Specialist Oncology Nurses Research Articles

Knowledge, attitudes, practices, and barriers of oncology nurses in promoting physical activity in cancer survivors: a cross-sectional survey in China

PurposeTo explore the knowledge, attitudes, and practices of Chinese nurses in promoting physical activity among cancer survivors and the relationships between these attributes and to identify the factors hindering nurses’ clinical practice.MethodsNurses from oncology-related departments of 10 public tertiary hospitals in Shandong Province completed self-administered questionnaires that included information about demographics; knowledge, attitudes, and practices of physical activity promotion; and barriers to clinical practice. The STROBE statement for observational studies was applied.ResultsA total of 502 valid questionnaires were obtained. The average standardized scores of knowledges, attitudes, and practice were 75.33%, 82.36%, and 62.60%, respectively. Oncology specialist nurses and nurses who had received relevant training had higher levels of knowledge, nurses from general hospitals reported higher levels of practice, and nurses who had learned the relevant guidelines were better in terms of knowledge, attitude, and level of practice. Attitude had a statistically significant mediating effect between knowledge and practice. Lack of time, lack of multidisciplinary clinical teams, and lack of clear guidelines were the most frequently reported barriers to practice.ConclusionIn China, nurses have a moderate level of knowledge and practice in promoting physical activity among cancer survivors, but a positive attitude. Numerous barrier factors present challenges in nurses’ clinical practice. Attitude plays a partial mediating role between knowledge and practice.

The relationship between core competence and perceived professional benefits among oncology specialist nurses: A cross-sectional study.

To investigate the current state and influencing factors of core competence of oncology specialist nurses as well as the relationship between core competence and perceived professional benefits. A cross-sectional correlational survey. This questionnaire survey was conducted with oncology specialist nurses working in a Grade III A (tertiary) Public Cancer Hospital in Jinan, China in March 2021. Based on informed consent, a convenience sampling of 350 nurses participated in the study, with 322 valid questionnaires collected. Using IBM SPSS21.0, the data were analysed to perform descriptive statistics, analysis of variance (ANOVA), multiple stepwise regression analysis and Pearson's correlation analysis. The overall average score of nurses' core competence was 224.28 ± 7.95, a medium level and the overall average score of their perceived professional benefits was 132.99 ± 5.05. Nurses' core competence was positively correlated with perceived professional benefits. The differences in professional title, education, working years and perceived professional benefits were statistically significant. The findings indicated that nurses' perceived professional benefit is an important factor affecting core competence. Nursing managers who take main responsibility for the quality of care should adopt measures to increase perceived professional benefits, which not only promote nurses' job satisfaction and happiness, but also enhance the development of their core competence and the quality of cancer care as well. All participants contributed to the conducting of this study by completing self-reported questionnaires.

Feasibility of an exercise-nutrition-psychology integrated rehabilitation model based on mobile health and virtual reality for cancer patients: a single-center, single-arm, prospective phase II study

ObjectiveExplore the feasibility of a mobile health(mHealth) and virtual reality (VR) based nutrition-exercise-psychology integrated rehabilitation model in Chinese cancer patients.MethodsWe recruited cancer patients in the Oncology department of the Affiliated Changzhou No. 2 People’s Hospital of Nanjing Medical University from October 2022 to April 2023. The rehabilitation program was provided by a team of medical oncologists, dietitians, psychotherapists, and oncology specialist nurses. Participants received standard anti-cancer therapy and integrated intervention including hospitalized group-based exercise classes, at-home physical activity prescription, behavior change education, oral nutrition supplements, and psychological counseling. An effective intervention course includes two consecutive hospitalization and two periods of home-based rehabilitation (8 weeks). Access the feasibility as well as changes in aspects of physical, nutritional, and psychological status.ResultsAt the cutoff date of April 2023, the recruitment rate was 75% (123/165). 11.4%patients were lost to follow-up, and 3.25% withdrew halfway. Respectively, the completion rate of nutrition, exercise, and psychology were 85%,55%, and 63%. Nutrition interventions show the highest compliance. The parameters in nutrition, psychology, muscle mass, and quality of life after the rehabilitation showed significant improvements (P < .05). There was no significant statistical difference (P > .05) in handgrip strength and 6-minute walking speed.ConclusionIt is feasible to conduct mHealth and VR-based nutrition-exercise-psychology integrated rehabilitation model in Chinese cancer patients. A larger multi-center trial is warranted in the future.Trial registrationChiCTR2200065748 Registered 14 November 2022.

