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Drury A, Boland V, Dowling M. Patient-Reported Outcome and Experience Measures in Advanced Nursing Practice: What Are Key Considerations for Implementation and Optimized Use? Semin Oncol Nurs 2024; 40:151632. [PMID: 38658204 DOI: 10.1016/j.soncn.2024.151632] [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: 01/28/2024] [Revised: 03/10/2024] [Accepted: 03/17/2024] [Indexed: 04/26/2024]
Abstract
OBJECTIVE To discuss the opportunities and challenges of implementing patient-reported outcome measures (PROMs) and patient-reported experience measures (PREMs) within advanced practice nursing services in cancer care. METHODS This discussion paper has been informed by an environmental scan of evidence from systematic reviews and primary studies evaluating the use and implementation of PROMs and PREMs. Literature from the contexts of cancer and chronic disease, including nursing and multidisciplinary supportive care literature, has been included. RESULTS Advanced practice nurses are well-positioned to evaluate and respond to PROMs and PREMs data; several studies have highlighted improved patient outcomes concerning quality of life, symptom distress, and functional status within nurse-led services. Nevertheless, the implementation of PROMs and PREMs in cancer care and nurse-led services is variable. Previous studies have highlighted implementation challenges, which can hinder comparability and generalizability of PROMs and PREMs instruments. Advanced practice nurses should consider these challenges, including ways to use standardized PROM instruments. Electronic PROMs, while efficient, may exclude individuals at risk of inequity. Complex, lengthy, and frequent administration of PROMs may also overburden people living with or after cancer, with people affected by cancer expressing preference for flexible use in some studies. Therefore, the involvement of people affected by cancer in planning for PROMs/PREMs implementation may overcome this challenge. Finally, organizational considerations in implementation should address financial investments, including initial costs for technology and training and consideration of the operationalization of PROMs within existing infrastructure for the seamless utilization of PROMs data. CONCLUSION Despite the potential of advanced practice nursing services to enhance patient-reported outcomes and experiences, variability in the implementation of PROMs and PREMs poses challenges. Use of validated measures, electronic or paper-based instruments, and the preferences of people affected by cancer for the use of PROMs and PREMs must be carefully considered in consultation with end users for successful implementation. IMPLICATIONS FOR PRACTICE In planning for the implementation of PROMs and PREMs within nurse-led services, implementation risks may be mitigated through establishing clear guidelines for their use, investment in the development of the required infrastructure, user education, and rigorous implementation processes, including patient involvement in PROMs/PREMs selection.
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Affiliation(s)
- Amanda Drury
- Associate Professor in General Nursing, School of Nursing, Psychotherapy and Community Health, Dublin City University, Glasnevin, Dublin, Ireland.
| | - Vanessa Boland
- Assistant Professor in General Nursing, School of Nursing & Midwifery, Faculty of Health Sciences, Trinity College Dublin, Dublin, Ireland
| | - Maura Dowling
- Associate Professor, School of Nursing and Midwifery, University of Galway, Ireland
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Getie A, Ayalneh M, Aytenew TM, Bimerew M, Wondmieneh A. Attitude of nurses towards palliative care and its associated factors in Ethiopia, systematic review and meta-analysis. BMC Palliat Care 2024; 23:67. [PMID: 38454390 PMCID: PMC10921755 DOI: 10.1186/s12904-024-01402-w] [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: 12/30/2023] [Accepted: 02/28/2024] [Indexed: 03/09/2024] Open
Abstract
INTRODUCTION Palliative care significantly improves the distressing symptoms of patients, especially those with cancer, heart disease, renal disease, and liver disease. The need for palliative care is increasing worldwide due to the growing burden of chronic disease. Nurses with an unfavorable attitude towards palliative care cannot skillfully assess the patient's needs, do not communicate effectively, and do not address the patient's problems adequately. Therefore, this study was aimed to assess the nurse's level of attitude towards palliative care in Ethiopia. METHODS Several databases were searched to find available articles. Microsoft Excel was used to extract and sort the data before it was exported to STATA/MP 17.0 for analysis. A weighted inverse variance random-effects model with a 95% confidence interval was employed to pool the data. Egger's test and Cochrane I2 statistics were used to assess heterogeneity and publication bias, respectively. Subgroup analysis was carried out to identify the source of heterogeneity. A log-odds ratio was employed to show the relationship between nurses' level of attitude towards palliative care and its related factors. P-value less than 0.05 was considered statistically significant. RESULT In Ethiopia, the pooled prevalence of favorable attitudes of nurses towards palliative care was 66.13% (95% CI: 54.00-78.27). The highest percentage of favorable attitudes towards palliative care among nurses was found in research studies done in Addis Ababa (80.31%; 95% CI: 72.00-88.63). Training on palliative care was significantly associated with the level of a nurse's attitude towards palliative care. Therefore, nurses who received palliative care training had a 2.5 times higher chance of having a favorable attitude towards palliative care than nurses who did not receive training on palliative care (AOR = 2.55; 95% CI: 2.28-2.82). CONCLUSION One-third of nurses had unfavorable attitude towards palliative care. Nurses who took palliative care training had a more favorable attitude than nurses who did not take palliative care training. Routine palliative care training is needed for nurses to improve their level of attitude towards palliative care.
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Affiliation(s)
- Addisu Getie
- Department of Nursing, College of Medicine and Health Sciences, Debre Markos University, Debre Markos, Ethiopia.
| | - Manay Ayalneh
- Department of Nursing, College of Medicine and Health Sciences, Injibara University, Injibara, Ethiopia
| | - Tigabu Munye Aytenew
- Department of Nursing, College of Medicine and Health Sciences, Debre Tabour University, Debre Tabour, Ethiopia
| | - Melaku Bimerew
- Department of Nursing, College of Medicine and Health Sciences, Injibara University, Injibara, Ethiopia
| | - Adam Wondmieneh
- Department of Nursing, College of Medicine and Health Sciences, Injibara University, Injibara, Ethiopia
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Chawak S, Chittem M, Dhillon H, Huligol N, Butow P. Development of a question prompt list for Indian cancer patients receiving radiation therapy treatment and their primary family caregivers. Psychooncology 2024; 33:e6295. [PMID: 38282221 DOI: 10.1002/pon.6295] [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: 08/01/2023] [Revised: 12/08/2023] [Accepted: 01/07/2024] [Indexed: 01/30/2024]
Abstract
AIM We aimed to develop two question prompt lists (QPLs), one for Indian cancer patients undergoing radiation therapy and the second for their primary family caregivers. METHODS The study comprised three phases: (1) qualitative interviews with patients (n = 65) and PFCs (n = 39) to identify their information needs, queries and concerns regarding RT; (2) development of draft QPLs using conventional content analysis and translation into Hindi and Marathi using European Organisation Research and Treatment of Cancer guidelines; and, (3) A readability analysis, and acceptability study with patients (n = 22), PFCs (n = 26) and Radiation Oncology (RO) staff (n = 20) exploring barriers to QPL implementation. RESULTS AND DISCUSSION Analysis in Phase I identified questions patients and PFCs asked or wanted to ask their physician. A list of 125 and 136 questions were generated for patients and PFCs, respectively. After five iterations, the draft QPLs were finalised, translated, and back-translated from English into Hindi and Marathi (Phase II). In Phase III, most patients and PFCs reported the QPLs were easy to read, they did not find it difficult to ask the questions, and the questions were not emotionally upsetting. Conversely, RO staff reported concerns that patients may find it difficult to discuss the questions with their physician. CONCLUSION The study highlights the need to empower patients and PFCs to ask questions and for staff to feel comfortable answering them. Implementing physician-endorsed QPLs could achieve these aims.
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Affiliation(s)
- Shweta Chawak
- Department of Liberal Arts, Indian Institute of Technology Hyderabad, Hyderabad, India
- Jindal School of Psychology and Counselling, O P Jindal Global University, Haryana, India
| | - Mahati Chittem
- Department of Liberal Arts, Indian Institute of Technology Hyderabad, Hyderabad, India
| | - Haryana Dhillon
- Centre for Medical Psychology & Evidence-based, Decision-making, School of Psychology, The University of Sydney, Sydney, New South Wales, Australia
| | - Nagraj Huligol
- Department of Radiation Oncology, Dr Balabhai Nanavati Hospital, Mumbai, India
| | - Phyllis Butow
- Centre for Medical Psychology & Evidence-based, Decision-making, School of Psychology, The University of Sydney, Sydney, New South Wales, Australia
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Ginsburg O, Vanderpuye V, Beddoe AM, Bhoo-Pathy N, Bray F, Caduff C, Florez N, Fadhil I, Hammad N, Heidari S, Kataria I, Kumar S, Liebermann E, Moodley J, Mutebi M, Mukherji D, Nugent R, So WKW, Soto-Perez-de-Celis E, Unger-Saldaña K, Allman G, Bhimani J, Bourlon MT, Eala MAB, Hovmand PS, Kong YC, Menon S, Taylor CD, Soerjomataram I. Women, power, and cancer: a Lancet Commission. Lancet 2023; 402:2113-2166. [PMID: 37774725 DOI: 10.1016/s0140-6736(23)01701-4] [Citation(s) in RCA: 21] [Impact Index Per Article: 21.0] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/01/2022] [Revised: 06/27/2023] [Accepted: 08/11/2023] [Indexed: 10/01/2023]
Affiliation(s)
- Ophira Ginsburg
- Centre for Global Health, US National Cancer Institute, Rockville, MD, USA.
