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1.
Semin Oncol Nurs ; 40(2): 151623, 2024 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-38538507

RESUMO

OBJECTIVES: To describe cancer survivors' and care partners' perceived stress and social support during the COVID-19 pandemic and assess the feasibility of audio diaries for assessing role-related needs and resources. METHODS: Participants (N = 51; n = 28 survivors, n = 23 care partners) recorded three monthly audio diaries reporting stress and support experiences. Diaries were transcribed and content-analyzed using a hybrid approach. Stress-related content was inductively coded, and social support content was deductively coded by type (instrumental, information, emotional, companionship, appraisal; κ = 0.75) then inductively coded. Descriptive statistics summarized sociodemographic data and compared coding frequencies by role. We developed narrative summaries of stress and support categories and selected quotes for contextual detail. RESULTS: Cancer-related stressors were most prevalent (28.8%), followed by work (26.8%), family (23.1%), social isolation (13.4%), and finances (8.0%). While no significant difference in reporting frequency was observed between roles, cancer-related stress was more prevalent for survivors while work-related stress was mentioned more by care partners. Emotional support was the most prevalent support type (32.1%), followed by companionship (25.3%), appraisal (17.9%), instrumental (16.67%), and informational support (8%). Survivors reported more appraisal support than care partners (χ2 = 6.48, df = 1, P = .011) and more support for self-care, while care partners expressed more other-oriented concerns and focused more on managing responsibilities and interactions outside the household. CONCLUSIONS: The pandemic complicated and intensified role-based stressors already present in the survivorship context. Our findings highlight the importance of informal social support networks, particularly when access to formal services is limited, and suggest that audio diaries can be an effective tool for assessing support needs and resources. IMPLICATIONS FOR NURSING PRACTICE: Nurses and healthcare providers should tailor social support assessments to address the distinct support needs and individual resources of cancer survivors and their care partners. This is especially critical in contexts that limit access to care and formal services.


Assuntos
COVID-19 , Sobreviventes de Câncer , Apoio Social , Estresse Psicológico , Humanos , COVID-19/epidemiologia , COVID-19/enfermagem , COVID-19/psicologia , Masculino , Feminino , Sobreviventes de Câncer/psicologia , Sobreviventes de Câncer/estatística & dados numéricos , Pessoa de Meia-Idade , Idoso , Adulto , Cuidadores/psicologia , Neoplasias/psicologia , Neoplasias/enfermagem , SARS-CoV-2 , Pandemias , Diários como Assunto
3.
Semin Oncol Nurs ; 40(2): 151588, 2024 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-38331627

RESUMO

OBJECTIVES: Cancer is a complex disease that is experienced by those affected by cancer and their loved ones differently. The importance of cancer patient navigation is quintessential to support those affected through the healthcare system and to supportive resources. Canadian cancer statistics advise of the continued increase of cancer and impacts on health care. With Canada being a large geographical area, large portions of the population live in rural and remote areas with decreased access to health services. In Canada, cancer navigation is different across the country; each province's or territory's health authority creates their own cancer navigation program based on the needs of their patients. This report aims to provide an overview of cancer in Canada, along with the different navigation programs available nationally. Additionally, it will review the role the Canadian Association of Nurses in Oncology/Association canadienne des infirmières en oncologie (CANO/ACIO) plays in creating a community of practice to support cancer patient navigators across the country. METHODS: The information on various provincial and territorial navigation programs was obtained through discussion with the CANO/ACIO Navigation Special Interest Group (SIG). All provinces and territories were interviewed with the exception of Quebec, Prince Edward Island, Nunavut, and Yukon. RESULTS: While the vast majority of navigation has a similar core intent, there are many differences between the provinces and territories in the navigation programs. These differences are based on geographical need and the individual health authorities. CONCLUSIONS: The Canadian Association of Nurses in Oncology/Association canadienne des infirmières en oncologie (CANO/ACIO) provides a community for cancer navigators to connect through a Special Interest Group (SIG), meeting virtually monthly to support each other across Canada to collaborate, identify issues, trends, and challenges. IMPLICATIONS FOR NURSING PRACTICE: Cancer patient navigation is a valuable resource for all individuals with cancer and their loved ones, particularly when faced with difficulties accessing care in rural and remote areas. Cancer patient navigators' scope is similar in intent, despite potential differences in programs. By connecting with other navigators through the CANO/ACIO navigation SIG, navigators across the country can provide a connection to discuss program similarities and barriers and opportunities for cancer navigation programs to work together to support each other and evolve their programs to meet the needs of their provincial and territorial residents.


