Job Satisfaction for Caregivers and Other Employees in Innovative Long-Term Care Homes for Residents With Cognitive Problems.

New housing models have emerged in Europe, Australia, the United States, and Canada. Intended for individuals with neurocognitive disorders, these models are characterized by a philosophy centered on the person, self-determination, liberty of choice, flexibility of care, acceptance of risk, and autonomy. Work and care are organized according to the pace and preferences of residents. The current multiple case study highlights the main sources of job satisfaction for caregivers and other employees in four innovative residential settings. Five themes are addressed as perceived by 58 employees: Work Motivation, Work Organization, Collaboration and Decision-Making Latitude, Quality of Work Life, and Continuing Education. These data will help inform clinical staff, policymakers, and the scientific community about clinical and organizational practices that contribute to job satisfaction in innovative residential settings. [Journal of Gerontological Nursing, 49(10), 36-43.].

Issues associated with a hereditary risk of cancer: Knowledge, attitudes and practices of nurses in oncology settings.

Documenting a patient's family history of cancer is useful in assessing their predisposition to some types of hereditary cancers. A group of nurses working with cancer patients were surveyed, by way of a questionnaire, to determine their level of knowledge about oncogenetics, describe various issues related to their capacity to identify, refer and support individuals with a hereditary risk of cancer, and explore their interest in continuing education on this topic. The findings show limited knowledge and a low sense of competence among the participating nurses, as well as a lack of access to university and continuing education programs in this field. Training focused on competency development would enhance their capacity to carry out an initial assessment of individuals who are potentially at risk for cancer and refer them to specialized resources.

Core areas of practice and associated competencies for nurses working as professional cancer navigators.

UNLABELLED: Fillion et al. (2012) recently designed a conceptual framework for professional cancer navigators describing key functions of professional cancer navigation. PURPOSE: Building on this framework, this study defines the core areas of practice and associated competencies for professional cancer navigators. METHODS: The methods used in this study included: literature review, mapping of navigation functions against practice standards and competencies, and validation of this mapping process with professional navigators, their managers and nursing experts and comparison of roles in similar navigation programs. FINDINGS: Associated competencies were linked to the three identified core areas of practice, which are: 1) providing information and education, 2) providing emotional and supportive care, and 3) facilitating coordination and continuity of care. CONCLUSION: Cancer navigators are in a key position to improve patient and family empowerment and continuity of care. IMPLICATIONS: This is an important step for advancing the role of oncology nurses in navigator positions and identifying areas for further research.

Professional navigation framework: elaboration and validation in a Canadian context.

PURPOSE/OBJECTIVES: To elaborate, refine, and validate the professional navigation framework in a Canadian context. RESEARCH APPROACH: A two-step approach consisting of a qualitative evaluative design and formal consultations. SETTING: Two applications of professional navigators in Quebec and Nova Scotia, Canada. PARTICIPANTS: Patient navigators, medical oncology specialists, nurses and oncology staff, administrators, family physicians, patients with cancer, and patients' families and significant others. METHODS: Individual interviews (n = 49) and focus groups (n = 10) were conducted with professional navigators, patients and family members, front-line staff, family physicians, and health administrators. Formal consultations (n = 13) occurred with clinical experts, managers, and researchers from across Canada. MAIN RESEARCH VARIABLES: The interview guide was based on an evaluative conceptual framework integrating questions related to the implementation process of the role of professional navigators and their organizational and clinical functions. FINDINGS: Results support a bi-dimensional framework and define key role functions. The first dimension, health system-oriented, refers to continuity of care. The second dimension, patient-centered, corresponds to empowerment. For each dimension, related concepts were illustrated from data. Examples of outcomes also were suggested. CONCLUSIONS: The framework brings clarity to the role and functions of professional navigators and suggests relevant outcomes for program evaluations. INTERPRETATION: With a clear definition of their role, professional navigators may be more efficient and less challenged in terms of setting priorities and making decisions while having to face demands from the health system and patients. The integrative framework could improve the effectiveness of cancer navigation programs.

