A proof-of-concept study of iCope: A nurse-led psychoeducational telephone intervention for women attending a rapid diagnostic centre for breast abnormality.

The period between the initial discovery of a suspicious breast lesion and a confirmed diagnosis is a time of significant psychological distress, heightened anxiety, and uncertainty for many women. This proof of concept (PoC) study explored the clinical outcomes and acceptability of iCope, a nurse-led psycho-educational telephone intervention aimed to assist with uncertainty, anxiety and coping in women going through a Rapid Diagnostic Centre (RDC) offering quick diagnosis of breast cancer (same day to three-day post-investigation). Guided by the Uncertainty Theory, and using a one-arm pretest-posttest design, two brief 15-minute telephone sessions were delivered by a nurse prior to the women's day of testing at the RDC and three days after the receipt of their results. Six women completed measures of anxiety, uncertainty, and coping before the clinic visit, three days and three weeks after receiving their test results. Results show that the implementation of the telephone intervention was challenging, yet may offer potential for positive impact. That is, trends of decreased uncertainty and anxiety in participants over time were noted. Considering the difficulty observed in the recruitment and delivering the two interventions in the timeline planned, feasibility testing is recommended before the conduct of a large-scale study.

Evaluation of Usability and Satisfaction of Two Online Tools to Guide Return to Work for Cancer Survivors on the Cancer and Work Website.

Prompt services and work-focused support systems are needed to aid cancer survivors returning to work or finding work. Purpose This knowledge translation and implementation project focused on the knowledge users' experience and need for refinement of three work-focused tools to support return to work and maintain work following cancer through their participation in a hands-on workshop. The tools assessed for their utility are a Job Analysis Tool (JAT), a Return to Work (RTW) tool, and a bilingual Canadian website on Cancer and Work. Methods Four workshops took place in three Canadian cities. Participants included cancer survivors, healthcare professionals, and employer representatives. Following an overview of the website and tools, workshop participants (N = 28) completed qualitative and quantitative satisfaction and usability questionnaires using the System Usability Scale and open-ended questions. Qualitative data was analyzed using content analyses from the think-aloud data and from the four open-ended questions collected during the users' use of the tools and website. Results Overall, most study participants reported high satisfaction with the JAT and RTW tools, the Cancer and work website and the workshop. Good usability scores were reported for the RTW planner (73.65 ± 12.61) and the website (74.83 ± 12.36), and only acceptable usability scores for the JAT (68.53 ± 11.90). Conclusion Overall, the study documented the value of the tools and the website to support the RTW process as assessed by several key knowledge user groups. The JAT is considered a helpful procedure to identify job demands in order to guide job accommodations. Given participants' responses that the tool is useful, the next steps are to implement the recommendations for improvement and knowledge dissemination to increase its uptake and the use of job analysis overall.

Towards the validation of a new, blended theoretical model of fear of cancer recurrence.

OBJECTIVE: Fear of cancer recurrence (FCR) is defined as "fear, worry, or concern about cancer returning or progressing". To date, only the seminal model proposed by Lee-Jones and colleagues has been partially validated, so additional model testing is critical to inform intervention efforts. The purpose of this study is to examine the validity of a blended model of FCR that integrates Leventhal's Common Sense Model, Mishel's Uncertainty in Illness Theory, and cognitive theories of worry. METHODS: Participants (n = 106) were women diagnosed with stage I to III breast or gynecological cancer who were enrolled in a Randomized Controlled Trial of a group cognitive-existential intervention for FCR. We report data from standardized questionnaires (Fear of Cancer Recurrence Inventory-Severity and Triggers subscales; Illness Uncertainty Scale; perceived risk of recurrence; Intolerance of Uncertainty Scale; Why do people Worry about Health questionnaire; Reassurance-seeking Behaviors subscale of the Health Anxiety Questionnaire, and the Reassurance Questionnaire) that participants completed before randomization. Path analyses were used to test the model. RESULTS: Following the addition of four paths, the model showed an excellent fit (χ2 = 13.39, P = 0.20; comparative fit index = 0.99; root mean square error of approximation = 0.06). Triggers, perceived risk of recurrence, and illness uncertainty predicted FCR. FCR was associated with maladaptive coping. Positive beliefs about worrying and intolerance of uncertainty did not predict FCR but led to more maladaptive coping. CONCLUSIONS: These results provide support for a blended FCR model.

