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Research paper thumbnail of Medical Cannabis as Adjunctive Therapy for Head and Neck Cancer Patients

Cureus, 2021

The goal of this systematic review was to define a consensus within the current literature regard... more The goal of this systematic review was to define a consensus within the current literature regarding the impact/effect of cannabis or cannabinoids on the treatment of patients with head and neck cancer. We conducted a review of PubMed, Embase, and Web of Science databases, using a comprehensive search strategy, focusing on articles relating to head & neck cancer and cannabis/cannabinoids without a time limit for publication. Two, independent reviewers screened articles based on title/abstract and included the ones selected by both. We then conducted a full-text review and excluded all articles which did not meet inclusion criteria. A single reviewer then assessed studies for methodological quality and extracted relevant data using a premade data collection tool. We identified five studies that met inclusion criteria. Studies were of varying quality and the majority investigated recreational cannabis use with only one study reporting dosing across participants. Lack of standardized cannabis exposure presents a wide array of potential confounding variables across the remaining studies. Meta-analysis was not attempted due to variability in reported outcomes. It is impossible to draw any conclusions regarding the benefit or adverse effects of current medical cannabis products in this patient population. The literature regarding the effect of cannabis/cannabinoids on head & neck cancer patients is limited. However, the current lack of evidence does not definitively disprove the efficacy of cannabis. High-quality studies are necessary for physicians to provide advice to patients who are either using or interested in cannabis as an adjunctive treatment.

Research paper thumbnail of Cancer Pain and Quality of Life

Journal of Hospice & Palliative Nursing, 2019

Cancer pain is an unrelenting symptom with the potential to alter the quality of life of patients... more Cancer pain is an unrelenting symptom with the potential to alter the quality of life of patients. To adequately manage pain, nurses caring for cancer patients need to fully understand each patient"s pain experience. The purpose of this study was to identify the intensity, distress, frequency, or constancy of pain in patients treated for cancer or cancer symptoms and to better understand patient barriers to pain management. This cross-sectional study included patients (N = 105) treated for cancer or cancer symptoms at 2 outpatient medical centers. Assessments included the Pain Barriers Scale, the Cancer Symptom Scale, and the Multidimensional QOL ScaleYCancer. Descriptive statistics and Spearman correlations were used to analyze the data. Sixty-nine percent of patients reported present pain of moderate to severe intensity that caused distress, was frequent/constant, or interfered with their lives. Patients with the greatest pain distress reported the greatest intensity of pain (r = 0.77) and the greatest interference (r = 0.78) with daily lives. Cancer pain was associated with significant distress and interference with life activities and occurred frequently or constantly for many study patients.

Research paper thumbnail of Validation of the Spanish version of the Cancer Symptom Scale in Hispanic cancer patients

International journal of nursing practice, Jan 4, 2018

To assess the validity of the translated Spanish Cancer Symptom Scale. Instruments to facilitate ... more To assess the validity of the translated Spanish Cancer Symptom Scale. Instruments to facilitate comprehensive and objective assessments of the cancer symptom experience in underrepresented populations are essential. The Cancer Symptom Scale was translated into Spanish, and a back translation was conducted. During June 2016, a sample of 121 Hispanic Puerto Rican patients with any cancer diagnosis, all undergoing cancer treatments, completed four paper surveys. A subgroup of 15 patients agreed to complete the Spanish Cancer Symptom Scale a second time after a short delay of 1 to 2 hours. Construct validity and reliability (internal consistency via Cronbach alpha and test-retest reliability) was evaluated. All the Intensity Items of the Spanish Cancer Symptom Scale correlated significantly with the matched items on the MD Anderson Symptom Inventory. In a subgroup of 77 participants, each Cancer Symptom Scale subscale total of scores correlated significantly with the total scores from ...

Research paper thumbnail of Feasibility of the Mobile Mindfulness-Based Stress Reduction for Breast Cancer (mMBSR(BC)) Program for Symptom Improvement among Breast Cancer Survivors

Psycho-oncology, Jan 30, 2017

The purpose of this pilot study was to test the feasibility of delivering the mobile Mindfulness-... more The purpose of this pilot study was to test the feasibility of delivering the mobile Mindfulness-Based Stress Reduction for Breast Cancer (mMBSR(BC)) program using an iPad and to evaluate its impact on symptom improvement. A single group, pre-posttest design was implemented among female stages 0-III breast cancer survivors (BCS) who completed treatment. Data were collected at baseline and week 6 on measures of psychological and physical symptoms and quality of life. The mMBSR(BC) program is a standardized, stress-reducing intervention that combines sitting and walking meditation, body scan and yoga and is designed to deliver weekly 2-hour sessions for 6 weeks using an iPad. The mean age of the 15 enrolled BCS was 57 years; one participant was non-Hispanic Black, and 14 were non-Hispanic White. Of the 13 who completed the study, there were significant improvements from baseline to 6 weeks post-mMBSR(BC) in psychological and physical symptoms of depression, state anxiety, stress, fear...

