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Boyle DA. The geriatric Asia-Pacific oncology nursing imperative. Asia Pac J Oncol Nurs 2023; 10:100319. [PMID: 38106439 PMCID: PMC10724487 DOI: 10.1016/j.apjon.2023.100319] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2023] [Accepted: 10/08/2023] [Indexed: 12/19/2023] Open
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Kapra O, Asna N, Amoyal M, Bashkin O, Dopelt K. The Oncology Clinical Nurse Specialist: A Rapid Review of Implementation Models and Barriers around the World. Curr Oncol 2023; 30:7425-7438. [PMID: 37623019 PMCID: PMC10453893 DOI: 10.3390/curroncol30080538] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2023] [Revised: 07/30/2023] [Accepted: 08/04/2023] [Indexed: 08/26/2023] Open
Abstract
The role of a clinical nurse specialist in oncology varies greatly between healthcare systems, and implementing this healthcare role with its multifaceted and co-existing responsibilities may prove challenging. While already integrated into healthcare systems and services in several European countries, Asia, Canada, and the United States, other countries are just beginning to develop clinical nursing specialties. The current study aims to provide healthcare policymakers with up-to-date evidence that focuses on the diverse modes of oncology clinical nurse specialist role implementation across several healthcare systems and pertinent implementation challenges as described in the literature. A rapid evidence assessment was carried out in order to provide policymakers with a rigorous review in a condensed timescale. Initially, only items in the English language were included, and "grey literature" was excluded. We searched PubMed between 1 January 2022 and 28 February 2022 and two independent scholars reviewed items. Based on 64 papers, both non-scientific and papers that met the initial criteria of the rapid review, we describe the modes of implementation of the oncology clinical nurse specialist in the United States, Canada, United Kingdom, Japan, Brazil and Australia. Barriers to implementation include conflicts around role boundaries, skepticism and lack of organizational support, as well as fears that oncology clinical nurse specialists will "encroach" on doctors' powers. In contrast, an oncology clinical nurse specialist is found to be universally more accessible to patients and their families and can help physicians deal with difficult workloads, among other advantages. Conclusions: This role offers a myriad of gains for cancer patients, oncology physicians, and the healthcare system. The literature demonstrates that it is a necessary role, albeit one that brings specific implementation challenges.
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Affiliation(s)
- Ori Kapra
- Department of Public Health, Ashkelon Academic College, Ashkelon 78211, Israel; (O.K.); (O.B.)
| | - Noam Asna
- Oncology Institute, Shaare Zedek Medical Center, Jerusalem 91031, Israel;
| | - Mazal Amoyal
- Palliative Care Unit, Barzilai Medical Center, Ashkelon 78306, Israel;
| | - Osnat Bashkin
- Department of Public Health, Ashkelon Academic College, Ashkelon 78211, Israel; (O.K.); (O.B.)
| | - Keren Dopelt
- Department of Public Health, Ashkelon Academic College, Ashkelon 78211, Israel; (O.K.); (O.B.)
- School of Public Health, Faculty of Health Sciences, Ben Gurion University of the Negev, Beer Sheva 84105, Israel
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Challinor J. Global Oncology Nursing Recruitment and Retention: A SWOT Analysis. Semin Oncol Nurs 2023; 39:151361. [PMID: 36621414 DOI: 10.1016/j.soncn.2022.151361] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
OBJECTIVES This article documents the current status of global recruitment and retention of oncology nurses. A strengths, weaknesses, opportunities, and threats model was used to identify internal-to-nursing recruitment and retention factors/influences and external opportunities and threats as well as strategies and initiatives to improve the current situation. DATA SOURCES Data sources include published and grey literature from around the world. CONCLUSION Despite the increasing cancer burden threatening public health worldwide, recruitment and retention of oncology nurses remains challenging. Nursing strengths include action by oncology nursing associations, prelicensure nurse recruitment and preceptorships, and models of hospital shared governance. Nursing weaknesses include nurse bullying, practice models that curtail clinical nurses' autonomy, and hierarchical and inflexible nursing leadership. External to nursing are opportunities exemplified by international partnerships in oncology care and international oncology conferences for networking and learning. Examples of external threats are a lack of oncology nursing faculty, disrespectful media portrayal of nurses, community misconceptions about cancer curability, and hazards of cancer nursing. IMPLICATIONS FOR NURSING PRACTICE Governments and hospital authorities wishing to successfully address cancer control must strategically plan for the recruitment and retention of an adequate nursing workforce. Opportunities such as government recognition of oncology specialty training, shared governance, continuing specialized education, advanced practice nursing roles and career paths, and participation in national cancer control planning will increase and sustain a critical oncology nursing workforce.
