathway impact analyses were performed and signaling pathways were defined with the Kyoto Encyclopedia of Genes and Genomes database. Fisher’s combined probability test was used to identify perturbed pathways between the Low and High symptom burden groups across both samples (false discovery rate < 0.005).

Findings and Interpretations

For the RNA-seq sample, 159 patients had High and 54 patients had Low symptom burden. For the microarray sample, 135 patients had High and 72 patients had Low symptom burden. Forty pathways were perturbed between the Low and High symptom burden groups. Of these pathways, two were endocrine (i.e., peroxisome proliferator-activated receptors, non-alcoholic fatty liver disease), four were neurodegenerative disease (i.e., pathways of neurodegeneration – multiple diseases, amyotrophic lateral sclerosis, Huntington disease, Parkinson disease), and three were neurotransmission (i.e., calcium, neuroactive ligand-receptor interaction, retrograde endocannabinoid) pathways. Common biological processes across the neurodegenerative disease pathways were abnormal protein aggregates, endoplasmic reticulum stress, mitochondrial dysfunction, and oxidative stress.

Discussion

This study is the first to suggest that perturbations in a number of endocrine, neurodegenerative disease, and neurotransmission pathways are associated with a high symptom burden in patients receiving chemotherapy. Findings provide new insights into neuroendocrine processes that may explain high symptom burden in oncology patients and may serve as novel targets for intervention.

Oncology Nursing Forum. 2025 Mar 1;52(2):33–34.

RS82. Do Health Information Seeking Behaviors among Patients Taking Oral Anticancer Medication for Multiple Myeloma Differ by Socioeconomic Status? An Exploratory, Qualitative, Descriptive Study

Emily He ¹, Abigail Lustyik ², Corrine Bozich ³, Grace Booze ⁴, Petra Duran Basso ⁵, Sarah Belcher ⁶

Purpose

Multiple myeloma is a high morbidity cancer that includes costly, life-long oral anticancer medication (OAM), requiring knowledge for disease and medication self-management. Little is known about health information seeking behavior (HISB) among these patients and whether HISB varies by socioeconomic status. This exploratory analysis identifies HISB themes by socioeconomic status groups.

Significance

Patient HISB contributes to disease and medication self-management among patients with multiple myeloma. Lower socioeconomic status has been associated with less engagement with HISB and trust in health professionals. Oncology nurses must be aware of these factors to support optimal patient self-management.

Methods

This qualitative, descriptive study is a secondary analysis of semi-structured interviews (n=17) conducted as part of a larger mixed-methods study of OAM adherence. Patients were recruited from a comprehensive cancer center in Southwestern Pennsylvania. Participant characteristics were collected via self-report. Socioeconomic status was operationalized using the University of Wisconsin-Madison Area Deprivation Index, a composite measure of socioeconomic disadvantage that includes income, education, employment, and housing quality domains; national percentile range: 1–100, least to most socioeconomically disadvantaged, dichotomized as low (ADI-L=1–50 [n=8]) and high (ADI-H=51–100 [n=9]). Two reviewers independently analyzed interviews to generate qualitative codes, which were then categorized thematically. Themes were compared by ADI group.

Findings and Interpretations

Most participants in both groups were male (ADI-L n=5, 62.5%; ADI-H n=8, 88.8%) and non-Hispanic white (ADI-L n=7, 87.5%; ADI-H n=5, 55.5%), with median age around 60 (ADI-L median 60, range 35–73; ADI-H median 61, range 45–80). ADI-L had higher levels of education (n=8, 100% college or beyond) relative to ADI-H (n=5, 55.5% no diploma or no college degree; n=4, 44.4% associate’s degree or beyond). Four themes emerged across both groups: desire for information (side effects, disease, funding, new updates); trust in physician as primary source and clarifier of information; passive receival of information (from doctor, pharmacist, or nurse); and mixed confidence in online health information. Two additional themes emerged for the ADI-H group: desire for information from peers and distrust of the physician.

Discussion

Findings reveal HISB similarities between socioeconomic status groups, while ADI-H included additional themes of desire for information from peers and distrust of the physician. Oncology nurses play a critical role in patient education and navigating patients to resources. Future larger, diverse, prospective studies are needed to understand HISB preferences to support cancer patient self-management.

Oncology Nursing Forum. 2025 Mar 1;52(2):34.

RS83. Uncertainty, Preparedness, and Distress of Family Caregivers before and after Hematopoietic Stem Cell Transplantation: A Secondary Analysis

Reza Heidari Soureshjani ¹, Leila Sayadi ², Tayeb Mohammadi ³, Heidi Donovan ⁴, Ali Karimi-rozveh ⁵, Mohammad Vaezi ⁶

Purpose

This study aimed to evaluate changes in caregiving preparedness, illness uncertainty, and psychological distress of family caregivers (FCGs) before and after hematopoietic stem cell transplantation (HSCT), and to explore the relationships among these factors.

Significance

The transition to home care after HSCT poses significant challenges for FCGs. Both illness uncertainty and caregiving are hypothesized to be modifiable factors that influence FCGs distress.

Methods

This secondary analysis involved 100 FCGs of HSCT patients, conducted between April 2023 and February 2024 at hospitals affiliated with Tehran University of Medical Sciences (Grant No.: 1400-3-160-55485). Data were collected during the first week of hospitalization (T0) and two weeks post-discharge (T1). Validated instruments assessed caregiving preparedness, illness uncertainty, and psychological distress. Correlation coefficients, paired t-tests, and regression models were used, with significance set at p < 0.05. Analyses were conducted using SPSS version 29.

Findings and Interpretations

The mean ages of patients and FCGs were 43.96 ± 13.96 and 38.56 ± 11.44, respectively. Caregiving preparedness and uncertainty declined significantly from T0 to T1 (p < 0.001), while distress levels remained unchanged (p = 0.113). Looking at associations within each of the timepoints, uncertainty of caregivers showed a positive correlation with distress at each timepoint with correlation coefficients of r = 0.402 (p = 0.001) at T0 and r = 0.299, (p = 0.021) at T1. Preparedness was not associated with distress at either timepoint. After adjusting for uncertainty, preparedness, and distress at T0, uncertainty at T1 emerged as a significant positive predictor of distress at T1 (B = 0.077, p = 0.015); preparedness at T1 was not significantly associated with T1 distress (B = 0.343, p = 0.486).

Discussion

Our findings emphasize the impact of uncertainty on distress among FCGs during the transition to home care after HSCT. While FCGs uncertainty decreased following hospitalization, they reported lower preparedness and persistent distress two weeks after discharge. When controlling for baseline values, higher post-discharge uncertainty was associated with increased distress, highlighting the need for targeted interventions such as enhanced discharge education, telehealth support, and tailored follow-up care. The lack of association between caregiving preparedness and distress is counter to previous research and warrants further study.

Oncology Nursing Forum. 2025 Mar 1;52(2):34–35.

RS84. The Incidence of CNS Metastases in HER-2 Negative Metastatic Breast Cancer: Possible Protective Effects of CDK4/6 Inhibition

Cameron Herbst ¹, Margaret Rosenzweig ²

Purpose

Central nervous system (CNS) metastases in breast cancer (BC) are challenging to manage and are often a harbinger of poor survival outcomes. The CNS can serve as a sanctuary for metastatic BC cells with later presentation in the disease course. Evolving MBC treatment options such as CDK4/6 inhibition may prevent rapidly fatal systemic disease, but due to the blood brain barrier, do not offer the same CNS protections. The purpose of this study was to: 1) describe the incidence of brain and leptomeningeal metastases in patients with HER2- metastatic breast cancer (MBC), regardless of hormone receptor status, across the course of MBC disease, and 2) compare incidence in the context of available treatment options.

Significance

Understanding CNS metastasis in MBC is important for breast cancer patient counseling and anticipatory guidance.

Methods

The Metastatic Breast Cancer REDCap database is a single-institution 25-year annotation of clinical, demographic, and treatment factors among patients with MBC. Data were dichotomized to pre-2015 and post-2015 (first CDK4/6i was FDA approved) and exported to SPSS for descriptive and comparative statistics.

Findings and Interpretations

Aim 1 Total cohort N = 1,118 (HER2- MBC); n = 262 cases developed CNS mets; 150 pre-2015; 112 post-2015. Assuming equal distribution of patients over the study duration, the incidence rate ratio (IRR) was calculated as 1.49, 95% CI [1.17, 1.91], p < 0.001. This suggests a 49% increase in incidence of CNS metastases in the period from 2015 to the present compared to pre-2015. The distribution of CNS metastases between the groups was statistically significant: X2 (1, N = 1,118) = 13.10, p < 0.001. Aim 2 Time between initial metastatic diagnosis and the development of CNS mets was calculated for both cohorts. Patients with CNS mets at initial presentation were omitted. The median time to develop CNS mets increased from the pre-2015 to the post-2015 cohort (16 vs 21.5 months), and this difference was statistically significant z = −2.19, p = .029.

Discussion

This descriptive study shows an increasing incidence of CNS metastases in the HER2- MBC population, likely secondary to improved systemic treatment options in the post-2015 period. Furthermore, in the post-2015 period the median time to develop CNS metastases increased, suggesting a possible protective effect by treatments introduced during that time.

Oncology Nursing Forum. 2025 Mar 1;52(2):35–36.

RS85. Utilizing a Communication Card to Enhance Communication for Limited-English Proficient Patients in the Ambulatory Care Setting

Jennifer Hotchkiss ¹, Erin Morrissey ², Jackie Tuskan ³, Julie Waitt ⁴, Nina Scott ⁵

Purpose

In our large, ambulatory oncology clinic in the Northeast, qualified interpreters are available to patients and families throughout their infusion visits; however, they are often unable to accompany patients the entire duration of treatment. This study evaluated the usability of standardized, multilingual communication cards and assessed their impact on patients’ ability to communicate basic needs during infusion visits, from the perspectives of the patient, nurse and clinic assistant.

Significance

An estimated 8% of patients newly diagnosed with cancer in the United Stated will have Limited-English Proficiency (LEP) (Farina et al., 2022). LEP patients report decreased satisfaction with care and have worse outcomes, potentially related to facing more barriers to accessing quality medical care (Bregio et al., 2022). Reported difficulty communicating with healthcare professionals highlights the necessity for tools and services to facilitate better communication between LEP patients and healthcare providers.

Methods

Cards were developed and translated in the top 5 non-English languages seen within our clinic: Russian, Arabic, Portuguese, Chinese, and Spanish. The cards cover four areas: reporting urgent symptoms or common needs; starting with “I feel...”, “I want...”, and “I want to talk to...”. Pre- and post-surveys were sent to clinicians to evaluate the impact of the cards on patient-clinician communication. LEP patients who utilized the cards were also asked to complete a satisfaction survey.

Findings and Interpretations

Pre- to post-intervention survey results indicated an increase from 30% (n=10) to 76% (n=13) of clinicians who felt that the current resources allow LEP patients to effectively communicate non-urgent clinical needs when an interpreter is not present. Pre-intervention, only 10% (n=10) of clinicians felt the current resources allowed patients to effectively communicate urgent clinical needs compared to 69% (n=13) post-intervention. 90% (n=32) of patients who utilized the cards found them easy or very easy to use. 93% (n=32) of patients found the cards helpful or very helpful. 96% (n=32) of patients were satisfied or very satisfied with the cards.

Discussion

Communication cards are an easy-to-use tool that can help address the disparities LEP patients face in the oncology ambulatory care setting. Survey results indicated that cards enhanced LEP patients’ ability to communicate non-urgent and urgent symptoms or concerns to their care team. Future work will focus on expanding the cards to more languages and exploring other uses of the card, such as for non-verbal patients.

Oncology Nursing Forum. 2025 Mar 1;52(2):36.

RS86. Relationship Between Fatigue and Mitochondrial Function in Patients with Breast Cancer Receiving Chemotherapy

Chao-Pin Hsiao ¹, Seunghee Margevicius ², Barbara Daly ³, Charles Hoppel ⁴

Purpose

To investigate changes in cancer-related fatigue (CRF) symptoms and their association with mitochondrial function in patients with breast cancer receiving chemotherapy (CT)-containing anthracyclines, compared to those with non-anthracycline-based CT.

Significance

Revealing the linkage between changes in CT-induced CRF and mitochondrial bioenergetic pathways is imperative to develop effective and evidence-based interventions for CRF, as well as to advance the science of symptom management.

Methods

This was a prospective, hypothesis-testing, longitudinal project. The revised Piper Fatigue Scale (r-PFS) was used to measure CRF. Mitochondrial function was measured from peripheral blood mononuclear cells (PBMC) and platelets using validated protocols in the O2k high-resolution respirometry system. Data were collected from each patient at 3 timepoints (baseline, midpoint, endpoint) and analyzed using SAS.

Findings and Interpretations

Sixty breast cancer patients receiving CT were enrolled (30 for each group). Significantly increased PFS scores were observed at midpoint (t=7.36, p<0.001) and endpoint (t=8.00, p<0.001) of CT in both groups. Altered mitochondrial function was determined in PBMC and platelets of breast cancer patients receiving CT overtime. Increased fatigue scores were significantly associated with increased platelets mitochondrial function (e.g., complex I and II, and maximal oxidative capacity, p<0.05) at midpoint in the CT-containing anthracyclines group, compared to the group with non-anthracycline-based CT.

Discussion

Patients with breast cancer receiving CT reported increased fatigue symptoms during and at the completion of CT. Patients treated with CT-containing anthracyclines presented increased mitochondrial function during CT, compared to those without anthracyclines. Altered mitochondrial function was associated with increased fatigue symptoms. Understanding the mechanism/pathway underpinning CRF will enable the design of targeted therapeutics and non-pharmacological interventions. Cytoprotective interventions (i.e., antioxidants) may have the potential to enhance individual antioxidant compacity to reduce CT-related cellular damage and improve CRF.

Oncology Nursing Forum. 2025 Mar 1;52(2):36–37.

RS87. Symptom Experiences in Head and Neck Cancer Survivors: A Systematic Review and Meta-Analysis

Yuwen Ji ¹, Seyedehtanaz Saeidzadeh ², Stephanie Gilbertson-White ³

Purpose

This systematic review and meta-analysis aims to synthesize the literature describing the impact of oral symptoms and dysphagia among head and neck cancer (HNC) survivors receiving curative treatment. Oral symptoms include dry mouth, taste impairment, trismus, and mouth/throat soreness. The purpose of this analysis is to describe prevalence and severity of oral symptoms and dysphagia, and 2) evaluate the impact of oral symptoms and dysphagia on patient reported outcomes (i.e., quality-of-life, oral functioning) in HNC survivors.

Significance

The population HNC survivors’ is growing due to novel treatments, improvements in cancer detection, and a shift toward HNC sub-types with better prognosis (e.g. Human Papilloma Virus). HNC treatments are typically intensive and multi-modal, resulting in many survivors experiencing severe and debilitating side-effects. Some treatment-related side-effects persist well past completion of primary treatment. Oral symptoms and dysphagia are among the most significant side-effects to their impact oral intake often leading to weight-loss. These functional and physical changes can negatively impact body image and lead to social isolation. It is crucial to understand these symptoms so we can better support the survivors.

Methods

The Cochrane guidelines for systematic review and meta-analysis were followed. Five major databases (i.e., PubMed, Embase, CINAHL, PsycInfo, and Scopus) were searched for studies published through 2024. Studies were included that focused on adult HNC survivors who received curative intent treatments (undergoing/completed) and experienced oral symptoms and dysphagia. Quantitative studies including cross-sectional, cohort, and interventional designs were eligible for inclusion. Mixed methods, qualitative, and reviews were excluded.

Findings and Interpretations

Across six included studies, the majority of the sample was male (80.0%), non-Hispanic White (85.8%), with oropharynx tumors (47.0%) as the primary site, and diagnosed at Stage II (30.7%).The mean age of participants was 60.05 years (SD = 10.2). Participants (n=999, 92.9%) completed treatment an average of 9.8 years ago. Studies revealed that participants with moderate or severe dysphagia experienced significantly reduced quality-of-life. The most substantial impacts reported were on swallowing, speech, and eating. Participants with hypopharyngeal cancers and those treated with surgery plus radiation/chemoradiation experienced the worst symptom severity and highest interference with daily life.