Abstract 92: Using Innovative Technology and Collaborative Efforts to Reduce Disparities and Inequities in Cancer Care and Improve the Lives of Patients in Low-Middle Income Countries in Sub-Saharan Africa: South African and Lesotho Experience of the ECHO Model

Abstract Purpose: Sub-Saharan Africa has huge disparities and inequities in cancer care. Some low resource countries have no facilities or trained oncologists and other healthcare professionals for cancer care. Patients often must travel long distances to access specialised cancer care such as radiotherapy, chemotherapy and palliative care. Patients with cancer in Lesotho who needed chemotherapy had to be flown to India; those who needed radiotherapy were referred to South Africa. Majority of the cancers diagnosed in the Northern cape province and Lesotho are in late stages and need treatment with chemotherapy and radiotherapy as part of the multimodality therapy. Methods: The Northern Cape Cancer Centre of Excellence and Research (NCCanCER) at Kimberley Hospital in South Africa collaborated with the Senkatana Hospital in Lesotho. Oncologists, specialist oncology nurses and IT personnel were trained at Project ECHO Institute in Albuquerque, NM to use the ECHO model for training, transfer of skills and mentorship. NCCanCER assisted Lesotho to set up a chemotherapy facility at Senkatana Hospital. An initial visit to the Kimberley Hospital Oncology Department for benchmarking was done by oncology staff from Lesotho. NCCanCER oncology staff went to Lesotho to provide on-site training in chemotherapy administration. Weekly virtual ECHO clinics were run from the Hub at Kimberley with spoke sites in Lesotho, Upington, Springbok and Kuruman. At the ECHO clinics, management of patients are discussed using evidence-based management protocols for continued training, transfer of skills, support and mentorship. Results: Doctors, nurses, pharmacists, social workers, clinical psychologists and community healthcare workers have been trained to provide cancer care and palliative care services in the underprivileged and underserved areas of the Northern cape and Lesotho. The first chemotherapy facility was opened in Lesotho in July 2022 and patients in Lesotho are no longer flown to India for chemotherapy. Patients in remote areas of the Northern cape province of South Africa can now receive chemotherapy and palliative care closer to their homes. There is continuous training, transfer of skills, expertise and mentorship of oncology staff. Conclusion: The ECHO model is useful in democratizing knowledge, transfer skills and expertise to improve care to patients in low resource countries. Citation Format: Daniel Osei-Fofie, Kabelo Mputsoe Cekwane, Mobashshar Hassan, Sophie Victoria Masuabi, Pearl Ntsekhe. Using Innovative Technology and Collaborative Efforts to Reduce Disparities and Inequities in Cancer Care and Improve the Lives of Patients in Low-Middle Income Countries in Sub-Saharan Africa: South African and Lesotho Experience of the ECHO Model [abstract]. In: Proceedings of the 11th Annual Symposium on Global Cancer Research; Closing the Research-to-Implementation Gap; 2023 Apr 4-6. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2023;32(6_Suppl):Abstract nr 92.

What is the role of the children's community nurse in childhood cancer care?

Aim: To highlight the experiences of children's community nurses (CCNs) within cancer care and to identify their day-to-day roles and responsibilities. Method: Questionnaires were completed by 12 CCNs and oncology specialist nurses within London, these were analysed using a coding software. Findings: Children and their families perceive CCNs as knowledgeable, happy and friendly professionals, essential in reducing hospital admissions and who have a positive impact on a child and their family's well-being. The CCN has a varied role in cancer care, however, currently in the UK there is no framework specific to caring for a child at home with cancer. In response to the findings, one has been written to identify care needs and to emphasise service expectations. Conclusion: Specific training for caring for a child with cancer should be prioritised for all staff working within a CCN team and to ensure best practice, the framework should be implemented once reviewed and services re-evaluated.

