RESUMEN
PURPOSE: Cancer survivors continue to experience issues that persist across the survivorship trajectory. This study aims to explore the relationship among survivorship care need, symptom experience, and quality of life (QoL) of multiethnic cancer survivors by using path analytic methods. METHODS: Participants were recruited from an academic medical center in Singapore that provides inpatient and outpatient oncology and hematology service. The Cancer Survivor Unmet Needs measure, physical effects subscale of the Cancer Survivors' Survey of Needs tool, and a Global QoL 10-point Likert scale were used to identify survivorship care needs, symptom experience, and QoL. Descriptive statistics were used to compute sociodemographic information, total survivorship needs, symptom experienced, and quality of life scores. The symptom experience model was used as the hypothetical model. The Analysis of Moment Structure was used to conduct the path analysis to evaluate the relationship between survivorship care needs, symptom experience, and quality of life. RESULTS: Older cancer survivors were more likely to have spent a longer duration having cancer. Males were unlikely to suffer from solid tumor malignancies. Survivors with solid tumor malignancies were less likely to require supportive care. Survivors who require more supportive care were more likely to have a greater symptom burden. Cancer survivors with more symptoms have poorer QoL. The findings from this study partially supported the symptom experience model. CONCLUSIONS: Our findings reveal that cancer survivors continue to experience symptoms across the survivorship trajectory. The results provide information for nurses during the planning and execution of survivorship care.
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Supervivientes de Cáncer/estadística & datos numéricos , Neoplasias/etnología , Calidad de Vida/psicología , Femenino , Humanos , Masculino , Persona de Mediana Edad , Neoplasias/mortalidad , Encuestas y CuestionariosRESUMEN
BACKGROUND: Clinical nursing education provides opportunities for students to learn in multiple patient care settings, receive appropriate guidance, and foster the development of clinical competence and professionalism. Nurse preceptors guide students to integrate theory into practice, teach clinical skills, assess clinical competencies, and enhance problem-solving and critical thinking skills. Previous research has indicated that the teaching competencies of nurse preceptors can be transferred to students' clinical learning to enhance their clinical competencies. OBJECTIVE: This study aimed to develop a clinical teaching blended learning (CTBL) program with the aid of web-based clinical pedagogy (WCP) and case-based learning for nurse preceptors and to examine the effectiveness of the CTBL program on nurse preceptors' clinical teaching competencies, self-efficacies, attitudes toward web-based learning, and blended learning outcomes. METHODS: A quasi-experimental single-group pretest and posttest design was adopted. A total of 150 nurse preceptors participated in the CTBL program, which was conducted from September 2019 to December 2019. A set of questionnaires, including the clinical teaching competence inventory, preceptor self-efficacy questionnaire, attitudes toward web-based continuing learning survey, and e-learning experience questionnaire, was used to assess the outcomes before and after the CTBL program. RESULTS: Compared with the baseline, the participants had significantly higher total mean scores and subdomain scores for clinical teaching competence (mean 129.95, SD 16.38; P<.001), self-efficacy (mean 70.40, SD 9.35; P<.001), attitudes toward web-based continuing learning (mean 84.68, SD 14.76; P<.001), and blended learning outcomes (mean 122.13, SD 14.86; P<.001) after the CTBL program. CONCLUSIONS: The CTBL program provides a comprehensive coverage of clinical teaching pedagogy and assessment strategies. The combination of the WCP and case-based approach provides a variety of learning modes to fit into the diverse learning needs of the preceptors. The CTBL program allows the preceptors to receive direct feedback from the facilitators during face-to-face sessions. Preceptors also gave feedback that the web-based workload is manageable. This study provides evidence that the CTBL program increases the clinical teaching competencies and self-efficacies of the preceptors and promotes positive attitudes toward web-based learning and better blended learning outcomes. The health care organization can consider the integration of flexible learning and intellect platforms for preceptorship education.
