Oncology Nurses' Attitudes and Engagement in Nursing Research.

OBJECTIVES: To assess nurses' attitudes and perceptions about research. SAMPLE & SETTING: 623 RNs at a National Cancer Institute-designated comprehensive cancer center in the midwestern United States. METHODS & VARIABLES: This study used a cross-sectional, descriptive survey to describe nurses' attitudes toward nursing research, perceptions of the research environment, and research involvement. RESULTS: Nurses' attitudes toward research were generally more positive than negative. Results suggested that the biggest obstacle to nurses participating in research is time. IMPLICATIONS FOR NURSING: Understanding oncology nurses' attitudes toward research and the research environment is vital for the future of patient outcomes research. Results from this study inform strategic goals for increasing nursing research capacity, including the use of research teams and access to research mentors and resources, as well as nursing research fellowship programs.

Research Agenda of the Oncology Nursing Society: 2019-2022.

PROBLEM STATEMENT: To define the Oncology Nursing Society Research Agenda for 2019-2022. DESIGN: Multimethod, consensus-building approach by members of the Research Agenda Project Team. DATA SOURCES: Expert opinion, literature review, surveys, interviews, focus groups, town hall, and review of research priorities from other cancer care organizations and funding agencies. ANALYSIS: Content analysis and descriptive statistics were used to synthesize research priority themes that emerged. FINDINGS: Three priority areas for scientific development were identified. IMPLICATIONS FOR NURSING: The Research Agenda can be used to focus oncology nurses' research, scholarship, leadership, and health policy efforts to advance quality cancer care, inform research funding priorities, and align initiatives and resources across the ONS enterprise.

Increasing cultural competence with LGBTQ patients.

Many nurses practicing today lack basic education about LGBTQ (lesbian, gay, bisexual, transgender, queer) patient care. How can they better prepare to care for this population? This article provides insight on LGBTQ people, their health risks and disparities, and how nurses can work with LGBTQ patients to improve outcomes.

The Development of an Oncology Clinical Nurse Specialist Fellowship Program.

New graduate clinical nurse specialists (CNSs) face many challenges when starting their new role. To address this, a CNS fellowship program was developed to mentor new CNSs during their first year of practice. This CNS fellowship program would provide opportunities to increase skills related to each of the CNS spheres of influence, including nursing practice, patient care, and systems and organization. Experienced CNSs mentored CNS fellows and identified learning opportunities. The fellows completed an online self-assessment based on the National Association of Clinical Nurse Specialists CNS Competency Checklist during week one of orientation and again at months 3, 6, 9, and 12. The CNS fellows completed and presented three projects designed to explore the spheres of the CNS role, along with a formal onboarding. The results of the fellowship depicted significant competency development within all three CNS spheres at program completion. The CNS fellowship program provided structure and guidance to the newly graduated CNSs and clearly transitioned staff nurses to advanced practice nurses. The fellowship has demonstrated a positive effect on both the new CNSs and the organization in which it was developed.

Current State of Knowledge About Cancer in Lesbians, Gay, Bisexual, and Transgender (LGBT) People.

OBJECTIVE: To review the current state of knowledge about cancer in lesbians, gay, bisexual, and transgender (LGBT) people by focusing on four major issues across the cancer continuum including: 1) lack of data collection on sexual orientation and gender identity; 2) need for a culturally competent workforce; 3) the need for a culturally competent health care system; and 4) creating LGBT tailored patient/client information and education. DATA SOURCES: Published literature. CONCLUSION: Oncology nurses and health care providers can work to improve the care of LGBT patients with cancer by following suggestions in this article. IMPLICATIONS FOR NURSING PRACTICE: Oncology nurses and other health care providers have many distinct occasions to improve overall cancer care for LGBT patients.

Oncology Nursing Is Evidence-Based Care.