Expediting drug development &amp; targeting early-stage disease: how is clinical trial design in immuno-oncology evolving?

Roisin McGuigan, Commissioning Editor, Bioinsights, speaks to Patrick Forde, Director, Thoracic Oncology Clinical Research Program, Associate Professor of Oncology, Johns HopkinsDr Patrick Forde is currently Co-Director of the Division of Upper Aerodigestive Malignancies at Johns Hopkins and also directs the multidisciplinary Thoracic Oncology Clinical Research Program. He has led development of a clinical-translational research program focused on the immuno-oncology of upper aerodigestive malignancies. Dr Forde’s research examines the role of immunotherapy for mesothelioma and lung cancer and his work has led to the development of several ongoing Phase 3 trials. He leads international Phase 2 and 3 clinical trials of novel immunotherapy approaches for lung cancer and mesothelioma that are currently active in Europe, Asia and North America while also serving as principal investigator for the thoracic cancer immunobiology biospecimen repository at Johns Hopkins. He is focused on providing compassionate, state of the art care for his patients in conjunction with a team of oncology specialist nurses, nurse practitioners and dedicated staff.

The potential of training specialist oncology nurses in real-life reporting of adverse drug reactions

Specialist oncology nurses (SONs) have the potential to play a major role in monitoring and reporting adverse drug reactions (ADRs); and reduce the level of underreporting by current healthcare professionals. The aim of this study was to investigate the long term clinical and educational effects of real-life pharmacovigilance education intervention for SONs on ADR reporting. This prospective cohort study, with a 2-year follow-up, was carried out in the three postgraduate schools in the Netherlands. In one of the schools, the prescribing qualification course was expanded to include a lecture on pharmacovigilance, an ADR reporting assignment, and group discussion of self-reported ADRs (intervention). The clinical value of the intervention was assessed by analyzing the quantity and quality of ADR-reports sent to the Netherlands Pharmacovigilance Center Lareb, up to 2 years after the course and by evaluating the competences regarding pharmacovigilance of SONs annually. Eighty-eight SONs (78% of all SONs with a prescribing qualification in the Netherlands) were included. During the study, 82 ADRs were reported by the intervention group and 0 by the control group. This made the intervention group 105 times more likely to report an ADR after the course than an average nurse in the Netherlands. This is the first study to show a significant and relevant increase in the number of well-documented ADR reports after a single educational intervention. The real-life pharmacovigilance educational intervention also resulted in a long-term increase in pharmacovigilance competence. We recommend implementing real-life, context- and problem-based pharmacovigilance learning assignments in all healthcare curricula.

Does training specialist oncology nurses improve ADR reporting?

Does training specialist oncology nurses improve ADR reporting?

The evolving challenges of specialist gynaecological cancer nurse roles - A qualitative study.

To determine how specialist gynaecological cancer nurses experience and perceive their role. An Interpretive Description qualitative study employing semi-structured interview methods was conducted. Specialist nurses working in Australia or New Zealand were recruited via the Australia and New Zealand Gynaecological Oncology Group and the Cancer Nurses Society of Australia to contribute to focus group, dyadic and/or individual interviews. Audio-recordings of the interviews were transcribed, de-identified, and subjected to a thematic analysis. Specialist cancer nurses participated in the study via one focus group interview (N=6), one dyadic interview (N=2) and 13 individual interviews between April - August 2016. Three major themes were inductively derived from 19 minor themes: 'Working between worlds' locates the role of the specialist nurse in the provision of gynaecological cancer care; 'The patient's 'go-to' person' highlights participants' relationships with patients; and 'When so much depends on one person' explores the personal and professional impact of working in a specialist nursing role. Specialist nurses identified themselves as an accessible source of support and expertise for both women with gynaecological cancers throughout their disease trajectory and multidisciplinary team members. The main challenges they faced were the evolving and expanding nature of their bespoke roles and the dependence on them as individuals in these roles. Clearer role boundaries, guidelines for practice, effective professional support, and active succession planning are recommended. This study explored the experiences and perceptions of gynaecological oncology specialist nurses. Despite similar roles being in place across many countries for several years, the roles continue to evolve and lack clear definition which is burdensome to their incumbents. This research indicates that it is now time for nursing leaders and the broader nursing profession to delineate scope of practice, standardise nomenclature and practice and embed these roles in nursing career and education pathways.

