Nurses In Cancer Care Research Articles

Raising the voice of specialist stoma care nurses: a call for a national strategy in stoma care

Specialist stoma care nurses (SSCNs) are highly educated professionals who play a critical role in the care of people living with a stoma. However, they experience some unique challenges. Currently in the UK, stoma care has no national standards, targets or best practice pathway, resulting in significant variation and an undervalued service. As members of an evidence-based profession, SSCNs need to demonstrate their value. Specialist nurses in cancer care and inflammatory bowel disease are supported by nationally, with pathways, targets and standards of care, as well as career and education frameworks. This system could be used for SSCNs. A national approach is needed to develop an evidence-based best-practice pathway, commissioned and implemented across the UK for all stoma patients and with SSCNs at its heart. SSCNs need to demonstrate their value through data and evidence. Working with Getting it Right First Time, a taskforce aims to review the evidence and establish minimum standards of care for all stoma patients. SSCNs should be co-ordinators and drivers of change at the highest level of national innovation, policy and decision-making. The work of SSCNs should be is recognised and valued because what they do matters.

Advanced Practice Nurses and Their Roles in Swiss Cancer Care: A Cross-Sectional Study

ObjectivesTo examine the advanced practice nurse workforce in Swiss cancer care and how their roles are being implemented (eg, role structures, processes) to achieve optimal outcomes for patients and their families, care organizations, and the broader health care system. MethodsA cross-sectional study was conducted. The sample included master-prepared advanced practice nurses in cancer care, who completed an online questionnaire from December 2021 to January 2022. Thirty-nine items assessed structures (eg, role characteristics, utilization), processes (eg, role activities, interventions), and perceived outcomes (eg, for patients, the health care system) of advanced practice nurses in Swiss cancer care. Data from closed questions were analyzed using descriptive statistics. Data from open-ended questions were organized and summarized into categories related to domains of advanced practice nursing and its reported frequency by the advanced practice nurses. ResultsThe participating advanced practice nurses (n = 53), worked in half of the 26 Swiss cantons. Interventions were identified within nine categories, of which most were targeted to patients and their families (n = 7), followed by health care professionals (n = 2). Perceived positive outcomes were patient symptom management, length of hospital stay, and health care costs. Participants felt less confident in cancer care (eg, autonomous practice) and reported 15 professional development needs (eg, medical interventions, teaching). ConclusionsThis study provides a comprehensive examination of 53 advanced practice nurses, detailing the characteristics of their roles and utilization across various jurisdictions and health care settings. The results highlight the diverse dimensions of advanced practice nursing and its potential to enhance cancer services and outcomes in Switzerland. Opportunities for role development support and expansion are identified. Implications for Nursing PracticeMore systematic health human resource planning is needed to expand the deployment of advanced practice nurses across jurisdictions, practice settings, and more diverse patient populations. Role development needs show the desire for specialized educational preparation in cancer care.

Developing quality indicators for cancer hospitals in China: a national modified Delphi process

ObjectiveAlthough demand and supply of cancer care have been rapidly increasing in recent decades, there is a lack of systemic quality measurement for cancer hospitals in China. This study aimed...

Are Australian Cancer and Palliative Care Nurses Ready to Prescribe Medicines? A National Survey

Registered nurse prescribing has been put forth, for decades, as an innovative approach to meet growing healthcare needs, particularly in areas of care where medications are essential and highly controlled such as for patients requiring cancer and palliative care. However, the adoption of innovative health delivery models requires acceptance by key stakeholders. This study explores cancer and palliative care nurses' attitudes toward nurse prescribing and their perceptions about educational requirements for a nurse prescriber. A cross-sectional survey was distributed to Australian nurses between March and July 2021. Data were collected using the Advancing Implementation of Nurse Prescribing in Australia online survey. Pearson χ2 tests were used to examine associations between nurses in cancer care, palliative care, and all other specialties on demographics, attitudes to nurse prescribing, and educational perspectives to become prescribers. Of the 4,424 nurses who participated in the survey, 161 nurses identified they worked in cancer care and 109 in palliative care settings. Although nurses have a common set of core capabilities, their work contexts and their professional experiences shape their attitudes toward practice. Nurses in cancer care were significantly less certain than nurses in palliative care [χ2(2) = 6.68, P = .04], and nurses from all other specialties [χ2(2) =13.87, P = <.01] of the benefits of nurse prescribing (ie, nurse prescribing would decrease health care system costs, reduce patient risk). Nurses in cancer care were more certain that successfully implementing nurse prescribing requires strong support from their medical and pharmacy colleagues. In addition, nurses working in cancer and palliative care agreed that improving patient care was their primary motivator for becoming a prescriber. Open to expanding their role and responsibilities, nurses in cancer and palliative care settings reported that successfully adopting nurse prescribing must be supported by their other healthcare colleagues within the same environment, which demands strong interprofessional collaborative efforts.

