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Bana M, Ribi K, Kropf-Staub S, Näf E, Schramm MS, Zürcher-Florin S, Peters S, Eicher M. Development and implementation strategies of a nurse-led symptom self-management program in outpatient cancer centres: The Symptom Navi© Programme. Eur J Oncol Nurs 2020; 44:101714. [PMID: 31954227 DOI: 10.1016/j.ejon.2019.101714] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2019] [Revised: 12/11/2019] [Accepted: 12/19/2019] [Indexed: 10/25/2022]
Abstract
PURPOSE The Symptom Navi© Programme (SN©P) is a structured nurse-led intervention supporting symptom self-management in cancer patients. We describe the development and evaluation of the intervention, implementation strategy, and the evaluation of nurse training for the Symptom Navi© Pilot Study. METHODS The intervention was developed using multiple methods (e.g. literature synthesis, focus groups) to produce SN©P information leaflets (SN©Flyers in French and German) and standardised training for nurses to deliver semi-structured consultations. We evaluated the SN©P using online surveys, focus groups, interviews, and the Item-Content Validity Index (I-CVI). Nurse training was evaluated in relation to content, acceptability, and confidence in implementing the SN©P. We examined the association between scored on the Work-related Sense of Coherence (Work-SoC) scale and nurses' confidence in implementing the SN©P. Thematic analysis was used to analyse qualitative data. Quantitative data was descriptively analysed and the Kendall Tau test was employed for correlations. RESULTS Patients and health care professionals confirmed that SN©Flyers and semi-structured consultations facilitated symptom self-management. Nurses considered training content/format acceptable and appropriate and felt confident in implementing the SN©P. Overall Work-SoC scores were correlated with nurses' confidence in implementing the SN©P (rπ = .47, p = .04). CONCLUSIONS Health care professionals and cancer patients perceived the SN©P as a useful support. Successful implementation of the SN©P depends on centre-specific factors including time, resources and workflow. CLINICAL TRIAL REGISTRY NCT03649984 and SNCTP000002381.
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Affiliation(s)
- Marika Bana
- University of Applied Sciences and Arts Western Switzerland HES-SO, School of Health Sciences, Route des Arsenaux 16a, CH-1700, Fribourg, Switzerland; Institute of Higher Education and Research in Health Care IUFRS, Faculty of Biology and Medicine, University of Lausanne and Lausanne University Hospital, SV-A Secteur Vennes, Route de la Corniche 10, CH-1010, Lausanne, Switzerland.
| | - Karin Ribi
- Institute of Higher Education and Research in Health Care IUFRS, Faculty of Biology and Medicine, University of Lausanne and Lausanne University Hospital, SV-A Secteur Vennes, Route de la Corniche 10, CH-1010, Lausanne, Switzerland; International Breast Cancer Study Group (IBCSG), Effingerstrasse 40, CH-3008, Bern, Switzerland.
| | - Susanne Kropf-Staub
- Hospital Group Lindenhof, Lindenhof, Bremgartenstrasse 117, Postfach, CH-3001, Bern, Switzerland.
| | - Ernst Näf
- Department of Practice Development in Nursing, Solothurner Spitäler, Kantonsspital Olten, Baslerstrasse 150, CH-4601, Olten, Switzerland.
| | - Monique Sailer Schramm
- University of Applied Sciences and Arts Western Switzerland HES-SO, School of Health Sciences, Route des Arsenaux 16a, CH-1700, Fribourg, Switzerland.
| | - Sabin Zürcher-Florin
- Hospital Group Lindenhof, Lindenhof, Bremgartenstrasse 117, Postfach, CH-3001, Bern, Switzerland.
| | - Solange Peters
- Department of Oncology, Centre Hospitalier Universitaire Vaudois (CHUV), Rue du Bugnon 21, CH-1011, Lausanne, Switzerland.
| | - Manuela Eicher
- Institute of Higher Education and Research in Health Care IUFRS, Faculty of Biology and Medicine, University of Lausanne and Lausanne University Hospital, SV-A Secteur Vennes, Route de la Corniche 10, CH-1010, Lausanne, Switzerland; Department of Oncology, Centre Hospitalier Universitaire Vaudois (CHUV), Rue du Bugnon 21, CH-1011, Lausanne, Switzerland.