Professional navigation: a comparative study of two Canadian models.

For many cancer control programs, cancer navigation has emerged as a specific strategy to improve access to supportive care and the patients' experience of cancer care. This study contributes to a better understanding of professional navigation by comparing two Canadian models: Quebec's Pivot Nurse in Oncology (PNO) and Nova Scotia's Cancer Patient Navigator (CPN). Qualitative interviews were conducted with professional navigators, patients and family members, front-line staff, physicians and health administrators (interviews: n = 49; focus groups: n = 10). The two models were analyzed using the professional navigation framework (Fillion et al., 2012). Although the models are different, results show that professional navigators in both programs perform similar functions and face similar challenges. This study highlights the complexity and the value of cancer navigation and recommends relevant actions to optimize its management within the health care system.

La Belle Mort en Milieu Rural: a report of an ethnographic study of the good death for Quebec rural francophones.

An ethnographic study was undertaken in two rural areas of Quebec to conceptualize the good death. The findings reveal that a good quality of life for the dying person and his or her family and friends is essential for a good death. The resulting conceptual model emphasized four dimensions: physical, spiritual, social, and emotiona/psychological. These dimensions were determined to be similar to those discovered through a previous urban study, indicating that there may be considerable overlap between good deaths in rural and urban areas. Some findings of this Quebec French-language rural study were similar to those of an Alberta English-language rural study, indicating that rural people may have some common needs and interests with regard to the good death. As such, there could be some common elements of the good death that transcend culture or ethnicity. Chief among these is the desire of rural people to die at home or in their home communities.

[The process of integrating oncology nurse navigators into joint (hospital-community) local teams]. / Processus d'implantation d'infirmières pivots en oncologie au sein d'equipes locales conjointes (Centre hospitalier-Communauté).

Implementing oncology nurse navigators or IPOs (which stands for "infirmière pivot en oncologie") is a key element of the Québec Cancer Control Program in order to improve the continuity of care. This qualitative study describes the process of implementing IPOs in teams working both in hospitals and in the community. Several groups of stakeholders (IPOs, physicians, nurses, various health workers, administrators, people with cancer and their families) described how they perceive the functions and effects related to this implementation. After putting results into perspective, we recommend developing measures promoting the dissemination of the role and integration of IPOs in formally defined health teams. We strongly advocate for the continuation of joint efforts in order to define and clarify this complex role.

The "good" rural death: a report of an ethnographic study in Alberta, Canada.

Much concern has centred on the "good" death since the modern hospice/palliative care movement began, and considerable progress has been made in urban services to promote the good death. Little is known about the perspectives of people who live in rural and remote areas of Canada on the good death and how this good death might be enabled in those areas. This report is of an ethnographic study in rural Alberta involving English-speaking Albertans. An identical study in Quebec will be reported elsewhere. The 2006-07 Alberta study involved 13 interviews with individuals to understand their personal viewpoints or perspectives and how they were shaped by their experiences, followed by focus group discussions in two representative rural communities for additional insights from rural policy-makers and care providers. Four themes in the Alberta data highlight critical elements of the good rural death. These findings are expected to contribute to rural/remote palliative and end-of-life care developments.

Planning and providing for a good death using rural French-Canadian and English-Canadian insights.

Little is known about what constitutes a good death, although palliative care is broadly aimed at enabling the good death. Good deaths could vary considerably across populations. A two-stage ethnographic study was conducted in rural Canada, involving English-speaking Albertans and French-Canadians in Quebec, to establish a conceptual understanding of the good death from a rural perspective. This study identified four common bicultural elements, as well as a conceptual model focusing on quality of life through four dimensions: physical, spiritual, social, and emotional/psychological. Rurality was identified as a dominant consideration for further study.