CN89 In cancer care nursing, does the use of surface wipe sampling for hazardous drugs lead to a safer occupational environment, in an outpatient and inpatient oncology/haematology setting? An evidence translation proposal

CN89 In cancer care nursing, does the use of surface wipe sampling for hazardous drugs lead to a safer occupational environment, in an outpatient and inpatient oncology/haematology setting? An evidence translation proposal

Facing negative emotions: Evaluation of a brief training in validating communication for contact nurses in cancer care

BackgroundContact nurses in cancer care (CNCC) often face challenges when communicating with patients and their families. The overall aim was to evaluate a brief digital validation training for CNCC, to test whether it was associated with increased validation and decreased invalidation. Associations between communication skills in validation and markers of work-related stress were also investigated. MethodsThis intervention study investigated associations between the training and validation skills using a within-group design with repeated measures (at pre, post, and eight-week follow-up). Additionally, associations between the training and occupational self-efficacy, self-validation, and exhaustion symptoms were explored. ResultsSeventeen CNCCs (all female with relatively long work experience) completed a five-week digital training program. Results indicated a statistically significant increase in validation and a statistically significant decrease in invalidation, showing that the nurses improved their communication skills following the training. No changes were found in markers of work-related stress. ConclusionThe results indicate that digital validation training for CNCCs is potentially beneficial by means of improving communication skills. This study further demonstrates that a brief digital training in validating communication to CNCC is associated with improved person-centered communication regarding strong negative emotions.

Global challenges and initiatives in oncology nursing education

Oncology nursing requires specialized education and clinical training. It is not possible to deliver safe cancer nursing care across the cancer continuum with only a general nursing education and experience. Complex cancer therapies, e.g., immunotherapies, and technologies, e.g., radiotherapy, and advanced surgeries, demand nursing support delivered by knowledgeable and skilled professionals. To achieve this required workforce, necessitates cancer education that begins at pre-licensure, strong onboarding training, competency standards, continuing education and oncology nursing leadership across cancer control activities, e.g., national cancer control planning. Nevertheless, current nursing shortages, the lack of qualified oncology nursing faculty and adequate nursing schools, as well as government accreditation of oncology nursing specialties threaten appropriate cancer nursing care in the future. Given the exponential growth of the public health burden of cancer everywhere, prompt attention to the single largest workforce to support this patient population is urgent. Guidance from international authorities such as the World Health Organization, International Council of Nurses, and oncology nursing associations/societies allows governments to appropriately scale up their oncology nursing workforce to improve survival. We present the challenges in oncology nursing education and successful interventions to address those challenges to provide an overview of the current status of oncology nursing education from around the world.

"I Decked Myself Out in Pink"

"I Decked Myself Out in Pink"

Position Statement on Cancer Nursing Leadership.

Position Statement on Cancer Nursing Leadership.

Surgical Oncologists and Nurses in Breast Cancer Care are Ready to Provide Pre-Test Genetic Counseling

BackgroundPre-test genetic counseling for patients with breast cancer is increasingly being provided by nongenetic healthcare professionals. We evaluated the attitudes, knowledge, and self-efficacy of surgeons, oncologists, and nurses regarding mainstream genetic testing and the feasibility to incorporate pre-test genetic counseling into routine care.MethodsWe offered an online training to healthcare professionals from 13 hospitals and implemented a mainstream genetic testing pathway in 11/13 (85%) hospitals. Questionnaires were sent before (T0) and 6 months after (T1) completing the training. Those who did not complete the training received a questionnaire to assess their motivations.ResultsIn 11 hospitals, 80 (65%) healthcare professionals completed the training, of whom 70 (88%) completed both questionnaires. The attitudes, (perceived) knowledge and self-efficacy of healthcare professionals were high both at baseline and 6 months after completing the training. After 6 months, their perceived knowledge about the advantages and disadvantages of a genetic test and implications for family members had significantly improved (p = 0.012 and p = 0.021, respectively). For the majority (89%), the time investment for pre-test genetic counseling was less than 15 min per patient and as expected or better. Healthcare professionals considered the total time investment feasible to incorporate mainstream genetic testing into their daily practice. The main barrier to complete the training was lack of time. The online training was considered useful, with a rating of 8/10.ConclusionSurgical oncologists and nurses in breast cancer care feel well-equipped and motivated to provide pre-test genetic counseling after completion of an online training module.

