Oncology Nursing for the Future: Multisector Planning Is Needed.

Assessing the landscape for oncology nursing of the future, the biggest problem that faces the specialty is that of workforce shortages. On the practice side, nursing turnover, resignations, and early retirements have contrib.

Oncology Nurse Navigation in Underserved Communities: Opportunities and Future Directions.

OBJECTIVES: Provide an overview of navigation in three disparate populations: rural, Native American/Alaska Native, and low- to middle-income countries. Discuss gaps in care and opportunities to improve cancer care. METHODS: A literature search was conducted in PubMed and on Google Scholar using search terms, nurse navigation, cancer, disparit*, low- to middle-income countries, Native American, American Indian, and rural. Peer-reviewed research studies, review articles, databases and websites of professional organizations, and historical books were reviewed to provide an overview of oncology nurse navigation in underserved communities. Experiences in working with these populations over the past 30 years were also provided to support current literature. RESULTS: Forty references were included in this overview of nurse navigation in underserved communities. Nurse navigation in these disparate areas is in its infancy. While some programs exist and outcomes have been positive, their dissemination is sparse. A need exists to expand nurse navigation into these areas to provide care for these underserved communities. CONCLUSION: Oncology nursing navigation for each of these underserved communities requires a culturally sensitive approach. Many of these approaches are universal to cultural competency and can be applied to most disparate populations. IMPLICATIONS FOR NURSING PRACTICE: Nurses comprise the largest workforce around the globe and are well-equipped to develop navigation programs in some of the most disparate communities around the world. To do so, it is important to use a foundation of building trust, embracing individual differences, providing culturally sensitive education and resources for growth, and good communication.

Sleep-Wake Disturbances in Oncology.

Sleep-wake disturbances are common in patients with cancer. Despite the high prevalence of altered sleep patterns in oncology settings, there remains a gap in consistent assessment of sleep, leading to an underrecognized and undertreated condition. Provider failure in addressing sleep-wake disturbances can result in chronic issues with insomnia and has a negative impact on quality of life and cancer survivorship. Often sleep-wake disturbances present in symptom "clusters" including, anxiety, depression, and fatigue, which adds to the complexity of managing sleep disorders in oncology. Aggressive management strategies for managing underlying symptom burden from disease or medications effects is a priority.

Oncology nursing workforce: challenges, solutions, and future strategies.

The global oncology nursing workforce is essential to achieving Sustainable Development Goals 3.4 (reduce non-communicable disease morbidity by a third by 2030) and 3.8 (universal health coverage). Unfortunately, challenges to a robust oncology nursing workforce include nursing shortages, recruitment barriers (eg, perceptions of a demanding specialty with complex care and hazardous work environments), and burnout. Innovative recruitment strategies, onboarding and continuing education programmes, occupational safety measures, and burnout prevention interventions are documented solutions. The long-term effect of COVID-19 on oncology care worldwide is unknown, but immediate therapy interruptions, workforce consequences, and threats to standard oncology nursing practice are addressed here. Retention of experienced oncology nurses is crucial for future cancer control in all countries and must be addressed, particularly in resource-constrained countries with few oncology nursing staff and continuing out-migration of nurses to resource-rich countries. As the cancer burden worldwide increases, the future of the oncology nursing workforce is reflected in the call from the International Council of Nurses, Nursing Now, and WHO for nurses to move to higher levels of leadership, advocacy, and policy making (ie, national cancer control planning) and assume responsibility for their key role in achieving global goals for cancer control.

Satisfacción y fatiga por compasión en personal de enfermería de oncología: estudio descriptivo y correlacional / Compassion satisfaction and compassion fatigue in oncology nursing staff: descriptive and correlational study