The psychological impact of the rapid diagnostic centres in cancer screening: A systematic review.

The purpose of this review is to assess the state of the literature and identify implications for nursing practice and future research on the psychological impact of rapid diagnostic centres (RDC) for women related to breast cancer. A systematic literature review was conducted on the topic and six studies were identified for data extraction and analysis. There is evidence that RDCs decrease short-term anxiety in women undergoing further cancer tests after cancer screening, and who receive a benign diagnosis. There is limited available research on the impact of anxiety on women who receive a diagnosis of cancer in RDCs, but some evidence showed that this sub-group had higher depression in the long term. Nurses need to be aware of the different needs of women undergoing further cancer screening tests after a cancer diagnosis and receiving these results in the same day.

Protocol of a randomized controlled trial of the fear of recurrence therapy (FORT) intervention for women with breast or gynecological cancer.

BACKGROUND: Clinically significant levels of fear of cancer recurrence (FCR) affect up to 49% of cancer survivors and are more prevalent among women. FCR is associated with psychological distress, lower quality of life, and increased use of medical resources. Despite its prevalence, FCR is poorly addressed in clinical care. To address this problem, we first developed, and pilot tested a 6-week, 2 h, Cognitive-existential group intervention therapy that targeted FCR in survivors of breast or gynecological cancer. Following the positive outcome of the pilot, we are now testing this approach in a randomized clinical trial (RCT). Goal and hypotheses: This multicenter, prospective RCT aims to test the efficacy of the intervention. The study hypotheses are that, compared to a control group, cancer survivors participating in the intervention (1) will have less FCR, (2) will show more favorable outcomes on the following measures: cancer-specific distress, quality of life, illness uncertainty, intolerance of uncertainty, perceived risk of cancer recurrence, and coping skills. We further postulate that the between-group differences will persist three and 6 months post-intervention. METHODS: Sixteen groups of seven to nine women are being allocated to the intervention or the control group. The control group receives a 6-week, 2 h, structurally equivalent support group. We are recruiting 144 cancer survivors from four hospital sites in three Canadian cities. The sample size was based on the moderate pre/post-test changes found in our pilot study and adjusted to the drop-out rates. MEASUREMENTS: The primary outcome, FCR, is measured by the Fear of Cancer Recurrence Inventory. Secondary outcomes measured include cancer-specific distress, perceived risk of cancer recurrence, illness uncertainty, intolerance of uncertainty, coping, and quality of life. We use reliable and recognized valid scales. Participants are to complete the questionnaire package at four times: before the first group session (baseline), immediately after the sixth session, and 3 and 6 months post-intervention. ANALYSIS: In the descriptive analysis, comparison of group equivalent baseline variables, identification of confounding/intermediate variables and univariate analysis are planned. Each participant's trajectory is calculated using Generalized Estimating Equation models to determine the time and group effects, after considering the correlation structures of the groups. An intent-to-treat analysis approach may be adopted. DISCUSSION: Our Fear of Recurrence Therapy (FORT) intervention has direct implications for clinical service development to improve the quality of life for patients with breast (BC) and gynecological cancer (GC). Based on our pilot data, we are confident that the FORT intervention can guide the development of effective psychosocial cancer survivorship interventions to reduce FCR and improve psychological functioning among women with BC or GC. TRIAL REGISTRATION: Dr. Christine Maheu registered the trial with ISRCTN registry (Registration number: ISRCTN83539618, date assigned 03/09/2014).

Empowerment and mentoring in nursing academia.

In 2011, there was an expected shortage of 200 full-time faculty. While there are an estimated 322 graduate students in Nurse Practitioner and Masters/PhD programs in Canada today, the supply of potential new faculty falls short of the anticipated demand in the years ahead (Canadian Association of Schools of Nursing). This mixed method study explored how organizational culture and the perceived level of psychological and structural empowerment are associated with one's work environment among Canadian nursing faculty and to explore the state of mentorship in schools of nursing.

Inclusive mosaic: promoting diversity in nursing through youth mentorship.

