RESUMEN
BACKGROUND: Breast cancer is the leading cancer affecting women in Singapore. Its survivors commonly experience decline in physical function and quality of life post-mastectomy, due to their upper limb morbidity and wound issues. Rehabilitation can address the aforementioned issues. When rehabilitation is accessible and easy to adhere, it can optimize recovery. Home-based tele-rehabilitation guided by healthcare professionals and self-managed by patients can potentially optimize the patients' adherence to rehabilitation and recovery. With that in mind, a team of breast cancer specialists (oncologists, nurses, and therapists) in Singapore has developed one of the first tele-rehabilitation systems for local women undergoing a unilateral mastectomy. To our knowledge, no such systems have been evaluated or proven effective as a treatment option among local breast cancer patients with acute disabilities. METHODS: This is a pilot quasi-experimental trial that aims to evaluate the feasibility of tele-rehabilitation and tele-drain care compared to usual care. Up to 40 patients (20 per group) will be recruited for this trial. They will be assigned to an intervention group that receives rehabilitation via a tele-rehabilitation system or a control group that receives rehabilitation in person at their clinic. The primary outcome of this trial is rehabilitation participation (i.e., the time spent on rehabilitation). The secondary outcomes are upper extremity functioning, perceived health, and quality of life. DISCUSSION: As part of this pilot trial, patients who opt in for the tele-rehabilitation will be asked to share their experience with and thoughts on the tele-rehabilitation system. With the evidence obtained from the tele-rehabilitation patients of this trial, we will be able to improve the current system for our future trial. Further, our additional data on rehabilitation participation, physical function, and quality of life will help us design a sufficiently powered future main trial. TRIAL REGISTRATION: The trial was approved by the National Healthcare Group's Domain Specific Review Board (#2019/00283) and registered with www.ClinicalTrials.gov (# NCT04269967 ) in February 2020.
RESUMEN
AIM: To explore the role-transition experiences of assistant nurse clinicians after their first year of appointment. BACKGROUND: The National Nursing Taskforce was set up in Singapore to examine the professional development and recognition of nurses. It created the assistant nurse clinician role as an avenue for the nurses' career development. The role was intended to assist nurse managers to guide the nursing team in the assessment, planning, and delivery of patient care. METHODS: A qualitative descriptive study design was adopted. A purposive sample of 22 registered nurses from six acute care institutions and two polyclinics in Singapore participated in the face-to-face interviews. An inductive content analysis approach was used to analyse the data. RESULTS: Four themes emerged: (a) promotion to assistant nurse clinician is a form of recognition and vindication; (b) there was uncertainty about the expected role of the assistant nurse clinician; (c) experience eases transition; and (d) there was a need for peer support, mentorship, and training. CONCLUSIONS: The job description of the assistant nurse clinician needs to be better defined to provide greater clarity about their clinical and administrative duties and what is expected of their performance. IMPLICATIONS FOR NURSING MANAGEMENT: It is essential for nurse managers to provide successful role-transition strategies to help the newly appointed assistant nurse clinicians to become efficient and effective leaders.