OBJETIVOS: (1) Conocer la percepción de Satisfacción y Fatiga por Compasión del personal de Enfermería de oncología; (2) estudiar la correlación entre variables sociodemográficas, profesionales y adaptativas (resiliencia, actitudes ante la muerte y personalidad) y la Satisfacción y Fatiga por Compasión y, (3) identificar variables predictoras para ambas dimensiones. MÉTODO: Estudio descriptivo, correlacional, de corte transversal. 69 enfermeras (62.7%) y 41 técnicos en cuidados auxiliares de Enfermería (37.3%) de los servicios de Oncología de Bizkaia (Servicio Vasco de Salud) dieron respuesta al ProQOL-V, CD-RISC-10, PRAM y NEO-FFI-3. Los datos se recogieron entre septiembre 2018 y marzo 2019. El estudio estadístico con el SPSS.22 implicó pruebas chi cuadrado, comparación de medias, correlación de Pearson y regresión logística multivariante. RESULTADOS: El 66.4% (n=73) presentó alta Satisfacción, y el 41.8% (n=46) se situó en niveles moderados de Fatiga por Compasión. Las personas con estudios previos sobre la muerte y/o duelo se percibieron más satisfechas. La Satisfacción estableció correlaciones más fuertes con resiliencia y extroversión, y la Fatiga lo hizo con neuroticismo y resiliencia. Emergieron 4 variables predictoras para la Satisfacción: edad, formación, resiliencia, y amabilidad; y 4 para la Fatiga: evitación y aceptación de escape ante la muerte, neuroticismo y apertura. CONCLUSIONES: La alta relación hallada entre la formación y la resiliencia con la Satisfacción por Compasión puede servir de guía a las instituciones académicas y asistenciales para orientar estrategias formativas, preventivas e interventivas que permitan dotar a los equipos de enfermería oncológica de recursos que les permitan optimizar la percepción sobre su rol de cuidado

OBJECTIVES: (1) To determine the perception of Compassion Satisfaction and Fatigue of oncology nursing staff; (2) to study the correlation between Compassion Satisfaction and Fatigue and sociodemographic, professional and adaptive variables (resilience, attitudes toward death, personality); and (3) to identify predictors of the two dimensions. METHOD: Descriptive, correlational, cross-sectional study. 69 nurses (62.7%) and 41 auxiliary care technicians (37.3%) from the Oncology Services in Biscay (Basque Health Service) completed the ProQOL-V, CD-RISC-10, DAP-R, and NEO-FFI-3. Data were collected between September 2018 and March 2019. The statistical analysis with SPSS.22 included chi-square tests, comparison of means, Pearson's correlation, and multivariate logistic regression. RESULTS: 66.4% (n=73) showed high Compassion Satisfaction, and 41.8% (n=46) were at moderate levels of Compassion Fatigue. People with prior studies related to death and/or grief were more satisfied. Compassion Satisfaction had stronger correlations with resilience and extroversion, and Compassion Fatigue did so with neuroticism and resilience. Four predictor variables emerged for Compassion Satisfaction: age, prior learning, resilience, and agreeableness; and four for Compassion Fatigue: attitudes of avoidance and escape concerning death, neuroticism, and openness. CONCLUSIONS: The high relationship found between training and resilience with Compassion Satisfaction can serve as a guide for academic and health care institutions to orient training, preventive and interventional strategies to provide oncology nursing teams with resources that allow them to optimize their care role

Revisão bibliométricada produção científica em enfermagem oncológica segundo a fenomenologia da prática de van manen / Bibliometric review: scientific production in oncologic nursing using the phenomenology practice of Van Manen

The phenomenology of practice is a qualitative scientific method, defended by van Manen, who intends to analyze the phenomenon associated with one's lived experience. This article aims to analyze the application of the scientific method of the phenomenology of practice in the scientific production published in the oncology nursing discipline between 2010 and 2018, through a bibliometric analysis. As a method of analysis of the articles we resorted to bibliometric review because it allows a quantitative and objective reflection through the use of bibliometric indicators. As a result of the analysis of the 19 articles, 73% of the articles have as target population the cancer patient and their experience of the disease and its treatment. The publications are made in journals with an average IF of 1,337 and with the maximum number of citations of 54. As a conclusion of this bibliometric analysis, the fact that the method of phenomenology of practice has been increasingly applicable in Nursing stands out. Oncology in recent years, with relevance in the production of knowledge and which provides this discipline to illustrate the life experience of the people being studied

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The Future of Immunotherapy in the Treatment of Cancer.