In this paper we describe the Inclusive Mosaic project, a community-university partnership in an outer-city community in a large Canadian metropolis aimed at promoting diversity in nursing. The project brought together nursing student mentors with middle school and high school youth from diverse backgrounds in a mentoring program aimed at increasing participants' interest in, and confidence in pursuing, higher education and a career in nursing or other health profession. The concepts of emancipatory education, self-efficacy, and possible selves provided the theoretical foundation. Project processes, activities, and outcomes are described, and a post-hoc evaluation encompassing the project's strengths, challenges, limitations, and successes is presented. Recommendations to inform future research and education are also provided.

Fear of cancer recurrence therapy (FORT): A randomized controlled trial.

OBJECTIVE: Most fear of cancer recurrence (FCR) interventions have small effects, and few target FCR. This randomized controlled trial (RCT) with breast and gynecological cancer survivors evaluated the efficacy of a cognitive-existential fear of recurrence therapy (FORT) compared to an attention placebo control group (living well with cancer [LWWC]) on FCR. METHOD: One hundred and sixty-four women with clinical levels of FCR and cancer distress were randomly assigned to 6-weekly, 120 min FORT (n = 80) or LWWC (n = 84) group sessions. They completed questionnaires at baseline (T1), posttreatment (T2; primary endpoint), 3 (T3), and 6 months (T4) posttreatment. Generalized linear models were used to compare group differences in the fear of cancer recurrence inventory (FCRI) total score and secondary outcomes. RESULTS: FORT participants experienced greater reductions from T1 to T2 on FCRI total with a between-group difference of -9.48 points (p = .0393), resulting in a medium effect of -0.530, with a maintained effect at T3 (p = .0330) but not at T4. For the secondary outcomes, improvements were in favor of FORT, including FCRI triggers (p = .0208), FCRI coping (p = .0351), cognitive avoidance (p = .0155), need for reassurance from physicians (p = .0117), and quality of life (mental health; p = .0147). CONCLUSIONS: This RCT demonstrated that FORT, compared to an attention placebo control group, resulted in a greater reduction in FCR posttreatment and at 3 months posttreatment in women with breast and gynecological cancer, indicating its potential as a new treatment strategy. We recommend a booster session to sustain gains. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Mentorship in nursing in Canada - A scoping review.

AIM: To review the literature on mentoring of nursing students in Canada. BACKGROUND: Mentorship in nursing has been in existence for a long time. Supportive, nurturing guidance by an experienced individual in the profession has been found to have many benefits both to the giver and the receiver. However, there is no uniformity in the length, model, delivery method and evaluation of mentorship programs' impact. The purpose of this scoping review is to appraise the available literature and synthesize knowledge on mentorship in nursing in Canada. DESIGN: Scoping Review METHODS: The scoping review was guided by the methodological framework developed by Hilary Arksey & Lisa O'Malley and the findings are reported using PRISMA ScR guidelines. A systematic search of MEDLINE, CINAHL, EMBASE and ERIC databases was conducted to identify articles describing nursing mentorship in Canada. RESULTS: After the initial screening, a total of 125 articles were included for a full-text review. Of the 48 items included, 28 were research articles and 20 were other forms of literature. Forty-eight items were included for data extraction. CONCLUSION: The scoping review revealed several benefits of mentorship. While synthesizing the evidence, it was noted that the components of the mentorship programs, such as the length, models, mode of delivery and the impact, vary with every nursing field. IMPLICATIONS FOR PRACTICE: Based on the results of the scoping review, it is recommended to consider the unique needs, strengths and challenges of the group for whom the mentorship is planned. One size may not fit all.

Fear of Cancer Recurrence, Health Anxiety, Worry, and Uncertainty: A Scoping Review About Their Conceptualization and Measurement Within Breast Cancer Survivorship Research.