Discussion

Further research is required, particularly among more diverse populations, such as women and non-white HNC survivors. In addition, the development and testing of self-management interventions is needed to reduce the devasting impact of HNC treatment side-effects.

Oncology Nursing Forum. 2025 Mar 1;52(2):37.

RS88. The Influence of Comorbidity Clusters on Palliative Care in Individuals with Lung Cancer

Lee Ann Johnson ¹, Marieke Johes ², Sarah Ratcliffe ³

Purpose

In individuals with lung cancer, we sought to 1) determine the number of individuals who received guideline concordant referrals and receipt of palliative care and 2) examine how comorbidity clusters influenced palliative care referral and receipt.

Significance

Lung cancer remains the leading cause of cancer deaths, but those who receive palliative care at the time of diagnosis experience longer survival. The main risk factors for lung cancer, age and smoking, are also risk factors for comorbid conditions, such as heart and kidney disease. The influence of comorbidity clusters on palliative care referrals and receipt of palliative care is unknown.

Methods

Data on patients with a lung cancer diagnosis were extracted from electronic health records. Finite mixture models using presence of the 16 comorbidities in the NCI lung cancer comorbidity index were built to segment the patient population into clusters. Patients were categorized based on palliative care: no palliative care referral, palliative care referral but no post-referral encounter, and post-referral palliative care encounter. Data were summarized by palliative care group and clinical characteristics.

Findings and Interpretations

The median (IQR) age for the sample (N=1814) was 68 (60,75). The majority were male(53%), white(83%), and were smokers(87%). Among participants, 78% received no referral to palliative care, 13.2% received palliative care more than 60 days after a diagnosis, and only 8.8% received a palliative care referral within 60 days of diagnosis. Those who had a recorded palliative care encounter (n=235), fell into the following comorbidity clusters: mild(12%), moderate(60%) and severe(28%). The vast majority had no known palliative care referral (n=1412, mild(14%), moderate(63%), severe(23%)) or had no post-referral encounter (n=167, mild(17%), moderate(60%), severe(22%)). Individuals with a palliative care referral but no encounter were more likely to receive chemotherapy within the 30 days of death (n=21, 21%) than those with a palliative care referral (n=17, 10%) or those with no palliative care referral (n=61, 12%).

Discussion

The sickest individuals with lung cancer, those who fall into the severe comorbidity clusters, might experience the largest benefits from an early palliative care encounter due to their complex medical status, but were seldom referred.

Oncology Nursing Forum. 2025 Mar 1;52(2):37–38.

RS89. Understanding the Perceptions of Rural Patients and Providers Regarding Participation in Clinical Trials

Randy Jones ¹, Rachel Lacy ², Lindsay Hauser ³, Beth O’Conner ⁴, Wendy Cohn ⁵, Linda Duska ⁶

Purpose

This study aims to explore patient and provider perceptions of clinical trial enrollment to increase accrual among underserved rural populations.

Significance

Rural patients often face poorer cancer outcomes and limited access to clinical trials compared to urban populations. Diversity in clinical trials is essential for generalizable results that improve treatment outcomes and quality of life for all patients. However, low enrollment among rural, underserved groups is a persistent issue, influenced by both patient and provider factors that are not fully understood.

Methods

Focus groups were conducted with rural residents to explore perceptions of clinical trial participation. Thematic analysis identified key patterns. A survey was distributed to healthcare providers (academic and community-based) treating rural patients to identify perceived barriers for clinical trial participation. The themes from patients and providers were compared.

Findings and Interpretations

Twenty-four rural patients participated in five focus groups. Four major themes emerged from patients: (1) Convenience and incentives influence patient participation; (2) Crucial need for information that patients can use to make an informed decision to participate in a clinical trial; (3) Importance of hearing about clinical trials by a healthcare provider; and (4) Lack of trust in how the clinical trial is being conducted. Sixty-four healthcare providers (53% physicians, 47% advanced practice providers) completed a clinical trial involvement perception survey. The most significant barrier providers identified for themselves was the lack of a clinic-wide system to identify clinical trials (48%). Barriers that providers identified for their patients included transportation (67%), time commitment (67%), lack of interest (56%), and financial constraints (34%).

Discussion

Providers believe that patients lack interest in clinical trials, but this view is contradicted by patient feedback. Providers do not fully recognize their role in informing patients about clinical trials, which affects enrollment. These findings highlight significant differences in perceptions between patients and providers about clinical trial participation in rural settings. Understanding these perspectives is crucial to improving access to clinical trials and enhancing cancer care for underserved populations. Additionally, these results will enable the development of future interventions to aid providers’ to attend to patients’ concerns regarding clinical trials.

Oncology Nursing Forum. 2025 Mar 1;52(2):38–39.

RS90. Shared Decision-Making and Racial Disparities in Prostate-Specific Antigen Screening: A Population-Based Study

Hyesong Joung ¹, David Martin ², Randy Jones ³

Purpose

This study aims to assess racial/ethnic differences in Prostate-Specific Antigen (PSA) screening and shared decision-making (SDM) use, evaluate the impact of SDM on screening rates, and examine if SDM modifies these differences.

Significance

Lower PSA screening rates among racial/ethnic minorities contribute to prostate cancer disparities, including higher mortality rates. To address disparities, the U.S. Preventive Services Task Force changed PSA screening guidelines recommending SDM for men aged 55–69 years. However, the disparities still persist. SDM could improve decision-making in screening and reduce these racial/ethnical inequities in prostate cancer outcomes.

Methods

A cross-sectional analysis of men aged between 55 and 69 years was conducted using data from the 2021–2023 Behavioral Risk Factor Surveillance System (BRFSS). Descriptive statistics and chi-square tests assessed racial/ethnic differences in PSA screening and estimated SDM (eSDM) use. Complex sample multiple logistic regression models were used to evaluate the impact of eSDM on PSA screening rates. Additionally, these models included an interaction term combining race/ethnicity and eSDM to examine whether eSDM modified the effect of race/ethnicity on PSA screening.

Findings and Interpretations

In a weighted sample, 10,778 men were eligible for PSA screening, with 45.7% undergoing screening within the past year. The results revealed that eSDM was a significant predictor of PSA screening (AOR=1.41, 95% CI=0.25, 0.57, p<.001). There were significant differences between race/ethnicity and PSA screening (p=0.024). However, in the model adjusting for eSDM and covariates, non-Hispanic black (NHB) (OR=0.80, 95% CI=0.47, 1.33, p=0.647), Hispanic (OR=1.12, 95% CI=0.65, 1.91, p=0.660), and Asian (OR=0.59, 95% CI=0.34, 1.03, p=0.066) men did not significantly differed in the screening rate compared to non-Hispanic white men (NHW). A significant interaction was observed between race/ethnicity and eSDM about PSA screening (pint=0.027). Additionally, regarding racial/ethnical differences, eSDM improved PSA screening rates in NHB, Hispanic, and NHW groups but showed a decrease in the likelihood of screening among Asian men.

Discussion

SDM might attenuate racial/ethnic disparities in PSA screening participation. Since there were determinants like health insurance, income, and access to healthcare, which significantly influenced the screening rate, a more detailed approach to these factors is needed. In addition, results suggest potential barriers for Asian men in engaging with PSA screening despite SDM. This study provides a foundation for encouraging detailed investigations into the health determinants affecting PSA screening among minority populations, ultimately aiming to optimize patient-centered SDM.

Oncology Nursing Forum. 2025 Mar 1;52(2):39.

RS91. Understanding the Caregiving Burden in Family Caregivers of AML Patients Receiving Outpatient-Based Treatment

Ahrang Jung ¹, Ahrang Jung ², Ashley Leak Bryant ³, Daniel Richardson ⁴

Purpose

The purpose of this ongoing study is to understand the caregiving burden of family caregivers with outpatient-based AML treatment.

Significance

With the FDA approval of oral venetoclax, older adults (75 years or older) with acute myeloid leukemia (AML) can now receive their treatment in an outpatient setting. However, this shift to outpatient-based AML treatment places a greater burden on family caregivers, most of whom have received no formal training. Family caregivers may have additional responsibilities that would have previously been managed by the inpatient care team.

Methods

This longitudinal qualitative study was conducted at a comprehensive cancer center. Eligible participants were identified by the patient (who had a new diagnosis of AML and were receiving venetoclax + hypomethylating agents) as their primary family caregiver. Semi-structured interviews were conducted at three time points: baseline (after diagnosis and cycle 1 of treatment), cycle 2, and cycle 4. The interviews were audio recorded, transcribed, coded, and analyzed using thematic analysis.

Findings and Interpretations

This study included six family caregivers (all females; 4 White, 1 Black, 1 Asian; mean age of 62.8 years) and a total of 13 interviews were completed. Of these, 6 interviews took place at baseline, 5 at cycle 2, and 2 at cycle 4. Analyses revealed three themes reflecting experiences of family caregivers during outpatient-based AML treatment: 1) cycle 1- “my life changed dramatically” (adjusting to full-time caregiving for a loved one), 2) cycle 2- managing uncertainty and the demands of caregiving, and 3) cycle 4 – finding new normal and preparing for the future.

Discussion

Family members, who care for older adults with AML at home, face significant challenges with caregiving from the time of diagnosis throughout the course of AML treatment. Oncology nurses can better support these patients and family caregivers by recognizing the caregiving burden and providing appropriate referral during outpatient-based AML treatment.

Oncology Nursing Forum. 2025 Mar 1;52(2):39–40.

RS92. Development and Effectiveness Evaluation of a Self-Management Program Based on Self-Efficacy Theory for Prostate Cancer Survivors

Shina Kim ¹, Onam Ok ², Shinhu Kang ³, Taejeong Youn ⁴, Seonyeong Choi ⁵, Eunsil Kim ⁶

Purpose

To develop and evaluate the effectiveness of a self-efficacy theory-based self-management program for prostate cancer survivors who underwent robot-assisted prostatectomy.

Significance

Despite the rapidly increasing incidence and survival rates of prostate cancer in South Korea, systematic management programs for survivors remain scarce. Effective self-management strategies are crucial for addressing the physical and emotional challenges these survivors face post-treatment.

Methods

This quasi-experimental study employed a non-equivalent control group pre-post design. Participants (experimental n=30, control n=31) were recruited from prostate cancer survivors who underwent robot-assisted prostatectomy. The experimental group received an educational program consisting of video education, booklet-based materials, and two phone consultations, while both groups completed assessments of distress, self-efficacy, coping with cancer, and quality of life at baseline, one week, and six weeks post-intervention using mobile surveys.

Findings and Interpretations

Repeated measures analysis revealed significant improvements in the experimental group compared to the control group for both distress (p=.002) and self-efficacy (p=.017). The experimental group’s distress scores decreased from 2.80±2.81 to 1.97±1.65, while self-efficacy increased from 76.40±16.08 to 80.83±13.14. However, no significant differences were observed between groups in coping with cancer or quality of life measures.

Discussion

While the self-management program effectively reduced distress and enhanced self-efficacy among prostate cancer survivors, its impact on coping mechanisms and quality of life was limited. These findings suggest the need for more comprehensive and sustained interventions for this population.

Oncology Nursing Forum. 2025 Mar 1;52(2):40.

RS93. Starlight Therapy: Reducing Anxiety in Women with Breast Cancer Receiving First-Line Chemotherapy

Alexa Lahera ¹, Leonardo Martinez ², Jilian Manrique ³, Richie Reich ⁴, Tina Mason ⁵

Purpose

The purpose of this pilot study was to determine the acceptability and feasibility of offering starlight therapy to females with breast cancer in an ambulatory setting. The secondary purpose was to preliminarily examine if starlight therapy reduces anxiety in these patients receiving cycle 1, day 1 treatment.

Significance

The predominant mental health symptom reported in women with breast cancer is anxiety, and this is undermanaged. Our patients often express anxiety, especially when starting treatment. Starlight therapy, studied in two hospice settings, reduced anxiety, and other symptoms in 90% of patients within 30 minutes. The Oncology Nursing Society notes that clinical effectiveness has not yet been established for starlight therapy, a complementary Snoezelen therapy using laser stars projection, for anxiety reduction.

Methods

IRB-approved informed consent was obtained. Data was collected at four time points (same day): before provider visit, after provider visit/before starlight therapy, after 15 minutes of starlight therapy, including feedback, and after chemotherapy infusion. The STAIS-5 instrument (anxiety) was administered, and heart rate and blood pressure were obtained at all time points. Patients were provided a blanket and recliner in a dark, blue-painted room with closed doors.

Findings and Interpretations

Twenty-eight breast cancer patients were of mean age 52 years. Majority were Caucasian (82%), non-Hispanic (89%), married/co-habiting (71%) with cancer stage II (41%). For feasibility, 100% completed the intervention and 93% completed all assessments. Ninety-six percent indicated satisfaction with the intervention. Anxiety scores dropped at each timepoint following baseline; largest drop before and after Starlight therapy (effect size = 1.1, p <0.0001). Clinical anxiety levels dropped from 66% at baseline to 0 at the last two time points. Heart rate dropped significantly in the time before and after Starlight administration (effect size = 0.65, p=0.0006). Participants overwhelmingly supported continuing starlight therapy and suggested adding soft music, celestial sounds, or white noise to the ambiance.

Discussion

Starlight therapy is noninvasive, creating a calming environment in our clinic within a dedicated room. This therapy adds to the possible options of complementary stress reduction methods. Patient feedback will be used to design a larger-scale study/to advocate for starlight therapy in various settings in collaboration with leadership and stakeholders such as the Patient Family Advisory Committee. Future research may include examining the sustained effects of anxiety on patients, effects on other symptoms, and use with informal caregivers.

Oncology Nursing Forum. 2025 Mar 1;52(2):40–41.

RS94. Safety of Advanced Practice Nurse-Led Site Marking – A Best Practice Implementation Study

Ang Yun Lee ¹, Grace Cham ², Seri Sastika Ramli ³, Kenneth Sooi ⁴, Samuel Guan Wei Ow ⁵, Chi Ching Lim ⁶

Purpose

This study aims to evaluate the safety of advanced practice nurse-led (APN-led) site marking for hematology-oncology patients in a same-day procedure setting, with a secondary aim of preventing procedural delay.

Significance

The prevention of wrong-site surgery (WSS) is a recognized International Patient Safety Goal, and key strategies include site marking and adherence to standardized protocols. At current practice, the resident physician performs site marking. From April to November 2024, resident physician unavailability and a lack of on-site medical officer resulted in 19 procedural delays, accounting for 8% (n=246) of all procedures. This is the first-time site marking will be nurse-led in the local tertiary hospital setting making it a novel approach with potential to enhance efficiency, optimize manpower resources and improve nurse satisfaction.

Methods

The study will be conducted from December 2024 to February 2025 in a setting where central venous access device (CVAD) insertions, chest tube insertions, lymph node and visceral organ biopsies are performed. Prior to implementation, all department physicians reached a consensus to proceed with the study, and hospital committees sanctioned its implementation. Institutional credentialing policies and site marking protocols were updated. As part of a competency framework, APNs attended an educational session and completed two supervised site markings per procedure site to demonstrate proficiency. Outcomes will include retrospective data on number, types and timeliness of site markings, and wrong site marking incidence. Satisfaction and confidence in APN-led site marking will be assessed by monthly surveys of registered nurses (RNs), medical officers (MOs) and APNs.

Findings and Interpretations

During competency assessments, 38 site markings were conducted by seven APNs without incidence of wrong site marking or delayed procedures. In December 2024, APNs performed site-markings for 21 of 22 listed procedures (95.5%) (Table 1) with the majority CVAD insertions (n=11). Survey findings indicated that all RNs (n=6), MOs (n=6) and APNs (n=7) strongly agree or agree that daily operations were better facilitated, site markings were done timely and were satisfied and confident in APN site-marking (Table 2, 3 and 4). To date, there were no occurrence of wrong site markings and no procedural delays.

Discussion

Preliminary results demonstrate that APN-led site marking is a safe and practical alternative to physician-led site marking in a same-day procedure setting, which optimizes manpower utilization and operational efficiency. Data collection will continue till February 2025.

Oncology Nursing Forum. 2025 Mar 1;52(2):41–42.

