Unveiling perspectives on the psychosocial impacts of childhood cancer survival on young adult survivors' reassimilation journey: A qualitative exploration.

Background: Approximately 82% of children with childhood cancer survive more than five years after diagnosis. Living as a cancer survivor elicits a new reality that can include psychosocial impacts. These psychosocial impacts interact collectively, especially regarding reassimilation, and are rarely explored. Objective: To explore the psychosocial impacts of surviving childhood cancer and reassimilation back into society in young adult survivors of childhood cancer. Methodology: Individual in-depth semi-structured interviews were conducted with childhood cancer survivors and explored psychosocial aspects associated with returning to work, school, and social environments after remission. Interpretive phenomenological analysis was conducted once interviews were manually transcribed. A group interview with survivors was held to discuss the study's findings and interpretation. Results: Individual interviews and the group interview revealed three major themes: outlook on reassimilating, outlook on coping, and outlook on cancer. Conclusions: This work is a first step to understanding how survivors' personal outlook on coping and healthcare system barriers play influential roles in reassimilation following cancer treatment. Survivors expressed the need for reliable survivorship information and improved communication with healthcare providers regarding what to expect, so they could feel prepared for life post-cancer. These aspects need to be explored more deeply through other qualitative studies.

Perceived barriers and solutions identified by healthcare professionals in utilizing web-based reminiscence therapy to support dementia care during the pandemic.

This paper presents findings from a qualitative study conducted in Ontario, Canada, exploring healthcare professionals' perceptions of barriers and solutions for implementing Web-Based Reminiscence Therapy (WBRT) in an institutionalized settings for dementia care during the COVID-19 pandemic. The study identified five major barriers, including the lack of on-boarding/educational training, need for technology availability and technical support, limited attention span of persons with dementia (PWD), availability of multi-sensory features, and time constraints due to staff workload. Seven major themes emerged related to proposed solutions/suggestions: (1) involving younger generations, (2) focusing on technology training, (3) integrating with other digital platforms, (4) adding narratives/descriptions to recollect memories, (5) ensuring accessibility, (6) adding QR codes for retrieving information, and (7) combining digital/traditional reminiscence methods. These findings provide valuable insights for implementing WBRT to facilitate dementia care and for the future refinement of its application.

Healthcare professionals' perception of using a web-based reminiscence therapy to support person with dementia during the COVID-19 pandemic.

BACKGROUND: Reminiscence therapy (RT) is the most common non-pharmacological treatment for dementia care. The therapy stimulates the senses to evoke memories having the potential to reduce Behavioral and Psychological Symptoms of Dementia (BPSD). Digital RT, such as web-based reminiscence therapy (WBRT), has the potential to support dementia care and reduce the caregiving burden. AIMS: This study aimed to explore healthcare professionals (HCPs) perceptions of utilizing WBRT in institutionalized settings to support persons with dementia during the COVID-19 pandemic. METHODS: A qualitative phenomenological descriptive study was adopted and guided by Graham's Knowledge to Action framework. Online training on the use of WBRT was conducted, followed by interviews with HCPs. RESULTS: Four major themes were identified on the potential use of WBRT in dementia care, including usability and efficacy, impact on caregiving, capability of reducing BPSD, and. feasibility during COVID-19 social distancing. DISCUSSION: This study recognized the potential use of WBRT to support the person with dementia during the pandemic in institutionalized settings. CONCLUSION: The knowledge generated from this study will guide the future application of WBRT to support dementia care in diverse healthcare settings.

Experience of oncology nurses with cancer survivors during transition from acute oncology treatment to primary care.

Background: Cancer care for Canadian cancer survivors remains fragmented. Little is known about the experience of Canadian oncology nurses providing cancer care for cancer survivors, as they transition from acute treatment to primary care. Objectives: This study aimed to (1) explore the experience of oncology nurses dealing with fragmented cancer care for cancer survivors in transition to survivorship; (2) identify oncology nurses' perspectives about what promotes or inhibits their delivery of quality cancer care; and (3) obtain their suggestions to improve cancer care. Design: This study used a phenomenological design to explore the experience of oncology nurses in caring for cancer survivors during transition to survivorship and examine how the nurse participants describe their experience. Semi-structured interviews were used to collect data and an interpretative phenomenological analysis approach was used to develop themes from the data. Results: Three oncology nurses participated in this study. The following five themes emerged: (1) Under personal transition: nursing assessment, symptoms management, patient education, resources offered, refusing label of cancer survivors, promoting adjustment to a new normal life, promoting return to work, and recognizing meaning of survivorship; (2) Under cancer survivor's care transition: promoting self-care management, communication, and maximal recovery of body functions; (3) Under nurse's positive experience promoting delivery of quality cancer care: caring for cancer survivors, experience and knowledge, and advocate for cancer survivors; (4) Under barriers that negatively affected delivery of cancer care: low socioeconomic status (especially low income), cultures and languages barriers, and limited time providing nursing care; and (5) Suggestions to improve cancer care: establishing a new position - primary nurse, increasing the number of healthcare professionals, and improving knowledge, skills, and experience. Conclusion: Oncology nurses' knowledge and experience provide a good foundation for quality cancer care and contribute to the health and wellbeing of cancer survivors.