A clearer pathway—The future of the gynaecological oncology specialist nurse role

BackgroundOver recent years there has been a proliferation in specialist nurse roles that require expertise and advanced practice in a particular field of nursing. In Australia and New Zealand, specialist nursing care of women with gynaecological cancers is recommended, however the role remains largely undefined and unregulated. AimsTo determine Australian and New Zealand gynaecological oncology specialist nurses’ perspectives on the future of their role, and make recommendations for future practice and education. MethodsAn interpretive descriptive methodology was adopted for this study. Gynaecological oncology specialist nurses participated in individual and focus group interviews and a thematic analysis of transcribed data was conducted. FindingsNineteen specialist nurses participated in the study and three major themes were derived from the interview data: The first theme, ‘Delineation of roles’ highlighted the challenges for specialist nurses inherent in new, poorly defined roles. ‘Identifiable career path’ explored the lack of clear education and career pathways and disparate nomenclature for their roles, which they believed impeded succession planning. The theme, ‘What should I be doing’, related to the bespoke development of participants’ current roles due to the paucity of formal guidelines for practice. DiscussionGynaecological oncology specialist nurse roles have emerged and developed with limited direction from the nursing profession. Poor role legitimacy and a weak professional identity were evident among participants. ConclusionsGynaecological oncology specialist nurses identified standardised nomenclature, defined career and education pathways, guidelines for practice, and succession planning as important elements in the progression of their roles.

Management of bone health in patients with cancer: a survey of specialist nurses

BackgroundPatients with cancer can experience bone metastases and/or cancer treatment–induced bone loss (CTIBL), and the resulting bone complications place burdens on patients and healthcare provision. Management of bone complications is becoming increasingly important as cancer survival rates improve. Advances in specialist oncology nursing practice benefit patients through better management of their bone health, which may improve quality of life and survival.MethodsAn anonymised online quantitative survey asked specialist oncology nurses about factors affecting their provision of support in the management of bone metastases and CTIBL.ResultsOf 283 participants, most stated that they worked in Europe, and 69.3% had at least 8 years of experience in oncology. The most common areas of specialisation were medical oncology, breast cancer and/or palliative care (20.8–50.9%). Awareness of bone loss prevention measures varied (from 34.3% for alcohol intake to 77.4% for adequate calcium intake), and awareness of hip fracture risk factors varied (from 28.6% for rheumatoid arthritis to 74.6% for age > 65 years). Approximately one-third reported a high level of confidence in managing bone metastases (39.9%) and CTIBL (33.2%). International or institution guidelines were used by approximately 50% of participants. Common barriers to better specialist care and treatment were reported to be lack of training, funding, knowledge or professional development.ConclusionThis work is the first quantitative analysis of reports from specialist oncology nurses about the management of bone metastases and CTIBL. It indicates the need for new nursing education initiatives with a focus on bone health management.

Role of Gynaecology Oncology Specialist Nurses in Improving Patient Follow-Up and Integration With the Health Care Team