RS95. Culturally Sensitive Nursing Interventions to Improve Patient-Reported Outcomes in Asian Prostate Cancer Patients Undergoing High-Dose Radiation Therapy

YI Lin Lin ¹, Yu Jen Wang ²

Purpose

This study aimed to evaluate the effectiveness of culturally tailored nursing interventions on patient-reported outcomes (PROs) among Asian prostate cancer patients receiving high-dose radiation therapy (RT). Sexual function, a topic less openly discussed in Asian cultures compared to Western societies, was a focus due to limited research in this population. Addressing this gap aims to enhance quality of life and satisfaction during RT.

Significance

Cultural differences in patient communication and symptom management can influence the effectiveness of oncology care. In Asian cultures, topics such as sexual health are often considered sensitive and under-discussed, leaving patient education and care needs inadequately addressed. Most existing studies on PROs and sexual function have been conducted in Western contexts, which may not fully address cultural variances. This study highlights the need for culturally specific interventions to ensure equitable and effective care for Asian prostate cancer patients, ultimately enhancing patient satisfaction and treatment outcomes.

Methods

A prospective observational study was conducted on 30 Asian prostate cancer patients (median age 73.5 years, 73.3% high-risk) undergoing volumetric modulated arc therapy (VMAT) in northern Taiwan. Culturally tailored interventions included:

■ Patient education integrating cultural beliefs.
■ Family-centered care discussions.
■ Culturally adapted symptom management.
■ Use of interpreters for communication.
■ Validated tools (EORTC QLQ-C30, QLQ-PR25, IIEF, IPSS, CPSQI) assessed PROs at baseline, during, and post-RT. Electronic PRO systems ensured data accuracy, with multivariable analysis identifying predictors of change.

Findings and Interpretations

■ Sleep Quality: Improved during RT, with 42.9% of patients falling asleep within 15 minutes (vs. 23.1% pre-treatment, p<0.05). CPSQI scores remained stable (4.28 to 4.69).
■ Fatigue: 68.9% reported moderate to severe fatigue during treatment. Fatigue subscale scores (EORTC QLQ-C30) increased from 30.4 to 55.7 (p<0.001).
■ Sexual Function: 72.1% reported erectile dysfunction, 64.7% decreased libido. Age (p=0.024), comorbidity index (p=0.032), and IPSS scores (p=0.016) predicted declines in sexual function.

Discussion

Culturally sensitive nursing interventions improved care satisfaction and understanding while addressing key barriers. However, fatigue and sexual dysfunction highlight areas needing further attention. This underscores the importance of culturally tailored care in enhancing patient experience and outcomes.

Oncology Nursing Forum. 2025 Mar 1;52(2):42.

RS96. A Pilot Clinical Trial of Technology-Based Dyadic Intervention for Improving Symptom Management and Advancing Health Equity Among Patients with Colorectal Cancer and their Caregivers

Yufen Lin ¹, Ilana Graetz ², Olatunji Alese ³, Darren Liu ⁴, Runze Yan ⁵, Canhua Xiao ⁶

Purpose

To enhance symptom management and promote health equity among patients with colorectal cancer (CRC) and their caregivers, we developed a technology-based dyadic intervention (CRCWeb) and evaluated its feasibility and preliminary efficacy in an 8-week pilot clinical trial.

Significance

Patients with CRC undergoing chemotherapy often experience distressing psychoneurological symptoms (PNS) such as fatigue, depression, anxiety, sleep disturbances, pain, and cognitive impairment. Similarly, cancer caregivers face substantial PNS due to caregiving-related stress and burden. These challenges are more severe in disadvantaged populations (e.g., low income, limited education), further compromising the quality of life for both patients and caregivers. Thus, there is an urgent need for innovative interventions to effectively address these issues.

Methods

We conducted a single-arm pre-post pilot trial involving CRC patient-caregiver dyads. The intervention featured three core modules: family support, symptom management, and coping skills. Participants engaged with these modules weekly via the CRCWeb mobile application, learning the content and integrating the activities into their daily routines. Feasibility outcomes (retention, adherence, and acceptability) and efficacy outcomes (PNS measured by PROMIS®) were evaluated among the participants.

Findings and Interpretations

The trial enrolled 20 CRC patient-caregiver dyads (40 participants), with 70% identifying as Black and 55% from disadvantaged backgrounds. The enrollment rate was 54.2%, and retention was 75%. Among retained participants, 87.5% completed all three modules and logged into CRCWeb at least three times, with logins ranging from 3 to 34. Overall, 85% of participants found CRCWeb useful and 95% of participants expressed satisfaction with it. Preliminary analyses showed a significant reduction in PNS, with average scores dropping from 2.477 (SD = 0.726) pre-intervention to 2.313 (SD = 0.754) post-intervention (p = 0.005). We also explored two social determinants of health closely related to symptom reduction: years of education and income level. The trend indicates that individuals with lower levels of education tend to experience more reductions in symptom levels (p = 0.07). Additionally, the data suggests that the more frequently participants login to CRCWeb, the greater their symptom level reduction.

Discussion

CRCWeb demonstrated high feasibility, acceptability, and promising preliminary efficacy in reducing PNS among CRC patients and their caregivers. These findings highlight its potential to address disparities and alleviate symptom burden in disadvantaged populations. Future research, including randomized controlled trials with larger sample sizes and extended follow-up periods, is warranted to rigorously evaluate its effectiveness.

Oncology Nursing Forum. 2025 Mar 1;52(2):42–43.

RS97. Exploring the Intersection of Gut Health and Well-Being among Healthcare Providers: A Cross-Sectional Study

Linda Liu ¹, Simi Joseph ²

Purpose

This study aims to assess the prevalence of gastrointestinal symptoms among healthcare providers and explore their association with stress levels, clinical practice environments, and quality of life in acute and outpatient care settings.

Significance

The well-being of healthcare providers is critical for the delivery of high-quality patient care. However, stress, burnout, and challenging clinical environments have significant implications for both mental and physical health, including gut health. The gut-brain axis highlights the intricate connection between gastrointestinal health and stress, with gut health issues potentially affecting overall well-being and job performance. Despite its importance, limited research has been conducted on the prevalence and impact of gut health issues among healthcare providers.

Methods

Using a cross-sectional survey design, 1500 healthcare providers from Cook County Health were invited to participate, with a target sample size of 102 respondents. The survey was conducted from December 15, 2024, to January 15, 2025, assessing demographics, gut health, stress levels, clinical environment factors, and quality of life using validated tools. Data analysis included descriptive statistics, t-tests, chi-square tests, and logistic regression to identify significant associations and predictors of gut health issues.

Findings and Interpretations

This study aims to provide novel insights into the relationship between stress and gut health among healthcare providers and identify actionable interventions to improve their well-being. The survey results will be available by January 31, 2025. As of December 18, 2024, there have already been 73 responses.

Discussion

Understanding the interplay between gut health and well-being can inform targeted interventions to enhance the physical and mental health of healthcare providers, ultimately promoting resilience and better patient outcomes.

Oncology Nursing Forum. 2025 Mar 1;52(2):43.

RS98. A Survivorship Program for Hodgkin’s Lymphoma in Brazil: Highlights for Estructuration

Luciana Lopes Manfredini ¹, Camila Viale Nogueira ², Bianca Scavazza ³

Purpose

70–80% of patients achieve a cure for Hodgkin’s Lymphoma (HL) with the available treatments. Despite the high survival rate and the promising treatments for this disease, there is a risk of late toxicity, which is a significant concern for HL survivors and challenges and encourages modern trials to focus on increasing cure rates and reducing long-term toxicity.

Significance

Accordingly, we aim to review the literature to develop care guidelines for HL survivors based on scientific evidence and that consider the Brazilian reality.

Methods

Methodological, exploratory study. A literature search was conducted on the main late effects of lymphoma survivors, and we conducted a database survey of patients treated at the institution for characterization purposes.

Findings and Interpretations

During the period from 2017 to 2024, the center attended to 439 cases of HL. The main long-term events reported in the literature are related to the development of cardiovascular diseases, cognitive impairment related to attention, working memory, and visual memory, concerns about the emergence of secondary cancers, endocrine toxicities involving the thyroid gland, infertility, and the risk of osteoporosis.

Discussion

Significant challenges persist in long-term care, and one of the gaps is the monitoring of patient-reported outcome measures, understanding the impacts not only on physical health but also on mental and social health through self-reports. Long-term studies with Brazilian patients are not available, so we find it timely to characterize the Brazilian population and the access difficulties. Currently, there are no well-defined programs for monitoring the fertility of oncology patients, only in more specialized centers, for example. Nursing can be a pioneer in designing the care pathway by taking a holistic view of the patient’s needs and structuring the survivorship program. Establishing an appropriate journey with the multidisciplinary team will bring more quality of life to the surviving patient.

Oncology Nursing Forum. 2025 Mar 1;52(2):43–44.

RS99. Exploring the Symptom Experience of Patients Taking Oral Anticancer Medications for Multiple Myeloma: A Qualitative, Descriptive Study

Abigail Lustyik ¹, Emily He ², Corrine Bozich ³, Grace Booze ⁴, Petra Duran Basso ⁵, Sarah Belcher ⁶, Sarah Belcher ⁷, Sarah Belcher ⁸

Purpose

Long-term oral anticancer medications (OAMs) are a mainstay of life-sustaining treatment for patients with multiple myeloma but can have dose-limiting side effects. Little is known about the symptom experience of patients taking these therapies. This study aimed to describe the symptom experiences of individuals taking OAMs for multiple myeloma.

Significance

The aim of this study is to explore the often overlooked and poorly understood symptom and side effect experience of patients taking OAMs for multiple myeloma.

Methods

This qualitative, descriptive study was a secondary analysis of semi-structured interviews (n=17) conducted between 3/2022–3/2023 as part of a larger mixed methods study of adherence to OAM maintenance therapy for multiple myeloma. Patients were recruited from a Comprehensive Cancer Center in Western Pennsylvania. Sociodemographic and clinical characteristics were collected via self-report and medical record review. The Edmonton Symptom Assessment Scale (ESAS) characterized overall (sum score range: 0–100) and individual (range: 0–10) symptom severity. Two reviewers independently analyzed interviews, using content and thematic analyses, and identified qualitative codes. Codes were organized into larger themes.

Findings and Interpretations

Most patients were male (n=13, 76.5%) and non-Hispanic white or Black (n=12, 70.6% and n=3, 17.6%) or Hispanic “other” race (n=2, 11.8%). Patients were taking either lenalidomide (n=13, 76.5%) or pomalidomide (n=4, 23.5%). The average participant age and median time on OAM therapy was 58.8 years (range: 36–80) and 16 months (IQR = 7; implementation adherence phase), respectively. The median overall symptom severity score was 13 (IQR = 24), with the most severely rated individual symptoms being worse sleep, fatigue, and pain (median scores: 3, 1, and 1, respectively). Four main symptom experience themes emerged: ambiguous patient attribution of symptoms (unclear symptom attribution – cancer or side effect from OAM or other); burdensome symptoms that interfered with life (causing psychological distress and life role limitations); variable provider interventions for symptoms (patient education, pharmacological intervention, specialty referrals); and the need for self-management of symptoms (lifestyle modifications, coping strategies, acceptance).

Discussion

Findings highlight the unique and burdensome symptom experience of patients taking OAMs for multiple myeloma. Symptom scores were low overall but varied. Symptoms varied and may be attributed to disease and/or medication side effects. Future research should further quantify the prospective symptom experience of patients taking OAMs for multiple myeloma to better support patient adherence to OAM therapy for multiple myeloma.

Oncology Nursing Forum. 2025 Mar 1;52(2):44.

RS100. Reduction of Pressure Injury Incidence in Oncology Patients: Educational Action with the Multiprofessional Team

Daiane Maroto Lopes Silva ¹, Taize Aparecida Sipauba Ceballos ², Adriana Zancheta Sousa Costa ³

Purpose

This study aimed to evaluate the impact of educational interventions implemented with the nursing team, which resulted in a 0.83% reduction in PI incidence over 10 months.

Significance

Cancer patients, depending on their performance, may present more or fewer risk factors for developing various skin lesions, with pressure injury (PI) being one of the most notable. The cancer treatment itself is an important risk factor for the increased incidence of pressure injuries.

Methods

A root cause analysis was conducted using the Ishikawa Diagram, based on data from the previous three months, to identify factors contributing to the high PI incidence. Subsequently, an action plan was developed, including workshops, training sessions, and case discussions with the multiprofessional team.

Findings and Interpretations

The study revealed that early intervention with educational actions directed at multiprofessional teams led to a significant reduction in the incidence of pressure injuries (PI). The results indicate that the implementation of preventive care protocols and continuous education of the teams are essential in reducing the risk of pressure injuries.

Discussion

This action resulted in a significant improvement in the unit’s indicators, contributing to enhanced quality of care, greater engagement with the multiprofessional team, and the elimination of additional costs related to the treatment of pressure injuries (PI), also helping to reduce financial costs for the institution.

Oncology Nursing Forum. 2025 Mar 1;52(2):44–45.

RS101. Oncology Nurses’ Palliative Care Instructional Assessment

Micah McArthur ¹

Purpose

The purpose of this study was to determine (a) what effect a palliative care online module has on the understanding of palliative care options in solid tumor oncology nursing care, and (b) what effect an online palliative care module has on a solid tumor oncology nurse’s recognition of palliative care options in solid tumor oncology nursing care.

Significance

Palliative care is a comfort care measure that compliments care of the chronically ill patient involving the mind, body, and soul. It is recognized as part of the solid tumor oncology patient treatment plan. Oncology nurses of patients with solid tumors often lack knowledge of palliative care regarding awareness in pain management, disease symptom management, and crucial conversations regarding goals of care which can result in costly, lower quality healthcare. Improving palliative care awareness creates nursing opportunities to advocate for the addition of comfort care measures for oncology patients.

Methods

This was a quantitative, one group pretest/posttest study, guided by the humanistic nursing theory. The Palliative Care Quiz for Nurses was utilized as the pretest/posttest and the online module providing information on palliative care was developed by the Center to Advance Palliative Care. Permissions were obtained to utilize these tools. The participants completed this research in an online environment. An online platform was utilized so participants could access the consent and study instructions, the demographic questionnaire, the pretest, online informational module, and the posttest.

Findings and Interpretations

There were 67 solid tumor oncology nurses that participated in this research. Data were analyzed using a dependent samples t test, which revealed a statistically significant difference in understanding of palliative care options (p < .001) with an effect size of d = .486, and a statistically significant difference in solid tumor oncology nurses’ recognition of palliative care options (p < .001) with effect size of d = .486. This moderate effect size represents the possibility of a positive impact to clinical practice through education.

Discussion

Future qualitative and mixed methods studies should be conducted which could provide information for better understanding of what knowledge solid tumor nurses need to understand palliative care. Having more nurses with specialized knowledge of palliative care could lead to improved quality of solid tumor oncology patient care and patient outcomes which may affect positive social change.

Oncology Nursing Forum. 2025 Mar 1;52(2):45–46.

RS102. Enabling Remote Access to Breathe Easier: Testing the Feasibility of a Mobile Mindfulness-Based Symptom Self-Management Intervention for Survivors of Localized Lung Cancer

Karen Kane McDonnell ¹, Amanda Dyer ², Fattona Umari ³, Matt McGrievy ⁴, Otis L Owens ⁵

Purpose

Our purpose was to adapt an evidence-based, in-person 8-week mindfulness intervention Breathe Easier (BE) into a progressive web application (PWA) to expand its accessibility and enhance sustainability. Primary specific aims included: 1) Adapt BE content to a mobile-accessible format; 2) Evaluate the feasibility of the BE PWA (usability, acceptability, intervention adherence, and content quality).

Significance

Approximately 80% of patients with lung cancer will be diagnosed with non-small cell lung cancer (NSCLC), and about 25% will present with localized disease (stages I–III). Post-treatment, survivors can experience debilitating emotional and physical health problems that compromise their quality of life. Public health, diagnostic and treatment advances are improving five-year survival rates (currently 59% for stages I–II, 32% for stage III) meaning survivors are living longer. Developing recovery-focused interventions for self-managing lung cancer as a chronic illness is imperative.