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Affiliation(s)
- Julia Challinor
- School of Nursing, University of California San Francisco, San Francisco.
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Abstract
BACKGROUND Most cancer treatment is provided in the ambulatory setting; thus, it is important to know what issues ambulatory oncology nurses identify in their practice with older cancer patients as well as resources that are helpful or are needed. OBJECTIVE The aim of this study was to capture ambulatory oncology nurses' perceptions of the unique aspects of caring for older patients and to present the development process, content validity testing, and psychometric evaluation of a survey designed to denote nurse perceptions of older adult care. METHODS An expert panel and 2 focus groups informed the development of a 34-item survey scored on a 5-point Likert-type agreement scale and 2 open-ended questions. Psychometric testing and descriptive statistics summarized the quantitative responses. Using thematic analysis, we identified the themes from the open-ended responses. RESULTS The survey demonstrated good psychometric qualities. A total of 401 participants, mostly staff from large, academic cancer centers, reported an average total score of 3.76, indicating generally positive perceptions of older adult care. The 269 (67%) open-ended responses were categorized into 4 main themes: concerns over medical issues, the need for specialized services, adequate support systems, and appropriate communication. CONCLUSIONS Although most perceived their geriatric practice environment favorably, nurses recognized the complexity of caring for older adults with cancer. They identified gaps in care, such as the need for geriatric specialists and better community resources, paid by insurance. IMPLICATIONS FOR PRACTICE Nurses need more time in the clinic to address complex advanced care planning, symptom burden and home services of older adults with cancer. Each institution should seek feedback from nurses to guide resource allocation.
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Law J, Dahlke S, Butler JI, Hunter KF, Martin LS, Pietrosanu M. Improving practicing nurses' knowledge and perceptions of older people: a quasi-experimental study. Int J Nurs Educ Scholarsh 2022; 19:ijnes-2022-0090. [PMID: 36473144 DOI: 10.1515/ijnes-2022-0090] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2022] [Accepted: 11/14/2022] [Indexed: 12/12/2022]
Abstract
OBJECTIVES This study aimed to determine if an e-learning module about understanding and communicating with older people can improve practicing nurses' ageist perceptions about older people. METHODS We used a quasi-experimental pre-post-test design. Participants completed a 13-item Ambivalent Ageism Scale before and after completing the Understanding and Communicating with Older People e-learning module as well as a Likert-style feedback survey with the option for written feedback on an open-ended question. RESULTS Pre-post-test comparisons indicated a statistically significant decrease in ageist attitudes and self-reported increases in knowledge and confidence in working with older people. Qualitative analysis of written feedback revealed that most participants felt the module enhanced their understanding of older people. CONCLUSIONS The e-learning activity has the potential to improve practicing nurses' knowledge and perceptions about working with older people and is likely to be associated with better patient-level outcomes.
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Affiliation(s)
- Joanna Law
- Faculty of Nursing, University of Alberta, Edmonton Clinic Health Academy, Edmonton, AB, Canada
| | - Sherry Dahlke
- Faculty of Nursing, University of Alberta, Edmonton Clinic Health Academy, Edmonton, AB, Canada
| | - Jeffrey I Butler
- Faculty of Nursing, University of Alberta, Edmonton Clinic Health Academy, Edmonton, AB, Canada.,School of Nursing, York University Centre for Aging Research and Education, Faculty of Health, York University, Toronto, ON, Canada
| | - Kathleen F Hunter
- Faculty of Nursing, University of Alberta, Edmonton Clinic Health Academy, Edmonton, AB, Canada
| | - Lori Schindel Martin
- Daphne Cockwell School of Nursing, Toronto Metropolitan University, Toronto, ON, Canada
| | - Matthew Pietrosanu
- Department of Mathematical and Statistical Sciences, University of Alberta, Edmonton, AB, Canada
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Lynch MP, Kagan SH, Hagan Thomas T, Fennimore L. Analysis of Age-Friendly Cancer Care Readiness. Oncol Nurs Forum 2021; 48:333-340. [PMID: 33856000 DOI: 10.1188/21.onf.333-340] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
OBJECTIVES Cancer care attuned to meeting the needs of older adults is imperative to ensure that they receive appropriate levels of treatment in accordance with their goals of care. Achieving age-friendly systems and geriatric-competent workforces require rethinking current models of cancer care delivery. This article reports on a descriptive study on the readiness of U.S. cancer programs to provide age-friendly cancer care. SAMPLE & SETTING A survey was sent to 567 ambulatory oncology leaders in the United States. Of the 81 respondents, 61 answered all questions. METHODS & VARIABLES The authors developed and administered an online survey assessing cancer programs' age-friendly cancer care practices and readiness. Survey questions were based on the elements of the 4Ms framework. Results were analyzed using frequencies and percentages for categorically measured survey items and measures of central tendency for continuously scaled survey items. RESULTS 67% of respondents reported that their program could deliver age-friendly cancer care within five years. Respondents less frequently indicated that they employed specific 4Ms elements. IMPLICATIONS FOR NURSING The results of this study suggest gaps in readiness to implement age-friendly cancer care. Recommendations to improve readiness include increasing awareness, expanding workforce preparation, and improving cancer program leadership engagement.