Background: All advanced gynecologic cancers treated initially with a curative intent should also be referred to palliative care at the outset for symptom management. Specialist nurses can play an integral role in this process as patients feel more comfortable to relay their symptoms to nurses rather than busy clinicians. The concept of specialist nurses has been introduced in June 2016 in the Gynecologic Oncology Department in Tata Medical Center. We aim evaluate our services through this prospective audit. Aim: i: To assess whether pre and posttreatment counseling and follow-up by gynecologic oncology specialist nurses lead to better patient care in the following areas. Increased patient participation in self-reporting of PROM (patient reported outcome monitoring) and uptake of follow-up methods via e-mail, telephone etc. ii: Coordinate administration of intraperitoneal chemotherapy and follow-up. iii: Detection of posttreatment complications and symptoms by telephonic follow up and coordination with the treating team including quality of life data collection. iv: Communicating MDT decisions to patients and arrange appropriate follow-up. v: Reduction of patient follow-up appointments and distress by coordinating with other departments i.e., palliative care team and gynae/medical oncology at same visit. vi: Develop patient information leaflets and providing preoperative education Methods: Prospective audit for service evaluation. Patients follow-up was done by face to face, telephone, e-mail in the pre and postoperative period, during chemotherapy and follow-up visits by 4 specialist nurses. Results: Between June 2016 and December 2017, specialist nurses conducted follow-up of 225 patients both in preoperative and postoperative period and collected 30 day morbidity data. Preoperative health education was given to all. 36 patients were coordinated with palliative care team on same day with gynecologic visit to reduce harassment/repeat appointments. Postchemotherapy follow-up was done for 80 patients after each cycle of chemotherapy. Coordination for 19 intraperitoneal chemotherapy was done by nurses during a 9 month period. As a result of regular follow-up visits, women were more comfortable in self-reporting of symptoms to the nurse including sensitive issues like body image and sexuality even by nonface to face methods including telephone calls/e-mails and postal mails. This has led to early detection of recurrences in 4 women, participation in multicentric national/international quality of life studies (SOCQER2/ SOCQER IND) and successful organization of survivorship programs in gynecologic oncology. Conclusion: Counseling, education and building up of interpersonal relationship with specialist nurses can improve patient participation. The role of CNS is vital to the advancement of nursing practice.

An investigation of training effects of the Shandong oncology specialist nurses

Objective To investigate training effects of Shandong oncology specialist nurses. Methods A self-designed questionnaire about training effects was used to investigate 149 oncology specialist nurses in 48 hospitals in Shandong province. Results The total score of training effects was 202.075±17.918. Differences were significant in human relations of training effects of oncology specialist nurses (F=3.439,P<0.05). 94.74% (126/133) of the oncology specialist nurses had no changeable in their work after training, 62.41% (83/133) served as skeleton staffs, only 22.56% (30/133) published in journals, 58.65% (78/133) of the specialist nurses had no chance to attend meeting and only 3.01% (4/133) had experiences to study for a month or more. Conclusions The training effects of Shandong oncology specialist nurses some abilities still need to be increased, the training contents need to be enriched, the use and management of the specialist nurses need to be further regulated, and the development of the oncology specialist nurses need to be further improved. Key words: Oncology specialist nurse; Training effects; Questionnaire

The adverse drug reaction reporting assignment for specialist oncology nurses: a preliminary evaluation of quality, relevance and educational value in a prospective cohort study

In a new prescribing qualification course for specialist oncology nurses, we thought that it is important to emphasize pharmacovigilance and adverse drug reaction (ADR) reporting. We aimed to develop and evaluate an ADR reporting assignment for specialist oncology nurses. The quality of report documentation was assessed with the “Clinical Documentation tool to assess Individual Case Safety Reports” (ClinDoc). The relevance of the reports was evaluated in terms of ADR seriousness, the listing for additional monitoring of the drug by European Medicines Agency (EMA), and lack of labelling information about the ADR. Nurses’ opinions of the assignment were evaluated using an E-survey. Thirty-three ADRs were reported, 32 (97%) of which were well documented according to ClinDoc. Thirteen ADRs (39%) were “serious” according to CIOMS criteria. In five cases (15%), the suspect drugs were listed for additional monitoring by EMA and in seven cases (21%), the ADR was not mentioned in the Summary of Product Characteristics. Twenty-five (78.1%) of the 32 enrolled nurses completed the E-survey. Most were > 45 years of age (68%), female (92%) and had extensive clinical experience (6–33 years). All agreed or completely agreed that the reporting assignment was useful, that it fitted in daily practice and that it increased their attention for medication/patient safety. A large majority (84.0%) agreed the assignment changed how they dealt with ADRs. Specialist oncology nurses are capable of reporting ADRs, and they considered the assignment useful. The assignment yielded valuable, relevant, and well-documented ADR reports for pharmacovigilance practice.