Objective: Fear of Cancer Recurrence (FCR), Health Anxiety (HA), worry, and uncertainty in illness are psychological concerns commonly faced by cancer patients. In survivorship research, these similar, yet different constructs are frequently used interchangeably and multiple instruments are used in to measure them. The lack of clear and consistent conceptualization and measurement can lead to diverse or contradictory interpretations. The purpose of this scoping review was to review, compare, and analyze the current conceptualization and measurements used for FCR, HA, worry, and uncertainty in the breast cancer survivorship literature to improve research and practice. Inclusion Criteria: We considered quantitative, qualitative, and mixed methods studies of breast cancer survivors that examined FCR, HA, worry, or uncertainty in illness as a main topic and included a definition or assessment of the constructs. Methods and Analysis: The six-staged framework was used to guide the scoping review process. Searches of PubMed, CINAHL, and PsycINFO databases were conducted. The principle-based qualitative analysis and simultaneous content analysis procedures were employed to synthesize and map the findings. Findings: After duplicate removal, the search revealed 3,299 articles, of which 82 studies met the inclusion criteria. Several critical attributes overlapped the four constructs, for example, all were triggered by internal somatic and external cues. However, several unique attributes were found (e.g., a sense of loss of security in the body is observed only among survivors experiencing FCR). Overall, findings showed that FCR and uncertainty in illness are more likely to be triggered by cancer-specific factors, while worry and HA have more trait-like in terms of characteristics, theoretical features, and correlates. We found that the measures used to assess each construct were on par with their intended constructs. Eighteen approaches were used to measure FCR, 15 for HA, 8 for worry, and 4 for uncertainty. Conclusion: While consensus on the conceptualization and measurement of the four constructs has not yet been reached, this scoping review identifies key similarities and differences to aid in their selection and measurement. Considering the observed overlap between the four studied constructs, further research delineating the unique attributes for each construct is warranted.

Bates-Jensen wound assessment tool: pictorial guide validation project.

PURPOSE: A group of 3 WOC nurses and a nurse researcher, in partnership with the author of the Bates Wound Assessment Tool (BWAT), sought to validate wound photographs depicting each characteristic of the instrument. INSTRUMENT: The BWAT contains 13 items that assess wound size, depth, edges, undermining, necrotic tissue type, amount of necrotic, granulation and epithelialization tissue, exudate type and amount, surrounding skin color, edema, and induration. These are rated using a modified Likert scale; a score of 1 indicates the healthiest and 5 indicates the most unhealthy attribute for each characteristic. In 2001, the PSST was revised and renamed the Bates-Jensen Wound Assessment Tool to reflect the global use of the tool with wound types beyond pressure ulcers. METHODS: Phase 1 involved the selection of digitalized wound photographs for 11 of the BWAT wound characteristics by the researchers. The photographs needed to be of high resolution and good quality for eventual publication and validated by the original BWAT author as being representative of the intended characteristic. In phase 2, a face-to-face validation exercise was completed to include, edit, or exclude these photographs. Corrections were made; additional photographs were obtained for the remaining characteristics and to replace those not validated. Phase 3 involved an electronic survey that achieved validation online. PARTICIPANTS: Phase 2 participants consisted of 15 WOC nurses with a mean of 11.5 years of experience with wounds. Phase 3 had 8 WOC nurses and 1 master's prepared wound care specialist, with approximately 10 years of experience. One third of participants in each phase were familiar with the BWAT. In a separate exercise to rate photographs that would be used for testing the implementation of the pictorial guide, 7 WOC nurses and 2 RNs who used the BWAT regularly and 2 researchers participated in a face-to-face discussion. RESULTS: A total of 214 photographs were reviewed in this study. Seventy-three percent (n = 55) of the photographs for the pictorial guide were endorsed in phase 2, and 100% (n = 53) in phase 3 to demonstrate the 65 BWAT characteristics. In addition, photographs that could be used for a competency exercise and for pre- and posttests were also rated by the panels. CONCLUSIONS: The photographic content of the BWAT pictorial guide has been validated by a small group of wound care experts. The purpose of the exercise was to create a visual learning aid to enhance the education around wound assessment and as a resource for nurses in practice. Now published in a pocket guide format, it is a standardized way to teach BWAT wound assessment skills in a consistent format.

Voices of internationally educated nurses: policy recommendations for credentialing.

BACKGROUND: The authors advance general policy recommendations for credentialing Internationally Educated Nurses (IENs) who migrate to practice nursing in developed, high-income countries. While examples are drawn primarily from a qualitative study exploring IEN experiences in Canada, the suggestions presented have broader application to any nursing, or midwifery, internationally educated professionals wanting, or needing, to practice outside their home country of education. Examples of credential processing are drawn from Australia, the European Union, New Zealand, the UK and the USA. METHODS: This study was guided by a biographical narrative (qualitative) research methodology. A convenience sample of 12 IENs volunteered to participate. RESULTS: The IENs offered recommendations based on their personal experiences, all of which have policy implications to make transparent, standardize and harmonize the credentialing processes both prior to, and upon arrival in their destination country. Suggestions are offered to make relevant the content of IEN integration programmes. CONCLUSIONS: The authors also suggested that national immigration agencies and nursing regulatory bodies could better coordinate their activities when processing potential IEN migrant applications.

