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Roche N, Le Provost JB, Borinelli-Franzoi MA, Boinon D, Martin E, Menvielle G, Dumas A, Rivera S, Conversano A, Matias M, Viansone A, Di Meglio A, Delaloge S, Vaz-Duarte-Luis IM, Pistilli B, Fasse L. Facing points of view: Representations on adjuvant endocrine therapy of premenopausal patients after breast cancer and their healthcare providers in France. The FOR-AD study. Eur J Oncol Nurs 2023; 62:102259. [PMID: 36623339 DOI: 10.1016/j.ejon.2022.102259] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [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: 06/10/2022] [Revised: 12/06/2022] [Accepted: 12/14/2022] [Indexed: 12/28/2022]
Abstract
PURPOSE Adjuvant endocrine therapy (ET) for 5-10 years is the backbone of the therapeutic strategy in patients with hormone receptor positive (HR+) early breast cancer (BC). However, long-term adherence to adjuvant ET represents a major challenge for most patients. According to prior studies, side effects of adjuvant ET are an important reason for poor adherence. In contrast, better communication and relational bond between patients and healthcare providers (HCPs) may improve adherence. The FOR-AD (Focus on non-adherence) study aimed at better understanding the representation of adjuvant ET by patients and their HCPs, in order to improve the care process. METHODS Three focus groups of premenopausal women (receiving adjuvant ET for variable amount of time) and two focus groups of HCPs (including oncologists, pharmacists, and nurses) were conducted, each including around ten participants. Thematic analyses using a general inductive approach were constructed to report participants' representations. RESULTS Two main themes emerged across groups, and appeared of major importance. Representations on adjuvant ET were often homogenous within each group, but differed between patients and their HCPs. The relationship between both groups was considerably discussed, particularly its importance in facilitating adherence to adjuvant ET. Suggestions on improving the care process were also given, such as systematically including psychologists in follow-up care paths and having a nurse navigator follow patients under treatment with adjuvant ET. CONCLUSION The present qualitative exploration may help buildi future tailored interventions to improve adherence to adjuvant ET, in particular regarding the role of nurse navigators.
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Affiliation(s)
- Nicolas Roche
- Supportive Care Department, Gustave Roussy Hospital, Villejuif, France.
| | | | - Maria-Alice Borinelli-Franzoi
- Department of Medical Oncology, Gustave Roussy Hospital, Villejuif, France; INSERM Unit 981, Molecular Predictors and New Targets in Oncology, Gustave Roussy, Villejuif, France
| | - Diane Boinon
- Supportive Care Department, Gustave Roussy Hospital, Villejuif, France; Laboratoire de Psychopathologie et Processus de Santé, F 92100, Université de Paris, Boulogne-Billancourt, France
| | - Elise Martin
- INSERM Unit 981, Molecular Predictors and New Targets in Oncology, Gustave Roussy, Villejuif, France
| | - Gwenn Menvielle
- Inserm, Institut Pierre Louis d'Epidémiologie et Santé Publique (IPLESP), Sorbonne Université, Paris, France
| | - Agnès Dumas
- Inserm Unit 1123, Unité ECEVE, Université de Paris, France
| | - Sofia Rivera
- Radiotherapy Department, Gustave Roussy Hospital, Villejuif, France
| | - Angelica Conversano
- Oncological and Reconstructive Plastic Surgery Department, Gustave Roussy Hospital, Villejuif, France
| | - Margarida Matias
- Department of Medical Oncology, Gustave Roussy Hospital, Villejuif, France
| | | | - Antonio Di Meglio
- INSERM Unit 981, Molecular Predictors and New Targets in Oncology, Gustave Roussy, Villejuif, France
| | - Suzette Delaloge
- Department of Medical Oncology, Gustave Roussy Hospital, Villejuif, France
| | - Ines-Maria Vaz-Duarte-Luis
- Department of Medical Oncology, Gustave Roussy Hospital, Villejuif, France; INSERM Unit 981, Molecular Predictors and New Targets in Oncology, Gustave Roussy, Villejuif, France
| | - Barbara Pistilli
- Department of Medical Oncology, Gustave Roussy Hospital, Villejuif, France
| | - Léonor Fasse
- Supportive Care Department, Gustave Roussy Hospital, Villejuif, France; Laboratoire de Psychopathologie et Processus de Santé, F 92100, Université de Paris, Boulogne-Billancourt, France
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Harvey C, Byrne AL, Willis E, Brown J, Baldwin A, Hegney AD, Palmer J, Heard D, Brain D, Heritage B, Ferguson B, Judd J, Mclellan S, Forrest R, Thompson S. Examining the hurdles in defining the practice of Nurse Navigators. Nurs Outlook 2021; 69:686-695. [PMID: 33583606 DOI: 10.1016/j.outlook.2021.01.011] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [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: 09/13/2020] [Revised: 12/22/2020] [Accepted: 01/17/2021] [Indexed: 10/22/2022]