Pharmacovigilance Training for Specialist Oncology Nurses —A Two Way Evaluation

Background: In a new prescribing qualifcation course for specialist oncology nurses, we thought it important to emphasize pharma-covigilance and adverse drug reaction (ADR)-reporting. To this end, our aim was to develop and evaluate an ADR reporting assignment for specialist oncology nurses. Methods: The quality of report documentation was assessed with the 'Clinical Documentation tool to assess Individual Case Safety Reports' (ClinDoc). The relevance of the reports was evaluated in terms of ADR seriousness, the listing for additional monitoring of the drug by European Medicines Agency (EMA), and lack of labelling information about the ADR. Nurses' opinions of the assignment were evaluated using an E-survey. Results: Thirty-three ADRs were reported, 32 (97%) of which were well documented according to ClinDoc. Thirteen ADRs (39%) were 'serious' according to CIOMS criteria. In 5 cases (15%) the suspect drugs were listed for additional monitoring by EMA and in 7 cases (21%) the ADR was not mentioned in the Summary of Product Characteristics. Twenty-fve (78%) of the 32 enrolled nurses completed the E-survey. Most were > 45 years of age (68%), female (92%), and had extensive clinical experience (6-33 years). All agreed or completely agreed that the reporting assignment was useful, that it ftted in daily practice, and that it increased their attention for medi-cation/patient safety. A large majority (84%) agreed the assignment changed how they dealt with ADRs. Conclusions: Specialist oncology nurses are capable of reporting ADRs, and they considered the assignment useful. The assignment yielded valuable, relevant, and well-documented ADR reports for pharmacovigilance practice.

The integration of BRCA testing into oncology clinics.

The PARP inhibitor, Olaparib, is approved for women with BRCA-mutated ovarian cancer. Therefore there is an urgent need to test patients and obtain results in time to influence treatment. Models of BRCA testing, such as the mainstreaming oncogenetic pathway, involving oncology health professionals are being used. The authors report on the establishment of the extended role of the clinical nurse specialist in consenting women for BRCA testing in routine gynaecology-oncology clinics using the mainstreaming model. Nurses undertook generic consent training and specific counselling training for BRCA testing in the form of a series of online videos, written materials and checklists before obtaining approval to consent patients for germline BRCA1 and BRCA2 mutations. Between July 2013 and December 2015, 108 women with ovarian cancer were counselled and consented by nurses in the medical oncology clinics at a single centre (The Royal Marsden, UK). This represented 36% of all ovarian cancer patients offered BRCA testing in the oncology clinics at the centre. Feedback from patients and nurses was encouraging with no significant issues raised in the counselling and consenting process. The mainstreaming model allows for greater access to BRCA testing for ovarian cancer patients, many of whom may benefit from personalised therapy (PARP inhibitors). This is the first report of oncology nurses in the BRCA testing pathway. Specialist oncology nurses trained in BRCA testing have an important role within a multidisciplinary team counselling and consenting patients to undergo BRCA testing.

Good Nutrition for Cancer Recovery - a nutritional resource for the treatment of cancer-induced weight loss

