Tami Borneman

• RN, MSN, CNS, FPCN
• Senior Researcher at City of Hope National Medical Center

Background Spiritual care is a key domain of quality palliative care as defined by national palliative care guidelines. Aims The aim of this project was to synthesize data and research experience by the authors over 30 years related to spirituality in patients with cancer. The research objectives for this analysis were to: Describe spirituality in...

Background: Family caregivers are central to the delivery of serious illness care and also have needs related to their role and experience. One aspect of the family caregiver quality of life (QOL) that has received less attention is caregiver spirituality. Objectives: The research objectives for this analysis were (1) Describe spirituality in oncol...

Existential distress at the end of life is a common experience for patients with a serious illness and those caring for them. Of paramount importance is the interdisciplinary team’s response to issues of faith, spirituality, and existential concerns, with compassion, intentional listening, and complete presence. This chapter will examine the multid...

Purpose: To describe and assess physical and psychosocial concerns and care processes related to cancer and treatment in gynecologic cancer survivors. Participants & setting: 44 survivors of gynecologic cancer at City of Hope National Medical Center in southern California were enrolled. Methodologic approach: A descriptive mixed-methods approa...

Background: Family caregivers provide complex care for patients with cancer, including management of multiple symptoms associated with the disease and its treatment. Objectives: The objective of this pilot project was to develop and conduct feasibility testing of a family caregiver educational intervention for symptom management. Methods: The...

The Interprofessional Spiritual Care Curriculum (ISPEC) was created to train interdisciplinary health care teams to recognize and address the spiritual needs of seriously or chronically ill patients. The curriculum, in a train-the-trainer format, employs didactic presentations, discussions, lab sessions, skill demonstrations, and video clips. In co...

Purpose To assess the feasibility, acceptability, and preliminary effects of a nurse-led intervention for managing fear of cancer progression in advanced cancer patients. Methods A single group mixed methods study was conducted in patients with stage III or IV gynecologic or lung cancer (n = 31) with dysfunctional levels of fear of progression or...

The purpose of this article is to describe the lessons learned in the course of a 5-year research study on a palliative care intervention for persons on a Phase 1 clinical trial. Patients who are participating in Phase 1 trials and the families who care for them may be especially vulnerable and require special attention. The patients are generally...

Objectives Patients with cancer who are at a transition to Phase I investigational treatments have been identified as an underserved population with regard to palliative care. This disease transition is often accompanied by spiritual and existential concerns. The study objective was to conduct a secondary analysis of data from a larger study testin...

Background: Understanding the experiences of patients with solid tumors who are in phase 1 clinical trials can help nurses to provide optimal care. Objectives: The purpose of this article is to describe patient perspectives of participating in a phase 1 trial and understanding their disease status and treatment options. In addition, the authors...

Objective: To review literature on the relationship of pain, spirituality, and suffering as it relates to the patient with cancer who is experiencing pain. Data sources: Peer-reviewed articles, textbooks, internet. Conclusion: Pain and suffering are distinct and yet closely related in patients with cancer. Oncology nurses are important in asse...

Context: A notable gap in the evidence-base for palliative care (PC) for cancer is that most trials were conducted in specialized centers with limited translation and further evaluation in "real-world" settings. Health systems are desperate for guidance on effective, scalable models. Objective: Determine the effects of a nurse-led PC interventio...

Background: While providing physical, psychological, and spiritual care to their loved ones with cancer, family caregivers (FCGs) are physically and emotionally vulnerable to the tolls of caregiving. Patients and FCGs experience the uncertainty that comes with illness and treatment, its side effects, the lack of control, the emotional upheaval, th...

Objectives: To describe a family caregiver communication typology and demonstrate identifiable communication challenges among four caregiver types: Manager, Carrier, Partner, and Lone. Data sources: Case studies based on interviews with oncology family caregivers. Conclusion: Each caregiver type demonstrates unique communication challenges tha...

Background: A notable gap in the evidence base for outpatient palliative care (PC) for cancer is that most trials were conducted in specialized oncology or academic centers with limited translation and further evaluation in "real-world" settings. Health systems are desperate for guidance regarding the most effective and sustainable PC service mode...

Family caregivers have enormous communication responsibilities tied to caregiving, such as sharing the patient’s medical history with providers, relaying diagnosis and prognosis to other family members, and making decisions about care with the patient. While caregiver stress and burden has been widely documented in the caregiving literature, little...