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Competencia Clínica/normas , Aprendizaje/fisiología , Enfermería/métodos , Preceptoría/organización & administración , Adulto , Femenino , Humanos , MasculinoRESUMEN
AIM: To explore nurses' perspectives on implementing advance care planning (ACP) in an acute setting. BACKGROUND: Advance care planning can assist patients to achieve peace of mind and a sense of control in decision-making. Nurses are well-positioned to integrate ACP into practice. METHODS: A descriptive, qualitative study using face-to-face semi-structured interviews was conducted among 16 nurses. A theoretical sampling strategy was used to inform data collection. Data were analysed using a thematic approach. RESULTS: Three major themes were found from nurses' narratives of implementing ACP: value of ACP, communicating ACP and barriers to advocating ACP. IMPLICATIONS FOR NURSING MANAGEMENT: Implementing ACP will require a multi-pronged approach, which includes specific training and changes in hospital policies. Findings from this study will enable hospital administrators to make informed decisions in preparing training programmes for ACP from nurses' perspectives. CONCLUSION: Advance care planning provides a clear direction for health care professionals in meeting patients' desired outcomes. However, a lack of understanding and acceptance among the public, as well as systematic clinical routine supporting nurses' roles and responsibilities in ACP, was recognized.
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Planificación Anticipada de Atención/normas , Enfermeras y Enfermeros/psicología , Percepción , Adulto , Planificación Anticipada de Atención/tendencias , Actitud del Personal de Salud , Femenino , Humanos , Masculino , Persona de Mediana Edad , Investigación Cualitativa , Cuidado Terminal/métodos , Cuidado Terminal/normasRESUMEN
Health delivery practices are shifting toward home care, because of better possibilities for managing chronic care, controlling health delivery costs, and increasing the quality of life and quality of health services, and the distinct possibility of predicting and thus avoiding serious complications. The study aimed to explore the benefits of an online Symptom Care and Management System in the home for patients receiving chemotherapy. A single-group experimental design was used. Thirty patients aged between 37 and 77 years undergoing their first or commencing a new course of chemotherapy treatment were recruited from November 2010 and December 2012 at a cancer center in Singapore. All patients used the Symptom Care and Management System to send daily symptom reports to the cancer center and received symptom management advice from the oncology nurse via teleconferencing during the first four chemotherapy treatment cycles. Patients' perceptions of the use of the Symptom Care and Management System were evaluated. All participants perceived the Symptom Care and Management System as a user-friendly interface and believed that they felt more involved in their care, and the system made it easier to understand some of the problems they experienced and helped them manage the symptoms more easily during the treatment. In addition, 29 participants (96.7%) felt that the nurse could contact them better via the Symptom Care and Management System, the Symptom Care and Management System helped them explain their symptoms to the nurse, and that it was simple to understand. The results presented in this study suggested that the Symptom Care and Management System has the potential to enhance remote monitoring and provides a feasible and acceptable way for a specific group of cancer patients to manage their symptoms at home.
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Antineoplásicos/administración & dosificación , Adulto , Anciano , Antineoplásicos/efectos adversos , Antineoplásicos/uso terapéutico , Femenino , Servicios de Atención de Salud a Domicilio , Humanos , Masculino , Persona de Mediana EdadRESUMEN
BACKGROUND: Noncognitive skills have a considerable role in influencing nursing students' performance in clinical and educational settings. Understanding how nursing students and educators perceive noncognitive skills is important given the broad classifications of noncognitive competencies. OBJECTIVE: This study sought to examine nursing students' and educators' perception of noncognitive skills. DESIGN: This study adopted a descriptive qualitative approach. SETTING: This study was conducted virtually via Zoom in one university in Singapore. PARTICIPANTS: Purposive sampling through a maximum variation technique was used to select 35 nursing students and 12 educators. METHODS: Semistructured interviews were conducted through eight virtual face-to-face focus group discussions. Interviews were audio- and videorecorded and transcribed verbatim. Data were analysed through thematic analysis. RESULTS: The participants stated that individual and interpersonal skills contribute to one's noncognitive skills. Two themes emerged from the participants' narratives: (1) the ability to manage oneself and (2) social interactions with others. The first theme describes the various individual characteristics such as growth mindset, adaptability, resilience, and emotional regulation. The second theme describes the importance of empathy and meaningful relationships as types of non-cognitive skills. CONCLUSIONS: The findings of this study provide the basis for the development of noncognitive assessment tools by educators. In addition, they pave the foundation for the curation of future programs that promote the noncognitive skills of nursing students. Hospital-based educators may use these findings to curate suitable programs for improving the noncognitive abilities of nurses.