| | | | | | | | - Freddie Bray
- International Agency for Research on Cancer, Lyon, France
| | - Carlo Caduff
- Department of Global Health and Social Medicine, King's College London, London, UK
| | - Narjust Florez
- Dana-Farber Cancer Institute, Boston, MA, USA; Harvard Medical School, Boston, MA, USA
| | | | - Nazik Hammad
- Department of Medicine, Division of Hematology-Oncology, St. Michael's Hospital, University of Toronto, Canada; Department of Oncology, Queens University, Kingston, Canada
| | - Shirin Heidari
- GENDRO, Geneva, Switzerland; Gender Centre, Geneva Graduate Institute, Geneva, Switzerland
| | - Ishu Kataria
- Center for Global Noncommunicable Diseases, RTI International, New Delhi, India
| | - Somesh Kumar
- Jhpiego India, Johns Hopkins University Affiliate, Baltimore, MD, USA
| | - Erica Liebermann
- University of Rhode Island College of Nursing, Providence, RI, USA
| | - Jennifer Moodley
- Cancer Research Initiative, Faculty of Health Sciences, School of Public Health and Family Medicine, and SAMRC Gynaecology Cancer Research Centre, University of Cape Town, Cape Town, South Africa
| | - Miriam Mutebi
- Department of Surgery, Aga Khan University, Nairobi, Kenya
| | - Deborah Mukherji
- Faculty of Medicine, American University of Beirut, Beirut, Lebanon; Clemenceau Medical Center Dubai, Dubai, United Arab Emirates
| | - Rachel Nugent
- Center for Global Noncommunicable Diseases, RTI International, Durham, NC, USA; Department of Global Health, University of Washington, Seattle, WA, USA
| | - Winnie K W So
- The Nethersole School of Nursing, Faculty of Medicine, The Chinese University of Hong Kong, New Territories, Hong Kong Special Administrative Region, China
| | - Enrique Soto-Perez-de-Celis
- Department of Geriatrics, National Institute of Medical Science and Nutrition Salvador Zubiran, Mexico City, Mexico
| | | | - Gavin Allman
- Center for Global Noncommunicable Diseases, RTI International, Durham, NC, USA
| | - Jenna Bhimani
- Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - María T Bourlon
- Department of Hemato-Oncology, National Institute of Medical Science and Nutrition Salvador Zubiran, Mexico City, Mexico
| | - Michelle A B Eala
- College of Medicine, University of the Philippines, Manila, Philippines; Department of Radiation Oncology, University of California Los Angeles, Los Angeles, CA, USA
| | | | - Yek-Ching Kong
- Faculty of Medicine, Universiti Malaya, Kuala Lumpur, Malaysia
| | - Sonia Menon
- Cochrane Hepato-Biliary Group, Copenhagen Trial Unit, Centre for Clinical Intervention Research, The Capital Region, Copenhagen University Hospital-Rigshospitalet, Copenhagen, Denmark
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Piazza M, Drury A. An integrative review of adult cancer patients' experiences of nursing telephone and virtual triage systems for symptom management. Eur J Oncol Nurs 2023; 67:102428. [PMID: 37952276 DOI: 10.1016/j.ejon.2023.102428] [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: 06/15/2023] [Revised: 09/21/2023] [Accepted: 09/29/2023] [Indexed: 11/14/2023]
Abstract
PURPOSE Telephone and virtual triage services are becoming increasingly common in ambulatory oncology settings. Few studies have evaluated their implementation from the perspective of service users. This study aims to evaluate the experiences of engaging with nurse-delivered telephone and virtual triage systems for symptom management among people undergoing cancer treatment. METHODS An integrative review was undertaken. MEDLINE, CINAHL, PsycInfo, Academic Search Complete and Scopus were systematically searched. Twelve publications met the inclusion criteria, and data related to cancer patients' perceptions of the triage process were extracted and analysed. RESULTS Telephone-based (n=7), app-based (n=5) and video-based teleconferencing (n=2) triage systems were evaluated positively overall, enhancing ease of health system navigation, avoidance of emergency department for consultation, and the information, reassurance and support provided to support self-management of symptoms. However, several factors influenced the users' engagement with triage services, including confidence to articulate symptoms, limited opening hours, waiting times for initial triage or follow-up and digital literacy. Collectively, these factors contributed to delayed reporting or under-reporting of symptoms, undermining the potential impact of services. Studies included variable reporting of intervention characteristics, including the qualification of nurses delivering and leading services. CONCLUSIONS Future evaluations of triage services must give greater consideration to the characterisation of interventions to ensure transferability, including nursing roles and qualifications. To ensure effective intervention and optimal supportive care for symptom management, patients must be prepared to engage triage services early. Future evaluations must ensure the impact of digital literacy on engagement with, and experience of, virtual triage is investigated.
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Affiliation(s)
- Martina Piazza
- Morgagni-Pierantoni Hospital (AUSL Romagna), 34, via Carlo Forlanini, Forlì, FC, 47121, Italy.
| | - Amanda Drury
- School of Nursing, Psychotherapy and Community Health, Dublin City University, Glasnevin, Dublin, 9, Ireland.
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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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Liebermann E, Sego R, Vieira D, Cheng Q, Xu B, Arome M, Azevedo A, Ginsburg O, So WK. Roles and activities of nurses in cancer prevention and early detection in low- and middle-income countries: A scoping review. Asia Pac J Oncol Nurs 2023; 10:100242. [PMID: 37435597 PMCID: PMC10331398 DOI: 10.1016/j.apjon.2023.100242] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2023] [Accepted: 05/08/2023] [Indexed: 07/13/2023] Open
Abstract
Objective Nurses play a crucial role in cancer control. Prior reviews presented the effectiveness of nursing interventions such as tobacco cessation counseling and cervical cancer screening but did not focus on low- and middle-income countries (LMICs). This scoping review addresses a gap in the literature by describing the roles and activities of nurses in cancer prevention and early detection in LMICs. Methods Following Arksey and O'Malley's scoping review framework, we searched seven databases using subject headings and keywords from 1990 to January 2021 and updated in April 2022. The reference lists of relevant studies were also searched. Two reviewers independently screened the relevance of studies through Rayyan, assessed full text articles, and extracted data using a Google Form. Conflicts were resolved by a third reviewer. Results A total of 180 studies were included, representing all six World Health Organization regions and 48 LMICs. The largest number of studies were from the African region (n = 72), the Americas (n = 49), and South-East Asia region (n = 29). The main nursing roles featured were patient/community education (n = 113), history taking and cancer risk assessment (n = 63), performing screening exams (n = 136), care coordination (n = 57), and training other healthcare professionals (n = 9). Conclusions This scoping review provides a comprehensive picture of nurses' role in cancer prevention and early detection in LMICs, across all six World Health Organization regions. Additional cancer workforce data sources at the country level are needed to fully understand the activities of nurses in cancer prevention. Future research is also needed to measure the impact of nursing educational and other interventions in both primary and secondary cancer prevention.
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Affiliation(s)
- Erica Liebermann
- College of Nursing, University of Rhode Island, RINEC 350 Eddy Street, Rm 223, Providence, RI 02903, USA
| | - Ruth Sego
- Department of Nursing & Midwifery, Amref International University, Nairobi, Kenya
| | - Dorice Vieira
- NYU Health Sciences Library, NYU Grossman School of Medicine, New York, USA
| | - Qinqin Cheng
- The Chinese University of Hong Kong, Hong Kong, China
| | - Binbin Xu
- The Chinese University of Hong Kong, Hong Kong, China
| | - Maureen Arome
- School of Public Health, Moi University, Eldoret, Kenya
| | | | - Ophira Ginsburg
- Center for Global Health, National Cancer Institute, Bethesda, USA
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Petrova D, Pollán M, Garcia-Retamero R, Rodríguez-Barranco M, Catena A, Castillo Portellano L, Sánchez MJ. Cancer awareness in older adults: Results from the Spanish Onco-barometer cross-sectional survey. Int J Nurs Stud 2023; 140:104466. [PMID: 36871541 DOI: 10.1016/j.ijnurstu.2023.104466] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2022] [Revised: 02/08/2023] [Accepted: 02/09/2023] [Indexed: 02/17/2023]
Abstract
BACKGROUND About half of all cancers are diagnosed in adults older than 65, making them the age group at highest risk of developing this disease. Nurses from different specialties can support individuals and communities in the prevention and early detection of cancer and should be aware of the common knowledge gaps and perceived barriers among older adults. OBJECTIVES The goal of the current research was to investigate personal characteristics, perceived barriers, and beliefs related to cancer awareness in older adults, with a special focus on perceptions about the influence of cancer risk factors, knowledge of cancer symptoms, and anticipated help-seeking. DESIGN Descriptive cross-sectional study. PARTICIPANTS Participants were 1213 older adults (≥65 years old) from the representative national Onco-barometer survey conducted in 2020 in Spain. METHODS Questions on the perceived influence of cancer risk factors, knowledge of cancer symptoms, and the Spanish version of the Awareness and Beliefs about Cancer (ABC) questionnaire were administered in computer-assisted telephone interviews. RESULTS Knowledge of cancer risk factors and symptoms was strongly related to personal characteristics and was limited among males and older individuals. Respondents from lower socio-economic background recognized fewer cancer symptoms. Having personal or family history of cancer had opposite effects on cancer awareness: It was related to more accurate symptom knowledge but also to lower perceptions about the influence of risk factors and more delayed help-seeking. Anticipated help-seeking times were strongly influenced by perceived barriers to help-seeking and beliefs about cancer. Worry about wasting the doctor's time (48% increase, 95% CI [25%-75%]), about what the doctor might find (21% increase [3%-43%]) and not having enough time to go to the doctor (30% increase [5%-60%]) were related to more delayed help-seeking intentions. In contrast, beliefs that reflected higher perceived seriousness of a potential cancer diagnosis were related to shorter anticipated help-seeking times (19% decrease [5%-33%]). CONCLUSIONS These results suggest that older adults could benefit from interventions informing them about how to reduce their cancer risk and addressing emotional barriers and beliefs associated with help-seeking delays. Nurses can contribute to educating this vulnerable group and are in a unique position to address some barriers to help-seeking. STUDY REGISTRATION Not registered.
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Affiliation(s)
- Dafina Petrova
- Instituto de Investigación Biosanitaria ibs.GRANADA, Granada, Spain; Escuela Andaluza de Salud Pública (EASP), Granada, Spain; CIBER of Epidemiology and Public Health (CIBERESP), Madrid, Spain.
| | - Marina Pollán
- CIBER of Epidemiology and Public Health (CIBERESP), Madrid, Spain; National Center for Epidemiology, Health Institute Carlos III, Madrid, Spain
| | | | - Miguel Rodríguez-Barranco
- Instituto de Investigación Biosanitaria ibs.GRANADA, Granada, Spain; Escuela Andaluza de Salud Pública (EASP), Granada, Spain; CIBER of Epidemiology and Public Health (CIBERESP), Madrid, Spain
| | | | - Lucia Castillo Portellano
- Instituto de Investigación Biosanitaria ibs.GRANADA, Granada, Spain; University Hospital Virgen de las Nieves, Granada, Spain
| | - Maria-José Sánchez
- Instituto de Investigación Biosanitaria ibs.GRANADA, Granada, Spain; Escuela Andaluza de Salud Pública (EASP), Granada, Spain; CIBER of Epidemiology and Public Health (CIBERESP), Madrid, Spain
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9
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The future of cancer nursing in Europe: Addressing professional issues in education, research, policy and practice. Eur J Oncol Nurs 2023; 63:102271. [PMID: 36827835 DOI: 10.1016/j.ejon.2023.102271] [Citation(s) in RCA: 12] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2022] [Accepted: 01/22/2023] [Indexed: 01/26/2023]
Abstract
Cancer nursing has evolved to meet the demands of rising cancer incidence, newer and more complex treatment options, and the emergence of specialist roles supporting patients from pre-diagnosis, through treatment, survivorship and end of life care. Nurses are involved in direct and in-direct care of people at risk of, and living with and after cancer in diverse contexts. As a result, nurses are positioned to have a significant influence on the processes and outcomes of cancer care, through education, research, policy, practice and leadership. However, nursing and cancer care face challenges, arising from workforce shortages, under-investment in services and under-representation in decision-making. This paper discusses the evolution of cancer nursing across education, policy, research, profession and practice, and sets an agenda for innovation and disruption across these domains to ensure sustainability of cancer care services and care for people living with and after cancer. We argue for the continued advancement of cancer nursing with critical focus on identifying and addressing inequities in role recognition and access to specialist cancer nursing education throughout Europe. Partnership, exchange of learning, and co-design will be central to progressing education, evidence and policy to support future growth in the cancer nursing workforce and embed cancer nurses in research and policy setting at local, national and international levels.