138 Background: Cancer patients receiving Phase I clinical trials are a population with advanced disease, high symptom burden, and with multiple QOL concerns including use of advance directives. Methods: An NCI funded R01 is currently in progress (2014-2019) as a randomized clinical trial to test a palliative care intervention (PCI) in this populat...

Advanced Practice Palliative Nursing is the first text devoted to advanced practice nursing care of seriously ill and dying patients and their families. This comprehensive work addresses all aspects of palliative care, including patients’ and families’ physical, psychological, social, and spiritual needs. Chapters cover the history and role of adva...

Methods: Patients undergoing treatments for NSCLC were enrolled in a prospective, quasi-experimental study whereby the usual care group was accrued first followed by the intervention group. Patients in the intervention group were presented at interdisciplinary care meetings and appropriate supportive care referrals were made. They also received fo...

Background: Spiritual well-being is an important dimension of quality of life (QOL) and is a core component of quality oncology and palliative care. In this analysis, we aimed to describe spiritual well-being outcomes in a National Cancer Institute (NCI)-supported Program Project that tested the effectiveness of an interdisciplinary palliative car...

Consistent with the recommendations of the Institute of Medicine Report on quality cancer care, attention to symptom management and quality of life concerns of patients with lung cancer should be addressed throughout the disease trajectory. As part of an National Cancer Institute-funded Program Project grant, this article reports on the patient and...

Palliative care, including symptom management and attention to quality of life (QOL) concerns, should be addressed throughout the trajectory of a serious illness such as lung cancer. This study tested the effectiveness of an interdisciplinary palliative care intervention for patients with stage I-IV non-small cell lung cancer (NSCLC). Patients unde...

Although newer in the traditional setting, palliative care and surgeries are emerging at a very rapid pace. As the path of the surgeon, the patient‘s disease trajectory, and the path of palliative intervention overlap, it is possible for professional and personal conflicts to arise, with negotiations needing to take place. Surgeons and palliative c...

This landmark title is the key resource for nurses working in the field of palliative care. Edited by renowned nursing experts, and written by a dynamic team of internationally known authorities in nursing and palliative medicine, the Oxford Textbook of Palliative Nursing covers the gamut of principles of care from the time of initial diagnosis of...

CASE STUDY Mr. G., an 82-year-old retired European man, was diagnosed with stage 4 non–small cell lung cancer (NSCLC) and recently enrolled on a phase II clinical trial. He is married and has two adult children, who are very supportive. He and his wife described themselves as nonpracticing Catholics. He had never smoked, and there was no personal...

Patients diagnosed with stage-IV lung cancer are forced to quickly transition from a cancer-free and perhaps healthy life to one of serious illness, uncertainty, and anticipation of a premature death. Health professionals may be too quick to label the patient as being in denial if they hope for healing. Hope may not be lost when reality is accepted...

Challenges and barriers continue to hinder the integration of palliative care models into comprehensive, ambulatory oncology care. This article aims to describe how symptoms, distress, and quality of life (QOL) data from the usual care phase of a National Cancer Institute-supported Program Project informed the development of an interdisciplinary, t...

Cancer-related fatigue is one of the most common symptoms experienced by patients receiving chemotherapy and/or radiation therapy. It is subjective in nature; therefore, assessing the extent of its interference with the patient’s quality of life and functional status is important. Assessment should also include contributing factors as well as under...

The purpose of this study was to describe patients' perceptions of the causes, relief, related symptoms, meaning, and suffering secondary to cancer-related fatigue (CRF). In total, 252 patients with breast, lung, colon, and prostate cancers were enrolled in a quasiexperimental study to test the effects of a clinical intervention on reducing barrier...

Pain and fatigue are recognized as critical symptoms that impact QOL for patients with colon cancer. Barriers to optimum pain and fatigue relief include patient-related beliefs and attitudes about the treatment of cancer-related symptoms. The overall objective of this paper was to describe quality of life (QOL) and barriers to pain and fatigue mana...

e19606 Background: Family caregivers play a key role in cancer care and are of significant support in advanced diseases such as lung cancer. This National Cancer Institute funded Program Project (P01) addresses palliative care, quality of life (QOL), and self care for family caregivers in lung cancer. The purpose of this study is to test usual care...

Pain and fatigue are recognized as critical symptoms that impact quality of life (QOL) in cancer, particularly in palliative care settings. Barriers to pain and fatigue relief have been classified into three categories: patient, professional, and system barriers. The overall objective of this study was to test the effects of a clinical intervention...