OBJECTIVES: To discuss future direction and present an overview of the evolution of immunotherapy long-term toxicity issues, financial toxicity, and new emerging survivorship considerations. DATA SOURCES: Peer-reviewed manuscripts, Web sites. CONCLUSION: Cancer treatments involving immunotherapy have had a major impact on long-term survival, toxicity, and survivorship issues. IMPLICATIONS FOR NURSING PRACTICE: Nurses play a pivotal role in the care of the cancer patient across the continuum. With the unique toxicities associated with immunotherapy, it is essential that nurses be keenly aware of all aspects of management, from physical to financial care.

Disparities in Hispanic Care.

Attendees at a 2019 ONS Congress session about disparities in clinical trials seemed to be aware that African Americans are underrepresented. But what about Hispanic patients with cancer? I sensed that some of my colleagues had not considered Hispanic recruitment before and were surprised to learn the facts about clinical trial disparities in this population.

Consulta de enfermagem na radioterapia de câncer de cabeça e pescoço: análise dentro do conceito custo-utilidade em saúde / Nursing consultation in the head and neck cancer radiotherapy: a cost-health utility relationship analysis / Consulta de enfermería en la radioterapia de cáncer de cabeza y cuello: análisis dentro del concepto costo-utilidad en salud

Objetivo: Descrever o uso do Questionário de Qualidade de Vida da Universidade de Washington, específico para Câncer de Cabeça e Pescoço, na consulta de enfermagem em Radioterapia. Método: Estudo transversal, prospectivo, de abordagem quantitativa do tipo descritiva-exploratório com 10 pacientes em radioterapia de cabeça e pescoço atendidos num Serviço de Radioterapia de um Hospital Universitário, entre 35 a 70 anos de idade, em início de radioterapia, com estadiamentos: III, IVA, IVB ou IVC, entre agosto e dezembro de 2016. CEPHUPE parecer 1.649.577. Resultados: A diferença de utilidade encontrada no início e ao final do tratamento foi importante para quantificar o impacto da consulta de enfermagem. O aumento da Utilidade acompanhou a diminuição dos eventos adversos da terapêutica, durante a consulta de Enfermagem. Conclusão: Este estudo possibilitou ao enfermeiro, a utilização do conceito de Utilidade para quantificar e acompanhar a melhora da Qualidade de vida, nas consultas de Enfermagem na Radioterapia

Objetivo: Describir el uso del Cuestionario de Calidad de Vida de la Universidad de Washington, específico para Cáncer de Cabeza y Cuello, en la consulta de enfermería en Radioterapia. En el presente trabajo se analizaron los resultados obtenidos en el análisis de los resultados obtenidos en el estudio de los resultados obtenidos en el estudio, III, IVA, IVB o IVC, entre agosto y diciembre de 2016. CEPHUPE opinión 1.649.577. Resultados: La diferencia de utilidad encontrada al inicio y al final del tratamiento fue importante para cuantificar el impacto de la consulta de enfermería. El aumento de la Utilidad acompañó la disminución de los eventos adversos de la terapéutica, durante la consulta de Enfermería. Conclusión: Este estudio posibilitó al enfermero, la utilización del concepto de Utilidad para cuantificar y acompañar la mejora de la Calidad de vida, en las consultas de Enfermería en la Radioterapia

Objective: This study aimed to describe the use of the University of Washington Quality of Life Questionnaire, limited to head and neck cancer, in nursing consultation applied to radiotherapy. Methods: A cohort and prospective study with a descriptive/exploratory quantitative approach was carried out with 10 patients under head and neck radiotherapy assisted at the Radiotherapy Service in a University Hospital, aged from 35 to 70 years old, at the treatment onset and in the cancer stages III, IVA, IVB or IVC from August to December 2016. Results: The difference in utility in the start and final stages of the treatment was important to quantify the nursing consultation impact. The Utility increased as the adverse events of therapeutics decreased during the nursing consultation. Conclusion: This study made possible the utilization of the concept of Utility by the nurses during nursing consultation applied to radiotherapy, in order to quantify and follow up the enhancement of the life quality

Reflections on the Emotional Hazards of Pediatric Oncology Nursing: Four Decades of Perspectives and Potential.

