Prospective roles for Canadian oncology nurses in breast cancer rapid diagnostic clinics.

The introduction of rapid diagnostic clinics for breast cancer increases oncology nurses' (ONs) responsibility for patient education and coordination of multidisciplinary care. Developed as an outcome of the E-Mentorship Oncology Nursing Program, this paper proposes new roles for these nurses to respond effectively and competently to such diagnostic innovation. The Oslo Manual Conceptual Framework of Innovation inspired the idea of change in prospective ONs' roles, corroborated by the Canadian Association of Nurses in Oncology's Standards of Practice and Competencies. New roles for ONs that are informed by the domain of information dynamics and evidence-based care are proposed.

Awakening professionals' critical awareness of health literacy issues within a francophone linguistic-minority population in Ontario.

INTRODUCTION: We carried out a qualitative evaluation of immediate learning and attitudinal change among health care and social services professionals who attended a workshop promoting critical reflection about health literacy among linguistic-minority Franco-Ontarians. METHODS: The study involved 41 francophone health care and social services professionals. The workshop facilitator used evocative objects to elicit reflection on health literacy. Data sources were audio-recordings of group discussions and feedback forms completed by participants. RESULTS: The study found that the workshop awakened participants' awareness of health literacy and stimulated them to promote health literacy in their professional practice. The workshop also broadened participants' vision of health literacy as a social determinant of health that interacts synergistically with culture, age, immigration status, social support, and socioeconomic status. CONCLUSION: Professionals expressed their awakened awareness of health literacy as collective accountability. This corroborates our claim that critical pedagogy applied to in-service education effectively stimulates professionals' awareness of their potential to change their practice and work environment.

TITRE: Susciter chez les professionnels une prise de conscience critique des enjeux liés à la littératie en santé pour des francophones en situation de minorité linguistique en Ontario. INTRODUCTION: Nous avons procédé à une évaluation qualitative des changements immédiats sur les plans de l'apprentissage et de l'attitude chez des professionnels de la santé et des services sociaux ayant participé à un atelier visant à susciter une réflexion critique sur la littératie en santé des Franco-Ontariens en situation de minorité linguistique. MÉTHODOLOGIE: L'étude a été réalisée auprès de 41 professionnels francophones de la santé et des services sociaux. L'animatrice de l'atelier a utilisé des objets évocateurs pour susciter la réflexion sur la littératie en santé. Les sources de données étaient les enregistrements audio des discussions de groupes et les formulaires de rétroaction remplis par les participants. RÉSULTATS: L'étude a révélé que l'atelier avait suscité chez les participants une prise de conscience à propos de la littératie en santé et les avait incités à promouvoir la littératie en santé dans leur pratique professionnelle. L'atelier a aussi élargi la vision de la littératie en santé qu'avaient les participants à sa dimension de déterminant social de la santé qui agit en synergie avec la culture, l'âge, le statut à l'égard de l'immigration, le soutien social et le statut socioéconomique. CONCLUSION: Les professionnels ont estimé que la prise de conscience des problèmes de littératie en santé relevait d'une responsabilité collective. Cela corrobore notre hypothèse selon laquelle une pédagogie critique appliquée à la formation continue stimule chez les professionnels la prise de conscience de leur capacité à vouloir changer leur pratique et leur milieu de travail.

French women's breast self-examination practices with time after undergoing BRCA1/2 genetic testing.

To assess the impact of BRCA1/2 genetic test results on cancer-free women's breast-self-examination (BSE) practices and to prospectively determine their influence on psychological functioning. A prospective longitudinal study on French women's BSE practices and frequencies in BRCA1/2 carriers (N = 217) and non-carriers (N = 313) 1 and 2 years following disclosure of the test results, along with psychological factors predicting BSE practices. Before disclosure, BSE was practised by 47.2% of the women, and increased to 57.3% 1 year later. No change in the women's practices was noted between 12 and 24 months after the test. Carriers and non-carriers practicing regularly BSE at baseline were, respectively 8 to 6 times more likely to be practising BSE regularly at 12 months after being tested. Among the carriers, having fewer depressive symptoms at baseline and believing in the ability of BSE to detect breast cancer were found to be the most decisive factors associated with BSE practices 1 year after disclosure, following adjustment for BSE baseline practices. Among the non-carriers, believing in the ability of BSE to detect breast cancer, greater post-test anxiety, and a higher perceived risk of breast cancer were found to be predictors of post-test BSE practices after adjusting for BSE baseline practices. In France, where performing BSE is neither mandatory nor recommended, an increase in BSE practices was found to occur after disclosure of women's genetic test results, regardless of their carrier status.

[Uncertainty and hope in seropositive women]. / L'incertitude et l'espoir des femmes séropositives.

This qualitative research study uses a phenomenological approach to understand the significant of uncertainty and hope in seropositive women and to determine the link between the two. Four seropositive women with children make up the sample. The findings illustrate that uncertainty can be divided into nine themes; reactions on learning or seropositivity; the unknowns of seropositive; the feeling that time and the future are limited; the law of silence; concerns about children; concerns about people withdrawing; concerns about intimate relationships; the image of people living with HIV, and the difficulty experiencing loss--especially loss of control over one's life. The findings also illustrate that hope can be divided into seven themes: seeking assistance through self-help groups; coherence with children; the changing perception of seropositivity; developing relationships with others living with HIV; the fight against HIV; a personal commitment to wellness; and new life experiences and spiritual growth. These findings could be used to determine measures to improve the well-being and health of seropositive women. The authors make recommendations for nursing practice.