Research paper thumbnail of Clinically Relevant Four-Level Cancer-Related Fatigue Among Patients With Various Types of Cancer

Journal of the Advanced Practitioner in Oncology, 2016

Symptom management, including the management of cancer-related fatigue, is a primary role of adva... more Symptom management, including the management of cancer-related fatigue, is a primary role of advanced practitioners (APs) specializing in oncology. Analyzing and/or translating research evidence into practice is essential in improving patient-centered outcomes. Translational research to improve clinicians' abilities to screen, assess, and intervene to reduce CRF is of high priority to the National Cancer Institute and the Oncology Nursing Society. However, fatigue is very subjective, and current research design issues make it difficult for APs to identify and utilize evidence-based assessment tools and guidelines. The purpose of this article is to act as a guide for APs on how to use the tools and guidelines to accurately define severity of CRF, recognize patient variables that may be barriers in preventing and/or treating CRF, and initiate effective interventions and patient education. ORIGINAL RESEARCH WANG et al. CE Learning Objectives After completing this educational activity, participants should be able to: 1. Analyze strengths and weaknesses of currently available evidence-based research in the area of cancerrelated fatigue (CRF) 2. Describe how assessment tools and guidelines can be translated into clinical practice and help to overcome barriers at the patient, professional and system level 3. Apply existing evidence-based tools and guidelines in defining severity of CRF 4. Recognize individual patient variables that may be barriers to prevention and/or treatment of CRF and develop more individualized and effective CRF treatment plans, patient education, and counseling Continuing Education Statement of Credit-Participants who successfully complete this activity (including the submission of the post-test and evaluation form) will receive a statement of credit. Physicians. The Meniscus Educational Institute is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians. The Meniscus Educational Institute designates this journal article for a maximum of 1.0 AMA PRA Category 1 Credits™. Physicians should claim only the credit commensurate with the extent of their participation in the activity. Nurses. This activity for 1.0 contact hours is provided by the Meniscus Educational Institute. The Meniscus Educational Institute is accredited as a provider of continuing nursing education by the American Nurses Credentialing Center's Commission on Accreditation. Provider approved by the California Board of Registered Nursing, Provider No. 13164, for 1.0 contact hours. Pharmacists. The knowledge-based accredited education lectures are intended for pharmacists involved in the care of cancer patients. This educational activity is sponsored by the Meniscus Educational Institute. The Meniscus Educational Institute is accredited by the Accreditation Council for Pharmacy Education (ACPE) as a provider of continuing pharmacy education. The ACPE Universal Activity Number assigned to this program, for 1.0 contact hours, is 0429-9999-16-001-H04-P. Financial Disclosures All individuals in positions to control the content of this program (eg, planners, faculty, content reviewers) are expected to disclose all financial relationships with commercial interests that may have a direct bearing on the subject matter of this continuing education activity. Meniscus Educational Institute has identified and resolved all conflicts of interest in accordance with the MEI policies and procedures. Participants have the responsibility to assess the impact (if any) of the disclosed information on the educational value of the activity.

Research paper thumbnail of Pain Measurement in Older Adults With Head and Neck Cancer and Communication Impairments

Cancer Nursing, 2004

The ability to communicate the presence of pain by means of verbal and nonverbal communication is... more The ability to communicate the presence of pain by means of verbal and nonverbal communication is crucial to facilitate the assessment of pain. Patients with communication impairment (CI) are limited in their ability to verbally report their pain and, consequently, mechanisms to elicit information about the pain experience must incorporate simple and valid methods to accomplish this goal. Pain measurement and the impact of the pain experience in older adults with CI are areas that have been studied on a limited basis in nursing. This study compared the effectiveness of 3 pain assessment tools in measuring pain intensity in the older adults with head and neck cancer and with CI. Multivariate repeated-measures analysis of variance revealed that there were no significant differences in the mean pain intensity scores when subjects used the Numeric Rating Scale, the Faces Pain Scale, and the Visual Analogue Scale at 3 different time intervals. The highest correlation coefficients between pain measurement tools were identified during the third time when the pain measurement tools were used to rate pain intensity. Subjects identified the Numeric Rating Scale as the preferred method to rate pain intensity. Canonical correlation analysis demonstrated that among the demographic variables evaluated in the study, education explained the largest variance in composite of the pain measurement scales.

