Bridging the gap from the oncology setting to community care through a cross-Canada environmental scan

Cancer Survivors' Evolving Perceptions of a New Supportive Virtual Program

This qualitative study begins to explore cancer survivors' evolving perceptions of "Focus on the Future," a 6-week supportive virtual program led by trained volunteers and health care professionals. Through purposive sampling, participants (n = 10) enrolled in the program were individually interviewed shortly before attending, mid-way through, and at program completion. Interviews were digitally recorded and transcribed verbatim. Thematic analysis was used to develop key elements of program expectations and users' perceptions over time. Three themes transpired from the data: (1) Trustworthiness and timeliness of survivorship information and expert guidance, (2) Normalization of survivors' experiences, and (3) Virtual program delivery issues. Some participants' perceptions remained unchanged from pre-program expectations to post-program completion such as appreciating the efficiency of virtual delivery and "health safe" exchanges given the COVID-19 pandemic. In contrast, other perceptions became more polarized including drawbacks related to "more superficial" virtual connections and uneven topic relevance as the program evolved. Program participants appreciated timely information and support from volunteers and experts through virtual means and consecutive weekly sessions. Gauging participants' perceptions across time also offer opportunities to adjust program content and delivery features. Future research should explore key program development strategies to ensure that cancer supportive programs are optimally person-centered, co-designed, and situation-responsive.

Use of environmental scans in health services delivery research: a scoping review

OBJECTIVE

To examine the extent and nature of evidence on the use of the environmental scan (ES) in the health services delivery literature.

DESIGN

Scoping review.

METHODS

This scoping review followed the five-stage scoping review methodology outlined by Khalil et al. A Peer Review of Electronic Search Strategies was completed. Seven electronic databases and the grey literature were searched. Pairs of researchers independently performed two levels of screening and data extraction. Data were analysed using qualitative content and thematic analysis.

RESULTS

Ninety-six studies were included in the scoping review. Researchers conducted ESs for many purposes, the most common being to examine the current state of programmes, services or policies. Recommendations were informed by ESs in 20% of studies. Most common data collection methods were literature review (71%), key informant or semistructured interviews (46%) and surveys (35%). Over half (53%) of the studies used a combination of passive (looking at information eg, literature, policies, guidelines) and active (looking for information eg, surveys, interviews) approaches to data collection. Person sources of data (eg, healthcare stakeholders, community representatives) and non-person sources of data (eg, documents, electronic databases, the web) were drawn on to a similar extent. The thematic analysis of the definitions/descriptions yielded several themes including instrument of discovery, knowledge synthesis, forward-looking and decision making. Research gaps identified included absence of a standard definition, inconsistencies in terminology and lack of guiding frameworks in the health services delivery context.

CONCLUSION

ESs were conducted to gather evidence and to help inform decision making on a range of policy and health services delivery issues across the continuum of care. Consistency in terminology, a consensus definition and more guidance on ES design may help provide structure for researchers and other stakeholders, and ultimately advance ES as a methodological approach. A working definition of ES in a health services delivery context is presented.

A Conceptual Framework of Self-advocacy in Women With Cancer

Researchers define self-advocacy as the ability of an individual with cancer to overcome challenges in getting their preferences, needs, and values met. While imperative in all health care settings, self-advocacy is especially important in cancer care. The goal of this article is to present a conceptual framework for self-advocacy in cancer. We review foundational studies in self-advocacy, define the elements of the conceptual framework, discuss underlying assumptions of the framework, and suggest future directions in this research area. This framework provides an empirical and conceptual basis for studies designed to understand and improve self-advocacy among women with cancer.

End-of-Life Care Provided for Cancer Patients: A Metasynthesis Study

In the health care setting, and especially in cancer patients nearing the end of life, administrators, medical staff, patients, and families face challenges of a social, legal, religious, and cultural nature in the process of care. The present study aimed to perform a metasynthesis of qualitative studies conducted on providing end-of-life care for cancer patients. The present metasynthesis was conducted using Sandelowski and Barroso's method. A literature search was performed in PubMed, Scopus, Web of Science, and Embase databases, from the inception to date, and a total of 21 articles were identified as eligible for inclusion in the study. Critical Appraisal Skills Programme (CASP) criteria were used for assessing the articles, and data were analyzed by the subject review. Six themes were extracted for end-of-life care including psychological support, palliative support, educational-counseling support, spiritual support, preferential support, and supportive interactions, each comprising a number of categories. The most frequently mentioned categories were high-value care (67%) and adaptive acceptance (57%). The findings of this metasynthesis support the view that nurses are moral agents who are deeply invested in the moral integrity of end-of-life care involving assisted death. The present study showed that providing high-value care and facilitating adaptive acceptance are important constituents of a holistic strategy for providing end-of-life care to cancer patients.

La qualité de vie à la suite à d’une cystoprostatectomie totale chez les hommes: perception des patients tunisiens

Introduction

La cystoprostatectomie totale (CPT) entraîne souvent des changements dans la qualité de vie postopératoire et, par le fait même, des répercussions psychologiques, physiques, sociales et sexuelles difficiles à assumer. La présente étude vise à décrire la qualité de vie postopératoire d’hommes tunisiens âgés ayant subi une CPT à cause d’un cancer de la vessie.

Méthodologie

Il s’agit d’une étude descriptive quantitative, menée auprès de 40 hommes cystoprostatectomisés. Les instruments de mesure utilisés sont: le questionnaire Stoma-Qualité de vie (Stoma-QOL) de Prieto, Thorsen et Juul (2005) , traduit et validé en arabe, ainsi que la version arabe du questionnaire de l’index international de la fonction érectile (IIEF5), validée par Shamloul, Ghanem et Abou-Zeid (2004) .

Résultats

77,5 % des participants obtiennent un score de qualité de vie médiocre. Toutes les dimensions de la qualité de vie sont touchées, à savoir l’image corporelle, physique et psychologique, la vie familiale et sociale, et enfin, la sexualité. En outre, tous les participants ont souffert d’impuissance sexuelle grave après l’intervention.

Conclusion

Le counseling pré et postopératoire s’avère nécessaire pour faciliter la transition après l’opération et assurer aux hommes ayant subi une CPT à cause d’un cancer de la vessie une meilleure qualité de vie liée à la santé.

Toward equitably high-quality cancer survivorship care

Although models of cancer survivorship care are rapidly evolving, there is increasing evidence of health disparities among cancer survivors. In the current context, Canada's survivorship care systems privilege some and not others to receive high-quality care and optimize their health outcomes. The aim of this study was to improve survivorship care systems by helping clinicians and decision makers to a better understanding of how various psychosocial/political factors, survivors' health experiences and health management strategies might shape the development of and access to high-quality survivorship care for Canadians with cancer. Using a nursing epistemological approach informed by critical and intersectional perspectives, we conducted a three-phased Interpretive Description study. We engaged in critical textual analysis of documentary sources, a secondary analysis of interview transcripts from an existing database, and qualitative interviews with 34 survivors and 12 system stakeholders. On the basis of these data, we identified individual, group, and system factors that contributed to gaps between survivors' expected and actual survivorship care experiences. By understanding what shapes survivorship care systems and resources, we help illuminate and unravel the complex nature of the issue, supporting clinicians and decision makers to find multi-layered approaches for equitably high-quality survivorship care.