Assuntos
Acesso aos Serviços de Saúde , Neoplasias , Navegação de Pacientes , Humanos , Canadá , Navegação de Pacientes/organização & administração , Neoplasias/enfermagem , Acesso aos Serviços de Saúde/organização & administração , Enfermagem Oncológica/organização & administração , Feminino , Masculino
4.
Semin Oncol Nurs ; 40(2): 151587, 2024 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-38342642

RESUMO

OBJECTIVE: The aim of this study is to explore the relationship that people with cancer and their family caregivers develop with symptom management technology during chemotherapy. DATA SOURCES: A longitudinal and multi-perspective interpretative phenomenological approach was adopted. Data were collected using one-to-one in-depth interviews with people with colorectal cancer using supportive digital health symptom management technology (n=3) and their family caregivers (n=4) at two time points during chemotherapy treatment. Data were analyzed using interpretative phenomenological analysis and followed COREQ guidelines. CONCLUSION: People with cancer and their family caregivers can develop emotional bonds with supportive symptom management technology during cancer treatment. Digital health technology can be experienced as a person guiding them during their cancer treatment. Participants felt vulnerable after the technology was returned to the research team. Participants recognized that it was not the technology that successfully facilitated them through their initial chemotherapy cycles; rather, the technology helped them learn to manage their symptoms and promoted their self-efficacy, as well as how to emotionally respond. IMPLICATIONS FOR NURSING PRACTICE: The relationship and psychological bonds people with cancer and their family caregivers develop with technology during treatment may be critically important for oncology nurses to be aware of should digital health be prescribed within the outpatient model of cancer care. This study indicates that technology may not be needed for a full treatment experience, as digital health can promote confidence and self-efficacy regarding symptom management and prepare people with cancer to be independent after the digital health technology is returned to the research team. However, further research is needed regarding individual preferences for digital health provision.


Assuntos
Cuidadores , Humanos , Feminino , Masculino , Pessoa de Meia-Idade , Cuidadores/psicologia , Idoso , Neoplasias Colorretais/psicologia , Neoplasias Colorretais/terapia , Neoplasias Colorretais/tratamento farmacológico , Adulto , Estudos Longitudinais , Tecnologia Digital , Neoplasias/psicologia , Neoplasias/terapia , Neoplasias/enfermagem , Pesquisa Qualitativa , 60713
6.
Semin Oncol Nurs ; 40(2): 151590, 2024 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-38395692

RESUMO

OBJECTIVES: The 2022 Oncology Nursing Society Oncology Navigation Standards of Professional Practice offer a framework for role delineation in oncology navigation. The goal of completing a job task analysis using the standards with four independent navigation teams was to identify a core map of work which would align skills, experience and knowledge with clinical nurse navigators, social work navigators, and patient navigators. Role delineation reduces suboptimal use of resources and inconsistent navigation services. METHODS: An independent job task analysis was conducted with each of the four oncology navigation teams. Patient navigators and clinical nurse navigators were asked to report on each requested task over a 2-week period. The team discussed and determined alignment or misalignment with the standards. This discussion included the request and skill level of each navigator. RESULTS: Sixty percent of the tasks identified in the job task analysis were in alignment with the standards for role and level of care. Thirty percent of the tasks aligned for role, but not for level of care, with nurse navigators performing a high number of non-nursing/clerical tasks. Ten percent were outside the scope of navigation. CONCLUSIONS: Four enterprise opportunities were identified: (1) formalize standards for Tumor Board management, (2) create a core model for essential metrics, (3) establish standardized process for medical record retrieval for new oncology patients, and (4) explore alternative staffing models. IMPLICATIONS FOR NURSING PRACTICE: Using a job task analysis allows time for meaningful exploration of roles and scope of work completed by the team. High work volume for navigation teams often leads to a "this is the way we've always done it" mentality. A job task analysis provides a structured approach with dedicated time and a safe space for navigators to "think critically" about their daily work, identify opportunities for change, and progress using this framework.


Assuntos
Enfermagem Oncológica , Navegação de Pacientes , Humanos , Navegação de Pacientes/normas , Navegação de Pacientes/organização & administração , Enfermagem Oncológica/normas , Feminino , Masculino , Neoplasias/enfermagem , Papel do Profissional de Enfermagem
7.
Semin Oncol Nurs ; 40(2): 151608, 2024 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-38402019