THEORETICAL PRINCIPLES: Pediatric oncology nurses are particularly vulnerable to emotional distress. Responsible for the oversight of a child's care, these nurses sustain close interactions with multiple patients and families over time, many of whom are coping with life-limiting diagnoses. The world of pediatric oncology nurses is one where tragedy is routinely witnessed thus demanding self-care and healing across a continuum. PHENOMENON ADDRESSED: The aim of this article is to outline and review the emotional sequelae of pediatric oncology nurses' work and to suggest interventions to support well-being in light of prolonged caregiving. Three major categories that are addressed include the aspects of clinical practice that influence caregiving, the risks of burnout, compassion fatigue, moral distress and grief, and interventions to counteract these phenomena. RESEARCH LINKAGES: Future-nursing research should focus upon the development of validated, psychometrically sound measurement tools to assess nurse-specific variants of burnout, compassion fatigue, moral distress, and nurse grief. Qualitative research should investigate the relationship between personal variables, workplace and team characteristics, age and experience, and their influence on the predominance of burnout, compassion fatigue, moral distress, and nurse grief. Lastly, the phenomena of resiliency demands further study.

Impacto de la enfermedad oncológica infantil. PErcepción de las familias y de las enfermeras. Proyecto de investigación / Research project. The impact of pediatric oncologic disease: families' and nurses' perception

Introducción. Vivir la experiencia de tener un hijoa con cáncer es una situación que genera una crisis en la familia que afecta no solo a nivel estructural, sino también emocional. Las enfermeras son las profesionales miembros del equipo multidisciplinar que se relacionan más tiempo con estas familias, por lo que es interesante saber cómo evidencian esta experiencia para poder mejorar la práctica asistencial, que debe contemplar una orientación holística dentro de los cuidados de alta complejidad que precisa un niño oncológico. Objetivos. Analizar el impacto en las familias producido por el debut de una enfermedad oncológica infantil; describir la percepción de las enfermeras sobre el impacto y la vivencia de las familias en el inicio de una enfermedad oncológica infantil y comparar la percepción que tienen las familias con la percepción de las enfermeras con respecto al debut de la enfermedad oncológica infantil. Ámbito de estudio. Unidad de Oncología y Hospital de Día del Hospital Sant Joan de Déu de Barcelona. Metodología. Estudio cualitativo siguiendo un enfoque basado en la fenomenología hermenéutica de Heidegger. Los participantes serán las familias de niños con cáncer y las enfermeras dedicadas a su cuidado. Para la recogida de datos se utilizará la entrevista en profundidad y, si se considerara pertinente, el grupo de discusión. El tipo de análisis utilizado será el de la temática bajo el método de análisis del contenido, siguiendo el método de análisis Guía QUAGOL (Qualitative Analysis Guide of Leuven) (AU)

Introduction. Going through the experience of having a child with cancer often results in a structural and emotional crisis for the family. Nurses, as professional members of a multidisciplinary team, interrelate the most with the families of oncologic pediatric patients. It is of great interest to provide evidence of nurses’ experience, in order to improve the care practice for children with cancer. Due to these patients’ highly complex needs in terms of care, a holistic approach is required. Objectives. To design a study which will determine the impact that the debut of an oncologic disease on a child has on families, by comparing nurses’ perception on the impact and experience of families going through this process to those of the actual family. Field of study. Oncology Unit and Day Hospital Sant Joan de Déu, Barcelona. Methodology. A qualitative study based on Heidegger’s hermeneutic phenomenology. The subjects of study will be parents of children with cancer and nurses involved in their care. For data collection, interviews and group discussions (if considered relevant) will be collected. The type of analysis used will be content analysis, following the QUAGOL Guide (Qualitative Analysis Guide of Leuven) (AU)

Oncology nurse reflection on the necessity of a pain assessment tool for Indonesian cancer patients