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Christiansen K, Buswell L, Fadelu T. A Systematic Review of Patient Education Strategies for Oncology Patients in Low- and Middle-Income Countries. Oncologist 2022; 28:2-11. [PMID: 36269170 PMCID: PMC9847564 DOI: 10.1093/oncolo/oyac206] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2022] [Accepted: 09/08/2022] [Indexed: 02/06/2023] Open
Abstract
INTRODUCTION Patient education can facilitate early cancer diagnosis, enhance treatment adherence, and improve outcomes. While there is increasing cancer burden in low- and middle-income countries (LMICs), there is little research to inform successful patient education in these regions. This systematic review summarizes the existing literature on oncology education and evaluation strategies in LMICs, identifies best practices, and highlights areas which require further investigation. METHODS The review was conducted using PRISMA guidelines and an a priori protocol. Four databases (Ovid Medline, Cochrane Libraries, Embase, and Cabi) were searched in December 2021. Two independent reviewers evaluated studies for inclusion. Using a coded data extraction form, information was collected about the study site, intervention characteristics, and evaluation methods. RESULTS Of the 2047 articles generated in the search, 77 met the inclusion criteria. Twenty-four countries were represented; only 6 studies (8%) were in low-income countries. The most common education methods included technology-based interventions (31, 40%) and visual pamphlets or posters (20, 26%). More than one education method was used in 57 (74%) studies. Nurses were the most frequent educators (25, 33%). An evaluation was included in 74 (96%) studies, though only 41 (55%) studies used a validated tool. Patient knowledge was the most common measured outcome in 35 (47%) studies. CONCLUSIONS There is limited empiric research on oncology patient education in LMICs. The available data show heterogeneity in education approaches and gaps in evaluation. Further research to determine successful patient education and evaluation strategies is urgently needed to improve treatment cancer outcomes in LMICs.
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Affiliation(s)
| | - Lori Buswell
- Division of Population Sciences, Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA, USA
| | - Temidayo Fadelu
- Corresponding author: Temidayo Fadelu, MD, MPH, Dana-Farber Cancer Institute, 450 Brookline Avenue, MA-1B-17, Boston, MA 02215, USA. Tel: +1 617 632 6401;
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11
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Sabourin KR, Borok M, Mawhinney S, Matimba M, Jaji F, Fiorillo S, Chifamba DD, Muserere C, Mashiri B, Bhodheni C, Gambiza P, Mandidewa R, Mutimuri M, Gudza I, Mulvahill M, Moore CM, Kutner JS, Simões EAF, Campbell TB. Evaluation of a training intervention to improve cancer care in Zimbabwe: Strategies to Improve Kaposi Sarcoma Outcomes (SIKO), a prospective community-based stepped-wedge cluster randomized trial. J Int AIDS Soc 2022; 25:e25998. [PMID: 36028920 PMCID: PMC9418419 DOI: 10.1002/jia2.25998] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2021] [Accepted: 07/27/2022] [Indexed: 12/02/2022] Open
Abstract
Introduction Most Zimbabweans access medical care through tiered health systems. In 2013, HIV care was decentralized to primary care clinics; while oncology care remained centralized. Most persons in Zimbabwe with Kaposi sarcoma (KS) are diagnosed late in their disease, and the prognosis is poor. Little is known about whether educational interventions could improve KS outcomes in these settings. Methods Interventions to improve KS detection and management were evaluated at eight Zimbabwe primary care sites (four rural/four urban) that provided HIV care. Interventions included a standardized KS clinical evaluation tool, palliative care integration, standardized treatment and improved consultative services. Interventions were implemented between February 2013 and January 2016 using a randomized stepped‐wedge cluster design. Sites were monitored for KS diagnosis rates and KS outcomes, including early diagnosis (T0 vs. T1 tumour stage), participant retention and mortality. Analyses controlled for within‐clinic correlations. Results A total of 1102 persons with suspected KS (96% HIV positive) were enrolled: 47% incident (new diagnosis), 20% prevalent (previous diagnosis) and 33% determined as not KS. Early (T0) diagnosis increased post‐intervention, though not significant statistically (adjusted odds ratio [aOR] = 1.48 [95% confidence interval (95% CI): 0.66–3.79], p = 0.37). New KS diagnosis rates increased 103% (95% CI: 11–273%), p = 0.02) post‐intervention; although paired with an increased odds of incorrectly diagnosing KS (aOR = 2.08 [95% CI: 0.33–3.24], p = 0.001). Post‐intervention, non‐significant decreases in 90‐day return rates (adjusted hazard ratio [aHR] = 0.69 [95% CI: 0.38–1.45], p = 0.21) and survival (aHR = 1.36 [95% CI: 0.85–2.20], p = 0.20) were estimated. Conclusions KS training interventions at urban and rural Zimbabwe decentralized primary care clinics significantly increased overall and incorrect KS diagnosis rates, but not early KS diagnosis rates, 90‐day return rates or survival.
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Affiliation(s)
| | - Margaret Borok
- Faculty of Medicine and Health Sciences, University of Zimbabwe, Harare, Zimbabwe
| | | | - Maxwell Matimba
- University of Zimbabwe Clinical Research Centre, Harare, Zimbabwe
| | - Francis Jaji
- University of Zimbabwe Clinical Research Centre, Harare, Zimbabwe
| | - Suzanne Fiorillo
- University of Colorado School of Medicine, Aurora, Colorado, USA
| | | | | | | | | | - Patricia Gambiza
- University of Zimbabwe Clinical Research Centre, Harare, Zimbabwe
| | | | - Mercia Mutimuri
- University of Zimbabwe Clinical Research Centre, Harare, Zimbabwe
| | - Ivy Gudza
- Faculty of Medicine and Health Sciences, University of Zimbabwe, Harare, Zimbabwe
| | | | - Camille M Moore
- National Jewish Health, Denver, Colorado, USA.,Colorado School of Public Health, Aurora, Colorado, USA
| | - Jean S Kutner
- University of Colorado School of Medicine, Aurora, Colorado, USA
| | - Eric A F Simões
- University of Colorado School of Medicine, Aurora, Colorado, USA.,Colorado School of Public Health, Aurora, Colorado, USA
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12
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Fadelu TA, Buswell L, Anderson BO. Improving Adherence to Adjuvant Endocrine Therapy in Sub-Saharan Africa: Challenges and Innovative Nurse-Driven Solutions. Oncologist 2022; 27:607-609. [PMID: 35699645 PMCID: PMC9355825 DOI: 10.1093/oncolo/oyac112] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2022] [Accepted: 05/11/2022] [Indexed: 11/21/2022] Open
Affiliation(s)
- Temidayo A Fadelu
- Center for Global Cancer Medicine, Dana-Farber Cancer Institute, Boston, MA, USA.,Harvard Medical School, Boston, MA, USA
| | - Lori Buswell
- Center for Global Cancer Medicine, Dana-Farber Cancer Institute, Boston, MA, USA
| | - Benjamin O Anderson
- World Health Organization, Geneva, Switzerland.,Department of Surgery and Global Health-Medicine, University of Washington, Seattle, WA, USA
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13
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Chen L, Li XH, Pan X, Pan QN, Huang HQ, Tao PY, Li GY, Ma JH, Huang JC. Nurses' knowledge, attitudes, and willingness to practice hospice care: An analysis of influencing factors. PLoS One 2022; 17:e0259647. [PMID: 35202415 PMCID: PMC8870562 DOI: 10.1371/journal.pone.0259647] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2021] [Accepted: 10/23/2021] [Indexed: 11/22/2022] Open
Abstract
Background Hospice care is a multidisciplinary approach that focused on patients’ quality of life, and nurses allocate more of their time with patients and patients’ families than those nurses working in other disciplines. Nurses’ knowledge of and attitudes toward hospice care can affect the quality of hospice care. At present, China’s hospice care institutions are suffering from an obvious shortage of nursing staff. Since clinical nurses are the main force behind the future provision of hospice care, their knowledge of, attitudes and willingness to practice can greatly promoted the growth of hospice care, however, available data on clinical nurses’ willingness to practice hospice care are limited. Methods A cross-sectional descriptive study design was employed to collect data from 1833 nurses working in tertiary or secondary general hospitals in Guangxi, China. We examined nurses’ demographic characteristics and scores on the Chinese version of the hospice care knowledge scale, the Chinese version of the Bradley Attitude Assessment Questionnaire, and a brief quiz concerning their willingness to practice hospice care in the future. Descriptive, single factor, multiple regression analyses and logistic regression analyses were used for data analysis. Results Nurses displayed moderate mean scores for both knowledge of and attitudes, and only 505 (27.5%) nurses expressed their willingness to practice hospice care, 1329 (72.5%) of nurses sampled expressed their unwillingness or uncertainty. Multivariate regression analyses showed that education, professional qualification, monthly income, whether they had been trained in hospice care, and willingness to practice hospice care were the main influencing factors of knowledge; education, whether they lived with someone aged >60 years, and whether they had been trained in hospice care were main factors influencing attitudes. Additionally, logistic regression analyses showed that hospice care knowledge, whether they had been trained in hospice care, and whether they had clinical experience affected the nurses’ willingness to practice hospice care. Conclusion This study highlighted a knowledge gap and moderate attitudes toward hospice care among nurses, and most nurses did not prefer to practice hospice care. Having been trained in hospice care was the main common factor of nurses’ knowledge of, attitudes toward, and willingness to practice hospice care in the future, indicating the necessity to provide nurses with more targeted hospice care training.