RESUMO

OBJECTIVES: The aim of this study was to determine the daily nursing care times of hospitalized inpatient oncology unit patients according to degree of acuity using the Perroca Patient Classification tool. DATA SOURCES: This study used a mixed method sequential explanatory design. The "Nursing Activity Record Form" and "Perroca Patient Classification Instrument" were used for quantitative data collection, and direct observation was performed for 175 hours via time-motion study. Descriptive statistics, between-group comparison, and correlation analysis were used for data analysis. Using a semistructured questionnaire, qualitative data were collected from individual in-depth interviews with seven nurses who participated in the quantitative part of the study. Qualitative data were analyzed by thematic analysis. The reporting of this study followed GRAMMS checklist. CONCLUSIONS: As a result of the integration of quantitative and qualitative data, daily nursing care duration was determined as 2 to 2.5 hours for Type 1 patients, 2.6 to 3.5 hours for Type 2 patients, 3.6 to 4.75 hours for Type 3 patients, and 4.76 to 5.5 hours for Type 4 patients. The findings showed that in an inpatient oncology unit, nursing care hours increased as patients' Perroca Patient Classification Instrument acuity grade increased; thus, the instrument was discriminative in determining patients' degree of acuity. IMPLICATIONS FOR NURSING PRACTICE: Nurse managers can utilize this study's results to plan daily assignments that are sensitive to patient care needs. The results can also help nurse managers to identify relationships between nurse staffing and patient outcomes at the unit level, as well as to develop ways to analyze such relationships.


Assuntos
Pacientes Internados , Enfermagem Oncológica , Humanos , Feminino , Masculino , Pacientes Internados/estatística & dados numéricos , Recursos Humanos de Enfermagem no Hospital , Neoplasias/enfermagem , Neoplasias/classificação , Adulto , Pessoa de Meia-Idade , Inquéritos e Questionários , Fatores de Tempo , Gravidade do Paciente , Cuidados de Enfermagem/normas , Cuidados de Enfermagem/estatística & dados numéricos , Pesquisa Qualitativa
8.
Semin Oncol Nurs ; 40(2): 151579, 2024 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-38402020

RESUMO

OBJECTIVES: This systematic review aimed to identify oncology nurses' experiences of using health information systems (HIS) in the delivery of cancer care. DATA SOURCES: The electronic databases searched included CINAHL, MEDLINE (EBSCO host), SCOPUS, Web of Science Core Collection, Google Scholar, OVID, and ProQuest Central (using advanced search strategy) and hand searching of reference lists of the included articles and relevant systematic reviews. Studies published in English language were examined. CONCLUSION: Twenty-six studies were included. Three themes emerged: (1) the transparency and application of the nursing process within HIS, (2) HIS enhancing and facilitating communication between nurses and patients, and (3) the impact of HIS on the elements of person-centered care. Nurses' experiences with HIS were overall positive. However, digital systems do not fully capture all elements of the nursing processes; this was confirmed in this review, through the nurses' lens. Most studies used HIS for symptom reporting and monitoring within non-inpatient settings and largely biomedical and lack insight into the person-centeredness and overall holistic care. IMPLICATIONS FOR NURSING PRACTICE: There are evidently varied views of HIS adoption across the globe. HIS can improve health-related quality of life and symptom burden, including self-reporting of symptoms among patients. However, there is a need for ongoing high-quality research, and clearer reporting than is evident in the current 26 studies, to fully understand the impact of HIS within the nursing processes and patient outcomes across all specialty cancer fields.


Assuntos
Neoplasias , Enfermagem Oncológica , Humanos , Enfermagem Oncológica/métodos , Neoplasias/enfermagem , Neoplasias/psicologia , Sistemas de Informação em Saúde , Atitude do Pessoal de Saúde , Assistência Centrada no Paciente , Masculino , Feminino
9.
Semin Oncol Nurs ; 40(2): 151585, 2024 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-38423821

RESUMO

OBJECTIVE: This quality improvement project was a collaborative effort with Penn Medicine's emergency department (ED) and oncology nurse navigators (ONNs). The goal of the project was to streamline patient transitions from the ED to the outpatient oncology clinic by developing a standardized referral process. The main objectives were to simplify and automate the referral process using the electronic medical record, improve multidisciplinary communication across the care continuum, ensure timely follow-up, and address barriers to oncology care. METHODS: The ED providers placed a consult to ONNs. The ONNs reached out to the patient within 48 hours of the consult. They maintained a database of patient referrals and collected information such as patient demographics, reason for referral, insurance, and patient outcomes. RESULTS: The ED providers referred 204 patients to the ONNs from April 2022 to September 2023. The development of a standardized referral process from the ED to the outpatient oncology clinic proved successful. Of the patients referred, the ONNs facilitated 98 cancer diagnoses and 80 of those patients are receiving oncology care at Penn Medicine. The median time to the patient's first appointments was seven days, diagnosis was 15 days, and treatment initiation occurred within 32 days. CONCLUSION: The project team achieved their goal of facilitating timely access to oncology care, ensuring continuity, and addressing patient-specific barriers. IMPLICATIONS FOR NURSING PRACTICE: This quality improvement initiative highlights the ONNs' role in enhancing access and equity in cancer care delivery. The success of the project underscores the ONN's expertise and leadership in addressing healthcare disparities in oncology care. Collaboratively, the teams created a new referral workflow improving care transitions from the ED to the outpatient oncology clinic. The project sets a precedent for optimizing patient care transitions, demonstrating the positive impact of ONNs as key members of the multidisciplinary healthcare team.