Abstract
BACKGROUND Nurse navigators are an emerging workforce providing care to people with multiple chronic conditions. The role of the navigators is to identify patients requiring support in negotiating their health care. PURPOSE A critical discourse analysis was used to examine qualitative data collected from nurse navigators and consenting navigated patients to identify key indicators of how nurse navigators do their work and where the success of their work is most evident. DISCUSSION Nurse navigators help patients who have lost trust in the health system to re-engage with their interdisciplinary health care team. This re-engagement is the final step in a journey of addressing unmet needs, essential to hospital avoidance. CONCLUSION Nurse navigators provide a continuum of authentic and holistic care. To acknowledge the true value of nurse navigators, their performance indicators need to embrace the value-added care they provide.
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Affiliation(s)
- Clare Harvey
- Central Queensland University, Townsville Campus, Finsbury Place, Queensland, Australia; Massey University, New Zealand.
| | - Amy-Louise Byrne
- Central Queensland University, Townsville Campus, Townsville, Queensland, Australia
| | - Eileen Willis
- Central Queensland University, Townsville Campus, Townsville, Queensland, Australia
| | - Janie Brown
- Curtin University, Perth, Western Australia, Australia; St John of God Midland Public and Private Hospital, Midland, Western Australia, Australia; Central Queensland University, Brisbane, Queensland, Australia
| | - Adele Baldwin
- Central Queensland University, Townsville Campus, Townsville, Queensland, Australia
| | - Adjunct Desley Hegney
- Central Queensland University, Brisbane Campus, Brisbane, Queensland, Australia; University of Adelaide, Adelaide, South Australia, Australia
| | - Janine Palmer
- Central Queensland University, Auckland District Health Board, Townsville Campus, Townsville, Queensland, Australia
| | - David Heard
- Central Queensland University, Townsville Campus, Townsville, Queensland, Australia
| | - David Brain
- Queensland University of Technology, Brisbane, Queensland, Australia
| | - Brody Heritage
- Murdoch University, Murdoch, Western Australia, Australia
| | | | - Jenni Judd
- Central Queensland University, Wide Bay Hospital Health Services, Bundaberg Queensland
| | - Sandy Mclellan
- Central Queensland University, Mackay City Campus, Mackay, Queensland, Australia
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Ferrua M, Mathivon D, Duflot-Boukobza A, Abbas M, Charles C, Barrais A, Legendre J, Mendes C, Pons M, Merad M, Minvielle E, Mir O, Scotté F. Nurse navigators' telemonitoring for cancer patients with COVID-19: a French case study. Support Care Cancer 2021; 29:4485-4492. [PMID: 33462724 PMCID: PMC7813165 DOI: 10.1007/s00520-020-05968-y] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2020] [Accepted: 12/22/2020] [Indexed: 02/08/2023]
Abstract
Purpose The Gustave Roussy Cancer Institute implemented a patient-reported outcome platform (CAPRI-COVID) for cancer patients with coronavirus disease 2019 (COVID-19) to quarantine patients at home while ensuring monitoring of COVID-related symptoms and securing the care pathway. In this study, we described the CAPRI-COVID intervention, evaluated its use, and presented results of the tracking indicators with a focus on the nurse navigators’ (NNs) activities and the experience of patients. Methods Data of 130 cancer patients with COVID-19 diagnosed from March 23 to June 5, 2020, were collected. Six COVID-related symptoms were monitored daily, either by the patient via the CAPRI mobile application (CAPRI App) or by NNs via telemonitoring. In the cases of worsening or new-onset symptoms, an automated alert was sent to the platform, and NNs could immediately consult an emergency physician for future course of action. Results All 130 patients (median age: 59 years; 59.2% female) were monitored during the study period. There were no deaths or admissions to the intensive care unit attributable to COVID-19; 7.8% of patients were hospitalized (excluding scheduled hospitalization), and 17.1% were admitted to the emergency department at least once during the monitoring period. NNs carried out 1412 regular monitoring calls (average of 10.9 calls per patient), while 55% of the patients downloaded the CAPRI App. Conclusions Most patients monitored with CAPRI-COVID were quarantined during the first wave of the pandemic. In addition to the CAPRI App, which helped limit phone calls, NNs played an essential role in patient management.