Objective: The purpose of this study was to obtain an overview on nurses' opinions and perceptions related to pain assessment and other problems experienced in evaluating pain in cancer patients. Method: This descriptive qualitative study was part of a series of studies to develop a pain assessment tool for cancer patients in Indonesia. Data were collected by semi-structured interviews from 16 oncology nurses. A cross-case comparison of the interview responses was used to analyze the data from verbatim interview transcripts. Results: Six themes were identified: pain as the main complaint reported by cancer patients; pain assessment using a pain scale; an awareness of the absence of nurses' role in pain management; a lack of understanding of pain conditions; acknowledgement that a pain assessment tool should be practical and user friendly; and the need to develop a pain assessment tool. We also explored the knowledge of nurses in pain management and achieved an in-depth understanding of the nurses' desire to seek additional knowledge related to pain assessment. Conclusions: A pain assessment tool should be developed to assist nurses to independently interpret data about pain and allow them to select or modify interventions consistent with the patients' needs. Pain management for cancer patients is one of the essential nurses' responsibilities in providing comprehensive meaningful nursing care

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Percepción de comportamientos de cuidado de pacientes y de enfermería oncológica: estudio comparativo / Perception of caring behaviors of patients and oncology nursing: comparative study

Objetivo. Describir y comparar la percepción del comportamiento del cuidado de los pacientes y el personal de enfermería en servicios de hospitalización, hematología y urgencias en una institución de oncología de referencia de Bogotá. Metodología. Estudio descriptivo comparativo realizado con 131 pacientes y 78 integrantes del personal de enfermería en tres servicios oncológicos. La percepción de cuidado se valoró con el Instrumento comportamiento profesional de cuidado de Horner. La comparación se realizó con pruebas no paramétricas. Resultados. Los pacientes de 54 años en promedio, mayoría femenina, independientes, con baja escolaridad presentaron una percepción de comportamientos de cuidado de enfermería de 77,3% en promedio siendo mejor en hematología (81,3%), seguida de medicina interna (77,3%) y más baja en urgencias (73,3%). Ellos perciben en su orden atributos de cortesía, relación, compromiso e interacción. El personal de enfermería con el 19% profesional, 81% auxiliar, de mayoría femenina con más de 6 años de experiencia, presentó una percepción de comportamientos de cuidado de 85,9% siendo similar en los tres servicios. Conclusión: Las características de los pacientes y del personal de enfermería en los diferentes servicios son similares. Para los pacientes la percepción de comportamientos de cuidado de enfermería por servicios total y en las dimensiones interacción y compromiso es positiva y diferente (p < 0,05). Para el personal de enfermería la percepción de comportamientos de cuidado es similar entre servicios y superior a la de los pacientes en su totalidad y en las dimensiones cortesía e interacción (AU)

Hematology, and Emergency. Methodology. This was a descriptive comparative study conducted with 131 patients and 78 members from the nursing staff in three oncology services. The perception of care was evaluated with Homer’s Professional Caring Behaviors Instrument. Comparison was performed through non-parametric tests. Results. Patients were on average 54 years of age, mostly females, independent, with low schooling and presented a perception of nursing care behaviors of 77.3%, with hematology averaging better (81.3%), followed by internal medicine (77.3%) and lower in emergency (73.3%). They perceive, in order, attributes of courtesy, relationship, commitment, and interaction. The nursing staff were 19% professionals, 81% aides, mostly females with over six years experience, presented perception of caring behaviors of 85.9% and similar in the three services. Conclusion. The characteristics of patients and of the nursing staff in the different services are similar. For patients, the perception of nursing care behaviors per total services and in the dimensions of interaction and commitment is positive and different (p < 0.05). For the nursing staff, the perception of caring behaviors is similar among services and above that of the patients in their totality and in the dimensions of courtesy and interaction (AU)

As necessidades de cuidado do cliente oncológico hospitalizado: aplicação da taxonomia nanda / Necesidades de atención de los pacientes con cáncer: aplicación de la taxonomía nanda / Care needs of hospitalized cancer patients: application of nanda taxonomy

Objectives: To identify care needs of cancer patient and correlate these needs with the domains of NANDA taxonomy. Method: Qualitative study conducted in clinical wards for hospitalization of adults of a university hospital in Rio de Janeiro. Seven interviews were conducted and analyzed by the method of thematic analysis. Results: The interviews showed that cancer patients have their sleep patterns, nutrition and eliminations changed during hospitalization. Also underlined the hope of a cure, the belief and support of family and friends actuate in the process of coping with the disease. In the interviews two dimensions of nursing were identified: Nursing related to techniques and proceedings, and Nursing related to therapeutic communication. Conclusion: To identify needs for nursing care means to completely observe those patients, see beyond the disease, see a human being who has beliefs, values , coping skills, and strong support from family and friends.