Methods

Feasibility testing was accomplished over an 8-week period. A purposive sample of ten survivors were recruited and provided with PWA access using an Android phone. In-person training was provided. Weekly recorded telephone chats assessed their experiences. Pre-and post-test surveys determined intervention feasibility and health status changes (breathlessness, fatigue, and quality of life). Exit interviews were conducted. Descriptive statistics were utilized for demographic, health status, and feasibility measures. All qualitative data was organized and managed using NVivo (v. 14) which allowed the computation of intercoder reliability. Thematic analysis was used to analyze qualitative data.

Findings and Interpretations

Participants’ average age was 69.1 years. They were mostly female (80%), white (70%), college-educated (50%), and reported being in good health (70%). Half were retired (50%), married (50%), and had earned incomes exceeding 50k/year. Of the 7 participants who completed pre-and post-tests, all experienced meaningful improvements in their health status. The BE PWA had both high acceptability and usability scores. The average BE PWA use over the 8-week intervention was 27 minutes daily. Exit interviews determined that participants were satisfied, planned to incorporate mindfulness into their lives, and felt shortly after treatment completion was the right time for PWA implementation. Participants gave suggestions to improve the PWA for future use.

Discussion

BE has the potential to improve symptom self-management through an on-demand mobile intervention. This feasibility testing provides insight into minor revisions and expanded intervention testing, with future impact extending nationwide.

Oncology Nursing Forum. 2025 Mar 1;52(2):46.

RS103. Association of Spiritual/religious Coping With the Health-Related Quality of Life of Women with Breast Cancer

Renata Menezes ¹, Simone Kameo ², Natália Santos ³

Purpose

The breast has several symbologies for women, as femininity, breastfeeding, self-esteem and beauty. In view of this, the presence of this type of cancer in a woman’s life can influence her behavior and impact several domains of her life.

Significance

Due to the diagnoses and treatments with new technologies and the number of women living with breast cancer, the greater interest in improving the health-related quality of life (HRQoL) of these patients is justified. And the spiritual/religious coping (SRC) is a variable related to HRQoL. The aim of this study was to evaluate the association of spiritual/religious coping with the health-related quality of life of women with breast cancer undergoing cancer treatment.

Methods

This was across-sectional, quantitative, descriptive and analytical research, conducted from March to October 2020, at Hospital de Câncer de Pernambuco, in Recife, Pernambuco, Brazil. Three assessment instruments were used - Sociodemographic and Clinical Characterization, Functional Assessment of Cancer Therapy-Breast plus Arm Morbidity (FACT-B+4) and Spiritual/religious coping scale (SRCOPE Scale). The scores of these last two instruments were calculated and analyzed according to the validation productions of the questionnaires. For the analyzes between the SRCOPE Scale indices and the domains of the FACT-B+4 questionnaire, two statistical tests were applied: the Shapiro-Wilk test and the Spearman correlation. The study did not have funding sources.

Findings and Interpretations

The sample size composed of 39 women, mostly adults (79.5%), married/stable union (48.7%), submitted to mastectomy along with lymphadenectomy (53.8%), Catholic (53.8%). A weak positive correlation was verified between the Social/family well-being domain of the FACT-B+4 questionnaire between the items SRC Positive and SRC Total of the SRCOPE Scale.

Discussion

Despite the existence of a positive, albeit weak, correlation between the two instruments, it is evident that HRQoL correlates with positively with spiritual and emotional well-being. The social and family support are fundamental factors for bringing the individual closer to religion, spirituality, belief or faith. Likewise the existence of religious beliefs and spiritual/religious coping are associated with an increase in the perception of social support. In this way, it is understood that the coping strategies need to be worked on in the first contact of the woman with the diagnosis of breast cancer, as well as the practices of nursing professionals must achieve a balance between the physical, emotional, social and spiritual domains.

Oncology Nursing Forum. 2025 Mar 1;52(2):46–47.

RS104. Unraveling Blinatumomab-Associated Neurotoxicity: Incidence and Interventions

Jessica Miles ¹

Purpose

The purpose of this research study was to assess incidence and symptoms of neurotoxicity associated with blinatumomab treatment of acute lymphoblastic leukemia (ALL) and identify related interventions taken.

Significance

Blinatumomab was the first bispecific antibody approved by the FDA, engaging CD3+ T-cells and cells expressing CD19 in the treatment of ALL. As research expanded in this field, a neurotoxicity syndrome associated with drugs that engage the T-cells against cancer cells was defined by the American Society of Transplant and Cellular Therapy (ASTCT), termed Immune Effector Cell-associated Neurotoxicity Syndrome (ICANS). In 2019, the ASTCT published guidelines for identifying, grading, and treating ICANS, utilizing the Immune Effector Cell-associated Encephalopathy (ICE) Score. In 2024, the blinatumomab prescribing information was updated to include the incidence of neurotoxicity consistent with ICANS in clinical trials, based on the data collected at the time of the trial. Newer bispecific antibodies have been studied using the ASTCT guidelines and include treatment algorithms based on ICANS grading. However, blinatumomab recommendations remain vague, leaving a gap in nursing assessment and interventions.

Methods

We conducted a retrospective cohort study of adults who received their first blinatumomab cycle for ALL on the inpatient unit at an academic tertiary medical center between 2020–2023. Information related to medication administration, disease process, and adverse events, including neurotoxicity, was extracted from electronic medical records. Descriptive statistics were used to examine rates of neurotoxicity and subsequent interventions.

Findings and Interpretations

The cohort included 28 patients with ALL who began blinatumomab treatment during the study period. Over half of patients (57%) experienced some grade of neurotoxicity (11% Grade 1, 18% Grade 2, 29% Grade 3). No patients experienced Grade 4 neurotoxicity or required ICU support. The most frequent manifestations of neurotoxicity were headache (39%), encephalopathy (39%), and tremors (36%). In the full cohort, 46% experienced encephalopathy and/or aphasia, consistent with ICANS symptoms. Interventions for management of neurotoxicity included holding the blinatumomab infusion up to 72 hours (81%) and initiating steroids (81%).

Discussion

Neurotoxicity remains a common adverse effect associated with blinatumomab treatment. We observed a higher incidence of symptoms consistent with ICANS than was reported per the manufacturer. Utilizing defined assessment tools, such as the ICE Score, would standardize nursing assessment and grading of neurotoxicity similar to newer bispecific antibodies and potentially prevent treatment interruptions due to more mild symptoms.

Oncology Nursing Forum. 2025 Mar 1;52(2):47.

RS105. Awareness and Effectiveness of Safety Precautions for Prevention of Secondary Exposure by Caregivers at Home: A Pilot Study

Dalete Mota ¹, Laurel McEllistrem ², Jordan Dow ³

Purpose

This study aimed 1) to investigate awareness regarding safety precautions for prevention of exposure to chemotherapy residues at home, and 2) to verify if caregivers are exposed to chemotherapy residues at home.

Significance

Intravenous (IV) infusion remains the most common route for administration of chemotherapies for cancer treatment at outpatient clinics. Part of the chemotherapy is excreted still in its active form, potentially contaminating the home environment and those who live in the same household. Nurses and other oncology team members instruct cancer patients and caregivers about the risks associated with exposure to chemotherapy at home. The evidence is scarce about how much patients and caregivers recall about the instructions they receive and their adherence to them, and little is known about the effectiveness of the measures adopted at home to prevent secondary exposure.

Methods

After IRB approval, a study was conducted with patients receiving IV chemotherapy containing platinum-based agents and caregivers from an outpatient cancer clinic in the Midwest. They answered a two-part survey regarding ten instructions commonly provided by oncology teams: the first part asked recollection of safety precaution instructions, and the second asked if they followed instructions. Patients provided urine and saliva for seven consecutive days, and sweat samples. Caregivers provided urine samples for the same period. Biological samples were analyzed using inductively coupled plasma mass spectrometry.

Findings and Interpretations

Five surveys and 160 biological samples were analyzed from five patient-caregiver dyads. Most participants reported receiving safety instructions from the nurse yet only remembered part of the instructions provided (compared to standard recommendations), and even fewer participants followed the instructions. They were most aware of the instructions to flush the toilet twice with lid closed and to use gloves when cleaning bathroom. The instructions most followed were related to the toilet. Data from biological samples suggests that caregivers are exposed to platinum at home with similar levels of patterns over the 7-day period of data collection.

Discussion

Participants recognize nurses for delivering safety instructions. Strategies to reinforce protective measures at home should be explored, as should further investigating exposure and its consequences. Reflections about the pilot study include the challenges of recruiting patients and caregivers and logistics related to daily sample collection.

Oncology Nursing Forum. 2025 Mar 1;52(2):47–48.

RS106. Patterns and Predictors of Colorectal Cancer Screening Behaviors among African Immigrants in the United States: An Integrative Review

Chinomso Nwozichi ¹, Ogechi Eke ², Isaac Kuhn ³, Emilo Meza Ortiz ⁴, Janet Konneh ⁵, Glenkeith Phillip ⁶

Purpose

To explore the patterns and predictors of CRC screening behaviors among African immigrants in the United States to identify barriers, facilitators, and opportunities for intervention.

Significance

Colorectal cancer (CRC) is a leading cause of cancer-related morbidity and mortality in the United States. Early detection through routine screening significantly improves survival rates. However, African immigrants often exhibit lower CRC screening rates compared to other populations due to unique cultural, socioeconomic, and systemic factors. Understanding both the patterns and predictors of screening behaviors within this population is vital for reducing disparities.

Methods

An integrative review framework was used to synthesize quantitative and qualitative research studies. Databases such as PubMed, CINAHL, PsycINFO, and Embase were systematically searched for studies published between 2010 and 2024. Search terms included “colorectal cancer screening,” “African immigrants,” “predictors,” “screening behaviors,” and “United States.” Articles were included if they focused on CRC screening in African immigrants, identified factors influencing screening behaviors, and were peer-reviewed. A thematic analysis was conducted to extract and categorize key patterns and predictors.

Findings and Interpretations

The review identified low CRC screening rates among African immigrants, often influenced by factors such as limited awareness, healthcare access, cultural beliefs, and language barriers. Predictors of screening included higher socioeconomic status, health insurance coverage, regular interaction with healthcare providers, and acculturation. Facilitators such as culturally tailored interventions, faith-based initiatives, and community health outreach programs showed promise in promoting screening. Gender and educational attainment were also significant predictors, with women and individuals with higher education levels more likely to engage in CRC screening.

Discussion

Understanding the patterns and predictors of CRC screening behaviors among African immigrants is critical for designing effective interventions. By addressing specific barriers and leveraging facilitators, healthcare systems can improve CRC screening uptake, ultimately reducing disparities and advancing health equity within this underserved population.

Oncology Nursing Forum. 2025 Mar 1;52(2):48.

RS107. Correlations Between Perceived Health Ratings, Colorectal Cancer Screening, and Digital Health Literacy Among Rural Dwellers

JoAnn Oliver ¹

Purpose

This pilot study aimed to investigate the correlation between a pilot study of rural dweller’s perceived health status, Digital Health Literacy (DHL) and Colorectal Cancer Screening among a subgroup of rural African Americans in Alabama.

Significance

The colorectal cancer (CRC) incidence rate in Alabama is 43.5 per 100,000 population, which is significantly higher than the national rate of 39.5. Additionally, the colorectal cancer mortality rate in Alabama is 16.1 per 100,000 population, exceeding the national rate of 14.3. l cancer screening among adults aged 45–75 years in Alabama was 58.6% (95% CI(55-9-61.2. There were no studies that focused on perception of health, Digital literacy and colorectal cancer screening among rural African Americans. Digital health literacy is vital to maintaining good health today, but it has become yet another barrier to healthcare for certain demographics, such as minority, rural, and elderly populations/

Methods

The sample participants completed surveys and were from four Alabama counties: Barbour, Lowndes, Marengo, and Sumter. DHL describes the skills to successfully navigate and use digital or electronic health information and patient resources. Data were collected from 14 African Americans, mainly women (76.8), with an average age of 61.8 years. The average travel time to reach a healthcare provider was 40.7 minutes. Participants indicated if they had smartphone and/or computer access. Participants were also surveyed on their skill level and knowledge of certain technologies. This data was codified into a DHL scale which was scored 0–12. A score of 0 indicates low DHL and a score of 12 indicates high DHL.

Findings and Interpretations

The average age of the 14 participants was 61.8 years. All were African American, majority female (76.9). and married (66.7). Over Seventy-six percent had not screened for colorectal cancer. Our data showed that of those with fair or poor health 50% had no access to a smartphone or computer.

Discussion

These results indicate the need for DHL intervention in rural African American communities. Low DHL can be another barrier to health care for the already at-risk population of rural African Americans. This study indicates the need for educational resources targeted to increase colorectal cancer awareness, risk and screening options. Increasing the use of digital access and literacy could be a significant factor colorectal cancer screening uptake.

Oncology Nursing Forum. 2025 Mar 1;52(2):48–49.

RS108. Financial Experiences of Black/african American Breast Cancer Survivors: A Meta-Ethnography using the Noblit and Hare Method

Anita F Oppong ¹, Gee Su Yang ², Cheryl Tatano Beck ³

Purpose

Breast cancer (BC) is a leading cause of cancer-related morbidity and mortality and imposes substantial financial strain on individuals and society. Racial minorities, particularly Black/African American (AA) women, face a heightened risk of financial toxicity during treatment, even when socioeconomic differences are accounted for. This review aimed to explore and provide meaningful interpretations of the financial experiences of Black/AA BC survivors (BCS).

Significance

The financial burden of BC treatment disproportionately affects Black/AA women, who are already impacted by systemic inequities in healthcare access and economic resources. Understanding this issue is crucial for improving treatment adherence, quality of life, and survivorship outcomes.

Methods

We conducted a systematic search to synthesize qualitative studies, published from 2009 to 2024, on the financial experiences of Black/AA BCS during treatment. The Meta-Ethnography Reporting Guidance (eMERGe) was used to follow the seven phases of meta-ethnography as outlined by Noblit and Hare (1988). Quality assessment of the studies was done using the Joanna Briggs Institute critical appraisal tool.

Findings and Interpretations

Seven studies involving 169 participants (136 Black women) were analyzed, with ages ranging from 28 to 80 years. The analysis revealed six (6) key themes related to profound financial concerns among Black/AA BCS, reflecting the multidimensional nature of financial toxicity. Survivors reported difficulties affording treatment despite having insurance, with many experiencing bankruptcy and struggling to support their families due to treatment costs. This financial instability led to significant psychological stress, indirectly influencing health outcomes. Financial strain also contributed to reduced treatment adherence and missed appointments. Recurring concerns about future financial burdens, such as lowered credit scores and ongoing debt, were prevalent. To cope with these challenges, some survivors relied on external resources, including cancer support programs, assistance from pharmaceutical companies, and clinical trial participation to offset treatment costs. These findings highlight the pervasive impact of financial burden on Black/AA BCS.

Discussion

This review highlights the substantial financial challenges faced by Black/AA BCS, an issue insufficiently addressed in the literature. These financial burdens extend beyond medical expenses, affecting treatment adherence, psychological well-being, and long-term quality of life. Addressing these disparities requires targeted interventions, such as improving access to affordable care, expanding financial assistance programs, and enhancing awareness of available resources. Systemic changes to reduce economic barriers and promote equity in healthcare delivery are critical to improving survivorship outcomes for Black/AA BCS.

Oncology Nursing Forum. 2025 Mar 1;52(2):49–50.

RS109. Cancer Rehabilitation Program: Analysis and Policy Proposal

So-Hyun Park ¹

Purpose

This study aims to analyze current cancer rehabilitation policies, examine Medicare reimbursement policies related to cancer rehabilitation, and propose policy change to improve cancer rehabilitation programs.

Significance

Oncology Nursing Society position statement emphasizes that cancer rehabilitation care is a right for all cancer patients at any stage of cancer and it should be a comprehensive and interdisciplinary approach including cancer patients and their families as decision makers. However, cancer rehabilitation program is currently not consistently structured and provided to all cancer survivors due to lack of health care policy that assures quality cancer rehabilitation program. Currently, cancer rehabilitation program is mainly provided by tertiary hospitals under rehabilitation department and objectives of cancer rehabilitation program may vary by facilities depending on their resources and policies.

