Nurse-led cancer care: A scope review of the past years (2003-2016)

Abstract

Nursing practice has been expanded greatly with time passing by. One innovative form of nursing practice is nurse-led care. The term “nurse-led care/service” has been introduced in nursing discipline for years as early as in 1960s [1]. Later, several nurse-led services were reported in 1980s and 1990s [2], [3], [4], [5], [6], [7]. The common characteristics in these units were that the nurses provided additional things to improve patients' care, and the standard of practice was extremely high [8]. The accelerating development of nurse-led care was triggered by the health care system reform in United Kingdom (UK) around 2000. In 1999, the UK government document ‘Making a difference’ was published [9], under the pressure of redesigning services to reduce waiting time and medical cost and to meet shortfalls in junior medical staffing [10]. Since then, nurse-led care has been reported in increasing studies [11]. The nurse-led care in cancer community has been developed with the cancer care reform as well. Under the pressure of increasing cancer patients, treatment delivery has changed a lot. Early discharge after surgery and outpatient-based or home-based adjuvant treatment have been widely used [12]. Under such health care reform, nurse-led care is one possible solution to improve the quality of cancer care, which has been highly recommended [13]. A previous review suggests that the nurse-led cancer care is effective, safe and acceptable by patients with higher satisfaction, compared with conventional care model [12]. Although encouraging outcomes of nurse-led care were reported both in cancer area and other areas, the researchers are interested to know how the encouraging outcomes have achieved. What are the effective components of nurse-led care? Corner (2003) indicates that the promising outcomes are not automatically achieved in all the studies of nurse-led care [12]. The structure and process of nurse-led care are highly associated with outcomes [14]. More studies are required to understand the complex and dynamic effects of nurse-led care [12]. It has been more than ten years since Corner's review on nurse-led cancer care [12]. It is time to examine the development of nurse-led cancer care worldwide. Therefore, this review aimed to understand nurse-led cancer care based on literature published during the past years and to explore important factors in structure and process which lead to positive outcomes of nurse-led cancer care. Specifically, the objectives of this review were: (i) to identify the practice scope of nurse-led cancer care; (ii) to examine the structure of nurse-led cancer care programs; (iii) to examine the process of nurse-led cancer care programs; (iv) to explore the outcomes adopted and achieved in nurse-led cancer care programs.