This issue of the Clinical Journal of Oncology Nursing (CJON) will be the final time that you will see the Evidence-Based Practice (EBP) feature column. Why? Because we have seen oncology nursing evolve in the past 20 years and EBP is everywhere! We use it in our clinics and hospital units, incorporate it into decisions about symptom management, and use evidence to develop survivorship guidelines. We discuss EBP in journal clubs and use applications on mobile devices to find the best interventions for our patients. We have oncology nurses sitting on committees to develop guidelines based on the best evidence and expert opinion. We have come a long way and it is our belief that EBP is included in almost every article in CJON and, therefore, a need no longer exists for an individual column about EBP. 
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Career Choice and Longevity in U.S. Psychiatric-Mental Health Nurses.

The demand for mental health services in the United States taxes the existing care continuum and is projected to increase as federal initiatives such as the Affordable Care Act and mental health parity improve access to, and coverage for, mental health services. Quality health care providers, such as psychiatric-mental health nurses, are needed to bolster the mental health system. Prior research has focused on the unpopularity of psychiatric nursing as a career choice for nursing students. The purpose of this study is to understand how seasoned psychiatric nurses came to choose and remain in the specialty; descriptive phenomenology is used. In a face-to-face interview, eight registered nurses described their experiences with psychiatric nursing as a student, their entry into psychiatric nursing, and factors related to their longevity in the specialty. Giorgi's Existential Phenomenological Research Method was employed to analyze the interview data. Three themes emerged related to career choice: Interest Developed Prior to or While in Nursing School, Personal Relevance, and Validation of Potential. Three themes emerged related to retention: Overcoming Stereotypes to Develop Career Pride, Positive Team Dynamics, and Remaining Hopeful. Nurse educators play an important role in identifying talent, validating capability, enhancing interest, and increasing students' confidence to pursue a psychiatric nursing career, while nursing administrators and clinical specialists play a key role in retention. Findings also stimulate pertinent questions surrounding the long-term viability of the psychiatric-mental health nursing specialty.

Success is not final: onward to the future of evidence-based practice.

The Oncology Nursing Society (ONS) is celebrating its 40th anniversary, so it seems only fitting that this column focuses on how evidence-based practice (EBP) has evolved for oncology nurses and ONS during the past 40 years. EBP has been around for a very long time. In the famous Notes on Nursing published in 1860, Florence Nightingale noted that, "The most important practical lesson that can be given to nurses is to teach them what to observe-how to observe-what symptoms can indicate improvement-what the reverse-which are important-which are of none" (p. 5). This quote seems pertinent given that a large part of what oncology nurses do is related to the management of symptoms, either from cancer or its treatment (e.g., chemotherapy, radiation). In addition, during the past 10-15 years, nurses have been immersed in providing symptom management interventions that are based on evidence, not just in hearsay or ritual. 
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The Iowa Model of Evidence-Based Practice to Promote Quality Care: an illustrated example in oncology nursing.

Evidence-based practice (EBP) improves the quality of patient care and helps control healthcare costs. Numerous EBP models exist to assist nurses and other healthcare providers to integrate best evidence into clinical practice. The Iowa Model of Evidence-Based Practice to Promote Quality Care is one model that should be considered. Using an actual clinical example, this article describes how the Iowa Model can be used effectively to implement an actual practice change at the unit or organizational level.

Priorities for oncology nursing research: the 2013 national survey.

PURPOSE/OBJECTIVES: To advance the goals of evidence-based care and prioritize the knowledge generation that addresses contemporary challenges in oncology nursing. Results are used to inform the development of the Oncology Nursing Society (ONS) Research Agenda and by the ONS Foundation to develop strategic research initiatives. DESIGN: Descriptive, cross-sectional survey. SETTING: Web-based survey. SAMPLE: 8,554 ONS members from all levels of education. All doctorally prepared members were invited to participate. A random stratified sample was obtained from the remainder of the membership. METHODS: The ONS Research Priorities Survey project team created the survey and analyzed and interpreted the results. Members received an email invitation and follow-up reminders for survey completion. MAIN RESEARCH VARIABLES: Oncology nursing research and evidence-based practice topic questions. FINDINGS: The response rate was 11%, which is comparable to previous surveys. Topics ranked included descriptive research on patient adherence; intervention studies to optimize adherence, achieve concordance with cancer screening guidelines in minority populations, manage neurologic and cardiovascular late effects, and manage symptoms and symptom clusters; and studies to identify optimal delivery models for survivorship care. These findings have direct implications for translating existing evidence into practice and underscore the need for intervention research focused on improving patient-centered outcomes. CONCLUSIONS: Results provide a broad assessment of member views regarding oncology research priorities. Given the response rate, additional strategies to encourage member participation will be considered. IMPLICATIONS FOR NURSING: The results, together with the updates of the ONS Research Agenda, can guide ONS and ONS Foundation research and evidence-based practice initiatives.