Assuntos
Instituições de Assistência Ambulatorial , Continuidade da Assistência ao Paciente , Serviço Hospitalar de Emergência , Neoplasias , Enfermagem Oncológica , Melhoria de Qualidade , Humanos , Serviço Hospitalar de Emergência/organização & administração , Feminino , Masculino , Enfermagem Oncológica/organização & administração , Enfermagem Oncológica/normas , Melhoria de Qualidade/organização & administração , Continuidade da Assistência ao Paciente/organização & administração , Neoplasias/terapia , Neoplasias/enfermagem , Instituições de Assistência Ambulatorial/organização & administração , Pessoa de Meia-Idade , Encaminhamento e Consulta/organização & administração , Adulto , Transferência de Pacientes/organização & administração , Transferência de Pacientes/normas , Idoso , Navegação de Pacientes/organização & administração
10.
Semin Oncol Nurs ; 40(2): 151617, 2024 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-38423822

RESUMO

OBJECTIVES: To examine the diagnostic performance of the FRAIL Scale for frailty screening with reference to the Fried phenotype and investigate its association with health outcomes in older cancer survivors. DATA SOURCE: In this cross-sectional quantitative study, participants were post-treatment cancer survivors aged 65 or above. Measurements included the FRAIL Scale, Fried phenotype, Geriatric Depression Scale-15 item, Modified Barthel Inventory, and EORTC Core Quality of Life Questionnaire. Receiver operating characteristic curve analysis was performed to evaluate the diagnostic performance of the FRAIL Scale with reference to the Fried phenotype. Health outcomes associated with being frail as estimated by the FRAIL Scale and Fried phenotype were also examined using regressions. RESULTS: Based on 293 older cancer survivors, the area under curve (AUC) of the FRAIL Scale was 0.79, and the optimal cut-off of 1 yielded a sensitivity of 92% and specificity of 41%. According to regression results, the FRAIL Scale was modified by adding an item on time since cancer treatment completion (AUC = 0.81), and using a cut-off of 2 for older cancer survivors, which yielded a sensitivity of 74% and specificity of 67%. The modified FRAIL Scale was associated with depressive symptoms, functional independence, fatigue, dyspnea, physical functioning, and role functioning. CONCLUSIONS: The modified FRAIL Scale is proposed for use in older cancer survivors, and a cut-off of 2 should be used. IMPLICATIONS FOR NURSING PRACTICE: The modified FRAIL Scale can serve as a brief screening tool for identifying frailty among older cancer survivors in practice.


Assuntos
Sobreviventes de Câncer , Idoso Fragilizado , Fragilidade , Avaliação Geriátrica , Humanos , Idoso , Estudos Transversais , Masculino , Feminino , Sobreviventes de Câncer/psicologia , Fragilidade/diagnóstico , Fragilidade/enfermagem , Idoso de 80 Anos ou mais , Avaliação Geriátrica/métodos , Fenótipo , Neoplasias/psicologia , Neoplasias/enfermagem , Inquéritos e Questionários , Qualidade de Vida , Programas de Rastreamento/métodos
11.
Semin Oncol Nurs ; 40(2): 151610, 2024 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-38423823

RESUMO

OBJECTIVES: This study aimed to determine the effect of an occupation-based nursing program (OBaNuP) on chemotherapy-induced symptoms and satisfaction in pediatric oncology patients. DATA SOURCES: This study was a randomized controlled trial. The study sample consisted of 60 hospitalized children with cancer who were aged 7 to 12. Participants were randomly assigned to an OBaNuP (intervention group, n = 30) or clinical routine care only (control group, n = 30). The intervention group participated in an OBaNuP for an average of 30 minutes per day for 5 days. The Memorial Symptom Assessment Scale 7-12 and Psychosocial Symptoms in Hospitalized Children and Child Satisfaction Questionnaire were completed by participants at baseline, the first meeting immediately after intervention, and 7 days and 14 days after the intervention. CONCLUSION: The average scores of chemotherapy-related symptoms differed over time between the intervention and control groups (P < .05). The psychosocial symptom score averages of the children in the intervention group significantly decreased at all time points compared to the control group (P < .05). The satisfaction mean scores of the children in the intervention group increased significantly at all time points compared to the control group (P < .05). IMPLICATIONS FOR NURSING PRACTICE: The OBaNuP initiative supported the decrease of chemotherapy-related and psychosocial symptoms, while also promoting an increase in satisfaction among children undergoing cancer treatment at the hospital consistently over all observed time periods.