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Position statement on oncology and cancer nursing care for older adults with cancer and their caregivers of the International Society of Geriatric Oncology Nursing and Allied Health Interest Group, the Canadian Association of Nurses in Oncology Oncology & Aging Special Interest Group, and the European Oncology Nursing Society. J Geriatr Oncol 2021; 12:1000-1004. [PMID: 33775576 DOI: 10.1016/j.jgo.2021.03.010] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2021] [Accepted: 03/17/2021] [Indexed: 02/07/2023]
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Yuan C, Timmins F, Thompson DR. Post-intensive care syndrome: A concept analysis. Int J Nurs Stud 2020; 114:103814. [PMID: 33220570 DOI: 10.1016/j.ijnurstu.2020.103814] [Citation(s) in RCA: 47] [Impact Index Per Article: 11.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2020] [Revised: 10/20/2020] [Accepted: 10/22/2020] [Indexed: 12/01/2022]
Abstract
OBJECTIVE Post-intensive care syndrome is a term used to describe new or worsening multidimensional impairments in physical, psychological cognitive and social status arising from critical illness and persisting beyond hospital discharge. It is associated with high morbidity among patients discharged from intensive care units. However, due to its complexities, which encompass physical, psychological, cognitive and social impairments, the exact nature of this condition has not been fully conceptualized. The aim of this analysis therefore was to define the concept of post-intensive care syndrome. This conceptual clarity provides a general definition that is essential for practitioners and researchers to gain a comprehensive understanding of the syndrome and provide for accurate measurement of its incidence and prevalence. DESIGN The Walker and Avant approach to concept analysis guided this investigation. DATA SOURCE An electronic search of the literature using PubMed, CINHAL, PsycArticles, Academic search complete, Science Direct, MEDLINE and Health Source databases informed the analysis. The search included both quantitative and qualitative studies related to post-intensive care syndrome published in English between 2010 and 2020. RESULTS Of the 3948 articles identified, 24 ultimately met the inclusion criteria. Analysis identified the defining attributes of post-intensive care syndrome as: (1) new or worsening multidimensional impairments; (2) physical dysfunction; (3) psychological disorder; (4) cognitive impairment; (5) failed social reconstruction; and (6) persistent impaired multidimensional symptoms extending beyond intensive care and hospital discharge. Antecedents were divided into two categories: pre-existing and those related to the intensive care admission. Consequences were identified as both positive (for example the establishment of coping processes) and adverse (for example decreased quality of life and caregiver burden). CONCLUSION Post-intensive care syndrome affects more than half of patients discharged from intensive care units. This operational definition and conceptual understanding of this syndrome will help improve understanding and inform the design of preventative strategies to improve long-term consequences of the syndrome. Future research and standardized instrument development will serve to better understand the scope and characteristics of this syndrome and inform the development of possible preventative interventions.