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Affiliation(s)
- Lin Chen
- Department of Nursing, The Second Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi, China
| | - Xiao-Hong Li
- Department of Nursing, The Second Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi, China
| | - Xiao Pan
- Department of Nursing, The Second Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi, China
| | - Qi-Ni Pan
- Department of Nursing, The Second Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi, China
| | - Hui-Qiao Huang
- Department of Nursing, The Second Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi, China
- * E-mail: (HQH); (PYT)
| | - Pin-Yue Tao
- Department of Nursing, The Second Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi, China
- * E-mail: (HQH); (PYT)
| | - Gao-Ye Li
- Department of Nursing, The First Affiliated Hospital of Guangxi Medical University, Nanning, Guxngxi, China
| | - Jin-Hui Ma
- Department of Nursing, The Fifth People’s Hospital of Chengdu, Chengdu, Sichuan, China
| | - Jing-Can Huang
- Department of Nursing, The Affiliated Hospital of Guilin Medical University, Guilin, Guangxi, China
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14
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The Global Power of Oncology Nurses in low- and middle-income countries. Asia Pac J Oncol Nurs 2022; 9:131-132. [PMID: 35136829 PMCID: PMC8813188 DOI: 10.1016/j.apjon.2022.01.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2022] [Accepted: 01/26/2022] [Indexed: 11/30/2022] Open
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15
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Palliative care practices among nurses at Cape Coast Teaching Hospital, Ghana: A cross-sectional study. INTERNATIONAL JOURNAL OF AFRICA NURSING SCIENCES 2022. [DOI: 10.1016/j.ijans.2022.100454] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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16
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Uwayezu MG, Nikuze B, Maree JE, Buswell L, Fitch MI. Competencies for Nurses Regarding Psychosocial Care of Patients With Cancer in Africa: An Imperative for Action. JCO Glob Oncol 2022; 8:e2100240. [PMID: 35044834 PMCID: PMC8789211 DOI: 10.1200/go.21.00240] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2021] [Revised: 10/19/2021] [Accepted: 12/17/2021] [Indexed: 12/28/2022] Open
Abstract
Psychosocial care is considered an important component of quality cancer care. Individuals treated for cancer can experience biologic or physical, emotional, spiritual, and practical consequences (eg, financial), which have an impact on their quality of living. With the establishment of cancer centers in Africa, there is growing advocacy regarding the need for psychosocial care, given the level of unmet supportive care needs and high emotional distress reported for patients. Nurses are in an ideal position to provide psychosocial care to patients with cancer and their families but must possess relevant knowledge and skills to do so. Across Africa, nurses are challenged in gaining the necessary education for psychosocial cancer care as programs vary in the amount of psychosocial content offered. This perspective article presents competencies regarding psychosocial care for nurses caring for patients with cancer in Africa. The competencies were adapted by expert consensus from existing evidenced-based competencies for oncology nurses. They are offered as a potential basis for educational program planning and curriculum development for cancer nursing in Africa. Recommendations are offered regarding use of these competencies by nursing and cancer program leaders to enhance the quality of care for African patients with cancer and their family members. The strategies emphasize building capacity of nurses to engage in effective delivery of psychosocial care for individuals with cancer and their family members.
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Affiliation(s)
- Marie Goretti Uwayezu
- School of Nursing and Midwifery, College of Medicine and Health Sciences, University of Rwanda, Kigali, Rwanda
| | - Bellancille Nikuze
- School of Nursing and Midwifery, College of Medicine and Health Sciences, University of Rwanda, Kigali, Rwanda
| | - Johanna E. Maree
- Department of Nursing Education, University of the Witwatersrand, Johannesburg & Netcare Education, Johannesburg, South Africa
| | - Lori Buswell
- Dana-Farber Cancer Institute, Boston, MA
- Partners in Health, Boston, MA
| | - Margaret I. Fitch
- School of Nursing and Midwifery, College of Medicine and Health Sciences, University of Rwanda, Kigali, Rwanda
- Bloomberg Faculty of Nursing, University of Toronto, Toronto, Ontario, Canada
- Rory Meyer's College of Nursing, New York University, New York, NY
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17
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Eustace RW. A Theory of Family Health: A Neuman's Systems Perspective. Nurs Sci Q 2021; 35:101-110. [PMID: 34939487 DOI: 10.1177/08943184211051365] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Understanding the social contexts of health and healthcare delivery from a multilevel thinking perspective offers nurses an opportunity to prioritize research and interventions that address communicable and noncommunicable diseases across the care continuum. The content of this paper explains the development of a multilevel theory of family health for Sub-Saharan families affected by the burden of breast cancer guided by Neuman's Systems Model. Implications for knowledge development in family nursing practice and research in the region are discussed.
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18
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Rubagumya F, Costas-Chavarri A, Manirakiza A, Murenzi G, Uwinkindi F, Ntizimira C, Rukundo I, Mugenzi P, Rugwizangoga B, Shyirambere C, Urusaro S, Pace L, Buswell L, Ntirenganya F, Rudakemwa E, Fadelu T, Mpunga T, Shulman LN, Booth CM. State of Cancer Control in Rwanda: Past, Present, and Future Opportunities. JCO Glob Oncol 2021; 6:1171-1177. [PMID: 32701365 PMCID: PMC7392739 DOI: 10.1200/go.20.00281] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
Rwanda is a densely populated low-income country in East Africa. Previously considered a failed state after the genocide against the Tutsi in 1994, Rwanda has seen remarkable growth over the past 2 decades. Health care in Rwanda is predominantly delivered through public hospitals and is emerging in the private sector. More than 80% of patients are covered by community-based health insurance (Mutuelle de Santé). The cancer unit at the Rwanda Biomedical Center (a branch of the Ministry of Health) is responsible for setting and implementing cancer care policy. Rwanda has made progress with human papillomavirus (HPV) and hepatitis B vaccination. Recently, the cancer unit at the Rwanda Biomedical Center launched the country’s 5-year National Cancer Control Plan. Over the past decade, patients with cancer have been able to receive chemotherapy at Butaro Cancer Center, and recently, the Rwanda Cancer Center was launched with 2 linear accelerator radiotherapy machines, which greatly reduced the number of referrals for treatment abroad. Palliative care services are increasing in Rwanda. A cancer registry has now been strengthened, and more clinicians are becoming active in cancer research. Despite these advances, there is still substantial work to be done and there are many outstanding challenges, including the need to build capacity in cancer awareness among the general population (and shift toward earlier diagnosis), cancer care workforce (more in-country training programs are needed), and research.
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Affiliation(s)
- Fidel Rubagumya
- Department of Oncology, Rwanda Military Hospital, Kigali, Rwanda.,University of Global Health Equity, Burera, Rwanda
| | | | | | - Gad Murenzi
- Department of Research, Rwanda Military Hospital, Kigali, Rwanda
| | | | | | - Ivan Rukundo
- Department of Radiology, Rwanda Military Hospital, Kigali, Rwanda
| | | | - Belson Rugwizangoga
- Department of Pathology, Kigali University Teaching Hospital, Kigali, Rwanda
| | | | - Sandra Urusaro
- Department of Oncology, Inshuti Mu Buzima, Kigali, Rwanda
| | - Lydia Pace
- Division of Women's Health, Brigham and Women's Hospital, Boston, MA
| | - Lori Buswell
- Department of Oncology, Dana-Farber Cancer Institute, Boston, MA
| | | | | | - Temidayo Fadelu
- Department of Oncology, Dana-Farber Cancer Institute, Boston, MA
| | | | - Lawrence N Shulman
- Center for Global Cancer Medicine, University of Pennsylvania, Philadelphia, PA
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19
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Mezgebu E, Anwarali S, Durañona M, Challinor J. Pediatric Oncology Nursing Research in Low- and Middle-Income Countries: Exemplars from Three Regions. Semin Oncol Nurs 2021; 37:151168. [PMID: 34148741 DOI: 10.1016/j.soncn.2021.151168] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
OBJECTIVE This study examined the status of pediatric oncology nursing research in three low- and middle-income countries (LMICs) as examples across three World Health Organization regions: East Africa, Eastern Mediterranean region, and Latin America. DATA SOURCES Published literature was identified from Google Scholar, PubMed, Scielo, Virtual Health Library, and reference lists of some articles. CONCLUSION The experiences of the three LMIC pediatric oncology nurses illustrate the situation of nurse research in their setting and identify relevant published literature. The authors highlight the challenges for nurses to conduct research (eg, lack of training, mentors, funding, and opportunities). Local evidence to inform nursing practice in LMICs is needed. Recommendations for ameliorating the situation include increased advanced practice nurse education, physician and hospital support, funding, and protected time. IMPLICATIONS FOR NURSING PRACTICE Pediatric oncology nursing practice is culturally and context-driven and requires locally acquired evidence to support best practices. Only when sufficient, sustainable, and local nursing research training and education is available in LMICs, will this evidence be generated. Nursing research training (eg, master's and PhD programs), funding, and protected time are three key steps to guide and motivate staff nurses as well as academic nurses to participate in research that informs the care of children and adolescents with cancer across all countries and not only those with significant resources.
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Affiliation(s)
| | - Shenila Anwarali
- Pediatric Oncology Department, Indus Hospital, Karachi, Pakistan
| | | | - Julia Challinor
- School of Nursing, University of California San Francisco, San Francisco, CA.
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20
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Oti NOO, de Villiers M, Adejumo P, Okumu R, Maliti B, Elkateb N, Hammad N. Strengthening of oncology nursing education and training in Africa in the year of the nurse and midwife: addressing the challenges to improve cancer control in Africa. Ecancermedicalscience 2021; 15:1209. [PMID: 33912234 PMCID: PMC8057781 DOI: 10.3332/ecancer.2021.1209] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2020] [Indexed: 12/24/2022] Open
Abstract
The Cancer burden in Africa is increasing. Nurses play a pivotal role in health care systems and find themselves in a key position to engage with patients, communities and other health professionals to address disparities in cancer care and work towards achieving cancer control in Africa. The rapidly evolving nature of cancer care requires a highly skilled and specialised oncology nurse to either provide clinical care and/or conduct research to improve evidence-based practice. Although Africa has been slow to respond to the need for trained oncology nurses, much has been done over the past few years. This article aims to provide an update of Oncology nursing education and training in Africa with specific focus on South Africa, Ghana, Nigeria, Kenya, Zambia and Egypt. Mapping oncology nursing education and training in Africa in 2020, the International Year of the Nurse and the Midwife, provides an opportunity to leverage on the essential roles of the oncology nurse and commit to an agenda that will drive and sustain progress to 2030 and beyond.