This chapter provides an overview of the significant challenges imposed by admission of a patient to an in-patient setting in hospitals and palliative care units and strategies for supporting family carers in these settings. The findings reveal that the intensive care unit (ICU) is an especially stressful environment for family carers and they ofte...

Introduction The global and U.S. population is aging at an unprecedented rate. Cancer is a disease affecting predominantly older persons with incidence and prevalence increasing with age. Fifty-seven percent of newly diagnosed cancers and 71 percent of cancer deaths occur in those aged 65 years or older. In addition to cancer, many older persons ha...

The National Consensus Project for Quality Palliative Care includes spiritual care as one of the eight clinical practice domains. There are very few standardized spirituality history tools. The purpose of this pilot study was to test the feasibility for the Faith, Importance and Influence, Community, and Address (FICA) Spiritual History Tool in cli...

9083 Background: Optimal symptom management is a critical aspect of supportive care in cancer. Patient-reported outcomes such as QOL can be negatively impacted by uncontrolled symptoms such as pain and fatigue. Research suggests that barriers (patient, professional, systems-related) to symptom management hinder the quality of supportive cancer care...

Pain and fatigue are recognized as critical symptoms that impact the quality of life of cancer patients. The barriers to pain and fatigue relief have been classified into three categories: patient, professional, and system barriers. The overall objective of this trial as to test the effects of the "Passport to Comfort" intervention on reducing barr...

Quality of Life (QOL) and symptom concerns are common in lung cancer. This article presents findings from 2 separate pilot studies that utilize an educational model to reduce barriers to pain and fatigue management ("barriers study") and an interdisciplinary palliative care approach to manage QOL concerns for patients with lung cancer ("QOL pilot")...

This article reviews the National Comprehensive Cancer Network's (NCCN's) guidelines for cancer-related fatigue (CRF) assessment and discusses many of the common barriers that hinder the translation of the CRF guidelines into practice settings. Current assessment and measurement scales validated in patients with cancer are highlighted, and case stu...

Purpose Patients with lung cancer experience many symptoms necessitating the use of supportive services. Prognosis remains poor despite advances in treatment, and as the disease progresses, symptom burden increases. This study evaluated quality of life (QOL) and symptom concerns in a cohort of 100 patients with lung cancer at a National Cancer Inst...

9546 Background: The relief of symptoms is a critical aspect of supportive care in medical oncology. This NCI funded study compared usual care to an educational and systems change intervention in a Comprehensive Cancer Center. This paper presents data comparing the total N=184 patients including Breast (40%), Lung (25%), Colon (20%) or Prostate (15...

Healthcare providers frequently lack the knowledge and skills to provide optimal pain management for cancer survivors. Scientific evidence and clinical guidelines are lacking in the management of chronic, persistent pain in survivors. The purpose of this article is to describe pain-related issues of cancer survivors using case presentations of sele...

Fatigue, despite being the most common and distressing symptom in cancer, is often unrelieved because of numerous patient, provider, and system barriers. The overall purpose of this 5-year prospective clinical trial is to translate the NCCN Cancer-Related Fatigue Clinical Practice Guidelines in Oncology and NCCN Adult Cancer Pain Clinical Practice...

The Agency for Health Care Policy and Research Pain Guidelines of 1994 recognized pain as a critical symptom that impacts quality of life (QOL). The barriers to optimum pain relief were classified into three categories: patient, professional, and system barriers. A prospective, longitudinal clinical trial is underway to test the effects of the "Pas...

Lung cancer remains a major source of death in the United States. With the aging of the population, health policy makers are challenged to develop systems of care for the complex needs of these patients. This study sought to determine quality of life and symptom concerns in lung cancer patients. The study also sought to determine how supportive car...

Cancer clinical trials are a necessary component of the effort to improve cancer prevention, diagnosis, and treatment. Essential to this process is the informed consent of the individuals who participate in these research studies. The purpose of this article is to describe patient, provider, and informed consent process issues with presentations of...

The cost associated with surgical procedures has been dramatically decreased by the ability to perform these procedures on an outpatient basis. Pain and nausea, two common symptoms after anesthesia and surgical procedures, are among the greatest concerns for patients and their family members. As a result of the distress and sequelae associated with...