What should be measured to assess the quality of community-based palliative care? Results from a collaborative expert workshop.

OBJECTIVES: The need for palliative care (PC) will continue to increase in Canada with population aging. Many older adults prefer to "age in place" and receive care in their own homes. Currently, there is a lack of standardized quality indicators (QIs) for PC delivered in the community in Canada. METHODS: A one-day workshop collected expert opinions on what should be measured to capture quality PC. Three brainstorming sessions were focused on addressing the following questions: (1) what is important to measure to support quality PC, regardless of setting? (2) Of the identified measures, are any of special importance to care provided in the home? (3) What are the challenges, barriers, and opportunities for creating these measures? The National Consensus Project (NCP) for Quality Palliative Care framework was used as a guide to group together important comments into key themes. RESULTS: The experts identified four themes that are important for measuring quality, regardless of care setting, including access to care in the community by a multidisciplinary team, care for the individual with PC needs, support for the informal caregiver (e.g., family, friends), and symptom management for individuals with PC needs. Two additional themes were of special importance to measuring quality PC in the home, including spiritual care for individuals with PC needs and home as the preferred place of death. The challenges, barriers, and potential opportunities to these quality issues were also discussed. SIGNIFICANCE OF RESULTS: PC experts, through this collaborative process, made a substantial contribution to the creation of a standardized set of QIs for community-based PC. Having a standardized set of QIs will enable health care professionals and decision makers to target areas for improvement, implement interventions to improve the quality of care, and ultimately, optimize the health and well-being of individuals with a serious illness.

Reflection on moving research forward during COVID-19: Strategies to continue, conclude and commence.

The COVID-19 pandemic required oncology nursing researchers to immediately and drastically adjust their research activities. During the 33rd Annual CANO/ ACIO Conference Roundtable Workshop October 2021 - Moving Research Forward During COVID-19, oncology nurses gathered to share and discuss strategies they will continue, conclude, and commence when leading research during and beyond the pandemic. Workshop participants identified the use of low technology, such as telephone and virtual calls without video, as a valuable data collection strategy they will continue for individual interviews. In contrast, attendees expressed their desire to stop conducting virtual focus groups when public health measures are lifted. Oncology nurses indicated an interest in beginning to use a hybrid in-person/virtual data collection approach and incorporate some technological features, such as QR codes, for recruiting participants. Workshop attendees also reflected on the impact of COVID-19 on oncology nursing practice and education, highlighting future research priorities and considerations.

Evaluation of a comprehensive geriatric assessment tool in geriatric cancer patients undergoing adjuvant chemotherapy: a pilot study.

PURPOSE: It is recommended to use comprehensive geriatric assessment (CGA) in clinical oncology practice to improve care for geriatric cancer patients and to identify medical and social issues that may need further intervention. The purpose of this pragmatic pilot study was to evaluate the effectiveness of the Hurria et al. CGA in cancer patients 70 years of age or older undergoing adjuvant chemotherapy, as well as the feasibility of integrating it into a busy clinic practice and the psychosocial impact on these patients. METHOD: Twenty-five patients were recruited. Descriptive analysis was performed via a geriatric assessment questionnaire completed by the participants prior to their first adjuvant chemotherapy treatment and during follow-up, 2 to 6 weeks after last treatment. Additionally, study staff performed a geriatric healthcare assessment at both time points. RESULTS: The results of this pilot study show that administration is feasible despite some challenges. Administration of a CGA in a clinic setting presented some logistical issues with regard to time and space available in clinic. Analysis of patient data indicated only minor variations in patient domains from pre-chemo to post-chemo confirming previous research. Participants expressed gratitude for the extra time spent with them at a stressful time in their lives. CONCLUSION: Further information regarding the usefulness of a comprehensive geriatric assessment with regard to improving treatment selection, identifying undetected medical problems, and avoiding toxicity will be obtained if the administration of comprehensive geriatric questionnaires is incorporated into the clinic setting and considered into the allocated time for staff workload.

Immigrant grandmothers' and mothers-in-law's cancer literacy within their family context.

Data from focus groups held in Montréal (Canada) with 13 women born in Cameroon, Colombia, and Democratic Republic of Congo were used to explore cancer knowledge among immigrant grandmothers and mothers-in-law and their influence over family cancer-preventative practices. Thematic analysis identified the following leading themes: cancer literacy and influence over family cancer preventative and early detection practices, cancer literacy in relation to family health behaviors, and barriers to accessing health services. Perceived external causes of cancer and its prevention are countered by healthy eating and exercises. Cancer literacy was contextualized by the development of women's ways of being and doing.