"We're Cancer Care Nurses": Perceptions About Providing Palliative Care in a Community Hospital.

Nurses play a key role in integrating palliative care into oncology. This project sought to better understand oncology nurses' perspectives about palliative care. Nurses from a community hospital were presented with a series of clinical scenarios and asked to comment on the appropriateness of palliative care in each case. A series of focus groups were held, inviting nurses' reflections about palliative care in relation to their practice. Nurses commenting on the clinical scenarios were unanimous that palliative care was appropriate in the most straightforward case: older adult, approaching the terminal phase of a cancer, having exhausted all curative treatment options, accepting death, wanting comfort, and contending with difficult symptoms. However, opinions on appropriateness varied in less straightforward cases, such as when patients did not accept death or when their cancer diagnosis was recent. In focus groups, nurses described a hybrid professional identity that integrates both oncology and palliative care. To them, this integration constituted the meaning of "cancer care." They further reflected on tensions they experience between their proximity to patients in everyday care and their (in)abilities to meet palliative care needs. Results suggest the need for stronger institutional supports of cancer nurses' palliative practice.

Registered nurses' views on consideration of patient perspectives during multidisciplinary team meetings in cancer care.

Multidisciplinary team meetings (MDTMs) represent an integral component of modern cancer care and have increasingly been implemented to ensure accurate and evidence-based treatment recommendations. During MDTMs, multiple and complex medical and patient-related information should be considered by a multi-professional team whose members contribute various perspectives. Registered nurses (RNs) are expected to share information on the patient perspective at MDTMs. However, research suggests that RNs' contributions to case discussions are limited and that patient perspective is generally underrepresented. Our aim was to explore RNs' views of the prerequisites for and barriers to the inclusion of the patient perspective in MDTMs in Swedish cancer care. Data were collected from four focus group interviews with 22 RNs who worked as contact nurses in Swedish cancer care. Interviews were transcribed and analysed using inductive content analysis. The analysis identified two categories and five subcategories. The participants presented different views and expressed ambivalence about the patient perspective in MDTMs. Subcategories were related to medical versus holistic perspectives, the added value of patient perspective, and possibilities for patient contributions. The participants also discussed prerequisites for the patient perspective to be considered in MDTM decision-making process, with subcategories related to structures promoting attention to the patient perspective and determinants of RNs' contributions to case discussions in MDTMs. This study demonstrates various views related to the patient perspective in MDTMs and identifies a great need to clarify the RN's role. Our results indicate that if enhanced presentation of the patient perspective in MDTMs is desired, key information points and structures must be established to collect and present relevant patient-related information.

Open and structured assessment in addressing hospitalized cancer-related problems: The perception of patients and nurses in Indonesia

Purpose Although the concept of ‘cancer-related problems’ is complex, few studies compare nurses’ and caregivers’ perspectives on cancer-related problems, particularly in eastern cultures. The study aimed to identify the perceptions of patients and nurses concerning to what extent the problems of patients with cancer were assessed and addressed during hospitalization in Indonesia. Method A descriptive correlational study with cross-sectional comparisons was conducted in three major cities in Indonesia. With a convenience sample of 119 patients (response rate = 79.3%) with cancer and 147 nurses (response rate = 71%). The domains of validated Problems and Needs of Palliative Care – short version were used to measure the perceptions of the patients and nurses regarding the assessing and addressing of patients’ problems. Results The patients stated that their physical and psychological problems were very often assessed (>84%) and addressed (>90%). Patients who reported difficulties spontaneously had a lower prevalence of problems than patients who reported problems to a professional, except for the psychological subscale (P-value 0.05). The open assessment reported that the problems exhibited lower frequency than structure assessment, while nurses addressed all sub-scale problems (P-value < 0.005). Patients’ educational status, age, gender, and time of diagnosis had positive correlations with their perceptions of cancer-related problems, which they voluntarily stated. Conclusion These findings indicate essential similarities and incongruities between patients with cancer and nurses perceive cancer-related problems. The results highlight the complex technical directions of cancer nursing care in Indonesia.