Methods

This study will analyze current policies and guidelines related to cancer rehabilitation, including Medicare reimbursement policies, and evaluate the cardiac rehabilitation program as a model for policy development, with a focus on the Medicare Improvements for Patients and Providers Act. Additionally, the study will review conceptual foundations and key components of cancer rehabilitation programs.

Findings and Interpretations

Systematic approach is needed to assess patient’s rehabilitation need at the time of diagnosis and cancer rehabilitation program needs to be designed to follow patients throughout their progress. It should be verified in the policy that cancer rehabilitation program is provided as continuum of care that fits and follows each patient’s need and progress through different facilities. Cancer rehabilitation program also should not be limited to a certain number of sessions. Monitoring for cancer rehabilitation program should be based on the patient’s type of cancer, its trajectories, treatment modalities, and expected side effects rather than number of sessions they received. Additionally, expanding Medicare to include the full spectrum of rehabilitation services is critical to ensure equitable access to high-quality care for all cancer survivors.

Discussion

Cancer rehabilitation program which includes physical, nutritional, psychological, informational, practical, spiritual, social, and financial domain is critical for cancer survivors to regain their previous function and maintain quality of life. Implementation of a consistent cancer rehabilitation model reimbursed by Medicare across different healthcare settings would ensure that all cancer survivors have access to similar quality of care, regardless of their location or the specific facility where they receive treatments.

Oncology Nursing Forum. 2025 Mar 1;52(2):50.

RS110. Korean American Women’s Compliance with American Cancer Society Dietary Recommendations

So-Hyun Park ¹, Jin Young Seo ²

Purpose

The purpose of this study is to examine Korean American women’s compliance level to dietary recommendations from American Cancer Society (ACS).

Significance

Incidence rates of breast cancer is increasing in Korean American women. Organizations including ACS provide guidelines for cancer prevention through weight management, physical activity, healthy diets, and reduced alcohol consumption. However, research on compliance with such recommendations in Korean American women remains limited. The unique dietary habits and cultural practices of ethnic minority groups, such as Korean American women, present distinct challenges for adherence to these recommendations. Understanding compliance level is essential for cancer prevention and addressing health disparities in this vulnerable population.

Methods

Korean American women participated in the quasi-experimental study of Koren Breast Cancer Risk Reduction Program which was a culturally tailored, community-based educational program designed to reduce breast cancer risk and increase screening. Participants’ diet data were collected with 4-day diet records. Participants were instructed on completing 4-day diet records using familiar household tools including standard measuring cups, spoons, and other typical kitchen items commonly found in Korean households. Diet data were analyzed using ESHA Food Processor nutrition analysis software program.

Findings and Interpretations

Fifty Korean American women who were at high risk for developing breast cancer participated in the study. At baseline, participants’ average daily serving of fruits and vegetables was 3.1, red meat was 0.8, and alcohol was 0. Fiber intake was used as a proxy for whole grain consumption and average daily total fiber intake was 4.7. Results showed low adherence level to the ACS dietary recommendations.

Discussion

The results underscore the significance of improving dietary behaviors among Korean American women to adhere to ACS dietary recommendations. Low compliance with these recommendations poses an increased risk for breast cancer, as diet plays a pivotal role in cancer prevention. Nurses and advanced practice nurses must recognize the unique dietary challenges faced by Korean American women and educate them to make informed dietary choices that reduce their risk of breast cancer and improve overall health outcomes.

Oncology Nursing Forum. 2025 Mar 1;52(2):50–51.

RS111. Family Caregivers as Hidden Patients: The Role of Chronic Conditions in Health and Caregiving Outcomes

Sumin Park ¹, Patricia Brandt ², Lauren Jones ³, Susan R Mazanec ⁴

Purpose

This study aims to describe the prevalence and types of chronic conditions among family caregivers (CGs) and examines their relationships with burden and health outcomes in CG and patients with cancer.

Significance

Growing evidence shows that caregiving responsibilities can adversely affect CGs’ physical and mental health, which, in turn, impact the well-being of the care recipient. As “hidden patients,” CGs face unique health challenges that are often overlooked. This study highlights these issues to inform interventions and policies that reduce burden and improve outcomes.

Methods

Baseline data from an ongoing randomized clinical trial testing a psychoeducational intervention using simulation techniques were analyzed. Information on nine chronic conditions, including arthritis, diabetes, high blood pressure, and stroke, was collected. Study variables were assessed using the PROMIS Global Health, PROMIS Fatigue 7a, Caregiver Reaction Assessment, and a single-item measure of health status. Data analyses included descriptive statistics, t-tests, and Pearson’s correlation.

Findings and Interpretations

Of the 244 CGs, 177 (72.5%) had at least one chronic condition, with 105 (43.0%) reporting multiple comorbidities. The most common condition was high blood pressure (n=93), followed by arthritis (n=76) and emotional or psychiatric problems (n=43). CGs with chronic conditions reported poor physical health (t=4.59. p<.001) and mental health (t=2.62, p=.009), greater fatigue (t=−.233. p=.021), and higher burden in the health problem domain (t=−2.15, p=.033). Additionally, CGs with more chronic conditions showed worse physical health (r=−.44, p <.001), mental health (r=−.28, p<.001), fatigue (r=.29, p<.001), and poorer patient health (r=−.19, p=.003).

Discussion

The findings highlight a significant association between CGs’ chronic conditions and their own health and the health of the patient. These results underscore the need for interventions addressing both caregivers’ health and caregiving responsibilities. Tailored strategies, such as health monitoring, stress management programs, and resources for managing comorbidities, could help mitigate these adverse effects and support caregivers in maintaining their own well-being.

Oncology Nursing Forum. 2025 Mar 1;52(2):51.

RS112. The Patient-Reported Perceptions and Patterns of Weight Change among Women During Early-Stage Breast Cancer Chemotherapy

Xueying Pei ¹, Wanyun Ma ², Margaret Rosenzweig ³

Purpose

Weight change is commonly reported as bothersome by women with early-stage breast cancer (ESBC) undergoing treatment and is also associated with poorer prognoses. Weight gain occurs more frequently than weight loss. These changes are multifactorial and often overlooked due to the acuity of treatment, diagnosis, or the sensitivity of the topic. This study aims to assess the patient-reported perceptions and patterns of weight change among women during ESBC chemotherapy.

Significance

Insights from these patient-reported experiences can help clinicians provide anticipatory guidance to women for potential weight change during chemotherapy and develop effective weight management strategies.

Methods

This longitudinal, descriptive study involved women with stage I–III breast cancer undergoing chemotherapy at seven urban cancer centers in Western Pennsylvania and Eastern Ohio. This research was part of the parent study, Symptom Experience Management and Outcomes According to Race and Social Determinants of Health (SEMOARS), which assessed racial differences in symptom incidence, management, and outcomes during ESBC chemotherapy. Clinical visits were audiotaped and analyzed. Data transcription was conducted using NVivo. Transcripts were purposively selected based on the discussions related to weight change, guided by keywords such as “weight,” “gain weight,” “lose weight,” and “weight change.” Two coders independently reviewed the transcripts to develop the initial codebook, which was compared and refined by reviewing one-third of the selected transcripts. Thematic analysis was performed to identify themes on coded transcripts until saturation was reached.

Findings and Interpretations

Of the total 452 available transcripts, 80 transcripts were included. Among women who perceived weight change, several key themes emerged: sensitivity to weight change (either gain or loss or both), chemotherapy side effects (two subthemes), weight stigma (two subthemes), lack of preparatory information, and diet and physical activity modifications. A distinct pattern of weight change observed was an initial weight loss followed by subsequent weight gain. Overall, women expressed dissatisfaction with their weight gain, as many had expected to lose weight during treatment.

Discussion

These findings highlighted a general lack of knowledge and support regarding potential weight change and management strategies for women during ESBC chemotherapy. Further personalized information and interventions are important to address these challenges, empowering women to better navigate weight change during their treatment.

Oncology Nursing Forum. 2025 Mar 1;52(2):51–52.

RS113. Patient- and Clinician-Perceived Barriers to and Facilitators of Implementing a Nurse-Led, Technology-Enhanced, Algorithm-Mediated Remote Symptom Management Application

Rachel Pozzar ¹, Rachel Pozzar ², Terri Jabaley ³, Mary Lou Siefert ⁴, Jeidy Batista ⁵, Michael Hassett ⁶, Michael Hassett ⁷, Marilyn Hammer ⁸, Marilyn Hammer ⁹

Purpose

To identify barriers to and facilitators of implementing a nurse-led, technology-enhanced, algorithm-mediated (Nurse TEAM) remote symptom management application.

Significance

Remote symptom management during chemotherapy is associated with better quality of life and fewer emergency department visits. However, optimal strategies for implementing remote symptom management applications in practice are unclear.

Methods

Guided by the Consolidated Framework for Implementation Research (CFIR), we recruited English- and Spanish-speaking patients with solid tumors undergoing chemotherapy and clinicians from two community-based ambulatory oncology clinics affiliated with our cancer center. To identify barriers to and facilitators of implementing Nurse TEAM, participants used a clickable prototype of the application, then completed individual, semi-structured interviews. We analyzed interview transcripts using directed content analysis and a codebook comprised of CFIR constructs. Next, we performed a secondary analysis of employee engagement survey data to identify barriers to and facilitators of implementing clinical practice change. Regular, paid, non-faculty staff at our institution completed the survey anonymously. Item response options were categorized as “favorable,” “unfavorable,” and “neutral.” A subset of items pertained to implementation determinants. We mapped these items to CFIR constructs, then identified those with the highest proportions of “favorable” and “unfavorable” responses.

Findings and Interpretations

In interviews with eight patients and 11 clinicians, facilitators of implementing Nurse TEAM included its planned integration into the electronic health record, evidence-based triage algorithm, and potential to improve symptom self-management. These facilitators represented the CFIR constructs “information technology infrastructure,” “evidence base,” and “relative advantage,” respectively. Barriers to implementing Nurse TEAM included disparate methods of communicating about symptoms across specialties, limited staff resources to respond to patients’ symptom reports, and the potential for symptom alerts to cause alarm fatigue. These barriers represented the CFIR constructs “networks and communications,” “available resources,” and “work infrastructure,” respectively. Among 4,609 survey respondents, organizational “culture” was most frequently rated favorably (96%), while “available resources” and “networks and communications” were most frequently rated unfavorably (21% and 16%, respectively).

Discussion

Qualitative and quantitative findings were congruent and suggest standardizing symptom communication, expanding resources, and optimizing workflows are implementation priorities for remote symptom management. Evidence-based strategies to address the implementation barriers we identified include organizing a clinician implementation team and identifying internal champions. The generalizability of our findings is limited by our single-institution design; nevertheless, our findings warrant consideration when planning novel approaches to remote symptom management.

Oncology Nursing Forum. 2025 Mar 1;52(2):52–53.

RS114. The Relationship Between Interpersonal Support and Receipt of Prescribed Full-Dose Chemotherapy in Early-Stage Breast Cancer: DO Race and Area Deprivation Matter?

Sarina Rashidi ¹, Xueying Pei ², Margaret Quinn Rosenzweig ³; the ONS Research Priority Team

Purpose

The ability to receive the full dose prescribed chemotherapy during early-stage breast cancer (ESBC) may be influenced by interpersonal support, exacerbated by racial and economic disparities. The purpose of this study was to: 1) compare interpersonal support according to race and income among a cohort of women receiving ESBC chemotherapy, 2) compare the amount of prescribed early-stage breast cancer chemotherapy received according to race and area deprivation and to, 3) determine the moderating effect of race and area deprivation on the relationship between interpersonal support and amount of chemotherapy received in ESBC.

Significance

The importance of interpersonal support in the ability to receive cancer therapy must be better understood to ensure equitable, lifesaving cancer treatment for all patients.

Methods

Descriptive, comparative design.

Setting

Large, urban cancer centers in Western PA and Eastern Ohio.

Sample

Women with ESBC receiving chemotherapy.

Instruments

Standard sociodemographic questionnaire. Race was self-report; Area deprivation index (ADI) calculated by patient zip code, higher scores indicating more deprivation, 0–100.

Interpersonal support

Interpersonal support evaluation list (ISEL) combining subscales including “tangible”, appraisal”, “self-esteem” “belonging” and total. Historically mean total is 60–90 among patients with cancer. Dosing of chemotherapy measured through infusion room records /chart review, measured against patient prescription and then percentage of chemotherapy received

Protocol

Baseline measurement prior to chemotherapy among women beginning early-stage breast cancer.

Analysis

Descriptive, comparative, and ANOVA as per SPSS.

Findings and Interpretations

Aims1 and 2

Total cohort –N=278; n=95 Black (33.9%), n=153 White (54.6%). Mean age – 52.9 (SD 12.3). Mean Area Deprivation Index (national) −62.4 (SD 26.7). Mean percentage of prescribed chemotherapy received: 82.9% of total (SD 20.3). Black – 78.9%; White 86.4% (p=.003). There were significant differences p=.05) in interpersonal support according to race (96.1 B vs. 101 W) and for area deprivation, (101.0 HD vs. 97.9 LD).

Aim 3

A significant moderation effect (p=0.035, F=4.524); for race was present between ISEL and chemotherapy received. There was no moderation effect for ADI.

Conclusion

While ISEL scores differ according to race and income, race, but not ADI moderates the relationship between ISEL scores and chemotherapy dose received.

Discussion

Interpersonal support is an important concern when understanding racial disparities in ESBC chemotherapy treatment and outcomes.

Oncology Nursing Forum. 2025 Mar 1;52(2):53.

RS115. Negotiating with Myself: A Grounded Theory Study of how Women with Sporadic Unilateral Early-Stage Breast Cancer Choose Contralateral Prophylactic Mastectomy

Nancy Roecklein ¹

Purpose

To explore and explain how women with a first diagnosis of sporadic unilateral early stage breast cancer choose contralateral prophylactic mastectomy (CPM).

Significance

Women in the United States with a first diagnosis of sporadic unilateral early-stage breast cancer continue to choose CPM, the surgical removal of their unaffected breast, against the advice of experts in the field. The scholarly literature in this area has primarily attempted to understand this surgical phenomenon within the breast cancer treatment paradigm. As such, there has been a focus primarily on shared decision making processes and oncologic outcomes. Given this bias, most studies devalued the choice for CPM and, in some instances, devalued the individual women making that choice, thus revealing a gap in understanding of woman’s direct engagement in the choice process. Direct knowledge of how women consider the choice for CPM is needed to expand nursing knowledge, add depth to the literature, inform best care practices, and attain optimal health outcomes for women.

Methods

Twenty-eight unstructured virtual interviews with women from all seven regions of the United States were conducted by a single researcher. Data collection, coding, and analysis followed classic grounded theory methodology.

Findings and Interpretations

Being done with cancer, defined along eight well-accepted and mutually co-dependent dimensions of wellness, emerged as the main concern among women choosing CPM. Negotiating with myself (NWM), an iterative sensemaking process involving three stages of Readying, Powering, and Prioritizing, emerged as the pattern of behavior which women engaged in to resolve their main concern. NWM was recognizable as a separate and distinct choice process that occurred prior to, and concurrent with, the shared decision making (SDM) process for breast cancer treatment of the affected breast. NWM is distinct from SDM along four variables, namely (1) timing, (2) expertise, (3) underlying choice process, and (4) outcomes. The choice for CPM may be more problematic due to competing messages related to patient empowerment and engagement, healthcare citizen duties, breast cancer narratives, postfeminist makeover culture, and objective breast cancer outcome measures.

Discussion

NWM provides a new conceptualization for how women choose CPM thus providing an inflection point for future research and clinical application. Population level messaging related to women’s health, and the impact such messaging may have on individual women’s healthcare choices, requires additional study.

Oncology Nursing Forum. 2025 Mar 1;52(2):53–54.

RS116. Racial Disparities in Symptom Profiles Over the Course of Early Stage Breast Cancer Chemotherapy

Hiba Abujaradeh ¹, Xueying Pei ², Julia O’Brien ³, Margaret Rosenzweig ⁴

Purpose

This study described and compared the symptom burden (fatigue, pain, and physical functioning) and change over time between Black and White women receiving Early-Stage Breast Cancer (ESBC) chemotherapy while considering social determinants of health.

Significance

Limited research has examined racial disparities in symptom burden prior to chemotherapy initiation, during, and at the completion of chemotherapy.