Cancer-induced weight loss is a debilitating condition which affects 31–87% of patients with cancer and is recognised to be a negative prognostic indicator for a range of malignancies. Although intensive nutritional intervention has been shown to play a beneficial role in weight stabilisation, one-to-one dietetic counselling is not available for all patients. The aim of the ‘Good Nutrition for Cancer Recovery’ initiative was to produce an Irish resource that translates clinical nutrition recommendations into simple information and nutritious recipes appropriate for patients with cancer-induced weight loss. High-protein, high-energy recipe guidelines, based on recommendations for nutritionally vulnerable patients, were developed and distributed to all members of the Irish Nutrition and Dietetic Institute, specialist oncology dietitians and nurses, patients and carers, as well as professional chefs from across Ireland. The resulting recipes were analysed and professional chefs consulted in order to optimise the nutritional composition of these meals. This process resulted in a 120-page resource for patients with cancer-induced weight loss, containing nutrition information, advice and a bank of nourishing recipes. Recipes were enriched and portion sizes adjusted to ensure that meals were nutrient dense and appropriate in size for patients with small appetites. Nineteen thousand copies of the resource were printed and distributed to >74 locations and made available to patients free of charge. An extensive outreach campaign was launched in order to disseminate the information to all relevant stakeholders. This extensive resource is now widely available to facilitate patients in achieving the energy and protein levels required to attenuate cancer-induced weight loss.

Exploring patient experiences of neo-adjuvant chemotherapy for breast cancer

Background and purposeNeo-adjuvant chemotherapy is recommended for ‘inoperable’ locally advanced and inflammatory breast cancers. For operable breast cancers, trials indicate no survival differences between chemotherapy given pre or post-surgery. Communicating evidence based information to patients is complex and studies examining patient experiences of neo-adjuvant chemotherapy are lacking. This study aims to explore the experiences of women who received neo-adjuvant chemotherapy for breast cancer. MethodsA qualitative approach using in-depth interviews with 20 women who had completed neo-adjuvant chemotherapy for breast cancer. Interview data were analysed using thematic analysis. ResultsThe sample included a relatively young group of women, with caring responsibilities. Five main themes emerged: coping with the rapid transition from ‘well’ to ‘ill’, information needs and decision making, needing support and empathy, impact on family, and creating a new ‘normal’. More support was needed towards the end of chemotherapy, when side effects were at their most toxic, and decisions about forthcoming surgery were being made. Some women were referred to psychological services, but usually when a crisis point had been reached. ConclusionInformation and support would have been beneficial at key time points. This information is vital in developing services and interventions to meet the complex needs of these patients and potentially prevent late referral to psychological services. Specialist oncology nurses are able to develop empathetic relationships with patients and have the experience, knowledge and skills to inform and support women experiencing neo-adjuvant chemotherapy. Targeting key time points and maintaining relationship throughout neo-adjuvant chemotherapy would be highly beneficial.

Evaluation of physical compatability and drug preparation times of the VialMate adaptor in intravenous drug preparation

BackgroundThe Baxter VialMate adaptor is a device used in the reconstitution of intravenously administered medicines. It is connected directly between the medicine phial and a small infusion bag resulting in...

Comparison of experienced burnout symptoms in specialist oncology nurses working in hospital oncology units or in hospices

This study aimed to clarify the differential contributions of situational and individual factors to burnout symptoms experienced by two independent groups of specialist oncology nurses working in oncology hospital units or in hospices. The study involved a group of specialist oncology nurses working in hospital oncology units (n = 59) and a group of specialist oncology nurses working in hospices (n = 33). Participants were invited to provide demographic data, and indicate the clinical setting in which they worked and their work experience; the Italian versions of the Maslach Burnout Inventory (MBI) (a measure of burnout symptoms), the Hospital Anxiety and Depression Scale (HADS) (a measure of anxiety and depression), and the Attachment Style Questionnaire (ASQ) (a measure of relational style) were then administered. The two groups of nurses were well matched for age, work experience, and levels of anxiety and depression. Regarding their relational style, the two groups only differed significantly on two subscales of the ASQ (i.e. "Confidence" and "Relationships as Secondary"). The two groups significantly differed in the levels of all burnout symptoms investigated (emotional exhaustion, depersonalization, and personal achievement), with nurses working in hospital units showing higher levels of burnout symptoms. Interestingly, multivariate regression analyses showed that the institutional factor (clinical setting in which nurses worked) clearly emerged as the only factor that influenced the level of all burnout symptoms, whereas the contribution of individual factors was less significant. These findings help to clarify the differential contributions of institutional and individual factors to burnout symptoms in specialist oncology nurses, and corroborate the need for interventions to contain nurses' burnout symptoms.