Assuntos
Antineoplásicos , Neoplasias , Enfermagem Oncológica , Humanos , Criança , Feminino , Masculino , Neoplasias/tratamento farmacológico , Neoplasias/enfermagem , Neoplasias/psicologia , Antineoplásicos/efeitos adversos , Antineoplásicos/uso terapêutico , Enfermagem Oncológica/métodos , Satisfação do Paciente , Inquéritos e Questionários
12.
Semin Oncol Nurs ; 40(2): 151586, 2024 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-38311537

RESUMO

OBJECTIVES: Provide an overview of navigation in three disparate populations: rural, Native American/Alaska Native, and low- to middle-income countries. Discuss gaps in care and opportunities to improve cancer care. METHODS: A literature search was conducted in PubMed and on Google Scholar using search terms, nurse navigation, cancer, disparit*, low- to middle-income countries, Native American, American Indian, and rural. Peer-reviewed research studies, review articles, databases and websites of professional organizations, and historical books were reviewed to provide an overview of oncology nurse navigation in underserved communities. Experiences in working with these populations over the past 30 years were also provided to support current literature. RESULTS: Forty references were included in this overview of nurse navigation in underserved communities. Nurse navigation in these disparate areas is in its infancy. While some programs exist and outcomes have been positive, their dissemination is sparse. A need exists to expand nurse navigation into these areas to provide care for these underserved communities. CONCLUSION: Oncology nursing navigation for each of these underserved communities requires a culturally sensitive approach. Many of these approaches are universal to cultural competency and can be applied to most disparate populations. IMPLICATIONS FOR NURSING PRACTICE: Nurses comprise the largest workforce around the globe and are well-equipped to develop navigation programs in some of the most disparate communities around the world. To do so, it is important to use a foundation of building trust, embracing individual differences, providing culturally sensitive education and resources for growth, and good communication.


Assuntos
Área Carente de Assistência Médica , Enfermagem Oncológica , Navegação de Pacientes , Humanos , Enfermagem Oncológica/tendências , Enfermagem Oncológica/organização & administração , Navegação de Pacientes/organização & administração , Neoplasias/enfermagem , Acesso aos Serviços de Saúde
13.
Semin Oncol Nurs ; 40(2): 151581, 2024 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-38326160

RESUMO

OBJECTIVES: The role of the oncology nurse navigator (ONN) before, during, and after a climate disaster is critical to ensuring that individuals with cancer continue to receive the necessary care and support. The objective of this article is to provide an overview of the essential role of the ONN by highlighting the application of core competencies to climate disasters. METHODS: Competencies available for ONNs from the Oncology Nursing Society include coordination of care, communication, education, professional role, and expertise. International Council of Nurses (ICN) core competencies for disaster nursing include eight domains: preparation and planning, communication, incident management systems, safety and security, assessment, intervention, recovery, and law and ethics. These competencies are explored for application to climate disaster preparation, mitigation, and response. RESULTS: The ONN competencies and the domains of the ICN disaster nursing competencies were integrated to outline the role of the ONN in disaster preparedness and response. CONCLUSION: The ONN is pivotal in maintaining the continuity of cancer care. The ONN's expertise is critical for navigating the difficulties presented by hurricanes, floods, wildfires, and other extreme climate events as well as existing barriers to cancer care. The ONN's adeptness at coordinating care, communicating effectively, and tapping into community resources will transfer to a climate disaster, ensuring minimal treatment interruptions and access to necessary care. IMPLICATIONS FOR NURSING PRACTICE: The ONN is integral to the cancer care team in preparing and responding to climate disasters. The ONN ensures ongoing access to cancer care and advocates for the specialized care that people with cancer need. The ONS ONN Core Competencies and the ICN Disaster Competencies are applicable for developing processes and procedures to address climate disasters in clinical practice.


Assuntos
Planejamento em Desastres , Papel do Profissional de Enfermagem , Enfermagem Oncológica , Humanos , Enfermagem Oncológica/organização & administração , Enfermagem Oncológica/normas , Planejamento em Desastres/organização & administração , Competência Clínica , Neoplasias/enfermagem , Mudança Climática , Navegação de Pacientes/organização & administração , Feminino , Masculino
14.
Semin Oncol Nurs ; 40(2): 151580, 2024 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-38290928

