Canadian Oncology Nursing Journal Revue canadienne de soins infirmiers

Canadian Oncology
Nursing Journal
Revue canadienne
de soins infirmiers
en oncologie
The ofcial publication of the Canadian Association of Nurses in Oncology
La publication ofcielle de l’Association canadienne des inrmières en oncologie
Fall/Automne 2013 ISSN: 1181-912X
Volume 23, No. 4 PM#: 40032385

Canadian Oncology Nursing Journal
Revue canadienne de soins infirmiers en oncologie
A publication of the Canadian Association of Nurses in Oncology—Une publication de l’Association canadienne des infirmières en oncologie
PUBLICATIONS MAIL AGREEMENT NO. 40032385. RETURN UNDELIVERABLE CANADIAN ADDRESSES TO:
Canadian Association of Nurses in Oncology, 375 West 5th Avenue, Suite 201, Vancouver, BC, V5Y 1J6, E-mail: [email protected]
Fall/Automne 2013
Volume 23, No. 4
Articles
236 Efficacy and side-effect profiles of lactulose, docusate sodium, and sennosides
compared to PEG in opioid-induced constipation: A systematic review
by Teresa Ruston, Dr. Kathleen Hunter, Dr. Greta Cummings, and Dr. Adriana Lazarescu
241 Efficacité et profils d’effets secondaires du lactulose, du docusate sodique et des
sennosides par rapport à ceux du PEG dans la constipation induite par les opioïdes :
examen systématique
par Teresa Ruston, Kathleen Hunter, Greta Cummings et Adriana Lazarescu
247 Measuring trends in performance across time: Providing information to cancer patients
by Margaret I. Fitch, Alison McAndrew and Tamara Harth
254 Mesurer les tendances temporelles en matière de rendement : la fourniture
d’information aux patients atteints de cancer
par Margaret I. Fitch, Alison McAndrew et Tamara Harth
Table of Contents/Table des matières
225 Editorial
226 Éditorial
Communiqué
262 CANO Chapters’ Corner
263 Le coin des sections de l’ACIO
264 Leadership Special Interest Group
265 Groupe d’intérêts spéciaux Leadership
265 Report from DAL Education
265 Rapport de la conseillère générale, Éducation
266 Director-at-Large Membership
267 Rapport de la conseillère générale, Services
aux membres
Features/Rubriques
230 Reections on research
231 Réexions sur la recherche
232 Feature
233 Article
268 Book review
269 Critique de livre

CONJ • RCSIO Fall/Automne 2013
Canadian Oncology Nursing Journal
Revue canadienne de soins infirmiers en oncologie
Canadian Oncology Nursing Journal/Revue canadienne de soins infirmiers en oncologie is a refereed journal.
Editor-in-Chief Margaret I. Fitch, RN, PhD, Odette Cancer Centre, Sunnybrook Health Sciences Centre, 2075 Bayview Avenue, Toronto, ON M4N 3N5
Phone: [phone]; Fax: [phone]; Email: [email protected]
Associate Editors Janice Chobanuk, RN, BScN, MN, CON(C)—books/media Jeanne Robertson, RN, B.Arts, BScN, MBA—French materials
Pat Sevean, RN, BScN, EdD—features Sharon Thomson, RN, MSc, BA. MS—manuscript review
Sally Thorne, RN, PhD, FCAHS—research
Reviewers Nicole Allard, RN, MSN, PhD, Bilingual, Maxine Alford, RN, PhD, Karine Bilodeau, inf., PhD(C), French, Joanne Crawford, RN, BScN,
CON(C), MScN, PhD(c), Dauna Crooks, DNSc, MScN, BScN, Jean-François Desbiens, inf., PhD, French, Sylvie Dubois, inf., PhD, Bilingual,
Corsita Garraway, EN(EC), MScN, CON(C), CHPH, Vicki Greenslade, RN, PhD, Virginia Lee, RN, BA, MSC(A), PhD, Bilingual,
Manon Lemonde, RN, PhD, Bilingual, Maurene McQuestion, RN, BA, BScN, MSc, CON(C), Beth Perry, RN, PhD, Karyn Perry BSN, MBA,
Patricia Poirier, PhD, RN, Dawn Stacey, RN, MScN, PhD, (CON), Jennifer Stephens, RN, BSN, MA, OCN, Pamela West, RN, MSc, ACNP,
CON(C), CHPCN(C), Kathleen Willison, RN, MSc, CVAA(c), CHPC(c), Patsy Yates, RN, PhD
Managing Editor Heather Coughlin, 613-735-0952, fax [phone], e-mail: [email protected]
Production The Canadian Oncology Nursing Journal is produced in conjunction with Pappin Communications, The Victoria Centre,
84 Isabella Street, Pembroke, Ontario K8A 5S5, 613-735-0952, fax [phone], e-mail [email protected], and
Vice Versa Translation, 144 Werra Rd., Victoria, British Columbia V9B 1N4, 250-479-9969, e-mail: [email protected].