Research paper thumbnail of Medical Cannabis as Adjunctive Therapy for Head and Neck Cancer Patients

Cureus, 2021

The goal of this systematic review was to define a consensus within the current literature regard... more The goal of this systematic review was to define a consensus within the current literature regarding the impact/effect of cannabis or cannabinoids on the treatment of patients with head and neck cancer. We conducted a review of PubMed, Embase, and Web of Science databases, using a comprehensive search strategy, focusing on articles relating to head & neck cancer and cannabis/cannabinoids without a time limit for publication. Two, independent reviewers screened articles based on title/abstract and included the ones selected by both. We then conducted a full-text review and excluded all articles which did not meet inclusion criteria. A single reviewer then assessed studies for methodological quality and extracted relevant data using a premade data collection tool. We identified five studies that met inclusion criteria. Studies were of varying quality and the majority investigated recreational cannabis use with only one study reporting dosing across participants. Lack of standardized cannabis exposure presents a wide array of potential confounding variables across the remaining studies. Meta-analysis was not attempted due to variability in reported outcomes. It is impossible to draw any conclusions regarding the benefit or adverse effects of current medical cannabis products in this patient population. The literature regarding the effect of cannabis/cannabinoids on head & neck cancer patients is limited. However, the current lack of evidence does not definitively disprove the efficacy of cannabis. High-quality studies are necessary for physicians to provide advice to patients who are either using or interested in cannabis as an adjunctive treatment.

Research paper thumbnail of Cancer Pain and Quality of Life

Journal of Hospice & Palliative Nursing, 2019

Cancer pain is an unrelenting symptom with the potential to alter the quality of life of patients... more Cancer pain is an unrelenting symptom with the potential to alter the quality of life of patients. To adequately manage pain, nurses caring for cancer patients need to fully understand each patient"s pain experience. The purpose of this study was to identify the intensity, distress, frequency, or constancy of pain in patients treated for cancer or cancer symptoms and to better understand patient barriers to pain management. This cross-sectional study included patients (N = 105) treated for cancer or cancer symptoms at 2 outpatient medical centers. Assessments included the Pain Barriers Scale, the Cancer Symptom Scale, and the Multidimensional QOL ScaleYCancer. Descriptive statistics and Spearman correlations were used to analyze the data. Sixty-nine percent of patients reported present pain of moderate to severe intensity that caused distress, was frequent/constant, or interfered with their lives. Patients with the greatest pain distress reported the greatest intensity of pain (r = 0.77) and the greatest interference (r = 0.78) with daily lives. Cancer pain was associated with significant distress and interference with life activities and occurred frequently or constantly for many study patients.

Research paper thumbnail of Validation of the Spanish version of the Cancer Symptom Scale in Hispanic cancer patients

International journal of nursing practice, Jan 4, 2018

To assess the validity of the translated Spanish Cancer Symptom Scale. Instruments to facilitate ... more To assess the validity of the translated Spanish Cancer Symptom Scale. Instruments to facilitate comprehensive and objective assessments of the cancer symptom experience in underrepresented populations are essential. The Cancer Symptom Scale was translated into Spanish, and a back translation was conducted. During June 2016, a sample of 121 Hispanic Puerto Rican patients with any cancer diagnosis, all undergoing cancer treatments, completed four paper surveys. A subgroup of 15 patients agreed to complete the Spanish Cancer Symptom Scale a second time after a short delay of 1 to 2 hours. Construct validity and reliability (internal consistency via Cronbach alpha and test-retest reliability) was evaluated. All the Intensity Items of the Spanish Cancer Symptom Scale correlated significantly with the matched items on the MD Anderson Symptom Inventory. In a subgroup of 77 participants, each Cancer Symptom Scale subscale total of scores correlated significantly with the total scores from ...

Research paper thumbnail of Feasibility of the Mobile Mindfulness-Based Stress Reduction for Breast Cancer (mMBSR(BC)) Program for Symptom Improvement among Breast Cancer Survivors

Psycho-oncology, Jan 30, 2017

The purpose of this pilot study was to test the feasibility of delivering the mobile Mindfulness-... more The purpose of this pilot study was to test the feasibility of delivering the mobile Mindfulness-Based Stress Reduction for Breast Cancer (mMBSR(BC)) program using an iPad and to evaluate its impact on symptom improvement. A single group, pre-posttest design was implemented among female stages 0-III breast cancer survivors (BCS) who completed treatment. Data were collected at baseline and week 6 on measures of psychological and physical symptoms and quality of life. The mMBSR(BC) program is a standardized, stress-reducing intervention that combines sitting and walking meditation, body scan and yoga and is designed to deliver weekly 2-hour sessions for 6 weeks using an iPad. The mean age of the 15 enrolled BCS was 57 years; one participant was non-Hispanic Black, and 14 were non-Hispanic White. Of the 13 who completed the study, there were significant improvements from baseline to 6 weeks post-mMBSR(BC) in psychological and physical symptoms of depression, state anxiety, stress, fear...