Originally published in 2001, the Textbook of Palliative Nursing has become the standard text for the field of hospice and palliative care nursing. In this new edition, the authors and editors have updated each chapter to ensure that the content is evidence-based and current references are included. They also have retained the important focus on ca...

To assist clinical nurses in translating research into clinical practice. City of Hope Quality-of-Life (QOL) Model to guide presentations and discussion, research utilization theories, and evidence-based practice literature. Based on percentage of individual participant involvement, the four domains of QOL, and a knowledge survey. Attendance, discu...

Costs associated with the provision of medical care continue to escalate. Therefore, providers must evaluate the cost-effectiveness and benefit to individual healthcare practices. The authors evaluated the immediate and short-term resource utilization needs of patients undergoing surgical intervention with curative or palliative intent. Three hundr...

To describe the concerns of family caregivers of patients undergoing palliative surgeries for advanced malignancies. Descriptive study with repeated measures. A National Cancer Institute-designated Comprehensive Cancer Center in the western United States. Family caregivers (N = 45) of patients with cancer. Family caregivers were assessed prior to p...

To describe a program of research related to outcomes of palliative surgery and focus on one phase of this research involving decision making by patients and surgeons considering surgery for advanced disease. Descriptive. 10 patients undergoing surgery and 3 oncology surgeons. Qualitative interviews were conducted with patients and their surgeons p...

We prospectively evaluated the effectiveness of major surgery in treating symptoms of advanced malignancies. Fifty-nine patients were evaluated for major symptoms of intent to treat and were followed up until death or last clinical evaluation. Surgeons identified planned operations before surgery as either curative or palliative and estimated patie...

purpose: The purpose of this National Cancer Institute-funded training project was to improve end-of-life care agencies through implementation of a palliative care curriculum. The Home Care Outreach for Palliative Care Education (HOPE) program was designed to improve the knowledge and skills of home healthcare professionals who provide care to the...

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Information contained in textbooks provides the foundation for undergraduate education and entry into clinical practice. Inadequate knowledge of health care professionals in end of life (EOL) has been documented and efforts are in progress to improve this care. This paper reports on a project to strengthen nursing education in EOL care. One of the...

PURPOSE. To evaluate the impact of a patient education program in a home care setting. METHODS. Using an experimental design, 149 patients with cancer were evaluated using pre-and postintervention measures of outcomes related to pain management. FINDINGS. Structured pain education yielded enhanced knowledge and attitudes about pain, quality of life...

While the emotional problems facing patients in pain and their families are significant, there is much to be done to ease suffering in terminal illness. Palliative care has demonstrated successful interventions to reduce the physical and emotional burdens of patients and families.

Ethnicity is an important factor not only in the incidence of cancer but also in relation to symptom management. Inadequate pain management at home has been demonstrated to result in associated physical symptoms as well as great distress to patients and family. The study purpose was to evaluate a structure program to educate patients about cancer p...

The experience of cancer pain is known to greatly affect family caregivers as well as patients. There are many demands placed on caregivers of cancer patients with pain at home as a result of the shifting of care from the acute setting to the home. These complex demands significantly affect caregiver quality of life. The purpose of this study was t...

To describe current use of routine analgesics in home care and the treatment of breakthrough pain. Descriptive, companion study. Homecare agencies in southern California. Convenience sample of 369 patients with cancer participating in a pain-education study. Data regarding breakthrough pain were derived from the homecare medical records and patient...

The purpose of this study was to describe perceptions of quality of life (QOL) of Hispanic patients with cancer pain. This qualitative pilot study is guided by the conceptual framework of pain and QOL. From interviews with 17 Hispanic patients with cancer pain, data on perceptions of QOL were analyzed and are reported here. The study demonstrated t...

The purpose of this pilot study was to describe the influence of culture on cancer pain management in Hispanic (Mexican and Central American) patients. This qualitative study is guided by the conceptual framework of the Pain and Quality of Life model and the Biocultural Model of Pain. It was developed as a companion study to a National Cancer Insti...

The purpose of this article is to illustrate the many demands placed on caregivers of cancer patients at home as a result of health care shifting from the acute care setting to the home. Case scenarios are presented from a study in progress, “Pain Education for Elderly Cancer Patients at Home.” Increasingly, caregivers assume responsibility for com...

The elderly are a vulnerable group and many will face several chronic illnesses, with cancer being likely among them. Each year approximately one million elderly are abused, with the most vulnerable being those who rely on family members for their care. Humphrey stated that old age "is sufficient cause to give up" even when the individual is not su...