Objetivos: Identificar as necessidades de cuidado do cliente oncológico e correlacionar essas necessidades com os domínios da taxonomia NANDA. Método: Estudo qualitativo realizado nas enfermarias clínicas de internação de adultos de um hospital universitário do Rio de Janeiro. Foram realizadas 7 entrevistas e analisadas através do método de análise temática. Resultados: As entrevistas apontaram que os clientes oncológicos possuem seu padrão de sono, nutrição e eliminações alterados durante a hospitalização. Também foi evidenciado a esperança na cura, a crença e o apoio da família e amigos influenciando no processo de enfrentamento da doença. Nas entrevistas foram apontadas duas dimensões da Enfermagem: a Enfermagem relacionada a técnicas e procedimentos, e a Enfermagem relacionada à comunicação terapêutica. Conclusão: Identificar as necessidades de cuidado de Enfermagem desses clientes significa observá-lo por completo, enxergar além da patologia, visualizar um ser que possui crenças, valores, capacidade de enfrentamento e um forte apoio de familiares e amigos.

Objetivos: Identificar las necesidades de atención de cáncer y se correlacionan estas necesidades de los clientes con las áreas de la taxonomía NANDA. Método: Estudio cualitativo realizado en las salas clínicas de hospitalización de adultos de un hospital universitario de Rio de Janeiro. Se realizaron siete entrevistas y se analizaron por el método de análisis temático. Resultados: Las entrevistas mostraron que los clientes de cáncer tienen su patrón de sueño, la nutrición y las eliminaciones cambiaron durante la hospitalización. También subrayó la esperanza de una cura, la creencia y el apoyo de familia y amigos influyen en el proceso de hacer frente a la enfermedad. En las entrevistas se identificaron dos dimensiones de la enfermería: enfermería relacionados técnicas y procedimientos, y de enfermería relacionados con la comunicación terapéutica. Conclusión: Identificar las necesidades para el cuidado de enfermería se refiere a aquellos clientes observan completamente, ver más allá de la patología, una visión que tiene que ser creencias, valores, habilidades de afrontamiento, y un fuerte apoyo de familiares y amigos.

Advanced breast cancer clinical nursing curriculum: review and recommendations

Purpose. The needs and concerns of patients with advanced breast cancer are changing at every phase of the care intervention. Management and coordination of hospital resources and services are also steadily evolving. The objective of the present expert report is to define a new oncology nursing role specialising in advanced breast cancer, to help guide patients throughout the whole healthcare itinerary. Methods. A group of eight experts in oncology nursing and medical oncology defined the content index of the curriculum document. A systematic review of bibliography was carried out, and the relevant contents were extracted. Based on these contents and the participants’ experience, recommendations were formulated and validated through a Delphi questionnaire and a participative meeting. Results. The advanced breast cancer clinical nurse (ABCCN) should develop a clinical, psychosocial role focused on coordinating patients in the healthcare network. The nurse would be in charge of evaluating and supervising the care administered and the healthcare resources used. The ABCCN should be aware and participate in the protocols and available resources, be able to solve conflicts, deal with burn-out signs and have clinical, coaching and team-working abilities. The proposed curriculum provides a specific process for the care of patients, as well as an implementation process. Conclusions. The ABCCN’s role is crucial to assume the best care and the optimisation of available resources. This review and consensus document provides the required tools for the implementation in hospitals (AU)

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Some Things Must Not Change.

The past three months have been a season of tremendous change, and many of us have been surprised by the political events that have taken place. January heralds a change in administration for the United States, and the future seems uncertain. I sense that change is going to be the new normal, and we have to be able to cope with it-and with each other-for a long time. What I want to talk about is those things that do not change and how we, as nurses and scientists, must remain true to our roots.
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