Complicated grief (CG) poses significant physical, psychological, and economic risks to bereaved family caregivers. An integrative review of the literature published 2009−2018 on CG associated with caregiving was performed using PubMed, PsychINFO, and Web of Science. The search returned 1428 articles, of which 32 were included in the review. Sixteen studies described risk and protective factors and 16 described interventions for CG. Caregiver-related risk factors included fewer years of education, depression, anxiety, poor physical health, and maladaptive dependency and attachment traits. Additional risk factors included lower perceived social support, family conflict at end-of-life, and family having difficulty accepting death. Care recipient-related risk factors are younger age, fear of death, and place of death. Protective factors included hospice utilization in reducing fear of death, high pre-bereavement spiritualty, and satisfaction with palliative care. Complicated grief treatment was the most widely-studied intervention. Social Workers and other clinicians can use this information to identify family caregivers at increased risk for CG and refer or implement an early intervention to lessen its impact.

For many patients, the cancer continuum includes a syndrome known as cancer-associated cachexia (CAC), which encompasses the unintended loss of body weight and muscle mass, and is often associated with fat loss, decreased appetite, lower tolerance and poorer response to treatment, poor quality of life, and reduced survival. Unfortunately, there are no effective therapeutic interventions to completely reverse cancer cachexia and no FDA-approved pharmacologic agents; hence, new approaches are urgently needed. In May of 2022, researchers and clinicians from Moffitt Cancer Center held an inaugural retreat on CAC that aimed to review the state of the science, identify knowledge gaps and research priorities, and foster transdisciplinary collaborative research projects. This review summarizes research priorities that emerged from the retreat, examples of ongoing collaborations, and opportunities to move science forward. The highest priorities identified include the need to (1) evaluate patient-reported outcome (PRO) measures obtained in clinical practice and assess their use in improving CAC-related outcomes; (2) identify biomarkers (imaging, molecular, and/or behavioral) and novel analytic approaches to accurately predict the early onset of CAC and its progression; and (3) develop and test interventions (pharmacologic, nutritional, exercise-based, and through mathematical modeling) to prevent CAC progression and improve associated symptoms and outcomes.

BACKGROUND: The loss of a loved one, especially by a caregiver, can be stressful. Grief can affect one emotionally, mentally, behaviorally, spiritually, and physically and affects individuals differently. Complicated grief (CG), especially for a caregiver, can be intense, prolonged, and interfere with normal activities accompanied by destructive thoughts and behaviors. AIM: To synthesize the available research on persons experiencing CG and the effect on cortisol levels. METHODS: A literature search for articles published on CG and cortisol was performed using PubMed, Cochrane Library, PsychINFO, and Web of Science. Search terms included CG, cortisol, and their variants. No date limitations were applied. In accordance with PRISMA, articles were sorted and evaluated against specific inclusion and exclusion criteria. RESULTS: The search yielded 18 articles, of which 5 were included in the review. CONCLUSIONS: Cortisol levels and diurnal patterns are shown to be affected in individuals experiencing CG. With prolonged bereavement and dysregulated cortisol, physical and mental health outcomes may result warranting a need for effective stress reduction therapies for this population.

The purpose of this study was to identify and evaluate information needs of wives of men diagnosed with prostate cancer postbrachytherapy and to measure the extent to which the needs are met. The study took place at the National Cancer Institute Comprehensive Cancer Center, and 65 wives of men with prostate cancer were recruited. Wives completed the Family Inventory of Needs-Wives in recovery room on day 1 postprocedure and the demographic data form. Information needs and perceived degree of these needs being met were identified. All needs were identified as important with varying degrees of these needs being met. One item was not rated as being unmet, whereas 4 items had scores of at least 30% for being unmet. Likelihood estimates identified needs with P value less than .05 in relation to educational level of wife. A wife's need for information is prompted by her spouse's illness. This supports the findings of earlier research. A multitude of information needs exist for wives, and the degree of these needs being met varies. An assessment of needs and degree of these needs being met can guide nurses in tailoring education. Direction on approaching information needs may be needed to decrease barriers to communication and foster quality care. Employing a multimodality approach to education, reassessing needs, and encouraging questions are essential.

Purpose: The purpose of this article is to present how metrics and dashboards, using the SMART model, are used to articulate the clinical nurse specialist (CNS) nurse researcher role. Description of the Project: Following the SMART model, a dashboard was created highlighting measurable metrics for each of the 3 spheres of impact to align with the center's nursing strategic plan and initiatives, including Magnet redesignation. Outcome: Metrics reflecting the 3 spheres of impact and corresponding dashboard with successfully met outcomes are presented for the CNS nurse researcher. Conclusion: Metrics and dashboards are important tools that CNSs can use to capture their activities, set goals, and articulate their unique roles to both internal and external stakeholders. Dashboards, such as the one presented, are easily adaptable and can be updated on a regular basis.