Statement The Canadian Oncology Nursing Journal is the official publication of the Canadian Association of Nurses in Oncology, and is
of purpose directed to the professional nurse caring for patients with cancer. The journal supports the philosophy of the national association.
The philosophy is: “The purpose of this journal is to communicate with the members of the Association. This journal currently acts as
a vehicle for news related to clinical oncology practice, technology, education and research. This journal aims to publish timely papers,
to promote the image of the nurse involved in cancer care, to stimulate nursing issues in oncology nursing, and to encourage nurses to
publish in national media.” In addition, the journal serves as a newsletter conveying information related to the Canadian Association
of Nurses in Oncology, it intends to keep Canadian oncology nurses current in the activities of their national association. Recognizing
the value of nursing literature, the editorial board will collaborate with editorial boards of other journals and indexes to increase the
quality and accessibility of nursing literature.
Indexing The Canadian Oncology Nursing Journal/Revue canadienne de soins infirmiers en oncologie is registered with the National Library
of Canada, ISSN 1181-912X, and is indexed in the Cumulative Index to Nursing and Allied Health Literature, (CINAHL), the
International Nursing Index and Medline.
Membership All nurses with active Canadian registration are eligible for membership in CANO. Contact the CANO national office. Refer to the
Communiqué section for name and contact information of provincial representatives.
Subscriptions The journal is published quarterly in February, May, August and November. All CANO members receive the journal. For
non-members, yearly subscription rates are $119.77 (HST included) for individuals, and $131.88 (HST included) for institutions.
International subscriptions are $156.11 (HST included). Payment must accompany all orders and is not refundable. Make cheques
payable to CANO-CONJ and send to the CANO national office. Notices and queries about missed issues should also be sent to the
CANO national office. Canadian Association of Nurses in Oncology, 375 West 5th Avenue, Suite 201, Vancouver, BC V5Y 1J6,
www.cano-acio.ca; telephone: [phone]; fax: [phone]; email: [email protected]
Author Guidelines for authors are usually included in each issue. All submissions are welcome. At least one author should be a
Information registered nurse, however, the editor has final discretion on suitability for inclusion. Author(s) are responsible for acknowledging all
sources of funding and/or information.
Language Policy/ The Canadian Oncology Nursing Journal is officially a bilingual publication. All journal content submitted and reviewed by the editors
Politique will be printed in both official languages. La Revue canadienne de soins infirmiers en oncologie est une publication officiellement
linguistique bilingue. Le contenu proprement dit de la Revue qui est soumis et fait l’objet d’une évaluation par les rédactrices est publié dans les
deux langues officielles.
Advertising For general advertising information and rates, contact Heather Coughlin, Advertising Manager, Pappin Communications, 84 Isabella St.,
Pembroke, Ontario K8A 5S5, 613-735-0952, fax [phone], e-mail [email protected]. All advertising correspondence and
material should be sent to Pappin Communications. Online rate card available at: www.pappin.com
Opinions expressed in articles published are those of the author(s), and do not necessarily reflect the view of the Canadian Association of Nurses in Oncology or
the editorial board of the Canadian Oncology Nursing Journal. Acceptance of advertising does not imply endorsement by CANO or the editorial board of CONJ.
All rights reserved. The law prohibits reproduction of any portion of this journal without permission of the editor.
Fall/Automne 2013
Volume 23, No. 4

CONJ • RCSIO Fall/Automne 2013 225
As I sit down to write this
editorial, my first as Editor-
in-Chief, the thought that
comes to mind is “a time of
new beginnings”. It is a time
for new beginnings on a
number of fronts.
Firstly, it is the fall, and a new academic
and school year is underway. This is always
an exciting time for me when classes start
again and students embark on new courses
of study, hopefully ready to learn and dis-
cover more about the world and people
around them. Some are beginning their
journey of lifelong learning, as they head
to school for the first time. Others are fur-
ther along in their journey, entering the
next grade or setting off to university. Do
you remember your first day of school? Or
beginning junior high or high school? What
about the first nursing class you attended?
Was it filled with excitement or mixed with
a little trepidation?
I must admit that the mix of excite-
ment and trepidation describes what I am
feeling as I start my new role and assume
the responsibilities of Editor-in-Chief. On
one hand, this new beginning is energiz-
ing and filled with a sense of potential. I
am deeply honoured to have been selected
for the role and do look forward to mak-
ing an effective contribution. But, on the
other hand, I feel a little anxiety and uncer-
tainty, as I prepare this first issue “on my
own”. The role embodies a large responsi-
bility. And the journal has such potential to
support oncology nurses in the future. Yet,
there are challenges ahead of us if we are
to make the very best use of the CONJ as a
tool to foster oncology nursing and cancer
patient care.