Systematic review of basic oral care for the management of oral mucositis in cancer patients.

PURPOSE: The purpose of this project was to evaluate research in basic oral care interventions to update evidence-based practice guidelines for preventing and treating oral mucositis (OM) in cancer patients undergoing radio- or chemotherapy. METHODS: A systematic review of available literature was conducted by the Basic Oral Care Section of the Mucositis Study Group of MASCC/ISOO. Seven interventions--oral care protocols, dental care, normal saline, sodium bicarbonate, mixed medication mouthwash, chlorhexidine, and calcium phosphate--were evaluated using the Hadorn (J Clin Epidemiol 49:749-754, 1996) criteria to determine level of evidence, followed by a guideline determination of one of the following: recommendation, suggestion, or no guideline possible, using Somerfield's (Classic Pap Cur Comments 4:881-886, 2000) schema. RESULTS: Fifty-two published papers were examined by treatment population (radiotherapy, chemotherapy, and hematopoietic stem cell transplant) and by whether the intervention aimed to prevent or treat OM. The resulting practice suggestions included using oral care protocols for preventing OM across all treatment modalities and age groups and not using chlorhexidine mouthwash for preventing OM in adults with head and neck cancer undergoing radiotherapy. Considering inadequate and/or conflicting evidence, no guidelines for prevention or treatment of OM were possible for the interventions of dental care, normal saline, sodium bicarbonate, mixed medication mouthwash, chlorhexidine in patients receiving chemotherapy or hematopoietic stem cell transplant, or calcium phosphate. CONCLUSIONS: The evidence for basic oral care interventions supports the use of oral care protocols in patient populations receiving radiation and/or chemotherapy and does not support chlorhexidine for prevention of mucositis in head and neck cancer patients receiving radiotherapy. Additional well-designed research is needed for other interventions to improve the amount and quality of evidence guiding future clinical care.

Oncology nurse navigator role delineation study: an oncology nursing society report.

The purpose of the Oncology Nursing Society (ONS) Oncology Nurse Navigator Role Delineation Study was to examine the job-function activities of the oncology nurse navigator, thus providing an understanding of this unique role. The Role Delineation Advisory Committee consisting mainly of oncology nurse navigators was formed to provide content expertise to Applied Measurement Professionals, which conducted the role delineation study. Three hundred and thirty nurses completed the survey. The study clearly defined tasks, knowledge areas, and skills that are very specific to the nurse navigator role; however, the overlap in knowledge with the general oncology nurse role needs to be explored. The ONS Board of Directors and the Oncology Nursing Certification Corporation Board of Directors currently are exploring the need for additional initiatives to help define the role and competencies of the oncology nurse navigator.

Increasing testicular self-examination in active duty soldiers: an intervention study.

In this intervention study, the researchers assessed the knowledge of and health beliefs regarding testicular cancer and testicular self-examination (TSE) in active duty Army Soldiers.

The barriers to and evidence for palliative care.

It is undeniable that there are barriers to providing palliative care. Recent research suggests there is value in palliative care for patients, families, and those providing this care. Specifically, the research suggests that the earlier a patient receives palliative care, the better outcomes they will receive. This article will serve 2 important purposes. First, this article will look at some of the barriers that sometimes prevent offering adequate palliative care to patient and families when the care is needed most. Second, this article will present results in a simplistic manner from actual research studies, which helps make the case through evidence of the value of palliative and quality end of life care.