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Affiliation(s)
- Naomi Oyoe Ohene Oti
- National Radiotherapy, Oncology and Nuclear Medicine Centre, Guggisberg Avenue, Harley Street, PO Box KB369, Korle Bu–Accra, Ghana
- Accra Cancer Registry, Guggisberg Avenue, Harley Street, PO Box KB369, Korle Bu–Accra, Ghana
- African Organisation for Research and Training in Cancer, 1ST Floor, Birkdale 1 River Park, Gloucester Road, Mowbray, Cape Town, 7901, South Africa
- https://orcid.org/0000-0002-1433-0364
| | - Martjie de Villiers
- Adelaide Tambo School of Nursing Science, Building 5, Room 327, Staatsartillerie Road, Pretoria West, Private Bag x 680, South Africa
- Tshwane University of Technology, Building 5, Room 327, Staatsartillerie Road, Pretoria West, Private Bag x 680, South Africa
- https://orcid.org/0000-0002-88109144
| | - Prisca Adejumo
- African Organisation for Research and Training in Cancer, 1ST Floor, Birkdale 1 River Park, Gloucester Road, Mowbray, Cape Town, 7901, South Africa
- University of Ibadan, Oduduwa Road, Ibadan, 900001, Nigeria
- https://orcid.org/0000-0003-3065-8308
| | - Roselyne Okumu
- African Organisation for Research and Training in Cancer, 1ST Floor, Birkdale 1 River Park, Gloucester Road, Mowbray, Cape Town, 7901, South Africa
- Kenyatta National Hospital, PO Box 20723-00202, Nairobi, Kenya
- https://orcid.org/0000-0002-2459-8532
| | - Biemba Maliti
- African Organisation for Research and Training in Cancer, 1ST Floor, Birkdale 1 River Park, Gloucester Road, Mowbray, Cape Town, 7901, South Africa
- Cancer Disease Hospital PO Box 51337, Lusaka, 10101, Zambia
- Zambia Oncology Nurses Society, PO Box UTH73, Lusaka, 10101, Zambia
- https://orcid.org/0000-0002-2552-7031
| | - Nagwa Elkateb
- African Organisation for Research and Training in Cancer, 1ST Floor, Birkdale 1 River Park, Gloucester Road, Mowbray, Cape Town, 7901, South Africa
- National Cancer Institute, Kasr Eleini St. fom Elkhalig, Cairo, 1196, Egypt
- https://orcid.org/0000-0002-3961-1736
| | - Nazik Hammad
- African Organisation for Research and Training in Cancer, 1ST Floor, Birkdale 1 River Park, Gloucester Road, Mowbray, Cape Town, 7901, South Africa
- Queens University, 99 University Ave, Kingston, ON K7L 3N6, Canada
- https://orcid.org/0000-0003-3963-5815
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21
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Yates P, Charalambous A, Fennimore L, Nevidjon B, So WKW, Suh EE, Woodford E, Young A. Position statement on cancer nursing's potential to reduce the growing burden of cancer across the world. Support Care Cancer 2021; 29:3435-3437. [PMID: 33709188 DOI: 10.1007/s00520-021-06030-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Affiliation(s)
- Patsy Yates
- International Society of Nurses in Cancer Care, Vancouver, Canada.
- Faculty of Health, Queensland University of Technology, O Block, D Wing, Level 7, Kelvin Grove, Brisbane, Queensland, Australia.
| | - Andreas Charalambous
- European Oncology Nursing Society, Brussels, Belgium
- Cyprus University of Technology, Limassol, Cyprus
| | | | | | - Winnie K W So
- Asian Oncology Nursing Society, Seoul, Republic of Korea
- The Nethersole School of Nursing, The Chinese University of Hong Kong, Ma Liu Shui, Hong Kong
| | - Eunyoung E Suh
- Asian Oncology Nursing Society, Seoul, Republic of Korea
- College of Nursing, Research Institute of Nursing Science, Seoul National University, Seoul, South Korea
| | - Emma Woodford
- European Oncology Nursing Society, Brussels, Belgium
| | - Annie Young
- Multinational Association of Supportive Care in Cancer, Aurora, Canada
- University of Warwick, Coventry, England
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22
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Yates P, Charalambous A, Fennimore L, So WKW, Suh EE, Woodford E, Young A. Position statement on Cancer Nursing's potential to reduce the growing burden of cancer across the world. Eur J Oncol Nurs 2021; 50:101891. [PMID: 33583691 DOI: 10.1016/j.ejon.2020.101891] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2020] [Accepted: 12/16/2020] [Indexed: 12/09/2022]
Affiliation(s)
- Patsy Yates
- International Society of Nurses in Cancer Care, Canada; Queensland University of Technology, Australia.
| | - Andreas Charalambous
- European Oncology Nursing Society, Belgium; Cyprus University of Technology, Cyprus
| | | | - Winnie K W So
- Asian Oncology Nursing Society, Republic of Korea; The Nethersole School of Nursing, The Chinese University of Hong Kong, China
| | - Eunyoung E Suh
- Asian Oncology Nursing Society, Republic of Korea; College of Nursing, Research Institute of Nursing Science, Seoul National University, Republic of Korea
| | | | - Annie Young
- Multinational Association of Supportive Care in Cancer, Canada; University of Warwick, Coventry, UK
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23
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Haskins L, Esperance B, Olivier H, Buswell L. Clinical Nurse Educator Mentorship: Implementation at an Oncology Program in Rwanda. Clin J Oncol Nurs 2021; 25:100-103. [PMID: 33480873 DOI: 10.1188/21.cjon.100-103] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
A long-term partnership among the Butaro Cancer Center of Excellence (BCCOE) in Rwanda, Partners in Health (PIH)/Inshuti Mu Buzima, and Dana-Farber Cancer Institute (DFCI) supports the development of oncology nurses through a clinical nurse educator role. Two senior Rwandan oncology nurses at BCCOE were hired as nurse educators and were mentored by a PIH/DFCI oncology nurse educator using the accompaniment approach. The formalized mentorship process included long-term accompaniment for all educator projects spanning staff training, quality improvement, research, and clinical practice, as well as development of nurse educator competencies and creation of a repository of resources.
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24
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Yates P, Charalambous A, Fennimore L, Nevidjon B, So WKW, Suh EE, Woodford E, Young A. Position Statement on Cancer Nursing's Potential to Reduce the Growing Burden of Cancer across the World. Asia Pac J Oncol Nurs 2021; 8:107-109. [PMID: 33688557 PMCID: PMC7934595 DOI: 10.4103/2347-5625.308313] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2020] [Accepted: 12/05/2020] [Indexed: 12/24/2022] Open
Affiliation(s)
- Patsy Yates
- International Society of Nurses in Cancer Care, Queensland University of Technology, Queensland, Australia.,Faculty of Health, Queensland University of Technology, Queensland, Australia
| | - Andreas Charalambous
- European Oncology Nursing Society, Cyprus University of Technology, Limassol, Cyprus.,Department of Nursing, Cyprus University of Technology, Limassol, Cyprus
| | - Laura Fennimore
- Oncology Nursing Society, The Chinese University of Hong Kong, Hong Kong, China
| | - Brenda Nevidjon
- Oncology Nursing Society, The Chinese University of Hong Kong, Hong Kong, China
| | - Winnie K W So
- Asian Oncology Nursing Society, The Chinese University of Hong Kong, Hong Kong, China.,The Nethersole School of Nursing, The Chinese University of Hong Kong, Hong Kong, China
| | - Eunyoung E Suh
- Asian Oncology Nursing Society, The Chinese University of Hong Kong, Hong Kong, China.,College of Nursing, Research Institute of Nursing Science, Seoul National University, Seoul, Korea
| | - Emma Woodford
- European Oncology Nursing Society, Cyprus University of Technology, Limassol, Cyprus
| | - Annie Young
- Multinational Association of Supportive Care in Cancer, Coventry, UK.,Warwick Clinical Trials Unit, Warwick Medical School, University of Warwick, Coventry, UK
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25
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Nukpezah RN, Khoshnavay Fomani F, Hasanpour M, Nasrabadi AN. A qualitative study of Ghanaian pediatric oncology nurses' care practice challenges. BMC Nurs 2021; 20:17. [PMID: 33435975 PMCID: PMC7802173 DOI: 10.1186/s12912-021-00538-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2020] [Accepted: 01/04/2021] [Indexed: 12/26/2022] Open
Abstract
BACKGROUND Pediatric cancer is a global problem, and some studies have emphasized that nurses caring for these children experience work-related challenges. This has caused many children diagnosed with cancer to have a prolonged hospital stay and suffer unnecessary pain. However, there is insufficient documentary evidence on this issue. This study aims to explore and understand the challenges faced by pediatric oncology nurses in caring for children in Ghana. METHODS An exploratory qualitative research design study was conducted from August 2019 to April 2020. The study was conducted at the pediatric oncology unit which is located at the Tamale Teaching Hospital (TTH), Ghana. The study was conducted among 14 Ghanaian pediatric oncology nurses who were purposively sampled. A semi-structured interview guide was used to collect data. The interviews were recorded, transcribed verbatim, and analyzed inductively using Elo and Kyngas content analysis approach. The criteria proposed by Guba and Lincoln were used to ensure the validity of the study. RESULTS From the analysis of participants transcripts, eight subcategories emerged from two major categories. The subcategories were; time-consuming care, low job motivations, inadequate logistics, work stress, reduced labour force, low knowledge level, lack of teamwork and the perception of contracting cancer. CONCLUSIONS The results point to several organizational and personal constraints experienced by the nurses who work at the pediatric oncology ward. It is hoped that by addressing these challenges, it would lead to further improvement in the care that is provided to children with cancer. There is the need for the administrative managers of hospitals, government and other stakeholders to invest in human, material and financial resources for delivering childhood cancer care services.
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Affiliation(s)
- Ruth Nimota Nukpezah
- Department of Pediatric Nursing, School of Nursing and Midwifery, International Campus-Tehran University of Medical Sciences, Tehran, Iran
| | - Fatemeh Khoshnavay Fomani
- Department of Pediatric Nursing, School of Nursing and Midwifery, Tehran University of Medical Sciences, Tehran, Iran
| | - Marzieh Hasanpour
- Department of Pediatric Nursing, NIDCAP Professional, Spiritual Health Branch of Research Center of the Quran; Hadith and Medicine, School of Nursing and Midwifery, Tehran University of Medical Sciences, Tehran, Iran
| | - Alireza Nikbakht Nasrabadi
- Department of Medical and Surgical Nursing, School of Nursing and Midwifery, Tehran University of Medical Sciences, Tehran, Iran.