I have had an excellent orientation
to my new role by the previous incum-
bent, Heather Porter. We have known
one another for some time and worked
together in various capacities over the
years. During the past six months, Heather
has been “schooling” me in the role of
Editor-in-Chief. I watched through one
issue, worked alongside her for the next
one, and now I have the lead. I know she
is not far away and has clearly offered
to help as I launch this new undertak-
ing for me. But I also know that I have
“large shoes to fill”. Heather has served
as Editor-in-Chief for nine years and pro-
vided stalwart leadership. The Canadian
Oncology Nursing Journal has continued
to grow and develop under her guidance.
We owe her a debt of gratitude and strong
vote of thanks for her efforts. Those who
come to the 2013 conference in Vancouver
will have the opportunity to celebrate her
achievements with her and express the
“thank you” in person.
Having a new person at the helm means
the journal is entering a new era. I believe it
is an excellent time to reflect upon its role
in our lives as Canadian oncology nurses.
New beginnings can be a time for reconsid-
erations, renewed priorities, or directional
change. I think now is the moment to con-
sider how the journal will continue to evolve
and serve our needs, as an oncology nurs-
ing community. There are many changes
unfolding in the publishing and communica-
tion world that will have a profound impact
on professional journals such as ours. We
need to be ready to act. We should not risk
being caught unaware and unprepared for
the changes. I encourage you to send me a
note ([email protected]) or call me
(416-480-5891) to share any ideas you have
about the journal. I would love to hear from
you. What needs to change? What needs to
stay the same?
As I look to the future, I cannot help but
feel we are living in exciting times. There is
great potential for the future. But exciting
times can also bring challenge. There are so
many changes emerging across cancer con-
trol and within patient care. Developments
in science and technology are contributing
to advances in diagnosis and treatment.
Protocols and procedures are ever more
complex. The numbers of patients entering
the cancer system and the proportion who
have pre-existing co-morbidities continue
to escalate. Health care reform is rampant
and pressures continue to find new ways
of delivering care. Financial constraints are
driving changes that often increase the dis-
tress we feel (both personally and profes-
sionally) about whether we are providing
high-quality care on a daily basis. I have col-
leagues across Canada tell me it has been
quite a while since they left work at the end
of the day feeling they had done a good job.
Yet, at the same time, we are entering
an era in cancer care where we have never
been before. Developments such as concur-
rent therapies, minimally invasive treatment
approaches, oral chemotherapy agents,
reduced radiation fraction protocols, tar-
geted diagnostics, and personalized medi-
cine are poised to revolutionize cancer care.
The implications for practice, patient expe-
riences and bioethics are staggering.
The ever-increasing cadre of individu-
als living after a cancer diagnosis and treat-
ment is already beginning to drive change in
the cancer care system. These survivors are
a product of the successes in cancer diagno-
sis, treatment and support over the past 30
years. While they may be living disease free
or many years with controlled disease, and
experiencing active productive lives, they
may also be challenged by late and long-
terms effects. Providing survivorship care
will be one of our key issues in the future.
However, the cadre of survivors offers
us one of most significant opportunities for
the future. Survivors have a wisdom which
has been gleaned from living through the
cancer experience. Their insight could be
invaluable in our efforts to improve patient
care. We need to find authentic ways of har-
nessing their wisdom and working together,
as partners. Their input can help us design
relevant interventions, user friendly clinical
processes, effective programs, and mean-
ingful policies.
As cancer patients and their fami-
lies move through their journey with can-
cer, I believe they need powerful oncology
nurses. The complexity of the current can-
cer care landscape may mean they need us
now more than ever before. Dealing with the
myriad of physical and psychosocial conse-
quences of diagnosis and treatment, as well
as the challenges of navigating the cancer
care system, can create significant distress
for individuals and their family members. It
has the potential to increase the burden of
suffering and decrease their quality of life.
I believe oncology nurses can have a signifi-
cant influence on this situation.
However, our capacity to make a differ-
ence is based on our professional knowledge
and skill. We must be up-to-date regarding
the knowledge that supports effective prac-
tice and astute in the performance of our
roles. We need to be leaders in whatever role
we hold, advocating for improvements and
quality care. We need to hone our ability to
truly listen to patients and families, work
in partnership with them, and achieve out-
comes of importance to them.
We have an important role to play in the
lives of cancer patients, survivors and their
family members. To be effective in our roles
as oncology nurses and truly make a differ-
ence in the lives of patients and their families,
we must base our practice on sound evidence.
We must be certain our practice decisions will
achieve the best result for the individuals for
whom we care. We must continue to learn, be
curious about innovation, and ready to adopt
improvements in patient care.
The Canadian Association of Nurses
in Oncology and the Canadian Oncology
Nursing Journal have important roles to
play in supporting oncology nurses across
the country. The association is just releasing
a new strategic plan designed to guide its
work over the next three years. We will look
Editorial