The role of oncology nurse navigators in enhancing patient empowerment within the diagnostic phase for adult patients with lung cancer.

OBJECTIVE: The objective of this study was to explore the role of oncology nurse navigators (ONN) in enhancing patient empowerment for adult patients with lung cancer during the diagnostic phase of cancer care. DESIGN: A qualitative descriptive design was used. Data were gathered through individual patient interviews and a focus group with the ONNs. RESULTS: Eight individuals participated: four adult patients with lung cancer and four oncology nurse navigators. Themes regarding the clinical functions of the ONN role in enhancing patient empowerment were identified: patient advocate, educational support, personalized symptom management, and resource navigation. CONCLUSION: ONNs are in a key position to adapt their practice to the emotional and supportive care needs required to promote patient and family empowerment.

The role of oncology nurse navigators in facilitating continuity of care within the diagnostic phase for adult patients with lung cancer.

OBJECTIVE: The objective of this study was to explore the role of oncology nurse navigators (ONN) in facilitating continuity of care for adult lung cancer patients during the diagnostic phase of cancer care. DESIGN: A phenomenological approach was used and involved semi-structured patient interviews and an oncology nurse navigators' focus group. RESULTS: Eight individuals participated, including four adult patients with lung cancer and four oncology nurse navigators. Themes regarding the organizational functions of the ONN role in facilitating continuity of care were identified: patient-focused care, needs assessments, shared decision-making, accessibility, and eliminating barriers. CONCLUSION: Awareness of the organizational functions of the ONN role could be used to create core areas of practice within nursing training modules to provide consistent and patient-centred continuity of care.

Improving Patient Engagement and Satisfaction: Lessons from a Patient-Driven Care Initiative in a Community-Based Hospital.

Lack of collaboration and alignment between members of the healthcare team interfere with the patient-centred care approach. The Patient-Driven Care Project was initiated in 2012. This model sought to advance a system of care that is patient-driven, family-centred and provider-guided to improve the value to patients and give them more control on their health journey. The evaluation revealed that the efforts should focus on sustainability and continuation of support and encouragement of hospital colleagues to ensure each patient and family experience is based on caring communication at every interaction with them.

Left behind: cancer disparities in the developed world.

Huge advances have been made in cancer treatments over recent decades; however, significant disparities still exist in the developed world on the basis of race, socioeconomic status, education level, geographical location, and immigration status and in the United States, insurance status. Cancer disparities persist in the continuum of cancer care from risk factors, screening, diagnosis, treatment, survivorship, and end-of-life care. The causes of disparities are complex and multifactorial. The MASCC (Multinational Association of Supportive Care in Cancer) Education Study Group would like to propose a framework of cancer disparities from a social perspective utilizing "social determinants of health" as delineated by the World Health Organization and highlight an unmet need for research and policy innovations to address cancer disparities in developed world.

Perceived roles of oncology nursing.

The Canadian Association of Nurses in Oncology (CANO) Standards of Care (2001) provides a framework that delineates oncology nursing roles and responsibilities. The purpose of this study was to explore how oncology nurses perceive their roles and responsibilities compared to the CANO Standards of Care. Six focus groups were conducted and 21 registered nurses (RNs) from a community-based hospital participated in this study. Transcripts were analyzed using qualitative inductive content analysis. Three themes were identified: (1) Oncology nurses perceive a gap between their defined roles and the reality of daily practice, as cancer care becomes more complex and as they provide advanced oncology care to more patients while there is no parallel adaptation to the health care system to support them, such as safe staffing; (2) Oncology nursing, as a specialty, requires sustained professional development and leadership roles; and (3) Oncology nurses are committed to providing continuous care as a reference point in the health care team by fostering interdisciplinary collaboration andfacilitating patient's navigation through the system. Organizational support through commitment to appropriate staffing and matching scope ofpractice to patient needs may lead to maximize the health and well-being of nurses, quality of patient care and organizational performance.

A comparison of online versus face-to-face teaching delivery in statistics instruction for undergraduate health science students.

The objective of this study was to assess if online teaching delivery produces comparable student test performance as the traditional face-to-face approach irrespective of academic aptitude. This study involves a quasi-experimental comparison of student performance in an undergraduate health science statistics course partitioned in two ways. The first partition involves one group of students taught with a traditional face-to-face classroom approach and the other through a completely online instructional approach. The second partition of the subjects categorized the academic aptitude of the students into groups of higher and lower academically performing based on their assignment grades during the course. Controls that were placed on the study to reduce the possibility of confounding variables were: the same instructor taught both groups covering the same subject information, using the same assessment methods and delivered over the same period of time. The results of this study indicate that online teaching delivery is as effective as a traditional face-to-face approach in terms of producing comparable student test performance but only if the student is academically higher performing. For academically lower performing students, the online delivery method produced significantly poorer student test results compared to those lower performing students taught in a traditional face-to-face environment.