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Maree JE, Khutjwe JV, Swart NC, Maree JE. Cancer nursing research output in Africa 2015 to 2019. A scoping review. INTERNATIONAL JOURNAL OF AFRICA NURSING SCIENCES 2021. [DOI: 10.1016/j.ijans.2021.100381] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
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Essential oncology nursing care along the cancer continuum. Lancet Oncol 2020; 21:e555-e563. [PMID: 33212045 DOI: 10.1016/s1470-2045(20)30612-4] [Citation(s) in RCA: 40] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2020] [Revised: 09/25/2020] [Accepted: 10/06/2020] [Indexed: 12/24/2022]
Abstract
Oncology nurses are at the heart of tackling the increasing global burden of cancer. Their contribution is unique because of the scale and the diversity of care roles and responsibilities in cancer care. In this Series paper, to celebrate the International Year of the Nurse and Midwife, we highlight the contribution and impact of oncology nurses along the cancer care continuum. Delivering people-centred integrated care and optimal communication are essential components of oncology nursing care, which are often played down. More oncology nurses using, doing, and leading research will further show the key nursing impact on care as part of a team. The oncology nurse influence in saving lives through prevention and early detection of cancer is noteworthy. Supportive care, the central pillar of oncology nursing, enables and empowers people to self-manage where possible. Globally, oncology nurses make a great positive difference to cancer care worldwide; their crucial contribution throughout the continuum of care warrants the inclusion and promotion of nursing in every country's cancer strategy. 2020 is the year of the nurse: let us take this learning to the future.
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Yates P, Charalambous A, Fennimore L, So WKW, Suh EE, Woodford E, Young A. Cancer Nursing's Potential to Reduce the Growing Burden of Cancer Across the World. Oncol Nurs Forum 2020; 47:625-627. [PMID: 33063784 DOI: 10.1188/20.onf.625-627] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
Cancer is the first or second leading cause of premature death (i.e., at ages 30-69 years) in 134 of 183 countries, and it ranks third or fourth in an additional 45 countries. An estimated 18.1 million new cancer cases and 9.6 million cancer-related deaths occurred worldwide in 2018. The incidence of cancer globally is expected to exceed 27 million new cancer cases per year by 2040 in part due to the aging of the population and greater susceptibility to aging-related diseases such as cancer. This estimated increase in cancer incidence will occur in all countries, but the predicted increase will be proportionately greatest in low and medium countries. Cancer is also a disease associated with significant morbidity. It is estimated that the total annual economic cost of cancer in 2010 was US$1.16 trillion per year.
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Kanwar VS, Schwartz KR, Salifu N, Abdelfattah AM, Anim B, Cayrol J, Sniderman E, Eden T. The role of twinning in sustainable care for children with cancer: A TIPPing point? SIOP PODC Working Group on Twinning, Collaboration, and Support. Pediatr Blood Cancer 2020; 67:e28667. [PMID: 32827347 DOI: 10.1002/pbc.28667] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/14/2020] [Revised: 07/18/2020] [Accepted: 08/06/2020] [Indexed: 02/06/2023]
Abstract
With the World Health Organization (WHO) Global Initiative for Childhood Cancer, there is renewed interest in sustainable interventions to improve childhood cancer care in low-/middle-income countries (LMICs). Practitioners in LMICs have traditionally practiced "twinning," i.e., targeted international pediatric oncology partnerships (TIPPs) between one or more institutions in a high-income country (HIC) and an LMIC, to improve care for children with cancer in the latter. The International Society of Paediatric Oncology Committee for Paediatric Oncology in Developing Countries Working Group on Twinning, Collaboration, and Support reviewed guidelines from https://cancerpointe.com and the current literature, gathered input from practitioners in LMICs, and in this article discuss the role of TIPPs in the WHO initiative.
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Affiliation(s)
- Vikramjit S Kanwar
- QURE Center for Complete Care, Ahmedabad, India and Albany Medical College, New York
| | | | | | | | - Bernard Anim
- Harvard School of Public Health, Boston, Massachusetts
| | - Julie Cayrol
- Royal Children's Hospital, University of Melbourne, Australia
| | | | - Tim Eden
- World Child Cancer and University of Manchester, Manchester, UK
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Position Statement on Cancer Nursing’s Potential to Reduce the Growing Burden of Cancer Across the World. Cancer Nurs 2020; 43:433-435. [DOI: 10.1097/ncc.0000000000000900] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
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Yakar HK, Oguz S, Öktem N, Yürük S. Nursing Students' Awareness about the Warning Signs of Cancer. Asia Pac J Oncol Nurs 2020; 8:81-85. [PMID: 33426194 PMCID: PMC7785077 DOI: 10.4103/apjon.apjon_34_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2020] [Accepted: 06/04/2020] [Indexed: 11/25/2022] Open
Abstract
Objective: Nursing students who take care of the patient in clinical area practices as a part of their internships in primary health care and clinical areas, should be aware of the warning signs of cancer so that they may inform the community about them. Methods: This study was conducted to determine the awareness of nursing students about the warning signs of cancer. The research was planned as a descriptive and cross-sectional study. The research was completed with 460 nursing students between February 2019 and May 2019. Results: The average age of the students participating in the study was 20.05 ± 2.04 years. Female nursing students were more familiar with the warning signs of cancer, than male nursing students. Second, third- and fourth-grade nursing students knew the warning sign of better than the first graders. More nursing students who had taken the internal diseases nursing course knew the warning sign of better compared to the students who did not take the course. Nursing students with a family member with a history of cancer knew the warning better than those who did not have a family history of cancer. Thickening or lump in the breast or elsewhere” was the most known warning sign of cancer (92.6%), whereas the least known sign was “indigestion or difficulty in swallowing” (47.0%). Conclusions: Female nursing students those who had taken the internal diseases nursing course and those who had a family member with a history of cancer were more aware of the warning signs of cancer.
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Affiliation(s)
- Hatice Karabuga Yakar
- Department of Nursing, Faculty of Health Sciences, Marmara University, Istanbul, Turkey
| | - Sıdıka Oguz
- Department of Nursing, Faculty of Health Sciences, Marmara University, Istanbul, Turkey
| | - Nuriye Öktem
- Oncology Department, Ankara City Hospital, Ankara, Turkey
| | - Serbülent Yürük
- Oncology Department, Faculty of Medicine Hospital, Istanbul University, Ankara, Turkey
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Pierz AJ, Randall TC, Castle PE, Adedimeji A, Ingabire C, Kubwimana G, Uwinkindi F, Hagenimana M, Businge L, Musabyimana F, Munyaneza A, Murenzi G. A scoping review: Facilitators and barriers of cervical cancer screening and early diagnosis of breast cancer in Sub-Saharan African health settings. Gynecol Oncol Rep 2020; 33:100605. [PMID: 32637528 PMCID: PMC7327246 DOI: 10.1016/j.gore.2020.100605] [Citation(s) in RCA: 28] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/14/2020] [Revised: 06/17/2020] [Accepted: 06/19/2020] [Indexed: 01/11/2023] Open
Abstract
To address gaps in access to cervical cancer screening and early diagnosis of breast cancer services in Sub-Saharan African (SSA), this scoping review was conducted to explore facilitators and barriers that exist on the patient-, provider-, and system-level. An extensive literature search was conducted in accordance with scoping review methodology and the Cochrane guidelines. Our search criteria were limited to original research studies conducted in community or clinical settings in SSA within the last 10 years (2010-2020). Themes found from this review included patient knowledge and provider education, access to screening services, trust, health-related behaviors, attitudes, values, and practices, community and social values, health infrastructure, resource allocation, and political will. Identified barriers included lack of knowledge about cervical and breast cancer among patients, gaps in education and training among providers, and lack of resources and health infrastructure at the facility level and within the overall health system. Facilitators included perceived risk of cancer, support and encouragement of the provider, and utilization of novel approaches in low-resource settings by health systems. To better address individual-, provider-, and health system and facility-based facilitators and barriers to care, there is a need for political and financial investment and further research on the health service delivery in specific national health systems, especially in the context of the global campaign to eliminate cervical cancer as a public health problem.
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Affiliation(s)
- Amanda J. Pierz
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, NY, USA
| | - Thomas C. Randall
- Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Massachusetts General Hospital, Boston, MA, USA
| | - Philip E. Castle
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, NY, USA
| | - Adebola Adedimeji
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, NY, USA
| | - Charles Ingabire
- Division of Clinical Education and Research, Rwanda Military Hospital, Kigali, Rwanda
| | | | | | - Marc Hagenimana
- Cancer Diseases Unit, Rwanda Biomedical Center, Kigali, Rwanda
| | - Lydia Businge
- Division of Clinical Education and Research, Rwanda Military Hospital, Kigali, Rwanda
| | - Francoise Musabyimana
- Division of Clinical Education and Research, Rwanda Military Hospital, Kigali, Rwanda
| | - Athanase Munyaneza
- Division of Clinical Education and Research, Rwanda Military Hospital, Kigali, Rwanda
| | - Gad Murenzi
- Division of Clinical Education and Research, Rwanda Military Hospital, Kigali, Rwanda
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Uwayezu MG, Sego R, Nikuze B, Fitch M. Oncology nursing education and practice: looking back, looking forward and Rwanda's perspective. Ecancermedicalscience 2020; 14:1079. [PMID: 32863873 PMCID: PMC7434500 DOI: 10.3332/ecancer.2020.1079] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2020] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND Oncology care is a highly specialised division of nursing which requires a higher level of training and education following basic preparation. Rwanda, a developing country, initiated education of oncology nurse specialists in 2015. This paper highlights the experience of establishing the programme. METHODS Selected literature and expert oncology nurses were consulted to provide direction for the development of this paper. The websites of oncology nursing organisations and the curriculum used by the University of Rwanda for preparing oncology nurses were also reviewed. RESULTS In 2015, Rwanda initiated the training of oncology nurse specialists (master's level). The programme has had two successful cohorts graduating. This programme is implemented in a module system with 14 modules. The modules emphasised on screening and diagnosis of different cancers and their treatment, management of treatment related side effects, palliative care, end-of-life care and rehabilitation. A part this formal education, Rwanda, through Partners in Health and the Rwanda Biomedical Center, is also offering in-service training of nurses on cancer treatment, preventive measures and early identification such as Clinical Breast Examination and screening of cervical cancer. CONCLUSION Oncology nurses can play a key role in the care of cancer patients and prevention activities when they have the appropriate education. Rwanda's experience in establishing a master's programme in oncology nursing could be of assistance to others who wish to develop a similar programme.