Methods

A longitudinal, repeated measures comparative design was employed. Time points of symptom measurement (PROMIS domains) at baseline, mid and end point were adjusted as per patient chemotherapy schedule. Linear mixed models were applied.

Findings and Interpretations

There were 149 patients, 36% Black 64% White (54±12 years) recommended to receive ESBC chemotherapy with adequate data for symptom analysis.

Pain

Main effect of race was significant (F(1, 390) = 29.43, p<.001) for pain, with Black patients experiencing significantly higher pain scores compared to White patients at pretherapy (Mean Difference; MD=3.7, p=.034), midpoint (MD=5.8, p=.002), and endpoint (MD=7.8, p<.001). In the model adjusted for area deprivation, BMI, and comorbidities, Black race and higher BMI were significant predictors of higher pain scores. Black patients experienced significant deterioration in pain over time.

Fatigue

Fatigue increased significantly from baseline for Black patients by endpoint (MDT1-T3= 8.7, p<.001) and for White patients at midpoint (MDT1-T2= 5.7) and at endpoint (MDT1-T3=10.1, p<.001). In the adjusted model, higher BMI predicted worse fatigue scores.

Physical function

Black patients had significantly lower physical function scores than White patients at midpoint (MD=4.0, p=.027). Physical function decreased by endpoint in Black (MDT1-T3=7.8, p<.001), and White patients (MDT1-T3=7.7, p<.001). In the adjusted model, only higher BMI and cardiopulmonary comorbidities significantly predicted worse physical function.

Discussion

Symptom burden significantly increased over the course of chemotherapy for all patients. Scores for pain and physical function were higher overall for Black patients and deteriorated at a greater rate for Black vs. White women. BMI was a significant predictor of pain, fatigue, and physical function. This assessment holds implications for proactive assessment and mitigation strategies.

Oncology Nursing Forum. 2025 Mar 1;52(2):54.

RS117. Exploring Psychological Distress among Oncology Nurses: Anxiety, Depression, and Implications for Care Quality IN Jordan

Ahmad Rajeh Saifan ¹

Purpose

This study focuses on how workplace pressures influence the psychological health of oncology nurses in Jordan and the quality of care they provide. It examines the prevalence and impact of anxiety and depression among these nurses, aiming to identify the root causes of distress and offer strategies to mitigate its effects.

Significance

Because of the emotionally demanding nature of their work, oncology nurses are particularly vulnerable to psychological distress, which is a global issue. There is limited research on this subject in Jordan, making this study crucial for understanding the unique challenges faced by oncology nurses in the region. By addressing these issues, the study establishes a foundation for improving nurses’ mental well-being and patient care outcomes.

Methods

Twenty-four oncology nurses from a large Jordanian hospital participated in semi-structured interviews as part of a qualitative methodology. Key themes and subthemes were found using thematic analysis. Throughout the study, rigorous adherence to ethical principles was maintained, including voluntary participation and secrecy.

Findings and Interpretations

Several important conclusions were drawn from the analysis. Anxiety and depression were found to be significantly influenced by high emotional demands, challenging communication with terminally ill patients, and a lack of workplace support. Many nurses experienced work-life imbalance and emotional exhaustion due to their inability to separate personal and professional responsibilities. Psychological distress was further exacerbated by organizational factors, such as unsafe working conditions, lack of recognition, and insufficient staffing. Coping strategies varied; some nurses demonstrated resilience, while others experienced severe burnout, negatively impacting their performance and the quality of patient care.

Discussion

The study highlights the urgent need for targeted mental health interventions for oncology nurses in Jordan. Addressing organizational issues, such as increasing staffing levels, fostering supportive leadership, and ensuring the availability of mental health resources, is essential for reducing stress and enhancing job satisfaction. These findings have global implications, emphasizing the importance of prioritizing nurses’ mental health to improve outcomes for both patients and healthcare providers. Future research should explore the long-term effects of workplace stress and evaluate the effectiveness of interventions aimed at improving nurses’ psychological well-being and the quality of care they provide.

Oncology Nursing Forum. 2025 Mar 1;52(2):54–55.

RS118. Changing the Unit Culture on Pressure Injury Prevention and Management in an Acute Care Medical Surgical Oncology Unit

Emily Schoh ¹, Andrea O’Hern ²

Purpose

The purpose of this mixed-method study was to decrease the number of hospital acquired pressure injuries over a 3-month time period on an adult oncology unit by creating an increased awareness in defining and performing ‘preventative practices’ and developing a standardized process for daily management for treatment and prevention of pressure injuries.

Significance

The hospital uses Microsoft Power BI to collect and measure monthly data rates per unit for hospital acquired pressure injuries. From January to May of 2024, the unit had 24 hospital-acquired pressure injuries (stage 2 to unstageable). Among these pressure injuries, 6 were reportable as defined by the Minnesota Department of Health and the Minnesota Hospital Association. Within these pressure injuries, 62.5% occurred on a patient’s sacrum, coccyx, or buttock area.

Methods

The methods of research included a blend of qualitative and quantitative data. Quantitative data viewed monthly rates of pressure injuries throughout the 3-month pilot and compared this to the previous 6 months. A weekly graph generated from the electronic medical record indicated compliance with turn and repositioning for patients who met intervention criteria according to Braden score. The previous 6-month data was compared to the 3-month pilot data and improvements in consistency were monitored. Qualitative data was gathered using leadership rounding and daily auditing. This data focused on preventative and maintenance practices that were standardized on the unit at the start of the pilot.

Findings and Interpretations

Upon completion, the data showed significant improvement in detection and prevention of pressure injuries. Although the unit had 9 hospital acquired pressure injuries reported during those 12 weeks, none of the pressure injuries were at a stage where it was deemed reportable. The location of pressure injury also changed from 62.5% occurring on the sacrum, coccyx, buttock area to 0%. Preventative measures implemented caused improvement by standardizing the cares and documentation expectations amongst the nursing staff.

Discussion

During the 3-month pilot improvement was made to prevention and treatment practices. To ensure a substantial culture change was well instituted, data measurements were reviewed weekly for 3 months after the pilot. This data showed improvement in preventative practices and a decrease in overall pressure injuries. Due to the pilot success, the healthcare system has looked to this pilot as a trailblazer to improving patient outcomes by changing unit culture through process development and education.

Oncology Nursing Forum. 2025 Mar 1;52(2):55–56.

RS119. Variability in Gene Expression and Patient-Reported Outcome Measures in Patients Undergoing Induction Chemotherapy for Acute Myeloid Leukemia

Joosun Shin ¹, Taichi Goto ², Hilary Heiling ³, Gregory Abel ⁴, Leorey Saligan ⁵, Marilyn Hammer ⁶

Purpose

The incidence of acute myeloid leukemia (AML) is 4.3/100,000. While variabilities in symptom experiences and gene expression have been identified in patients with solid tumors, less is known among patients with hematologic malignancies.

Significance

This study aimed to assess variabilities in patient-reported outcomes (PROs) and correlative peripheral blood gene expression in newly diagnosed patients with AML hospitalized for induction chemotherapy.

Methods

This exploratory pilot feasibility study aimed to enroll a small sample (N = 10) of patients with AML. Symptom questionnaires were completed at enrollment and weekly through week 4 or discharge, whichever came first. Whole blood samples were collected at enrollment and week 4/discharge. Demographic and clinical data were extracted from the Electronic Health Records. PROs (i.e., pain, sleep disturbance, depression, anxiety, global health, physical function) were assessed using the PRO Measurement Information System (PROMIS). Descriptive statistics of demographic, clinical, and symptom variables and coefficients of variation (CV) of peripheral whole blood gene expression for each gene (N = 31,655) at enrollment were calculated to evaluate for variability. Gene set enrichment analysis (GSEA) was conducted on genes with a CV ³0.7 (N = 11,394).

Findings and Interpretations

The median age was 69.5 years (range 35–74), six were female, and all were non-Hispanic White. Median PROMIS T-scores at enrollment were 48.6 (36.3–60.3) for pain, 54.2 (35.7–64.9) for sleep disturbance, 48.6 (37.1–67.9) for depression, 52.3 (37.1–79.9) for anxiety, 42.1 (35.1–50.7) for global physical health, 54.7 (35.5–63.6) for global mental health, and 51.1 (42.2–56.0) for physical function. The median CV of gene expression was 0.48 (0.19–0.92), indicating significant variability. FRMPD2, AC073464, AC103808, ASCL1, and KCNK2 were the five genes exhibiting the most variability. Enriched biological processes included modulation of chemical synaptic transmission, enriched molecular functions (i.e., monoatomic ion channel activity), and enriched cellular components (i.e., collagen-containing extracellular matrix and synaptic membrane) (Figure 1).

Discussion

This exploratory study highlights large amounts of variability in PROs and peripheral blood gene expression among patients with AML undergoing induction chemotherapy. Findings suggest that the symptom experiences of patients newly diagnosed with AML can be highly individualized. Larger, more diverse patient cohorts are warranted to deepen understanding of these variabilities and contributors.

Oncology Nursing Forum. 2025 Mar 1;52(2):56.

RS120. Integrating Palliative Care in Adults Undergoing Allogeneic Hematopoietic Stem Cell Transplantation: An Evidence-based Needs Assessment for Patients and Clinicians

Abigail Short ¹, Mika Kuroki ², Ashley Leak Bryant ³, Katie Allman ⁴, Tamryn Fowler Gray ⁵, Lorinda Coombs ⁶

Purpose

This quality improvement project aims to use an evidence-based palliative care outcome scale to assess the needs of adult allogeneic hematopoietic stem cell transplant (HSCT) recipients at an academic medical center in the southeastern United States. A retrospective review of palliative care referrals revealed that in 2023, of 201 HSCT patients (excluding readmissions), 16 referrals were placed by inpatient providers over 12 months for adult HSCT patients in the Bone Marrow Transplant Unit. Reasons for consultation included goals of care, symptom management, hospice needs, and disease progression.

Significance

Approximately 1.4 million individuals in the United States are diagnosed with hematological malignancies. Due to the complex nature of these conditions, patients often require intensive therapies like HSCTs. While HSCTs have curative potential, they also entail significant morbidity and mortality risks. Palliative care can enhance patient outcomes but is underutilized. There is a pressing need to better identify the timing and severity of unmet palliative care needs from the perspectives of patients and clinicians.

Methods

Adult allogeneic HSCT recipients and clinicians were surveyed every seven days using the Integrated Palliative Care Outcome Scale (IPOS) to evaluate patient needs across four palliative care domains. The surveys assessed previous palliative care experiences, perspectives of patients and clinicians, and demographic information for both groups. Surveys were conducted via a QR code linked to Qualtrics, employing unique patient codes for data de-identification and longitudinal tracking. IPOS scores and demographic data were compared between patients and clinicians.

Findings and Interpretations

A total of 16 patients and 9 HSCT clinicians participated. Preliminary results show clinicians scored an average of five points lower on the IPOS scale than patients, suggesting a discrepancy in perceived palliative care needs. The most notable difference was in the physical domain, with patients scoring an average of 11.4 versus 6.5 for clinicians. Only one patient reported receiving palliative care before HSCT. Patients commonly reported emotional distress, poor appetite, and pain as symptoms that would benefit from palliative care consultation.

Discussion

Findings highlight a critical gap between patient-reported needs and clinician perceptions of palliative care timing and appropriateness in HSCT. Integrating evidence-based assessments can empower patients to communicate their evolving needs, allowing clinicians to better address ongoing palliative care needs. Routine assessments could foster timely interventions, improving patient experience, health outcomes, and overall satisfaction with care.

Oncology Nursing Forum. 2025 Mar 1;52(2):56–57.

RS121. Self-Reported Financial Impact of Cancer Care on the Malignant Hematology Outpatient

Christine Simonelli ¹, Katherine Hagemann ², Richie Reich ³, Tina Mason ⁴

Purpose

The purpose of this study was to quantitatively examine and qualitatively explore the financial impact of cancer care for malignant hematology outpatients as measured by COmprehensive Score for financial Toxicity (COST) FACIT, Consumer Financial Protection Bureau (CFPB) Financial Well-Being Scale, and open-ended questions.

Significance

Financial toxicity from oncology care is at the forefront of the healthcare industry with the growing expense of specialized drug therapy. However, the focus has been on that expense versus the collateral impact on other expenses applied to daily living. Pandemic-related financial losses and personal and family stress can compound this impact. While the term financial toxicity is not new, a better understanding of risk factors, experiences, and outcomes of financial toxicity is needed.

Methods

IRB approval was obtained, recruitment flyers were posted in clinic, and eligible patients were approached by study team members. Interested participants completed a REDCap survey that included demographic tool, COST FACIT version 2, CFPB Financial Well-Being Scale, and open-ended questions. The relationships between participant factors, and financial toxicity and financial wellbeing were tested separately for each factor using univariate linear regression models. Statistical significance was defined as p<0.05.

Findings and Interpretations

Malignant hematology patients (N=122) had a mean age of 62 years, majority were male (53%), White/Caucasian (78%), and Non-Hispanic/Non-Spanish (84%). More than half had some kind of comorbidity (57%). The most common cancer diagnosis was multiple myeloma (33%), followed by non-Hodgkin’s lymphoma (30%), chronic leukemia (20%), acute leukemia (15%), and Hodgkin’s lymphoma (3%). The most common cancer treatment was oral chemotherapy (74%). Factors statistically related to financial toxicity included age (less toxicity in older participants); gender (higher scores for females); education; employment status; annual income; use of Medicaid (more toxicity); and VA insurance (less toxicity). The factors related to financial wellbeing were similar except no insurance factors were significantly related. Themes identified include indirect costs, reducing/eliminating expenses, mental/physical/social impact, and impact on family.

Discussion

Financial toxicity is prevalent in our malignant hematology population. Data will be used to create a comprehensive financial toxicity tool kit with interdisciplinary collaboration. Currently, financial content discussed with patients includes pharmaceutical resources for reduced or free drug programs. Other identified needs, e.g., food insecurity, will be included in the toolkit. Ultimately, this toolkit will be rolled out to all clinics with the expectation of customizing toolkits for individual populations.

Oncology Nursing Forum. 2025 Mar 1;52(2):57–58.

RS122. Investigation of Associations Between Gut Microbiome Related Factors and Fatigue in Patients with Breast Cancer Receiving Chemotherapy – A Pilot Study

Komal Singh ¹, Cindy Tofthagen ², Brenda Ernst ³, Jun Chen ⁴, Stephen Johnson ⁵, Linda Chlan ⁶

Purpose

To evaluate changes in (1) symptom characteristics; (2) gut microbiome abundance; and (3) levels of metabolites in stool and serum, before the first cycle of chemotherapy (T1) and after the first or second cycle of chemotherapy (T2) that are associated with patients who experience fatigue at T2.

Significance

Despite evidence-based interventions, up to 90% of the patients with breast cancer experience fatigue during chemotherapy. Of these patients, up to 30% experience persistent fatigue during survivorship. Identifying risk factors for fatigue will help provide individualized interventions to improve patient quality of life during treatment and beyond. Few studies have investigated underlying biological mechanisms for fatigue. Of these studies, some provide preliminary evidence for associations between gut microbiome related functions and fatigue in patients with cancer. Our pilot study funded by intramural and extramural grant awards investigated several phenotypic factors, gut microbiome abundance and metabolites associated with fatigue.

Methods

Patients with breast cancer (n=35) provided demographic, clinical data, as well as symptom assessment data using the Memorial Symptom Assessment Scale at T1 and T2. In addition, patients provided stool and blood samples at T1 and T2 timepoints. For aim 1 we performed, descriptive statistics and univariate analysis to evaluate differences in symptom characteristics from T1 to T2 in the fatigue group; for aim 2, longitudinal UniFrac distances evaluated changes in microbiome diversity; and, for aim 3, volcano plot analyses identified fold change in metabolites from T1 to T2 in stool and serum that were associated with fatigue.

Findings and Interpretations

Fatigue was associated with chemotherapy-induced gastrointestinal symptoms (i.e., nausea, diarrhea, dry mouth, change in the way food tastes (p<0.05)). In addition, fatigue was associated with a decrease in Firmicutes, increase in Bacteroidetes, an increase in Proteobacteria phyla and changes in levels of several lipid metabolites(p<0.05). Decrease in Firmicutes/Bacteroidetes ratio and a shift in levels of lipid metabolites are associated with inflammatory processes that alter the bidirectional communication in the gut-brain axis which may lead to fatigue and co-occurring gastrointestinal symptoms.