RESUMO

OBJECTIVES: This manuscript aims to provide an extensive review of the literature, synthesize findings, and present substantial insights on the current state of transitional care navigation. Additionally, the existing models of care, pertaining to the concept and approach to transitional care navigation, will be highlighted. METHODS: An extensive search was conducted though using multiple search engines, topic-specific key terminology, eligibility of studies, as well as a limitation to only literature of existing relevance. Integrity of the evidence was established through a literature review matrix source document. A synthesis of nursing literature from organizations and professional publications was used to generate a comparison among various sources of evidence for this manuscript. Primary evidence sources consisted of peer-reviewed journals and publications from professional organizations such as the AHRQ, Academic Search Premier, CINAHL Plus with Full Text, and the Talbot research library. RESULTS: A total of five systematic reviews (four with meta-analysis) published between 2016 and 2022 and conducted in several countries (Brazil, Korea, Singapore, and the US) were included in this review. A combined total of 105 studies were included in the systematic reviews with 53 studies included in meta-analyses. The review of the systematic reviews identified three overarching themes: care coordination, care transition, and patient navigation. Care coordination was associated with an increase in care quality rating, increased the health-related quality of life in newly diagnosed patients, reduced hospitalization rates, reduced emergency department visits, timeliness in care, and increased appropriateness of healthcare utilization. Transitional care interventions resulted to reduced average number of admissions in the intervention (I) group vs control (C) (I = 0.75, C = 1.02) 180 days after a 60-day intervention, reduced readmissions at 6 months, and reduced average number of visits 180 days after 60-day intervention (I = 2.79, C = 3.60). Nurse navigators significantly improved the timeliness of care from cancer screening to first-course treatment visit (MD = 20.42, CI = 8.74 to 32.10, P = .001). CONCLUSION: The care of the cancer patient entails treatments, therapies, and follow-up care outside of the hospital setting. These transitions can be challenging as they require coordination and collaboration among various health care sites. The attributes of transitional care navigation overlap with care coordination, care transition, and patient navigation. There is an opportunity to formally develop a transitional care navigation model to effectively addresses the challenges in care transitions for patient including barriers to health professional exchange of information or communication across care settings and the complexity of coordination between care settings. The transitional care navigation and clinic model developed at a free-standing NCI-designated comprehensive cancer center is a multidisciplinary approach created to close the gaps in care from hospital to home. IMPLICATIONS FOR NURSING PRACTICE: A transitional care navigation model aims to transform the existing perspectives and viewpoints of hospital discharge and transition of care to home or post-acute care settings as two solitary processes to that of a collective approach to care. The model supports provides an integrated continuum of quality, comprehensive care that supports patient compliance with treatment regimens, reinforces patient and caregiver education, and improves health outcomes.


Assuntos
Navegação de Pacientes , Cuidado Transicional , Humanos , Cuidado Transicional/organização & administração , Navegação de Pacientes/organização & administração , Neoplasias/terapia , Neoplasias/enfermagem , Continuidade da Assistência ao Paciente/organização & administração , Enfermagem Oncológica/organização & administração
15.
Semin Oncol Nurs ; 40(2): 151582, 2024 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-38290927

RESUMO

OBJECTIVES: The goal of this article is to define the role and responsibilities of the oral anticancer medication nurse navigator. METHODS: This article combines findings from a review of scientific literature including research studies, quality improvement projects, case studies, standards, and guidelines combined with the experience and professional insights of the authors in the role creation and function of the oral anticancer medication nurse navigator. RESULTS: The role of the oral anticancer medication nurse navigator includes coordination of patient care, pre-treatment assessment of barriers to adherence, patient and caregiver education, planned follow-up and coaching, and symptom management. Professionally, the role includes the development of interdisciplinary workflows, coordination of care with internal and external stakeholders, clinical staff education, the application of technology, and advocacy. CONCLUSION: The oral anticancer medication nurse navigator uses the nursing process to coordinate care of the individual taking these medications. The role optimizes patient outcomes and benefits the healthcare organization through reduced healthcare costs and the ability to meet accreditation needs. IMPLICATIONS FOR NURSING PRACTICE: The role of the oral anticancer medication nurse navigator provides value to patients taking oral anticancer medications and to the healthcare team.


Assuntos
Antineoplásicos , Papel do Profissional de Enfermagem , Enfermagem Oncológica , Navegação de Pacientes , Humanos , Antineoplásicos/administração & dosagem , Antineoplásicos/uso terapêutico , Administração Oral , Enfermagem Oncológica/métodos , Neoplasias/tratamento farmacológico , Neoplasias/enfermagem
16.
J Hosp Palliat Nurs ; 25(5): E94-E101, 2023 10 01.
Artigo em Inglês | MEDLINE | ID: mdl-37525347

RESUMO

The quality of care provided to patients with cancer at the end of their lives remains unsatisfactory, especially during their last days and hours of life. This study aimed to investigate knowledge and practice behaviors of oncology nurses in relation to the care of the dying and to analyze the influencing factors. A convenience sample of 222 oncology nurses was recruited from 14 hospitals in Beijing, China, in January 2022. These nurses completed an online survey that included a demographic and work characteristics questionnaire and knowledge and practice behavior questionnaires regarding the care needs of dying cancer patients. The self-perceived knowledge and practice behavior of oncology nurses toward the care of the dying were found to be moderate. However, their understanding of airway management, restlessness, and delirium management was insufficient. In addition, their ability to effectively communicate recommendations for discontinuing unnecessary procedures, medications, treatments, and monitoring was inadequate. Nurses' previous end-of-life care education and experience of caring for dying patients influenced their knowledge. Nurses' practice settings, experience of caring for dying patients, and their knowledge were key factors in shaping their behaviors. Providing targeted continuing education for nurses in hospital settings and exploring the nursing pathway may be important ways to bridge their knowledge gap and enhance their practice behaviors toward caring for dying patients.