CN50 Facing negative emotions: Evaluating the effects of training in affirmative communication for contact nurses in cancer care

In cancer care, contact nurses daily meet people who deal with strong, aversive emotions in relation to that they have or may have cancer where the risk of dying is constantly present. This places demands on the ability of contact nurses to master difficult conversations with strong emotional expressions. One communication method known for its regulating effects on emotions is affirmative communication, so called validation. The overall aim of the current study was to evaluate effects of a training in validating communication for contact nurses in cancer care, aimed to strengthen their ability to work in a person-centered way. This study had a within-group design with pre-, post- and follow-up measurements (2 months). Specifically, the study aimed to evaluate whether the validation training coincided with an increase in validation and a decrease in invalidation. Contact nurses from six regions (n = 17) with a generally long work experience as a nurse participated in a digital validation training for six weeks (three training sessions plus three pre-recorded theoretical lectures). Communicative behaviors were assessed through video-recordings of interactions between the nurses and fictitious patients. The videos were encoded by independent coders and analyzed with dependent MANOVA. The contact nurses showed a significant increase in validation and a significant decrease in invalidation after the training. These effects remained at the 2-month follow-up. Experienced healthcare professionals' affirmative communication skills can be improved after a brief training in validation.

Adult patient communication experiences with nurses in cancer care settings: a qualitative study

BackgroundThe patient communication experience is an important outcome measure that guides quality improvements in healthcare settings specifically in cancer care. Therefore, this study aimed to explore the patient’s communication experiences with nurses in cancer care settings.MethodsSemi-structured face to face interviews were conducted with 21 participants who received cancer care at two Saudi Arabian tertiary healthcare facilities between Aug 2019 to Dec 2019. The study used a qualitative descriptive design. The interviews were audio-recorded and transcribed verbatim. Thematic analysis was used to analyse the data using six stages of Braun and Clarke.ResultsFour major themes were identified and a total of eleven sub-themes. The major themes were; (1) The importance of patient-nurse relationships, (2) Providing appropriate information to patients, (3) Responding to patients emotional needs and (4) Verbal communication between nurses and cancer patients.ConclusionsSome participants felt that their communication with nurses was limited, but generally, most felt that communication was acceptable irrespective of barriers such as language, culture, religion, gender, workload and healthcare preferences. Participants drew a comparison between Saudi and non-Saudi nurses as well as between nurses and doctors communication skills. They felt that Saudi nurses had good communication skills, but non-Saudi nurses were more competent in some aspects such as kindness, politeness, respectful and non-verbal communication. They also felt that doctors were more accurate in their information than nurses.

Self-reported Professional Competence Among Swedish Contact Nurses in Cancer Care: A Cross-sectional Study

Background: Since 2011, patients in Swedish cancer care have been offered a contact nurse (CN). The CN role is to improve patient participation, care continuity, and provide information and manage patients’ symptoms and needs across the whole continuum of the cancer pathway. A competence profile for the CN role is yet to be developed, and it is important to assess CNs’ self-reported competence to assure that they are well equipped for the role. Objectives: To assess self-reported professional competence among contact nurses working in Swedish cancer care and relate the findings to education level and clinical experience. Methods: The Nurse Professional Competence scale short form (35 items) was used to assess the nurses’ professional competence. Data were collected through a web-based survey in 2017 in 2 regional cancer centers in Sweden. Results: One hundred eight CNs participated in the study and reported highest scores in “value-based nursing care” and lowest scores in “development, leadership, and organization of nursing care.” Higher age, extended clinical work experience, and academic degree were significantly associated with higher competence. Conclusions: CNs with extensive work experience and CNs with an academic degree reported higher scores concerning their generic competence. There is a need in future studies to assess CNs’ specific competence in cancer care. Implications for Practice: There is room for improvement in the competence development of CNs, primarily in the areas of leadership and organization of nursing care. What is Foundational: CNs’ competence regarding leadership and organization should be improved, preferably as part of academic education.

