Telemedicine in geriatric oncology - lessons learned from the COVID-19 experience.

PURPOSE OF REVIEW: Telemedicine quickly became integrated into healthcare caused by the Coronavirus 19 (COVID-19) pandemic. Rapid use of telemedicine into healthcare systems was supported by the World Health Organization and other prominent national organizations to reduce transmission of the virus while continuing to provide access to care. In this review, we explored the effect of this swift change in care and its impact on older adults with cancer. RECENT FINDINGS: Older adults are susceptible to the COVID-19 virus caused by various risk factors, such as comorbidity, frailty, decreased immunity, and cancer increases vulnerability to infection, hospitalization, and mortality. We found three major themes emerged in the literature published in the past 18 months, including access to care, telemedicine modes of communication, and the use of technology by older adults with cancer. These findings have brought insight into issues regarding healthcare disparities. SUMMARY: The utilization of telemedicine by older adults with cancer has potential future benefits with the integration of technology preparation prior to the patient's initial visit and addressing known health disparities. The hybrid model of care provides in-person and or remote access to clinicians which may allow older adults with cancer the flexibility needed to obtain quality cancer care.

Finding a Place in Your Practice for Older Adults With Cancer.

The care of older adults differs from the care of younger patients, and specialized knowledge about aging and caring for older adults can help guide their care. Nurses can use geriatric assessment tools, many of which can be.

Using Goal Achievement as an Outcome Measure Following a Gero-Oncology Educational Program for Oncology Nurses: The GrOW Curriculum.

PURPOSE: This article describes the qualitative analysis of goal achievement by oncology nurses who attended a gero-oncology course. PARTICIPANTS & SETTING: Four annual programs were completed and included 140 teams of oncology nurses from cancer settings across the United States. METHODOLOGIC APPROACH: Self-determination theory and achievement goal theory provided the conceptual framework for understanding what motivates people to achieve goals and how goals can measure outcomes. SMART goals were used to measure outcomes and barriers. FINDINGS: Goal achievement at 18 months showed that 70% of developed goals were in process or completed. The top three goal categories were professional education, structure/team building, and resource development. Top barriers included time constraints and staffing shortages. IMPLICATIONS FOR NURSING: Encouraging oncology nurses to set specific goals while attending an educational program supports successful integration of new knowledge in their practice setting.

Geriatric Oncology Workshop (GrOW): Development and Evaluation of a Nationwide Nursing Curriculum.

INTRODUCTION: Oncology nurses are key in caring for older adults with cancer, but few have received specialized training in gerontology. To address this, a geriatric oncology curriculum was developed for oncology nurses. MATERIALS & METHODS: The Geriatric Oncology Workshop (GrOW) was developed and delivered to oncology nurses (n = 387) from 2016 to 2019. Workshops were evaluated using: 1) Assessment of preparedness, comfort, and skills; 2) Knowledge gained; 3) Participant evaluations of workshop (4-point Likert-type scale); 4) Faculty evaluations (10-point Likert-type scale); and 5) Follow-up assessment of goals. Descriptive statistics (frequencies, proportions, medians, means) were used to describe participants and results. Paired t-test was used to evaluate participants' knowledge gain, and linear mixed modeling was used to evaluate longitudinal changes in preparedness, comfort, and skill levels. RESULTS: Overall, 387 oncology nurses participated in GrOW. Participant-rated workshop evaluation means were 3.7 to 3.9. Overall, nurses had statistically significant increases in pre- to post- questionnaire scores of 18.8% (p < 0.001) in workshop 1, 26.8% (p < 0.001) in workshop 2, 24.9% (p < 0.001) in workshop 3, and 18.6% (p < 0.001) in workshop 4, with an overall mean of 22.4% (p < 0.001) knowledge gained for all four workshops. Nurses reported an increase in skill, comfort, and preparedness at 18 months for workshop 1, 2, and 3 and in skill and comfort at 12 months for workshop 4 (p < 0.01). Faculty evaluation scores ranged from 9.3 to 10.0. DISCUSSION: A geriatric oncology curriculum designed for oncology nurses can improve levels of evidence-based knowledge and provide more skill, comfort, and preparedness in caring for this population.

Preparing Cancer Patients and Family Caregivers for Lung Surgery: Development of a Multimedia Self-Management Intervention.

The surgical treatment of lung malignancies often results in persistent symptoms, psychosocial distress, and decrements in quality of life (QOL) for cancer patients and their family caregivers (FCGs). The potential benefits of providing patients and FCGs with preparatory education that begins in the preoperative setting have been explored in multiple medical conditions, with positive impact observed on postoperative recovery, psychological distress, and QOL. However, few studies have explored the benefits of preparatory educational interventions to promote self-management in cancer surgery, including lung surgery. This paper describes the systematic approach used in the development of a multimedia self-management intervention to prepare cancer patients and their FCGs for lung surgery. Intervention development was informed by (1) contemporary published evidence on the impact of lung surgery on patients and FCG, (2) our previous research that explored QOL, symptoms, and caregiver burden after lung surgery, (3) the use of the chronic care self-management model (CCM) to guide intervention design, and (4) written comments and feedback from patients and FCGs that informed intervention development and refinement. Pilot-testing of the intervention is in process, and a future randomized trial will determine the efficacy of the intervention to improve patient, FCG, and system outcomes.