Concept analysis of cancer survivorship and contributions to oncological nursing

Aim

This study aims to analyse the concept of cancer survivorship using Rodgers' evolutionary concept analysis model.

Background

The lack of a consensus definition as well as the confusion and debate concerning the definitions of “survivor” and “cancer survivorship” hinder an understanding of the intrinsic needs associated with the latter.

Design

Concept analysis.

Method

A systematic literature search was performed using the following databases: PubMed, CINAHL, Web of Science, LILACS, and PsycINFO with studies published between 2000 and 2014. The final sample contained 39 studies that were analysed on the basis of Rodgers' model and inductive thematic analysis, discussed through the lens of the medical anthropology concept of culture.

Findings

Cancer survivorship is a broad concept that can be understood using 8 themes: changes in life plans, positive and negative aspect dualities, life reflections, identity change, individual experiences, symptom control, the need for support, and quality of care. These themes are summarized using 2 attributes: liminality process and culturally congruent care.

Conclusions

This article contributes to understanding of cancer survivorship and the processes that are intrinsic to this concept. It calls for future investigations to enhance cancer survivorship across its 2 domains at the personal (patient's life) and clinical (nursing practice) levels.     

Predicting aggressive behaviour in acute forensic mental health units: A re‐examination of the dynamic appraisal of situational aggression's predictive validity

In the present study, we explored the predictive validity of the Dynamic Appraisal of Situational Aggression (DASA) assessment tool in male (n = 30) and female (n = 30) patients admitted to the acute units of a forensic mental health hospital. We also tested the psychometric properties of the original DASA bands and novel risk bands. The first 60 days of each patient's file was reviewed to identify daily DASA scores and subsequent risk‐related nursing interventions and aggressive behaviour within the following 24 hours. Risk assessments, followed by documented nursing interventions, were removed to preserve the integrity of the risk‐assessment analysis. Receiver–operator characteristics were used to test the predictive accuracy of the DASA, and generalized estimating equations (GEE) were used to account for repeated risk assessments, which occurs when analysing short‐term risk‐assessment data. The results revealed modest predictive validity for males and females. GEE analyses suggested the need to adjust the DASA risk bands to the following (with associated odds ratios (OR) for aggressive behaviour): 0 = low risk; 1, 2, 3 = moderate‐risk OR, 4.70 (95% confidence interval (CI): 2.84–7.80); and 4, 5, 6, 7 = high‐risk OR, 16.13 (95% CI: 9.71–26.78). The adjusted DASA risk bands could assist nurses by prompting violence‐prevention interventions when the level of risk is elevated.