Research paper thumbnail of Clinically Relevant Four-Level Cancer-Related Fatigue Among Patients With Various Types of Cancer

Journal of the Advanced Practitioner in Oncology, 2016

Symptom management, including the management of cancer-related fatigue, is a primary role of adva... more Symptom management, including the management of cancer-related fatigue, is a primary role of advanced practitioners (APs) specializing in oncology. Analyzing and/or translating research evidence into practice is essential in improving patient-centered outcomes. Translational research to improve clinicians' abilities to screen, assess, and intervene to reduce CRF is of high priority to the National Cancer Institute and the Oncology Nursing Society. However, fatigue is very subjective, and current research design issues make it difficult for APs to identify and utilize evidence-based assessment tools and guidelines. The purpose of this article is to act as a guide for APs on how to use the tools and guidelines to accurately define severity of CRF, recognize patient variables that may be barriers in preventing and/or treating CRF, and initiate effective interventions and patient education. ORIGINAL RESEARCH WANG et al. CE Learning Objectives After completing this educational activity, participants should be able to: 1. Analyze strengths and weaknesses of currently available evidence-based research in the area of cancerrelated fatigue (CRF) 2. Describe how assessment tools and guidelines can be translated into clinical practice and help to overcome barriers at the patient, professional and system level 3. Apply existing evidence-based tools and guidelines in defining severity of CRF 4. Recognize individual patient variables that may be barriers to prevention and/or treatment of CRF and develop more individualized and effective CRF treatment plans, patient education, and counseling Continuing Education Statement of Credit-Participants who successfully complete this activity (including the submission of the post-test and evaluation form) will receive a statement of credit. Physicians. The Meniscus Educational Institute is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians. The Meniscus Educational Institute designates this journal article for a maximum of 1.0 AMA PRA Category 1 Credits™. Physicians should claim only the credit commensurate with the extent of their participation in the activity. Nurses. This activity for 1.0 contact hours is provided by the Meniscus Educational Institute. The Meniscus Educational Institute is accredited as a provider of continuing nursing education by the American Nurses Credentialing Center's Commission on Accreditation. Provider approved by the California Board of Registered Nursing, Provider No. 13164, for 1.0 contact hours. Pharmacists. The knowledge-based accredited education lectures are intended for pharmacists involved in the care of cancer patients. This educational activity is sponsored by the Meniscus Educational Institute. The Meniscus Educational Institute is accredited by the Accreditation Council for Pharmacy Education (ACPE) as a provider of continuing pharmacy education. The ACPE Universal Activity Number assigned to this program, for 1.0 contact hours, is 0429-9999-16-001-H04-P. Financial Disclosures All individuals in positions to control the content of this program (eg, planners, faculty, content reviewers) are expected to disclose all financial relationships with commercial interests that may have a direct bearing on the subject matter of this continuing education activity. Meniscus Educational Institute has identified and resolved all conflicts of interest in accordance with the MEI policies and procedures. Participants have the responsibility to assess the impact (if any) of the disclosed information on the educational value of the activity.

Research paper thumbnail of Pain Measurement in Older Adults With Head and Neck Cancer and Communication Impairments

Cancer Nursing, 2004

The ability to communicate the presence of pain by means of verbal and nonverbal communication is... more The ability to communicate the presence of pain by means of verbal and nonverbal communication is crucial to facilitate the assessment of pain. Patients with communication impairment (CI) are limited in their ability to verbally report their pain and, consequently, mechanisms to elicit information about the pain experience must incorporate simple and valid methods to accomplish this goal. Pain measurement and the impact of the pain experience in older adults with CI are areas that have been studied on a limited basis in nursing. This study compared the effectiveness of 3 pain assessment tools in measuring pain intensity in the older adults with head and neck cancer and with CI. Multivariate repeated-measures analysis of variance revealed that there were no significant differences in the mean pain intensity scores when subjects used the Numeric Rating Scale, the Faces Pain Scale, and the Visual Analogue Scale at 3 different time intervals. The highest correlation coefficients between pain measurement tools were identified during the third time when the pain measurement tools were used to rate pain intensity. Subjects identified the Numeric Rating Scale as the preferred method to rate pain intensity. Canonical correlation analysis demonstrated that among the demographic variables evaluated in the study, education explained the largest variance in composite of the pain measurement scales.