Paradox of a graduate human science curriculum experienced online: a faculty perspective.

BACKGROUND: Program evaluation contributes to evidence-based nursing education. Exploring graduate faculty experience with developing and teaching an online master's of science in nursing program contributes to building a science of nursing education. METHODS: A multimodal methodology for conducting a program evaluation is participatory and demonstrates both formative (improve the quality of the program) and summative (determine the worth of the program) components. Faculty participated through questionnaires, journals, and focus groups. RESULTS: In the context of a philosophy that values understanding lived experience as foundational for nursing, faculty are teaching in an environment that is disembodied, technology based, and at a distance. Faculty relationships with students reveal emerging curricular issues. CONCLUSIONS: Research into the intersection of pedagogy and technology reveals similarities with contemporary literature and many lived paradoxes to be accounted for in evaluation of graduate nursing education.

A critical care bridging program to prepare fourth-year baccalaureate students for specialty practice.

BACKGROUND: The preparation, recruitment and retention of qualified critical care nurses represents a major challenge in this era of health human resource constraints. PURPOSE: To assess the impact of a critical care bridging program (CCBP) on students' confidence (self-efficacy) to care for critically ill patients. METHOD: A convenience sample of students and their preceptors was used in this pilot study. RESULTS: Student and preceptor mean self-efficacy scores showed improvement following the CCBP. Preceptors reported significant improvement in students' confidence in all subscales except self-development. CONCLUSION: Innovative educational approaches for the preparation of new graduates to critical care environments are needed.

Factor structure and reliability of the brain impairment behavior scale.

Stroke is a leading cause of adult disability because of its physical and cognitive consequences. Cognitive changes are important contributors to family caregivers' experiences of emotional distress. To date, measures to assess cognition treat it as a global construct, but it is more likely that unique domains differentially affect family caregivers. The research objectives in this study were to: (1) identify the different domains of cognitive changes in the form of behavioral and psychological symptoms after stroke, and (2) establish the reliability of the Brain Impairment Behavior Scale (BIBS) in measuring cognitive domains. Family caregivers of stroke survivors (N = 300) completed the BIBS as part of cross-sectional and longitudinal studies. A subsample of caregivers completed the BIBS twice, 2 weeks apart, to examine the scale's test-retest reliability. We used exploratory factor analysis to identify four domains of behavioral and psychological symptoms in the BIBS: apathy, depression/emotional distress, comprehension/memory problems, and irritability. Internal consistency for the subscales representing each identified domain ranged from .78 to .91, and the 2-week intra-class correlation coefficients ranged from .75 to .88. Future research and clinical use of this measure will increase our understanding of how specific domains of stroke survivors' behavioral and psychological symptoms affect the well-being of family caregivers.

Benefits and challenges in the use of art as an intervention for making sense of the cancer experience: a qualitative systematic review protocol.

REVIEW QUESTION/OBJECTIVE: How does art contribute as a psychotherapeutic tool in making sense of the cancer experience? What is the meaningfulness of integrating art (as either creator or consumer) for patients throughout the cancer experience?

Research corner: study synapses.

Distinguishing between true and quasi-experimental studies and the benefits of one group, within subjects designs: a discussion of the research design used in: Self-efficacy of staff nurses for health promotion counselling of patients at risk for stroke.

Psychosocial aspects of caregiving to stroke patients.

A high percentage of individuals who have suffered a stroke will be cared for at home, primarily by aging spouses and/or relatives. Providing care to a family member with a chronic or life-threatening condition can be both emotionally rewarding and distressing for the care provider. The objective of this research was to test the factors associated with caregiver experiences. The findings of a convenience sample of 48 caregivers indicated that the higher the amount of caregiver burden, the greater the lifestyle impact and emotional distress for the caregiver. Caregiver satisfaction was not found to be associated with emotional well-being. The amount of support, both instrumental and social, did not improve the emotional well-being of the caregiver. The caregiver's sense of mastery was found to moderate the relationship between lifestyle impact and emotional well-being and also between caregiver satisfaction and emotional well-being.