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Bana M, Ribi K, Kropf-Staub S, Zürcher-Florin S, Näf E, Manser T, Bütikofer L, Rintelen F, Peters S, Eicher M. Implementation of the Symptom Navi © Programme for cancer patients in the Swiss outpatient setting: a study protocol for a cluster randomised pilot study (Symptom Navi© Pilot Study). BMJ Open 2019; 9:e027942. [PMID: 31289075 PMCID: PMC6615799 DOI: 10.1136/bmjopen-2018-027942] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
INTRODUCTION Self-management interventions show promising results on symptom outcomes and self-management behaviours. The Symptom Navi© Programme (SN©P) is a nurse-led intervention supporting patients' symptom self-management during anticancer treatment. It consists of written patient information (Symptom Navi© Flyers (SN©Flyers)), semistructured consultations and a training manual for nurses. METHODS AND ANALYSIS This pilot study will evaluate the implementation of the SN©P based on the Reach Effectiveness-Adoption Implementation Maintenance framework at Swiss outpatient cancer centres. We will use a cluster-randomised design and randomise the nine participating centres to the intervention or usual care group. We expect to include 140 adult cancer patients receiving first-line systemic anticancer treatment. Trained nurses at the intervention clusters will provide at least two semistructured consultations with the involvement of SN©Flyers. Outcomes include patients' accrual and retention rates, patient-reported interference of symptoms with daily functions, symptom burden, perceived self-efficacy, quality of nursing care, nurse-reported facilitators and barriers of adopting the programme, nurses' fidelity of providing the intervention as intended, and patients' safety (patients timely reporting of severe symptoms). We will use validated questionnaires for patient-reported outcomes, focus group interviews with nurses and individual interviews with oncologists. Linear mixed models will be used to analyse patient-reported outcomes. Focus group and individual interviews will be analysed by thematic analysis. ETHICS AND DISSEMINATION The Symptom Navi© Pilot Study has been reviewed and approved by Swiss Ethic Committee Bern (KEK-BE: 2017-00020). Results of the study will be disseminated in peer-reviewed journal and at scientific conferences. TRIAL REGISTRATION NUMBER NCT03649984; Pre-results.
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Grants
- Swiss Cancer League, Bern, Switzerland
- Lindenhofgruppe, Bern, Switzerland
- CHUV, Departement of Oncology, Lausanne, Switzerland
- Heds-FR, School of Health Sciences, Fribourg, Switzerland
- Dr. Hans Altschüler Stiftung, St. Gallen, Switzerland
- Institute of Higher Education and Research in Health Care, Faculty of Biology and Medicine, University of Lausanne, Switzerland
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Affiliation(s)
- Marika Bana
- HedS-FR School of Health Sciences, University of Applied Science and Arts Western Switzerland, Fribourg, Switzerland
- IUFRS Institut de formation et de recherche en soins, Université de Lausanne Faculté de biologie et médecine, Lausanne, Switzerland
| | - Karin Ribi
- IUFRS Institut de formation et de recherche en soins, Université de Lausanne Faculté de biologie et médecine, Lausanne, Switzerland
- Quality ofLife Office, International Breast Cancer Study Group, Bern, Switzerland
| | | | | | - Ernst Näf
- Department of Practice Development in Nursing, Solothurner Spitaler AG, Solothurn, Switzerland
| | - Tanja Manser
- FHNW School of Applied Psychology, University of Applied Sciences and Arts Northwestern Switzerland, Olten, Switzerland
| | | | | | | | - Manuela Eicher
- IUFRS Institut de formation et de recherche en soins, Université de Lausanne Faculté de biologie et médecine, Lausanne, Switzerland
- Departement of Oncology, CHUV, Lausanne, Switzerland
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