Discussion

Clinicians need to monitor fatigue during chemotherapy and provide appropriate pharmacological/non-pharmacological interventions to improve outcomes. This study provides directions for future research to investigate gut microbiome factors (e.g., lipid metabolites) associated with patient fatigue. Future personalized interventions may include prebiotics/probiotics recommendations to alleviate fatigue and co-occurring symptoms in breast cancer during treatment and beyond.

Oncology Nursing Forum. 2025 Mar 1;52(2):58.

RS123. A Mixed Methods Systematic Review of Access and Early Integration of Palliative care: Characteristics in Non-Hospital Settings

Kim Slusser ¹, Kim Slusser ², Mary Beth Flynn Makic ³, Ashley Leak Bryant ⁴, Figaro Loresto ⁵, Heather Coats ⁶

Purpose

This mixed methods systematic review answers these research questions 1) What are the characteristics of palliative care (PC) access in non-hospital settings in the US for individuals living with cancer? and 2) What factors facilitate or deter whether PC is integrated early alongside standard cancer care?

Significance

In the United States (US), individuals living with cancer experience significant health challenges. Studies have shown that early integration of PC improves the quality of life for these individuals and their care partners/caregivers. The American Society of Clinical Oncology recommends integration of PC as early as eight weeks after a cancer diagnosis. Although 95% of National Cancer Institute Comprehensive Cancer Centers and 40% of other US cancer programs offer outpatient PC, incorporating PC early alongside standard cancer care treatment outside hospital settings remains suboptimal.

Methods

This study followed the Joanna Briggs Institute methodology for mixed methods systematic reviews and used a convergent integrated design. The convergent integrated design converted efficacy and effectiveness findings from quantitative data into qualitative textual descriptions and narrative interpretations. These transformed data were combined with the findings from the qualitative data and synthesized to provide a comprehensive understanding of PC access and early integration. The review included studies published in English between January 2013 and January 2024. The Conceptual Framework of Access to Healthcare and its five dimensions of access (approachability, acceptability, availability, affordability, appropriateness) guided the categorization and organization of the review’s findings.

Findings and Interpretations

The review included 51 studies using quantitative, qualitative, and mixed methods. The findings highlighted facilitators and challenges of PC access and early integration. While findings supported use of traditional PC approaches for early integration, embedded PC clinics, lay navigation, and telehealth were found to be promising alternatives, particularly for historically minoritized and rural populations. The review’s findings led to the development of the Conceptual Framework for Early PC Access and Integration for Individuals Living with Cancer.

Discussion

Unique approaches to early PC integration in practice and research are needed to address existing inequities in PC access and improve early integration for individuals living with cancer and their care partners/caregivers.

Oncology Nursing Forum. 2025 Mar 1;52(2):58–59.

RS124. Let’s Talk About Sex: Incorporating A Resource Guide on Sexual Health During Cancer Treatment

Grace Stearns ¹, Megan Andrasik ², Delaney Ellfeldt ³, Mia Park ⁴, Erin Kugler ⁵, Becky Brown ⁶

Purpose

Identifying and addressing sexuality concerns of female breast and gynecological oncology patients through tailored education and resources.

Significance

Female breast and gynecologic cancer patients receive essential education on treatment side effects but often lack information on how treatments impact sexuality. This gap stems from limited resources and healthcare providers’ discomfort or lack of training in addressing sexual health. Recognizing this need, a team of infusion nurses developed an evidence-based intervention to educate patients and provide crucial resources on sexual health during treatment.

Methods

The nurses conducted a literature review on sexuality in adult female breast and gynecological cancer patients, discovering that many patients lacked adequate information and education. This patient population was selected due to the high correlation with sexual health dysfunction identified in the literature. To address this, the nurses developed a resource guide (in English and Spanish) on sexuality during cancer treatment. This guide was introduced during the initial chemotherapy education visit and used as discussion points during treatment appointments. To further identify sexual concerns, the ‘Sexual Satisfaction Questionnaire’ (SEXSAT-Q) was utilized. The SEXSAT-Q was found to be a reliable tool for measuring sexual satisfaction and concerns in female oncology patients and was administered during Cycle 2 or 3 of their treatment course.

Findings and Interpretations

Over 75% of survey respondents expressed significant concerns about sexuality during treatment, particularly regarding desire, satisfaction, and functioning. 80% found the sexuality resource guide essential to addressing their concerns and provided them with tools to help navigate sexual health issues.

Discussion

Sexual problems are common among breast and gynecological oncology patients, significantly affecting their physical and psychological well-being. Incorporating a comprehensive sexual health resource guide into routine patient education can promote healthy sexual functioning, validate patient concerns, and foster more open communication about sexual health between nurses and patients.

Oncology Nursing Forum. 2025 Mar 1;52(2):59–60.

RS125. Factors Associated with Fatigue for Older Adults with Acute Myeloid Leukemia, Myelodysplastic Syndrome: A Prospective Longitudinal Study

Danielle Steele Anderson ¹, Ashley Leak Bryant ², Lorinda A Coombs ³, Todd Schwartz ⁴, Daniel Richardson ⁵, Victoria Crowder ⁶

Purpose

This prospective longitudinal study investigated fatigue-related factors in older adults with AML/MDS during chemotherapy cycles 1 and 2 with hypomethylating agents and Venetoclax (HMA+VEN). It examined how GI symptoms, nutritional risk, sarcopenia, and functional decline contribute to fatigue and QOL over time.

Significance

For older adults ( ≥60) with acute myeloid leukemia (AML) and myelodysplastic syndromes (MDS), symptoms from the disease and treatments can impair quality of life. Symptoms often include gastrointestinal side effects, which may lead to malnutrition, sarcopenia, weight loss, and fatigue. Malnutrition and sarcopenia further contribute to mobility decline and reduced functional status, outlining the need for a more structured approach to symptom management.

Methods

A quantitative, prospective longitudinal study design was used with assessments conducted every 1–2 weeks during Cycles 1 and 2 of chemotherapy. Assessments included: GI Symptoms and Fatigue: European Organization for Research and Treatment of Cancer Quality of Life Core Questionnaire (EORTC QLQ-C30) fatigue and GI symptom sub-scales; Nutritional Status: Malnutrition Screening Tool (MST), body mass index (BMI), and weight loss tracking. Sarcopenia and Functional status: Hand grip strength and Eastern Cooperative Oncology Group Performance Scale (ECOG). Data analysis was conducted using SAS software using Pearson’s correlation coefficient to explore the relationships between fatigue, nutritional status, and related factors.

Findings and Interpretations

The study identified three key findings:

■ Patients experienced challenges during Cycles 1 and 2 of HMA+VEN treatment, including GI symptoms, increased nutritional risk, weight loss, fatigue, and changes to QOL
■ Baseline fatigue was strongly correlated with diarrhea (r=0.71), ECOG scores (r=0.61), and approached significance with appetite (r=0.59)
■ Changes in fatigue from Cycle 1 to Cycle 2 had a significant negative correlation with patient food security (r=−0.59), and a positive correlation with care partners (r=0.65).Example: patients with improved fatigue during Cycle 1 had higher food insecurity.

Discussion

This study highlights the contributors to fatigue in older adults with AML/MDS, particularly GI symptoms and nutritional challenges. The findings demonstrate that fatigue is a prominent factor during early treatment cycles and may be correlated with diarrhea, functional status, and food security. Early and ongoing assessments and personalized interventions are critical to helping with fatigue, optimizing nutritional status, and improving overall QOL. Future research should focus on developing interventions tailored to the unique needs of older adults with AML and MDS undergoing chemotherapy.

Oncology Nursing Forum. 2025 Mar 1;52(2):60.

RS126. Optimizing Symptom Management Through RN-Led Symptom Assessments and Collaborative Adaptive Strategies

Danielle Steele Anderson ¹, Victoria Crowder ², Dawn Klemm ³, Ashley Leak Bryant ⁴

Purpose

This intervention highlights the registered nurse’s role in leading symptom assessments, facilitating interdisciplinary collaboration, and implementing adaptive strategies to optimize symptom management in oncology patients. Using the Patient-Reported Outcomes version of the Common Terminology Criteria for Adverse Events (PRO-CTCAE), the PACT(Palliative and Supportive Care Intervention Team) RN guides patients, care partners, and the PACT team to identify challenges, set individualized SMART goals, and prevent physical, cognitive, and emotional decline.

Significance

Symptom burden can impact quality of life and functional independence. Early identification and proactive management of symptoms are critical to improving outcomes. The RN-led approach focuses on symptom monitoring while implementing interdisciplinary collaboration. The RN plays a leadership role in bridging symptom assessment with tailored interventions. This intervention improves patient outcomes and engages care partners and team members to achieve patient-centered goals.

Methods

■ Symptom Assessment Protocol: Daily assessments during Cycles 1–2. Weekly assessments during Cycles 3–7. Symptom data are used to identify trends, evaluate severity, and recognize challenges.
■ Collaborative Goal Setting: The RN leads the team (PT, OT, research assistants) to develop individualized SMART goals based on patient-reported symptoms, functional challenges, motivation, and interests.
■ Monitoring and Intervention: Weekly phone calls with patients and care partners address symptom progression, functional changes, and goal adherence. RN modify care plans based on PRO-CTCAE responses and feedback from care partners.
■ Team Communication and Documentation: Research assistants assist in tracking data, documenting responses, and supporting follow-ups to ensure continuity of care. PT and OT address functional challenges faced by patients. The PT focuses on improving physical strength, mobility, and endurance, while the OT emphasizes strategies to enhance daily living activities and adaptive techniques to manage limitations

Findings and Interpretations

■ Patients reported improvement in key symptoms, including fatigue, pain, and functional challenges.
■ Individualized goals helped prevent physical, cognitive, and emotional decline.
■ Weekly phone calls enhanced caregiver involvement and support, ensuring alignment with patient care goals.
■ RN leadership facilitated clear communication among PT, OT, ensuring cohesive patient-centered care.

Discussion

This intervention highlights the RN’s leadership in symptom assessment and management within an interdisciplinary team. The RN drives the identification of symptoms and challenges, guiding the development of SMART goals and appropriate interventions. The RN-led approach highlights nursing leadership as a cornerstone for improving symptom management and functional outcomes in oncology care.

Oncology Nursing Forum. 2025 Mar 1;52(2):60–61.

RS127. Social Determinants of Health and Cancer-Related Cognitive Impairments: A Systematic Review

Bora Sun ¹, Oscar Franco-Rocha ², Patel Mansi ³, Kate Oppegaard ⁴, Ashley Henneghan ⁵

Purpose

The purpose of this systematic review is to synthesize quantitative evidence on the relationships between Social Determinants of Health (SDOH) and Cancer-Related Cognitive Impairment (CRCI) in survivors of non-central nervous system (CNS) cancers. Guided by Healthy People 2030’s SDOH framework, this review focuses on economic stability, health care access and quality, neighborhood and built environment, and social and community context to explore how these factors influence CRCI prevalence and/or response to treatment.

Significance

CRCI negatively impacts memory, attention, executive function, and processing speed, and poses significant challenges for the United States’ cancer population, which is expected to reach 22.5 million by 2032. Little is known about the role of SDOH play in CRCI, which may contribute to disparities in CRCI prevalence and/or persistence.

Methods

This systematic review synthesizes quantitative evidence on the relationships between SDOH and CRCI. The systematic review followed Stern et al.’s methodological framework and PRISMA guidelines, with the protocol registered in PROSPERO (ID 573283). Searches were performed in December 2024 across PubMed, Embase, PsycINFO, CINAHL, Web of Science, and Cochrane Library using terms related to CRCI and SDOH domains. Search strategies were developed with a health sciences librarian and optimized using the Systematic Review Accelerator. Primary peer-reviewed studies involving adults with non-CNS cancer, that reported correlational or group difference data on at least one SDOH factor (economic stability, health care access and quality, neighborhood and built environment, and social and community context) and cognitive outcomes were included. Studies focused solely on education attainment, work outcomes, animal models, psychometric development, or protocols were excluded. Screening, extraction, and conflict resolution were performed by the co-authors using Covidence software.

Findings and Interpretations

Findings are in progress. Initial search results yielded 1,786 articles, Screening, extraction, and data synthesis are underway. Screening and extraction will be completed by 1/31/25 with synthesis completed by 3/1/25. We estimate 20–30 articles will be included in the final analyses.

Discussion

This review will summarize what is known about the relationships between SDOH and CRCI, as well as suggest directions for future research. Increased knowledge of how SDOH impact CRCI and what research is needed will aid in the development of interventions that mitigate CRCI disparities.

Oncology Nursing Forum. 2025 Mar 1;52(2):61.

RS128. CO2 Laser Treatment for Atrophic Vaginitis: Impact on Sexual Health of Cancer Survivors

Bruna Tirapelli Gonçalves ¹, Nathália Luiza Matias Leite ², Maria Eduarda Hames ³

Purpose

to describe whether fractional CO2 laser contributes to improving satisfaction and sexual functionality of cancer survivors.

Significance

Given the therapeutic advances and increased survival rates of cancer patients, there is a growing concern about the quality of life of survivors. Atrophic vaginitis is a condition that describes a set of urinary, vaginal, and sexual alterations that directly impact the quality of life of cancer survivors. Treatment is closely related to the severity of symptoms, so CO2 laser is an emerging alternative to intervene in the event and promote the health of women after cancer.

Methods

Descriptive cross-sectional study with patients who underwent CO2 laser applications for the treatment of atrophic vaginitis at the cancer center in the city of São Paulo. In the study, two questionnaires were applied after acceptance and completion of the informed consent form; the first contained sociodemographic and clinical data and the second was the Female Sexual Function Index. Additional data were subsequently collected from medical records. The project was approved by institutional Research Board (IRB).

Findings and Interpretations

Forty-four patients were included, with a median age of 58 years. Most of them were married, heterosexual and sexually active. The protocol of 3 applications was followed by the patients, however, most of them stated that they had no improvement after laser application. The worst total score belonged to single patients, no significant relationships were found between the number of sessions and the total score, the time between the last session and completion of the instrument did not influence satisfaction and there was no relation between the type of treatment and the total score.

Discussion

The use of CO2 laser for the management of atrophic vaginitis is promising, but larger and more robust studies are needed to prove its effcacy and efficiency

Oncology Nursing Forum. 2025 Mar 1;52(2):61–62.

RS129. Engagement with an Automated Online Symptom Management Intervention in Women with Recurrent Ovarian Cancer: Mixed Methods Study

Yan Wang ¹, Kai-Lin You ², Heidi Donovan ³

Purpose

This study explored how patients with recurrent ovarian cancer engaged with WRITE Symptoms, a randomized controlled trial testing an online symptom management intervention.

Significance

Patient engagement is critical for maximizing the benefits of interventions and achieving better health outcomes. However, cancer survivors often disengage from online interventions over time.

Methods

A convergent mixed methods design was used to analyze data from the self-directed arm of WRITE Symptoms. Data from 166 participants included self-reported baseline assessments of sociodemographic, Symptom Representation Questionnaire, Spielberger State/Trait Anxiety Inventory, Revised Life Orientation Test, and Interpersonal Support Evaluation List. Engagement was assessed by (1) the number of completed symptom management modules, (2) strategies implemented, and (3) word counts in response to intervention prompts. Multiple linear regression identified significant factors influencing engagement. Content analysis of participant feedback explored experiences from narrative satisfaction surveys (N=24) and reasons for withdrawal (N=34).

Findings and Interpretations

Participants were predominantly white (93%;145/157), middle-aged (76%;119/157), married or cohabiting (76%;119/157), and unemployed (61%; 96/157). Approximately 76% (126/166) completed at least one module, 79% (84/106) used six or more strategies, and 90% (132/147) wrote more than 200 words in response to intervention prompts. Older participants (P = 0.046), those with higher anxiety (P<0.01), and those with severe comorbidities (P = 0.01) were less likely to complete modules. Participants with higher optimism levels (P = 0.01) and those perceiving greater symptom impact (P<0.01) implemented more strategies. Participants appreciated the intervention’s informational and psychosocial support and its role in fostering positive behavioral changes but highlighted challenges with the delivery mode and the relevance of monthly assessment. Suggestions for improvement included aligning assessments with user needs and incorporating additional supportive resources. Withdrawal reasons were categorized into intervention-related challenges (e.g., navigation difficulties, dissatisfaction with design or delivery) and individual-level factors (e.g., health issues, increased responsibilities, reduced motivation).