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Affiliation(s)
- Marie Goretti Uwayezu
- School of Nursing and Midwifery University of Rwanda, College of Medicine and Health Sciences, University of Rwanda, Kigali, Rwanda
| | - Ruth Sego
- School of Nursing and Midwifery University of Rwanda, College of Medicine and Health Sciences, University of Rwanda, Kigali, Rwanda
- Rory Meyer’s College of Nursing, New York University, New York, USA
| | - Bellancille Nikuze
- School of Nursing and Midwifery University of Rwanda, College of Medicine and Health Sciences, University of Rwanda, Kigali, Rwanda
| | - Margaret Fitch
- School of Nursing and Midwifery University of Rwanda, College of Medicine and Health Sciences, University of Rwanda, Kigali, Rwanda
- Rory Meyer’s College of Nursing, New York University, New York, USA
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Knowledge, attitude and self-efficacy towards palliative care among nurses in Mongolia: A cross-sectional descriptive study. PLoS One 2020; 15:e0236390. [PMID: 32702007 PMCID: PMC7377484 DOI: 10.1371/journal.pone.0236390] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2019] [Accepted: 07/06/2020] [Indexed: 12/20/2022] Open
Abstract
Background Nurses have a primary role in providing palliative and end-of-life (EOL) care. Their knowledge of EOL care, attitudes toward care of the dying, and palliative care self-efficacy are important in care delivery. Little is known regarding palliative care preparedness among Mongolian nurses. This study examines palliative care knowledge, attitude towards death and dying, and self-efficacy among Mongolian nurses, and examines predictors of self-efficacy. Methods A cross-sectional descriptive study was conducted. Participants were 141 nurses employed at the National Cancer Center in Mongolia. Data was collected using a self-administered questionnaire. Results The median score for the knowledge of palliative care was 8.0/20. “Psychosocial and spiritual care” was the lowest score on the palliative care knowledge subscale. The mean score for attitude toward care of the dying was 69.1%, indicating positive attitudes. The mean score for the palliative care self-efficacy was 33.8/48. Nurses reported low self-efficacy toward communicating with dying patients and their families, and managing delirium. Palliative care knowledge and duration of experience as an oncology nurse significantly predicted self-efficacy toward palliative care, accounting for 14.0% of the variance. Conclusions Palliative education for nurses should address the knowledge gaps in EOL care and focus in increasing palliative care self-efficacy. Considering palliative care knowledge and nursing experience as an oncology nurse were significant predictors of self-efficacy toward palliative care, more effort is needed to fill the knowledge gaps in EOL care among nurses, especially for less experienced nurses.
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Challinor JM, Day SW, Afungchwi GM, Alqudimat MR. Pediatric Oncology Nursing Research in Low- and Middle-Income Countries. PEDIATRIC ONCOLOGY 2020. [DOI: 10.1007/978-3-030-25804-7_15] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
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Effectiveness of patient-targeted interventions to increase cancer screening participation in rural areas: A systematic review. Int J Nurs Stud 2020; 101:103401. [DOI: 10.1016/j.ijnurstu.2019.103401] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2019] [Revised: 08/12/2019] [Accepted: 08/15/2019] [Indexed: 01/22/2023]
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Brennan ME, Kerin-Ayres K, Perera S, Samarakoon S. The Emergence of Breast Care Nursing in A Developing Nation: A Sri Lankan-Australian Training Partnership. Asia Pac J Oncol Nurs 2019; 7:49-54. [PMID: 31879684 PMCID: PMC6927161 DOI: 10.4103/apjon.apjon_40_19] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2019] [Accepted: 07/24/2019] [Indexed: 11/23/2022] Open
Abstract
Objective: In Sri Lanka, the incidence of breast cancer is increasing. Yet, Sri Lankan nurses have limited specialist education opportunities and no formal recognition of the breast care nurse (BCN) role to address this growing need. This project aimed to encourage the emergence of the BCN role in Sri Lanka by delivering a workshop for nurses to increase the knowledge and confidence in delivering breast cancer care. Methods: This project was initiated by Zonta, a nonprofit, service organization, in collaboration with the National Cancer Control Programme of the Ministry of Health, Nutrition and Indigenous Medicine, Sri Lanka. A 2-day intensive workshop was designed by a collaborative team of Australian and Sri Lankan health professionals and delivered in Colombo. Its effectiveness was evaluated by measuring the knowledge about breast cancer, confidence with clinical care, and satisfaction with the workshop. Results: Fifty nursing participants attended the workshop. Outcomes included a statistically significant increase in knowledge about breast cancer (P = 0.012) and confidence in clinical care (P < 0.003 for all aspects of confidence). All participants were highly satisfied with the workshop, agreeing that the content was relevant and that they developed new skills. Conclusions: Nurses in Sri Lanka have unmet needs for specialty training and education. A 2-day workshop can improve knowledge and confidence, with the potential to improve patient care and increase the recognition of the BCN role. Lessons learnt from the collaboration between the nongovernment and government partners provide a model for the development of specialist nursing education.
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Affiliation(s)
- Meagan E Brennan
- Westmead Breast Cancer Institute, Westmead Hospital, Westmead, Sydney, NSW, Australia.,Western and Northern Clinical Schools, School of Medicine, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia
| | - Kim Kerin-Ayres
- Westmead Breast Cancer Institute, Westmead Hospital, Westmead, Sydney, NSW, Australia.,The Cancer Survivorship Clinic, Concord Repatriation General Hospital, Concord, NSW, Australia
| | - Suraj Perera
- National Cancer Control Programme, Ministry of Health, Colombo, Sri Lanka
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Foulkes M. Holding it together: the art of collaboration. BRITISH JOURNAL OF NURSING (MARK ALLEN PUBLISHING) 2019; 28:S3. [PMID: 31556733 DOI: 10.12968/bjon.2019.28.17.s3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Affiliation(s)
- Mark Foulkes
- Macmillan Lead Cancer Nurse and Nurse Consultant in Acute Oncology, Royal Berkshire NHS Foundation Trust, Reading and UKONS Board Member
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Sarfati D, Dyer R, Vivili P, Herman J, Spence D, Sullivan R, Weller D, Bray F, Hill S, Bates C, Foliaki S, Palafox N, Luciani S, Ekeroma A, Hospedales J. Cancer control in small island nations: from local challenges to global action. Lancet Oncol 2019; 20:e535-e548. [PMID: 31395475 PMCID: PMC7746435 DOI: 10.1016/s1470-2045(19)30511-x] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2019] [Revised: 06/13/2019] [Accepted: 06/13/2019] [Indexed: 12/16/2022]
Abstract
Cancer is a leading cause of death in small island nations and is forecast to increase substantially over the coming years. Governments, regional agencies, and health services of these nations face daunting challenges, including small and fragile economies, unequal distribution of resources, weak or fragmented health services, small population sizes that make sustainable workforce and service development problematic, and the unavailability of specialised cancer services to large parts of the population. Action is required to prevent large human and economic costs relating to cancer. This final Series paper highlights the challenges and opportunities for small island nations, and identifies ways in which the international community can support efforts to improve cancer control in these settings. Our recommendations focus on funding and investment opportunities to strengthen cancer-related health systems to improve sharing of technical assistance for research, surveillance, workforce, and service development, and to support small island nations with policy changes to reduce the consumption of commodities (eg, tobacco and unhealthy food products) that increase cancer risk.
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Affiliation(s)
- Diana Sarfati
- Department of Public Health, University of Otago, Wellington, Wellington, New Zealand.
| | - Rachel Dyer
- Department of Public Health, University of Otago, Wellington, Wellington, New Zealand
| | - Paula Vivili
- Public Health Division, Pacific Community, Noumea, New Caledonia
| | | | | | - Richard Sullivan
- School of Cancer and Pharmaceutical Sciences, King's College London, London, UK
| | - David Weller
- James Mackenzie Professor of General Practice, Usher Institute of Population Health, Sciences and Informatics, College of Medicine and Veterinary Medicine, University of Edinburgh, Edinburgh, UK
| | - Freddie Bray
- Cancer Surveillance Section, International Agency for Research on Cancer, Lyon, France
| | - Sarah Hill
- Global Health Policy Unit, University of Edinburgh, Edinburgh, UK
| | - Christopher Bates
- Nossal Institute for Global Health, Melbourne School of Population and Global Health, Melbourne, VIC, Australia
| | - Sunia Foliaki
- Centre for Public Health Research, Massey University-Wellington Campus, Wellington, New Zealand
| | - Neal Palafox
- Pacific Regional Cancer Programs, Department of Family Medicine and Community Health, John A Burns School of Medicine, University of Hawaii at Manoa, Honolulu, HI, USA; Population Sciences in the Pacific Program, University of Hawaii Cancer Center, Honolulu, HI, USA
| | - Silvana Luciani
- Department of Noncommunicable Diseases and Mental Health, Pan American Health Organization, Washington, DC, USA
| | - Alec Ekeroma
- Obstetrics and Gynaecology, University of Otago, Wellington, Wellington, New Zealand; National University of Samoa, Le Papaigalagala Campus, To'omatagi, Samoa
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Mitema A, Maree L, Young A. Cancer treatment in Africa: the importance of the role of nursing. Ecancermedicalscience 2019; 13:944. [PMID: 31552117 PMCID: PMC6722106 DOI: 10.3332/ecancer.2019.944] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2018] [Indexed: 12/27/2022] Open
Abstract
Nurses in all aspects of oncology have a key role to play in the delivery of effective cancer care. Unfortunately, oncology nursing is not yet an established nursing subspecialty in most of Africa; six out of 22 African countries reported as having no trained oncology nurses at all. The need for more personnel and quality training programmes are an absolute necessity.