Assuntos
Neoplasias , Enfermeiras e Enfermeiros , Enfermagem Oncológica , Assistência Terminal , Humanos , Atitude do Pessoal de Saúde , Estudos Transversais , População do Leste Asiático , Neoplasias/enfermagem , Enfermeiras e Enfermeiros/normas , Assistência Terminal/métodos , Conhecimentos, Atitudes e Prática em Saúde , Qualidade da Assistência à Saúde , Enfermagem Oncológica/normas , China
17.
J Cancer Educ ; 38(5): 1548-1556, 2023 10.
Artigo em Inglês | MEDLINE | ID: mdl-37024607

RESUMO

Clinical nurses need learning programs that are useful in nursing support for patients' decision-making (NSPDM) regarding cancer clinical trials (CCTs). The usefulness of the learning program can be evaluated if the practices of NSPDM before and after participation in the learning program can be compared. We developed a scale to measure the level of self-assessed NSPDM regarding participation in a CCT. Thirty-two items of scale were developed in Japanese based on previous literature. Based on the results of a pilot study, items with similar meanings were removed and the validity of the 26 scale items was statistically examined in terms of construct validity and reliability. The study population was clinical nurses and included clinical research nurses. We received 102 valid responses from clinical nurses. Based on the bias of the boxplot distribution and the ceiling and floor effects for the items analysis of the 26-item draft scale, 17 items remained. Exploratory factor analysis (EFA) revealed that the scale consisted of three subscales and 17 items. Regarding fit indices of the model, the goodness-of-fit index (GFI), adjusted GFI (AGFI), comparative fit index (CFI), and root mean square error of application (RMSEA) were 0.775, 0.704, 0.477, and 0.081, respectively. The Cronbach's alpha coefficient for the overall scale was 0.951, with subscales ranging from 0.820 to 0.942. The validity and reliability of this scale were acceptable. This scale may be helpful to evaluate the usefulness of learning programs, i.e., the practice level of NSPDM.


Assuntos
Tomada de Decisões , Neoplasias , Humanos , Neoplasias/enfermagem , Projetos Piloto , Psicometria , Reprodutibilidade dos Testes , Inquéritos e Questionários , Ensaios Clínicos como Assunto , Japão
18.
Nurs Sci Q ; 36(2): 174-180, 2023 04.
Artigo em Inglês | MEDLINE | ID: mdl-36994955

RESUMO

Cancer survivors have unique life challenges that threaten their well-being. Concept building has identified fearless tenacity as a process that is critical to meaningful survival, by expanding understanding of how cancer survivors get along day by day as they transcend the course of cancer treatment and move beyond to pursue life purpose. This work establishes a foundation for nurses wishing to promote self-worth through fostering fearless tenacity. It sets a direction for research and practice grounded in the discipline through a specific nursing theory and solid footing from both extant literature and the real life experiences.


Assuntos
Sobreviventes de Câncer , Neoplasias , Humanos , Neoplasias/enfermagem , Sobreviventes de Câncer/psicologia
19.
REME rev. min. enferm ; 27: 1496, jan.-2023. Tab.
Artigo em Inglês, Português | LILACS, BDENF - Enfermagem | ID: biblio-1527177

RESUMO

Objetivo: validar o conteúdo de uma cartilha para melhorar a qualidade de vida no cotidiano de familiares/cuidadores de pacientes oncológicos em cuidados paliativos domiciliares. Métodos: estudo de caráter metodológico. Dados coletados de setembro de 2021 a maio de 2022. Os participantes foram 17 juízes especialistas, sendo 14 da área da saúde e 3 de outras áreas. Estudo mediado por um questionário estruturado de acordo com a escala Likert, possui itens dispostos em objetivos, estrutura, apresentação e relevância. Resultados: dos 21 itens do questionário dos juízes da área da saúde somente três resultaram em escore I (inadequado). Revela-se a tecnologia validada, pois conforme a literatura é necessário obter um índice de validação de conteúdo em pelo menos 70%, e o índice alcançado foi de 88%. Conforme as sugestões dos juízes produziu-se a versão adequação da tecnologia. Conclusão: considera-se que a cartilha está validada e com os ajustes poderá a promover o autocuidado, podendo reduzir desconhecimentos e dar mais qualidade de vida aos familiares/cuidadores de pacientes oncológicos em fim de vida.(AU)