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Affiliation(s)
- Chu Yuan
- School of Nursing and Midwifery, Trinity College Dublin, Dublin, Ireland.
| | - Fiona Timmins
- School of Nursing and Midwifery, Trinity College Dublin, Dublin, Ireland
| | - David R Thompson
- School of Nursing and Midwifery, Queen's University Belfast, Belfast, UK
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Timmins F. An overview of 5‐year patterns and trends in the Journal of Nursing Management. J Nurs Manag 2020; 28:457-460. [DOI: 10.1111/jonm.12866] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- Fiona Timmins
- School of Nursing and Midwifery Trinity College Dublin Dublin Ireland
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Finding meaning in life: an exploration on the experiences with dependence on care of patients with advanced cancer and nurses caring for them. Support Care Cancer 2020; 28:4493-4499. [DOI: 10.1007/s00520-020-05300-8] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2019] [Accepted: 01/09/2020] [Indexed: 01/10/2023]
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Role of the geriatrician, primary care practitioner, nurses, and collaboration with oncologists during cancer treatment delivery for older adults: A narrative review of the literature. J Geriatr Oncol 2018; 9:398-404. [DOI: 10.1016/j.jgo.2018.04.008] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2017] [Revised: 03/09/2018] [Accepted: 04/25/2018] [Indexed: 12/20/2022]
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Bridges J, Lucas G, Wiseman T, Griffiths P. Workforce characteristics and interventions associated with high-quality care and support to older people with cancer: a systematic review. BMJ Open 2017; 7:e016127. [PMID: 28760795 PMCID: PMC5642668 DOI: 10.1136/bmjopen-2017-016127] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
Abstract
OBJECTIVES To provide an overview of the evidence base on the effectiveness of workforce interventions for improving the outcomes for older people with cancer, as well as analysing key features of the workforce associated with those improvements. DESIGN Systematic review. METHODS Relevant databases were searched for primary research, published in English, reporting on older people and cancer and the outcomes of interventions to improve workforce knowledge, attitudes or skills; involving a change in workforce composition and/or skill mix; and/or requiring significant workforce reconfiguration or new roles. Studies were also sought on associations between the composition and characteristics of the cancer care workforce and older people's outcomes. A narrative synthesis was conducted and supported by tabulation of key study data. RESULTS Studies (n=24) included 4555 patients aged 60+ from targeted cancer screening to end of life care. Interventions were diverse and two-thirds of the studies were assessed as low quality. Only two studies directly targeted workforce knowledge and skills and only two studies addressed the nature of workforce features related to improved outcomes. Interventions focused on discrete groups of older people with specific needs offering guidance or psychological support were more effective than those broadly targeting survival outcomes. Advanced Practice Nursing roles, voluntary support roles and the involvement of geriatric teams provided some evidence of effectiveness. CONCLUSIONS An array of workforce interventions focus on improving outcomes for older people with cancer but these are diverse and thinly spread across the cancer journey. Higher quality and larger scale research that focuses on workforce features is now needed to guide developments in this field, and review findings indicate that interventions targeted at specific subgroups of older people with complex needs, and that involve input from advanced practice nurses, geriatric teams and trained volunteers appear most promising.
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Affiliation(s)
- Jackie Bridges
- Faculty of Health Sciences, University of Southampton, Southampton, UK
- NIHR CLAHRC Wessex
| | - Grace Lucas
- Faculty of Health Sciences, University of Southampton, Southampton, UK
| | - Theresa Wiseman
- Faculty of Health Sciences, University of Southampton, Southampton, UK
- The Royal Marsden NHS Foundation Trust
| | - Peter Griffiths
- Faculty of Health Sciences, University of Southampton, Southampton, UK
- NIHR CLAHRC Wessex
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Hsu T. Educational initiatives in geriatric oncology - Who, why, and how? J Geriatr Oncol 2016; 7:390-6. [PMID: 27567256 DOI: 10.1016/j.jgo.2016.07.013] [Citation(s) in RCA: 39] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2016] [Revised: 04/19/2016] [Accepted: 07/18/2016] [Indexed: 01/23/2023]
Abstract
The population is aging accounting for a large increase in anticipated cancer cases. Specialty training for trainees interested in geriatric oncology have been established in many countries and is growing globally. However, the number of clinicians with a particular interest in geriatric oncology and who complete training in both specialties is low. There are insufficient geriatric oncologists and geriatricians to address the unique needs of this population of patients. The majority of older adults with cancer are, and will continue to be, treated by oncologists. Currently clinicians caring for patients with cancer receive little to no formal training in caring for older adults, resulting in gaps in knowledge as well as a lack of confidence when treating older adults with cancers. Key strategies to accelerate the uptake and impact of educational initiatives to address this gap include the use of effective educational strategies, broad dissemination of educational material that is freely available, and the integration of geriatric oncology topics into teaching, curriculum, assessments and exams.
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Affiliation(s)
- Tina Hsu
- Department of Medical Oncology, The Ottawa Hospital Cancer Centre, 501 Smyth Rd., Ottawa, ON, K1H 8L6, Canada.
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