Discussion

Demographic, clinical, and psychosocial factors significantly influence engagement with online symptom management interventions. Enhancing engagement and efficacy requires tailoring content to diverse needs. Future studies should focus on identifying patients at risk of disengagement and providing targeted support, such as personalized navigation tools and flexible assessment schedules, to improve relevance and reduce burden. Adaptive approaches like these could enhance accessibility and retention, particularly for patients facing significant health or motivational barriers.

Oncology Nursing Forum. 2025 Mar 1;52(2):62–63.

RS130. A New Measure of Symptom Burden for Checkpoint Inhibitor Immunotherapy

Loretta A Williams ¹, Meagan Whisenant ², Shu-En Shen ³, Donna Malveaux ⁴, Darcy Ponce ⁵, Mehmet Altan ⁶

Purpose

The purpose of this study is to develop and validate a patient-reported outcome (PRO) questionnaire to measure symptom burden in patients receiving treatment with immune checkpoint inhibitors (ICIs).

Significance

Since 2010, treatment with ICIs have significantly increased survival in patients with a variety of cancers, including non-small cell lung cancer (NSCLC) and metastatic melanoma. While ICIs are often well tolerated, they can have significant side effects. Validated PRO questionnaires allow accurate patient symptom measurement during treatment. Accurate measurement is critical for symptom science, an oncology nursing research priority. No ICI-specific PROs currently exist.

Methods

English-speaking patients, 18 years of age or older, with a diagnosis of NSCLC, beginning a first or second cycle of initial ICI therapy were eligible. All patients were treated at a comprehensive cancer center. Each patient gave human subjects’ research-approved consent and was asked to complete a preliminary MD Anderson Symptom Inventory (MDASI) for ICI every 2 weeks for 6 months as well as a single-item quality of life (QOL) question and the Functional Assessment for Cancer Therapy - general (FACT-G) monthly. The 27-item preliminary MDASI-ICI was developed using qualitative patient interviewing and expert panel review.

Findings and Interpretations

One hundred twenty-eight patients completed the initial assessment, and 112 patients completed the retest for psychometric validation. One hundred eleven patients completed at least one additional assessment for longitudinal sensitivity evaluation. After psychometric validation, one symptom item (confusion) was dropped from the MDASI-ICI leaving 20 symptom items and 6 interference items. Cronbach α coefficients for internal consistency were 0.918 for symptom items and 0.928 for symptom interference items. Intra-class correlations for test-retest reliability were 0.764 for symptom items an 0.773 for symptom interference items. MDASI-ICI symptom and interference scores were significantly higher in patients reporting poor QOL (range p=0.0008–0.0284) and significantly correlated with FACT-G total scores (all p<0.0001). Longitudinal mixed modeling found that symptoms of pain, fatigue, disturbed sleep, distress, drowsiness, diarrhea, and coughing decreased significantly with time (range p=0.0005–0.0483). Other symptoms and symptom interference did not change significantly with time.

Discussion

The MDASI-ICI has good internal consistency, test-retest reliability, discriminant validity with QOL, and concurrent validity with the FACT-G. The MDASI-ICI detected significant symptom improvements with time. The MDASI-ICI is a psychometrically-sound, sensitive PRO measuring symptom burden of ICIs for use in research or practice.

Oncology Nursing Forum. 2025 Mar 1;52(2):63.

RS131. Exploring the Relationship Between the Gut Microbiome and Musculoskeletal Symptoms in Breast Cancer Survivors Receiving Aromatase Inhibitors

Gee Su Yang ¹, Zhe Guan ², Shreya Patel ³, Susan Tannenbaum ⁴

Purpose

Aromatase inhibitors (AIs) are the gold standard treatment for breast cancer survivors (BCS), reducing cancer recurrence risk, but nearly half of women prescribed AIs have difficulty tolerating side effects, particularly AI-associated musculoskeletal symptoms (AIMSS) that manifest as joint pain, stiffness, myalgia, and bone pain. The mechanisms underlying AIMSS remain unclear, and no reliable treatments are available to reduce pain and improve daily functioning. This study aimed to understand the mechanisms by which gut microbiota (GM) are associated with AIMSS in BCS.

Significance

AIMSS compromises patients’ quality of life and potentially leaves them at increased risk of cancer mortality and morbidity. Women with AIMSS often have challenges with treatment adherence.

Methods

In a cross-sectional, observational study design, BCS who had been on AIs for at least three months were recruited through the Cancer Center and social media. Data on musculoskeletal symptoms and lifestyle were collected, and GM was characterized through fecal 16S rRNA sequencing. We compared GM α- and β-diversity between higher and lower pain groups (cut-off: Western Ontario and McMaster Universities Osteoarthritis Index [WOMAC] Q3 score) and used Spearman correlation to analyze relationships between pain and demographic/lifestyle factors. A Poisson regression model identified GM associated with AIMSS.

Findings and Interpretations

This study included 50 BCS, mostly White (94%) with an average age of 61.78±9.66 years. Seventy percent were prescribed anastrozole, 12% exemestane, and 14% letrozole. Most participants were at stage I (50%) or stage II (36%) of cancer, and 70% received radiation therapy. The mean WOMAC score was 21.3. The total WOMAC score was significantly associated with younger age (b=−0.509, p=.046) and Black race (b=−26.986, p=.008), and it was positively correlated with stress and negatively correlated with physical activity and leisure activity. The GM of the lower pain group had higher bacterial richness and diversity compared to the higher pain group, although no significant difference was observed. Using a Poisson regression model to fit the total WOMAC score, significant associations were observed with the genera Christensenellaceae, Hungatella, Clostridia, Faecalibacterium, Lachnospiraceae, Gastranaerophilales, Bacteroides, Flavonifractor, Roseburia, and Butyricicoccus.

Discussion

Our results suggest that GM composition is linked to AIMSS and may serve as a potential biomarker, and the symptom could be targeted through dietary manipulation. Larger prospective studies are needed to assess how AIs impact GM over time and its relationship with AIMSS.

Oncology Nursing Forum. 2025 Mar 1;52(2):63–64.

RS132. Relationship Poverty with Emergency Department and Urgent Care Visits among People with Cancer: Analysis of 2022 National Health Interview Survey (NHIS)

Nayung Youn ¹, Soomin Koh ², Alithea Zorn ³, Stephanie Gilbertson-White ⁴, Yamnia Cortes ⁵

Purpose

This study aimed to explore the association between the federal poverty level (FPL) and Emergency departments (ED) and urgent care (UC) visits among people with cancer, considering other clinical and demographic factors.

Significance

Poverty is a social constructure, leading to disparities in cancer outcomes such as delayed diagnosis, suboptimal treatments, and limited access to healthcare. Individuals living in poverty are more likely to use ED/UC more frequently for the health problems that could be managed at scheduled appointments or that could have been prevented. The extent that individuals with cancer living in poverty rely on ED/UC visits has not been well studied.

Methods

We conducted a cross-sectional study with a nationally representative sample of 3,412 adults with cancer extracted from the 2022 National Health Interview Survey. Sociodemographic and clinical characteristics were assessed using Chi-square and ANOVA via weighted survey estimates. Poverty was assessed using FPL categories (<100%, 100 to <200%, 200 to <400%, and ≥400%), and self-reported ED and UC visits were combined into five ordinal categories (i.e. 0 to ≥4). Associations between poverty and ED/UC visits were examined using ordinal logistic regression (α=0.05).

Findings and Interpretations

The sample had a mean(±SD) age of 66.1(±13.7) years, was predominantly female (56%), non-Hispanic White (84.1%), and had a household income <400% FPL (52.8%). Individuals reporting ≥4 ED/UC visits in the past year were younger, more likely to be at <100% FPL and have ≥5 comorbidities than those with no ED/UC visits. In unadjusted regression, FPL <100% was significantly associated with more ED/UC visits (OR: 1.45, 95% CI: 1.04–2.03). However, this was no longer significant after adjusting for age and the number of comorbidities. Age (OR: 0.98, 95% CI: 0.98–0.99) and higher category of comorbidities (OR: 1.36; 1.88; 3.33 for 1~2, 3~4, ≥ 5 comorbidities, respectively) were associated with increased ED/UC visits.

Discussion

While poverty may be associated with more ED/UC visits, this relationship is not independent of age or the number of comorbidities, which are significant predictors of increased ED/UC visits. Further research is needed to identify factors contributing to ED/UC visits for people with cancer living in poverty. Also, oncology nurses should prioritize screening for poverty and financial hardship to identify patients at higher risk for ED/UC reliance and to provide tailored interventions in this population to reduce the ED/UC visits.

Oncology Nursing Forum. 2025 Mar 1;52(2):64.

RS133. Sexual Health Education Needs for Colorectal Cancer Patients: A Literature Review

Jaime Young ¹

Purpose

This literature review aims to evaluate the evidence for sexual health education for patients undergoing treatment for colorectal cancer treatment.

Significance

Colorectal cancer (CRC) is the third most often diagnosed cancer in the United States. CRC treatment is multimodal, involving surgery, systemic therapy, and radiation therapy, and can cause many adverse effects, including changes in sexual health. Sexual health is an often overlooked area in cancer treatment, though many CRC patients express a need for sexual health education prior to treatment. To ensure quality sexual health education to CRC patients, the current available evidence was reviewed. The main objective is to find the optimal timing and method of education regarding sexual health for CRC patients.

Methods

This is a literature review done in accordance to the PRISMA 2020 guidelines. A database search was performed with EBSCOhost and PubMed until December 2024. The articles were then screened according to inclusion and exclusion criteria.

Findings and Interpretations

Out of 832 articles screened, 5 were identified that met the criteria of sexual health educational interventions for CRC patients, and included 339 participants. The studies demonstrated mixed results, with some improving sexual health outcomes and others having no effect on sexual health outcomes. Education interventions were varied in their timing and format, with phone based education being utilized most frequently. Most educational interventions were performed after treatment for CRC, with 1 providing education prior to treatment.

Discussion

Though sexual health is an important topic to colorectal cancer patients, the evidence is not sufficient to determine the optimal timing or format of sexual education. Previous studies found CRC patients preferred sexual health education prior to treatment, however few education interventions were focused on education prior to treatment. More research is needed to determine optimal timing and format for sexual health education for CRC patients.

Oncology Nursing Forum. 2025 Mar 1;52(2):64–65.

RS134. Natural Language Processing to Extract Acute Symptom Clusters from Oncology Triage Notes

Yingzi Zhang ¹, Arthur Hong ², Calandra Jones ³, Kristine Kwekkeboom ⁴

Purpose

The study aimed to use natural language processing (NLP) to extract symptoms and symptom clusters from oncology triage notes.

Significance

Patients with cancer undergoing treatment often visit the emergency department (ED) for cancer- and treatment-related symptoms. While primary complaints are documented, multiple symptoms are common. Unstructured triage notes in the electronic health record contain rich data that describe the constellation of symptoms leading to an ED visit.

Methods

An NLP framework was developed to extract all symptom terms from a corpus of clinical notes (N=7777). We preprocessed clinical notes using spaCy, then extracted symptoms terms with Bidirectional Encoder Representations from Transformers for Biomedical Text Mining (BioBERT), a biomedical language model pre-trained on PubMed and PMC texts for named-entity recognition. We mapped the extracted terms to standardized symptom concepts using a predefined set of synonyms through exact and fuzzy matching. A training dataset with ground truth labels (n=1103) were used to evaluate the model’s performance. Error analysis was conducted to improve model performance, focusing on identifying negation terms and symptoms based on numerical thresholds or ranges. The elbow method identified the optimal number of clusters, and the K-Medoids algorithm characterized the symptom clusters.

Findings and Interpretations

Of the corpus, the most frequently documented symptoms were pain (29%), fever (19.7%), fatigue (16.5%), vomiting (13.3%), nausea (9.9%), shortness of breath (9.7%), cough (7.9%), swelling (7.6%), diarrhea (6.1%), and headache (5.0%). The model demonstrated consistently high specificity (above 0.96) and strong performance across most metrics, with accuracy and precision exceeding 0.87 and 0.8, respectively, for all symptoms. F1 scores for the top 10 symptoms were good to excellent, with the highest scores observed for “vomiting” and “cough” (0.90) and the lowest for “fever” (0.76) and “swelling” (0.75). A total of seven symptom clusters were identified, including fatigue and generalized symptoms (n=1505), anxiety and neuropsychological symptoms (n=1227), hematuria and bleeding (n=577), nausea, vomiting, and digestive symptoms (n=414), dizziness and fatigue (n=210), chest pain and cardiovascular symptoms (n=466), and fever and inflammatory symptoms (n=564).

Discussion

We characterized symptom clusters from free-text triage notes made prior to cancer patients’ ED visit using a pre-trained clinical NLP method. Next, these symptom clusters will be used to predict ED visit acuity level and hospitalization likelihood, to help drive triage improvement.

PERMALINK

Late-Breaking Abstracts

Footnotes

User and Usability Testing of a Conversational Chatbot Supporting Cancer Genetic Education and Testing

Jinghua An, PhD

Jinghua An, PhD

Sherry Grumet, MA, MS, LGC

Scott Walters, PhD

Emily Heidt, BS

Anita Kinney, PhD, RN, FAAN, FABMR

Anita Kinney, PhD, RN, FAAN, FABMR

Purpose

Significance

Methods

Findings and Interpretations

Discussion

Group-Based Trajectory Modeling of Fatigue and its Genetic Associations During the First year of Breast Cancer Treatment

Katrina Carr, BSN, RN

Susan Sereika, PhD

Catherine Bender, PhD, RN, FAAN

Yvette Conley, PhD, FAAN

Sue Wesmiller, PhD, RN

Purpose

Significance

Methods

Findings and Interpretations

Discussion

The Multidimensional Impact of Social Determinants of Health on Symptoms in Breast Cancer Survivors

Zahra A Barandouzi, PhD, RN

Hannah Choi, MSN, RN

Yufen Lin, PhD, RN

Deborah Bruner, PhD, RN, FAAN

Hongjin Li, PhD, RN, FAAN

Purpose

Significance

Methods

Findings and Interpretations

Discussion

A Nurse-Led Intervention to Enhance Quality of Life among Early Phase Cancer Clinical Trial Participants

Debra Lundquist, PhD, RN

Rachel Jimenez, MD

Nora Horick, MS

Dejan Juric, MD

Ryan Nipp, MPH, MD

Betty Ferrell, RN, PhD, MA, CHPN, FAAN, FPCN

Purpose

Significance

Methods

Findings and Interpretations

Discussion

Distinct Symptom Subgroups in Patients with Colorectal Cancer: Differences in Social Determinants of Health and Diet Quality

Youran Lee, MSN, BSN, RN

Qing Yang, PhD

Donald Bailey Jr, PhD, RN, FAAN

Melissa Kay, PhD, MS, MPH, RD

Rosa Gonzalez-Guarda, PhD, MPH, RN, FAAN

Purpose

Significance

Methods

Findings and Interpretations

Discussion

A Primary Palliative Care Communication Intervention (Precursor) for the Patient-Caregiver-Provider Triad in the Setting of Incurable Cancer: Results of a Pilot Study

Kristin Levoy, PhD, MSN, RN, OCN, CNE

Kristin Levoy, PhD, MSN, RN, OCN, CNE

Alexia Torke, MD, MS

Alexia Torke, MD, MS

Krista Longtin, PhD

Marianne Matthias, PhD

Marianne Matthias, PhD, VA HSR

Susan Hickman, PhD

Susan Hickman, PhD

Purpose

Significance

Methods

Findings and Interpretations

Discussion

I19. Innovative Strategies in the Care of a Patient with Paraplegia Requiring Radiation Isolation

Philip Bernaldez, MSN BSN RN

Mary Myers, MSN RN PCCN

Assumpta Ude, PhD FNP-BC