Objective: to validate the content of a booklet to improve the quality of life in the daily lives of family members/caregivers of cancer patients in-home palliative care. Methods: this was a methodological study. Data were collected from September 2021 to May 2022. Participants were 17 experts, 14 from health care and 3 from other areas. The study was mediated by a questionnaire structured according to the Likert scale, with items arranged in objectives, structure, presentation, and relevance. Results: of the 21 items in the questionnaire of the health area experts, only three resulted in a score of I (inadequate). The technology was validated since, according to the literature, obtaining a content validation index of at least 70% is necessary, and the index achieved was 88%. According to the experts' suggestions, the appropriate technology version was produced. Conclusion: the booklet is considered validated and, with the adjustments, it may promote self-care, reducing unawareness and giving more quality of life to family members/caregivers of cancer patients at the end of life.(AU)


Objetivo: validar el contenido de un folleto para mejorar la calidad de vida en el día a día de los familiares/cuidadores de pacientes oncológicos en cuidados paliativos a domicilio. Métodos: estudio metodológico. Datos recogidos desde septiembre de 2021 a mayo de 2022. Participaron 17 jueces expertos, siendo 14 del área de salud y 3 de otras áreas. El estudio estuvo mediado por un cuestionario estructurado según la escala de Likert, con elementos ordenados en objetivos, estructura, presentación y relevancia. Resultados: de los 21 elementos del cuestionario de los jueces del área de la salud sólo tres resultaron en la puntuación I (inadecuado). Se revela la tecnología validada, ya que según la bibliografía es necesario obtener un índice de validación de contenido de al menos 70%, y el índice alcanzado fue de 88%. De acuerdo con las sugerencias de los jueces, se produjo la versión adecuada de la tecnología. Conclusión: se considera que el folleto está validado y con los ajustes podrá promover el autocuidado, pudiendo reducir el desconocimiento y dar más calidad de vida a los familiares/cuidadores de pacientes con cáncer al final de la vida.(AU)


Assuntos
Humanos , Cuidados Paliativos , Materiais de Ensino , Educação em Saúde , Estudos de Validação como Assunto , Neoplasias/enfermagem , Enfermagem Oncológica , Qualidade de Vida , Inquéritos e Questionários
20.
Horiz. enferm ; 34(2): 418-428, 2023.
Artigo em Espanhol | LILACS | ID: biblio-1509728

RESUMO

INTRODUCCIÓN. La calidad de la interacción humana entre el profesional de la salud y la persona atendida es fundamental en la oncología tanto a nivel ético como práctico. El presente artículo de naturaleza teórica tiene como OBJETIVO: Reflexionar sobre la conceptualización de cómo debe ser la relación interpersonal entre el profesional de enfermería y la persona con un proceso oncológico, es decir, conocer a partir de determinados conceptos su relevancia en el trato humano para una mejor praxis del cuidado de enfermería. METODOLOGÍA: Reflexión teórica basada en conceptos de intersubjetividad y cuidado de enfermería a través de la revisión de literatura. Se enfocará fundamentalmente en el pensamiento de Hildegard E. Peplau dada la relevancia de la visión interactiva - integrativa de su teoría de las relaciones interpersonales como un proceso interpersonal significativo, terapéutico. Asimismo, del Filósofo Martin Heidegger. RESULTADOS: Abordar el cuidado de enfermería bajo la perspectiva de la comprensión del "Ser" con su entorno y no solo el "estar ahí" significa para la persona la importancia del cuidado adecuado en pro de la recuperación, prestando atención empática de las emociones y sentimientos para comprender el sufrimiento del otro y de esta forma se pueda brindar un cuidado significativo. CONCLUSIONES: Los profesionales de enfermería tienen un rol fundamental en la construcción del vínculo terapéutico a través de la relación interpersonal de modo que les permita satisfacer las necesidades de la persona con un proceso oncológico y brindar cuidados significativos de enfermería.


INTRODUCTION. The quality of the human interaction between the health professional and the person being cared for is essential in oncology, both ethically and practically. The present article of theoretical nature has as OBJECTIVE: To reflect on the interpersonal relationship between the nursing professional and the person with an oncological condition, and to examine its relevance in the humane treatment of such persons in the provision of nursing care. METHOD: Theoretical reflection based on concepts of intersubjectivity and nursing care through literature review. It will focus primarily on the concepts of Hildegard E. Peplau, given the relevance of her interactive-integrative vision of interpersonal relationships as key to a meaningful, therapeutic interpersonal process. It also considers the concepts of the philosopher Martin Heidegger. RESULTS: Approaching nursing care from the perspective of understanding the "Being" within its environment, and not only "being there", facilitates recovery. By paying empathic attention to emotions and feelings in an effort to understand the suffering of the other, meaningful care can be provided. CONCLUSIONS: Nursing professionals have a fundamental role in building therapeutic bonds through interpersonal relationships in a way that allows them provide meaningful nursing care to persons with oncologic conditions.


Assuntos
Humanos , Masculino , Feminino , Neoplasias/enfermagem , Relações Enfermeiro-Paciente , Empatia , Enfermeiras e Enfermeiros/psicologia
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