Abstract

Nurses’ self-evaluation of their autonomy in carrying out nursing activities is considered an important index for investigating improvement in the quality of nursing activities. In this study, questionnaires were administered to nurses working in cancer hospitals in order to investigate their self-evaluation of their own abilities in implementing nursing activities and the following major factors related to that evaluation：（1）their sense of responsibility as an oncology nurse（2）practical nursing skills and（3）self-efficacy. Responses were received from 104 nurses（response rate 34.67％）.

Scores on the scale measuring autonomy in nursing activities and scores on the self-efficacy scale were similar to scores previously reported in research publications. Multiple variables showed correlation with the score measuring autonomy in nursing activities. Multiple regression analysis revealed that two indices of practical nursing skills, namely, years of nursing experience and generalized self-efficacy, had an influence on autonomous nursing activities.

Results showing the correlation between autonomy and related factors provide a number of insights into the nature of nurses who contribute to autonomous nursing activities.

Abstract

The purpose of this study was to investigate whether or not Japanese visiting nurses were aware of the potential hazards of occupational exposure to anticancer drugs, and to learn if Japanese visiting nurses utilized preventative measures while working with anticancer drugs and patients. A self-rating questionnaire was mailed to Japanese visiting nurses at 1045 visiting nursing service stations, and 385 subjects successfully completed the questionnaire.

The results showed that 31％ of the Japanese visiting nurses were aware of their occupational exposure to anticancer drugs and the related health risks. Approximately 20％ of the nurses（75 nurses）working in nursing services had experience using anticancer drugs, but 61％ of them were not aware of the actual potential hazards of occupational exposure. The Japanese visiting nurses performed work with hazardous items although they had not been given any authorized procedures. This work consisted of doing things such as removing needles from patients and handling waste from patients who had been given anticancer drugs, but only 20％（15 of 75 nurses）reported using preventative measures, and only 12％（9 of 75 nurses）informed patients and the patients’ families of this fact. Japanese visiting nurses who were aware of the potential hazards of occupational exposure had already performed this type of work at some time prior, so they were already aware of the health risks, but there were more nurses that had not been informed at all. This information can be seen in the chi-square test.

Patients who are using anticancer drugs are increasing throughout Japan yearly, and this can also be said for the number of patients within hospitals. Our results indicate needs for improving the work practice guidelines, education for visiting nurses handling anticancer drugs about awareness of occupational exposure and preventative measures, and similar information for patients and their families.

Abstract

The purpose of this study is to clarify whether adoption of FACT/GOG-NtxV4.0（FACT）in the critical pathway and its management by the medical team was useful for management of peripheral neuropathy during bortezomib treatment for multiple myeloma. In our hospital, FACT was adopted in the critical pathway for management of peripheral nerve disorders in bortezomib therapy. This critical pathway was managed by the medical care team comprising physicians, nurses and pharmacists, for early recognition of peripheral neuropathy and dose adjustment of bortezomib. Medical records of patients treated with bortezomib and subjects to this critical pathway were studied retrospectively to examine the circumstances of patients’ assessment of FACT, changes in FACT scores upon starting bortezomib treatment, patients’ major complaints for peripheral nerve disorders, modification of dosage and treatment of bortezomib, and the usefulness of our approach for management of peripheral neuropathy.

As a result, FACT self-assessment was fairly good, and total mean FACT scores of patients with peripheral neuropathy decreased significantly（p＝0.0004）after one or two cycles of bortezomib. This result may be related to patients’ unpleasant peripheral nerve sensations and suggests that our approach could be useful for detecting early symptoms of peripheral neuropathy. In addition to the results above, the average treatment cycle of bortezomib was 8.7 cycles, comparing favorably against previously reported data. It is presumed that applying this critical pathway contributed to dose adjustment of bortezomib in patient treatment, and it may be possible to expand its use into other areas of nursing care.