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Affiliation(s)
- Anastasia Mitema
- Ocean Road Cancer Institute, Ocean Road, Dar es Salaam, Tanzania
| | - Lize Maree
- Department of Nursing Education, University of the Witwatersrand, Johannesburg 2193, South Africa
| | - Annie Young
- Warwick Medical School, University of Warwick, Coventry CV4 7AL, UK
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Watson L, Fitch M, Mushani T, Savage P, Strohschein FJ, Puts MTE, Kenis C, Newton L, McQuestion M. CANO/ACIO International Symposium: Working in partnership within and beyond our Canadian borders to enhance oncology care. Can Oncol Nurs J 2019; 29:210-215. [PMID: 31966009 PMCID: PMC6970470] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/10/2023] Open
Affiliation(s)
- Linda Watson
- President, Canadian Association of Nurses in Oncology. Scientific Director, Applied Research and Patient Experience, Cancer Control Alberta, Alberta Health Services. Assistant Professor (Adjunct), Faculty of Nursing, University of Calgary
| | - Margaret Fitch
- Professor (Adjunct), Bloomberg Faculty of Nursing, University of Toronto, Editor in Chief, CONJ
| | - Tayreez Mushani
- Advance Practice Nurse Educator, Princess Margaret Cancer Centre, University Health Network, Adjunct Faculty, Aga Khan University
| | - Pamela Savage
- Director of Professional Practice, Princess Margaret Cancer Centre, University Health Network
| | - Fay J Strohschein
- Doctoral Candidate, Ingram School of Nursing, McGill University, Montreal, QC. Co-Chair, Oncology and Aging Special Interest Group, CANO/ACIO
| | - Martine T E Puts
- Associate Professor, Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, Toronto, ON. Co-chair, Nursing and Allied Health Interest Group, SIOG
| | - Cindy Kenis
- Clinical Nurse Specialist, Departments of General Medical Oncology and Geriatric Medicine, University Hospitals Leuven, Belgium. Co-chair, Nursing and Allied Health Interest Group, SIOG
| | - Lorelei Newton
- Assistant Professor, School of Nursing, University of Victoria, Victoria, BC. Co-Chair, Oncology and Aging Special Interest Group, CANO/ACIO
| | - Maurene McQuestion
- Clinical Nurse Specialist, H&N Site Group, Radiation Medicine Program. Co-Lead H&N Survivorship Programme, Princess Margaret Cancer Centre. Adjunct Lecturer, Bloomberg Faculty of Nursing, University of Toronto
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Galassi A, Morgan C, Muha C. Making the invisible visible: Oncology nursing efforts of NCI-designated cancer centers in LMICs. J Cancer Policy 2018; 17:34-37. [PMID: 37990688 PMCID: PMC10662967 DOI: 10.1016/j.jcpo.2017.03.013] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
An increasing majority of new cancer cases and mortality occur in low- and middle-income countries (LMICs). Nurses provide most cancer care in LMICs, yet receive limited, if any, oncology education and training. To better understand the efforts taking place to address this need, the Center for Global Health (CGH) at the US National Cancer Institute (NCI) undertook a study of global oncology nursing projects at NCI-designated cancer centers. The 62 comprehensive and clinical NCI-designated cancer centers were surveyed about the nature and scope of their efforts in strengthening oncology nursing internationally. We received responses from 43 of the 62 cancer centers, with 21centers reporting a total of 29 projects. Twenty-three of 29 projects had involvement in an LMIC. The most common types of projects were research studies and short-term intensive trainings, most of which were for discrete tasks. Unsurprisingly, of the projects that had specific foci, most focused on breast or cervical cancer, and palliative care. Of the 22 projects that reported project costs, almost 90% were under $200,000 USD, suggesting that strengthening the global cancer workforce can be done with limited expense. While this study is limited to efforts of NCI-designated cancer centers, the findings reveal limited engagements in education and training of oncology nurses, who provide most of the cancer care in LMICs, but also provide tangible areas for strengthening this workforce and improving oncology care delivery.
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Affiliation(s)
- Annette Galassi
- Center for Global Health, U.S. National Cancer Institute, 9609 Medical Center Drive, Rockville, MD 20850, United States
| | - Camille Morgan
- Center for Global Health, U.S. National Cancer Institute, 9609 Medical Center Drive, Rockville, MD 20850, United States
| | - Catherine Muha
- Center for Global Health, U.S. National Cancer Institute, 9609 Medical Center Drive, Rockville, MD 20850, United States
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Buswell L, Umuhizi D, Hategekimana V, Muhayimana C, Kennell-Heiling S. Voices of Hope From Rural Rwanda: Three Oncology Nurse Leaders Emerge. Oncol Nurs Forum 2017; 43:661-4. [PMID: 27541559 DOI: 10.1188/16.onf.661-664] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
The cancer burden in low- and middle-income countries (LMICs) has been well described in the literature (International Agency for Research on Cancer, 2012; Ott, Ullrich, Mascarenhas, & Stevens, 2011; Thun, DeLancey, Center, Jemal, & Ward, 2010). According to the World Health Organization ([WHO], 2015), about 14 million new cancer cases occurred in 2012, and more than 60% of those cases were in Africa, Asia, and Central and South America; of the 8.2 million cancer-related deaths in 2012, more than 70% occurred in these regions (Bray & Møller, 2006).
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Vanderpuye V, Grover S, Hammad N, PoojaPrabhakar, Simonds H, Olopade F, Stefan DC. An update on the management of breast cancer in Africa. Infect Agent Cancer 2017; 12:13. [PMID: 28228841 PMCID: PMC5307840 DOI: 10.1186/s13027-017-0124-y] [Citation(s) in RCA: 98] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2016] [Accepted: 02/03/2017] [Indexed: 01/04/2023] Open
Abstract
Background There is limited information about the challenges of cancer management and attempts at improving outcomes in Africa. Even though South and North Africa are better resourceds to tackle the burden of breast cancer, similar poor prognostic factors are common to all countries. The five-year overall Survival rate for breast cancer patients does not exceed 60% for any low and middle-income country (LMIC) in Africa. In spite of the gains achieved over the past decade, certain characteristics remain the same such as limited availability of breast conservation therapies, inadequate access to drugs, few oncology specialists and adherence to harmful socio-cultural practices. This review on managing breast cancer in Africa is authored by African oncologists who practice or collaborate in Africa and with hands-on experience with the realities. Methods A search was performed via electronic databases from 1999 to 2016. (PubMed/Medline, African Journals Online) for all literature in English or translated into English, covering the terms “breast cancer in Africa and developing countries”. One hundred ninety were deemed appropriate. Results Breast tumors are diagnosed at earlier ages and later stages than in highincome countries. There is a higher prevalence of triple-negative cancers. The limitations of poor nursing care and surgery, inadequate access to radiotherapy, poor availability of basic and modern systemic therapies translate into lower survival rate. Positive strides in breast cancer management in Africa include increased adaptation of treatment guidelines, improved pathology services including immuno-histochemistry, expansion and upgrading of radiotherapy equipment across the continent in addition to more research opportunities. Conclusion This review is an update of the management of breast cancer in Africa, taking a look at the epidemiology, pathology, management resources, outcomes, research and limitations in Africa from the perspective of oncologists with local experience.
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Affiliation(s)
- V Vanderpuye
- National center for Radiotherapy and Nuclear Medicine, Korle-Bu Teaching Hospital, Accra, Ghana
| | - S Grover
- Hospital of University of Pennsylvania, Department of Radiation Oncology, (Botswana-UPENN program), 3400 Civic Center Blvd., Philadelphia, PA 19104 USA
| | - N Hammad
- Cancer Centre of Southeastern Ontario, Burr 2, Kingston General Hospital, 25 King Street W, Kingston, ON K7L 5P9 Canada
| | - PoojaPrabhakar
- University of Texas Southwestern Medical Center, Dallas, TX USA
| | - H Simonds
- Division of Radiation Oncology, Tygerberg Hospital/University of Stellenbosch, Tygerberg, South Africa
| | - F Olopade
- The University of Chicago, 5841 S Maryland Avenue, MC 2115, Chicago, IL 60637 USA
| | - D C Stefan
- Walter Sisulu University Nelson Mandela Dr, Nelson Mandela Drive, Mthatha, 5100 Eastern Cape South Africa
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LeBaron VT, Palat G, Sinha S, Chinta SK, Jamima BJB, Pilla UL, Podduturi N, Shapuram Y, Vennela P, Rapelli V, Lalani Z, Beck SL. Recommendations to Support Nurses and Improve the Delivery of Oncology and Palliative Care in India. Indian J Palliat Care 2017; 23:188-198. [PMID: 28503040 PMCID: PMC5412128 DOI: 10.4103/ijpc.ijpc_153_16] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
CONTEXT Nurses in India often practice in resource-constrained settings and care for cancer patients with high symptom burden yet receive little oncology or palliative care training. AIM The aim of this study is to explore challenges encountered by nurses in India and offer recommendations to improve the delivery of oncology and palliative care. METHODS Qualitative ethnography. SETTING The study was conducted at a government cancer hospital in urban South India. SAMPLE Thirty-seven oncology/palliative care nurses and 22 others (physicians, social workers, pharmacists, patients/family members) who interact closely with nurses were included in the study. DATA COLLECTION Data were collected over 9 months (September 2011- June 2012). Key data sources included over 400 hours of participant observation and 54 audio-recorded semi-structured interviews. ANALYSIS Systematic qualitative analysis of field notes and interview transcripts identified key themes and patterns. RESULTS Key concerns of nurses included safety related to chemotherapy administration, workload and clerical responsibilities, patients who died on the wards, monitoring family attendants, and lack of supplies. Many participants verbalized distress that they received no formal oncology training. CONCLUSIONS Recommendations to support nurses in India include: prioritize safety, optimize role of the nurse and explore innovative models of care delivery, empower staff nurses, strengthen nurse leadership, offer relevant educational programs, enhance teamwork, improve cancer pain management, and engage in research and quality improvement projects. Strong institutional commitment and leadership are required to implement interventions to support nurses. Successful interventions must account for existing cultural and professional norms and first address safety needs of nurses. Positive aspects from existing models of care delivery can be adapted and integrated into general nursing practice.
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Affiliation(s)
- Virginia T LeBaron
- Department of Acute and Specialty Care, University of Virginia School of Nursing, Charlottesville, VA, USA
| | - Gayatri Palat
- Palliative Access Programme, Two Worlds Cancer Collaboration-INCTR, Canada.,Department of Pain and Palliative Care, South Indian Cancer Hospital, India
| | - Sudha Sinha
- Department of Medical Oncology, South Indian Cancer Hospital, India.,Department of Pediatrics, South Indian Cancer Hospital, India
| | | | | | | | | | - Yadamma Shapuram
- Department of Pain and Palliative Care, South Indian Cancer Hospital, India
| | - Padma Vennela
- Department of Pain and Palliative Care, South Indian Cancer Hospital, India
| | - Vineela Rapelli
- Department of Pain and Palliative Care, South Indian Cancer Hospital, India
| | - Zahra Lalani
- Palliative Access Programme, Two Worlds Cancer Collaboration-INCTR, Canada.,Vancouver Hospice Society, British Columbia Cancer Agency, Canada
| | - Susan L Beck
- Division of Acute and Chronic Care, University of Utah College of Nursing, Salt Lake City, Utah, USA
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Mbah Afungchwi G, Challinor J. Addressing Childhood Cancer in Low-Resource Countries: Current Challenges, Strategies, and Recommendations. Oncol Nurs Forum 2016; 43:525-8. [PMID: 27314196 DOI: 10.1188/16.onf.525-528] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Children and adolescents represent a small, but critically important, number of patients with cancer worldwide (14.1 million newly diagnosed adults versus 160,000 children annually). The life years saved when a child is cured of cancer are about 71 compared to 15 years for an adult in most high-income countries (HICs). In HICs, about 80% of children survive cancer. Unfortunately, in low- and middle-income countries (LMICs), the survival rates are generally 50% or less. In these resource-limited settings, only 15%-37% of children and adolescents have access to cancer treatment, and most are diagnosed with advanced-stage disease, making cure impossible.
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