Purpose: Adolescents and young adults (AYAs) with cancer need self-management strategies to cope with multiple symptoms. Self-efficacy, self-regulation, and negotiated collaboration are key theoretical components of the self-management process and have not been fully explored with AYAs with cancer. This study examined the effects of a heuristic symptom assessment tool on AYAs' self-efficacy for symptom management, AYAs' self-regulation abilities related to their symptoms, and communication with their providers about symptoms. Methods: AYAs (15-29 years of age) receiving chemotherapy used the Computerized Symptom Capture Assessment Tool (C-SCAT) to illustrate their symptom experience and discuss their symptoms with providers during two clinic visits. Participants completed the PROMIS Self-efficacy for Managing Symptoms Scale, a measure of satisfaction with provider communication, and a short interview about self-regulation and communication behaviors at baseline and after each provider visit. Results: Eighty-five AYAs who used the C-SCAT showed improved self-efficacy for managing symptoms. Qualitative data suggest that the C-SCAT was useful for enhancing a number of AYAs' self-regulation abilities related to symptom management, such as awareness and recall of symptoms, how symptoms were related, and how they planned to talk about their symptoms to providers. AYAs reported C-SCAT facilitated communication with providers about symptoms and symptom management because it was a visual prompt showing priority and related symptoms. Conclusions: Because AYAs continue to experience multiple distressing symptoms, symptom selfmanagement remains an important area for practice and research. Use of heuristic tools, such as the C-SCAT, may help AYAs more effectively self-manage their symptoms for better health outcomes.
Nurses must always stress human rights protection and uphold the values and ethics of the profession. The purpose of this position statement is to bring the topic of human rights to the forefront and provide nurses with specific actions to protect and promote human rights in every practice setting. It describes the relationship between nurses' ethical obligations, the concept of human rights, and professional nursing practice. Statement of ANA Position The American Nurses Association believes that respect for the inherent dignity, worth, unique attributes, and human rights of all individuals is a fundamental principle ("Code of Ethics for Nurses with Interpretative Statements" [American Nurses Association, 2015, p. 1]). Nurses establish relationships of trust and provide nursing services according to need, setting aside any bias or prejudice (ANA, 2015, p. 1). This statement on ethics and human rights provides the foundation and context for all other position statements related to the practice of nursing. The protection and promotion of human rights in health and health care are fundamental functions of the American Nurses Association. Recommendations ANA supports the following recommendations: All nurses advocate for human rights of patients, colleagues, and communities.
Intersectionality theory has been used by nursing scholars to offer insight into how multiple systems of oppression mutually interact to impact health and to examine how multiple social modes of existence shape individual and group experiences of health inequality. The application of intersectionality theory, however, requires a reflexive critical lens to more effectively inform nursing science and practice. We draw on a comprehensive integrative literature review to offer a critical reflection by considering the semantic and structural consistency, generalizability, simplicity and complexity, and the utility and value of intersectionality theory to nursing science and practice. If nurses are to effectively utilize intersectionality theory, it is essential that we are able to analyze and speak to the multiple modes of existence based on historical, social, economic, and political processes that impact the health of those we serve. Critical examination of intersectionality enables nurses to further consider its value and usefulness when applied to nursing science and practice, particularly when addressing health and social inequalities.
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