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31, P = .005) and loneliness (β = 0.18, P = .024) were significantly more likely to be in the high symptom burden group.

This study provides evidence that 5 key symptoms among cancer caregivers appear to cluster into 2 groups, those with low symptom burden and those with high symptom burden. Caregiving burden (impact of health) and loneliness were significant factors differentiating symptom cluster membership.

Identifying symptom clusters may lead to better prevention and treatment strategies that target symptoms in cancer caregivers. Identifying factors that place a group at high risk of symptom burden can be used to guide individualized and tailored interventions.

Identifying symptom clusters may lead to better prevention and treatment strategies that target symptoms in cancer caregivers. Identifying factors that place a group at high risk of symptom burden can be used to guide individualized and tailored interventions.

Cancer-related fatigue (CRF) is a major issue facing breast cancer survivors (BCS) that can negatively impact their symptoms and quality of life.

The aims of this study were to examine levels of fatigue, identify preferred types of fatigue self-management, and explore the relationship between fatigue levels and management choices by cancer stage.

This cross-sectional descriptive study included 229 BCS recruited from 5 hospitals in Korea. The study inclusion criteria were limited to BCS between 20 and 69 years old in stages 1, 2, or 3 who were undergoing or had completed active therapy. selleck chemicals The Revised Piper Fatigue Scale and a questionnaire developed for fatigue management were used for data collection.

The stage 2 group experienced more fatigue (mean, 5.31) than the other cancer stage groups, and significant differences in fatigue were found between stages 1 and 2 (P < .001). Fatigue self-management choices showed different correlations with fatigue levels in each stage. Physical activity control was most frequently used in stage 1, whereas exercise was most frequently used in stages 2 and 3. Multivariate regression analysis showed that exercise consistently and effectively decreased all fatigue dimensions.

Stage 2 BCS experienced the greatest level of CRF, and fatigue levels and management choices differed in BCS by cancer stage.

Recognizing how CRF and patients' preferences for fatigue self-management may differ by cancer stage can alert clinicians in assessing CRF and tailoring effective fatigue management for BCS.

Recognizing how CRF and patients' preferences for fatigue self-management may differ by cancer stage can alert clinicians in assessing CRF and tailoring effective fatigue management for BCS.Leaders need to have a change framework in order to be successful in building the future of nursing. Health care leaders need to combine their knowledge of culture, technology, and the science of change in order to lead innovation in their organizations. Leaders should also understand the negative behaviors that stop change and kill innovation.The coronavirus-2019 (COVID-19) pandemic has resulted in turbulent times challenging nurse leaders to adopt, adapt, and develop new leadership competencies to navigate current and future challenges. In never-imagined approaches, nurse leaders have responded to a different type of crisis management. In this new era, nursing leadership will need competencies to reshape the future of nursing and nurses' role in caring for patients, families, and promotion of healthy communities along with a focus on reducing health disparities. The pandemic has drawn critical focus on the health and well-being needs of nurses. The American Organization for Nursing Leadership and the Association for Leadership Science in Nursing have offered insights of nursing leadership competencies critical for practice and education in shaping the future.The nursing profession faces both a labor shortage and a diversity problem. Nine proactive strategies-rooted in the disruptive demographic trends that are transforming our nation-are advanced to address these 2 critical issues.Challenges in the nurse work environment, particularly those resulting from nurse shortages and the retirement wave, can affect the health and well-being of all Americans, not just nurses themselves or the health care organizations where they work. Many of the solutions to significantly expand the number of nurses in America will take many years to realize. However, there are some important changes that health care organizations can put into effect relatively quickly to enhance the work environment for nurses, which can improve care quality and safety, patient satisfaction, and the well-being of nurses. The biennial Survey of Registered Nurses by AMN Healthcare, which polled nearly 20 000 RNs, found that nurses are eager for many workplace changes that would create a healthier workplace while enhancing their professional and personal lives. These institutional changes also create opportunities for improving the health of the organizations themselves. Analysis of survey data found that improving professional development, flexibility and work-life balance, safety and team engagement, and organizational response to workplace violence can create a healthier workplace for nurses. These are known solutions that have yet to be fully engaged.Since the introduction of the Future of Nursing report in 2011, Indiana nursing has successfully implemented many of the recommendations. This article describes these accomplishments. Notable examples include increasing the diversity of the workforce, placement of nurses on community boards and governmental appointments, promoting the advancement of nursing education, and increasing the number of nurses with baccalaureate degrees. Furthermore, Indiana supports the proliferation of new doctoral programs with a scholarship fundraising program to assist nurses with the cost of their education.When the Institute of Medicine released its report, commonly known as the Future of Nursing report, every state was challenged to take on the work of implementing the 8 recommendations. The Texas Team Action Coalition achieved measurable results in many areas; however, sustainability of efforts was challenging due to the volunteer nature of the work. As Robert Wood Johnson Foundation's focus shifted from Advancing Health Through Nursing to Building a Culture of Health for All, the Texas Team sought to realign its work accordingly. This article details initiatives of the Texas Team over the past 10 years and describes current efforts to position itself to champion anticipated recommendations from the 2020-2030 Future of Nursing report from the National Academy of Medicine.