Toward Transformative Engagement: Ethical and Effective Clinical-Research Partnerships in Cancer Care Nursing

Background: Clinical nurses have the potential to conduct impactful practice-focused research, enhancing institutional research cultures and improving patient outcomes. However, collaboration between clinical nurses and academic nurse scientists can be challenging and resource intensive. Objective: Describe how transformative clinical-research partnership facilitates achieving mutual goals for clinical nurses and academic nurse scientists. Methods: The Virtual Supportive Cancer Care Research (ViSuCaRe) Study, a multisite, mixed-method study, was conducted through a clinical-research partnership to explore the experience of patients and clinicians engaging in supportive cancer care via telehealth during the COVID-19 pandemic. Results: We describe research and quality improvement products and identify how the ViSuCaRe Study addressed three common challenges to clinical-research partnerships. (1) Study conception, construction, and development prioritized frontline clinical staff involvement; (2) Data collection and analysis engaged clinical partners in recruitment, interviewing, data management, coding, and theory-building; (3) Subsequent analyses, products, and dissemination efforts emerged from evolving needs of clinical partners and shifted in accordance with their arising priorities. Conclusions: Using an approach to collaboration centered on transformative engagement offers clinical nurses and academic nurse scientists. Implications for Practice: Frontline clinical staff should have consistent and meaningful roles in developmental, analytic, and dissemination-directing processes. Supporting clinical nurses’ engagement in research activities will enable them to identify and address problems that impact practice, enhance research cultures, and promote evidence-based practice. Foundational: Using a model of transformative engagement, rooted in community engagement, allows nurses to carry out collaborative practice-focused research. Clinical-academic partnerships offer an economical approach to enhancing clinical nurses’ research capacities.

Thoracic Society of Australia and New Zealand Position Statement: Respiratory nursing.

The Thoracic Society of Australia and New Zealand's (TSANZ) Position Statement recognizes the pivotal role respiratory nurses play in the lung health of Australians and New Zealanders. The national and international lung health strategies are evidence based to ensure optimal professional clinical support for patients. Respiratory nurses are essential to the success of these strategies as a professional workforce, irrespective of healthcare setting, as they are at the forefront of the delivery of world‐class evidence‐based respiratory care. Respiratory nursing, as an entity, does not have the status as a nursing specialist area despite its range of professional practice across the life span and diverse settings, including disease prevention, public health, occupational health, symptom management, health education, surgery, rehabilitation, non‐invasive ventilation, support for a life‐limiting illness and adjustments to living with a chronic disease. Recognition of the specialized nature of work and specialist nursing practice status has been conferred by nurse registration boards upon cancer, emergency, cardiac, critical care, midwifery, mental health and palliative care nurses. It is time to confer this speciality practice recognition upon respiratory nurses of Australia and New Zealand. Through this position statement, the TSANZ advocates for respiratory nursing as a speciality area of professional nursing practice, thus supporting registered nurses in respiratory practice as well as the development of future generations of respiratory nurses. Furthermore, this statement validates the strong partnerships between all professions within the society for the advancement of lung health.

Altered prerequisites: A cross-sectional survey regarding cancer care in Sweden during COVID-19 from the viewpoint of contact nurses in cancer care

Contact nurses in cancer care were vital in sustaining cancer care in Sweden during the COVID-19 pandemic. The aim of this study was to investigate their experiences of providing care to people with cancer in these exceptional circumstances to identify emerging challenges and opportunities that must be addressed moving forward. A survey distributed to contact nurses was supplemented with questions regarding the pandemic. The study design was a cross-sectional survey, analyzed with descriptive statistics and content analysis, reported in accordance with STROBE. Almost half of respondents (n = 337) reported not being able to provide the same support as before the pandemic. Analysis of open-ended question responses (n = 232) revealed a main theme: Altered prerequisites for providing care. Three categories related to altered interaction, accessibility, and nursing reality were revealed. Thorough reflection is needed to make use of lessons learned and avoid sustaining the short-term solutions needed to cope with the acute phase of the pandemic.

How my CAR-T therapy research seeks to improve cancer care and empower nurses

Emma Williams’ research into CAR-T therapy for people with relapsed and refractory diffuse large B cell lymphoma hopes to improve knowledge of the cancer treatment and underline the importance of nurse research