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Affiliation(s)
- Marie Ferrua
- Research Department, Gustave Roussy, Villejuif, France.
| | - Delphine Mathivon
- Department of Ambulatory Cancer Care, Gustave Roussy, Villejuif, France
| | | | - May Abbas
- Interdisciplinary Cancer Pathways Division (DIOPP), Gustave Roussy, Villejuif, France
| | - Cécile Charles
- Interdisciplinary Cancer Pathways Division (DIOPP), Gustave Roussy, Villejuif, France.,Laboratory of Psychopathology and Health Processes (EA 4057), University of Paris Descartes, Sorbonne, Paris, France
| | - Amandine Barrais
- Department of Ambulatory Cancer Care, Gustave Roussy, Villejuif, France
| | - Jennifer Legendre
- Department of Ambulatory Cancer Care, Gustave Roussy, Villejuif, France
| | - Christine Mendes
- Department of Ambulatory Cancer Care, Gustave Roussy, Villejuif, France
| | - Magali Pons
- Interdisciplinary Cancer Pathways Division (DIOPP), Gustave Roussy, Villejuif, France
| | | | | | - Olivier Mir
- Department of Ambulatory Cancer Care, Gustave Roussy, Villejuif, France
| | - Florian Scotté
- Interdisciplinary Cancer Pathways Division (DIOPP), Gustave Roussy, Villejuif, France
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Westman B, Ullgren H, Olofsson A, Sharp L. Patient-reported perceptions of care after the introduction of a new advanced cancer nursing role in Sweden. Eur J Oncol Nurs 2019; 41:41-48. [PMID: 31358256 DOI: 10.1016/j.ejon.2019.05.009] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [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: 01/24/2019] [Revised: 05/15/2019] [Accepted: 05/31/2019] [Indexed: 10/26/2022]
Abstract
PURPOSE Extensive research results show quality improvements associated with advanced cancer nursing roles. Despite this, these roles are not implemented in many countries. The aim of this cross-sectional, population-based study was to compare patients' perception of care, before and after the introduction of a new advanced nursing role, the coordination contact nurse (CCN), in a region in Sweden. METHOD All patients (with gynaecological, haematological, Head & Neck, upper gastrointestinal cancers) diagnosed in the region the year prior and one-year post introducing the new CCN role were identified from the Swedish Cancer Register. Data were collected using the European Organization of Research and Treatment of Cancer [EORTC] Quality of Life Questionnaire (QLQ-C30 and QLQ-INFO25) and a study specific questionnaire. RESULT The results, based on baseline (n = 869) and follow-up data (n = 1003), show statistically significant patient-reported improvements after the introduction of the CCN role, regarding health-related patient information (EORTC QLQ- INFO25 global mean score increased from 41.23 to 44.16, p = 0.0006). We found statistically significant improvements related to availability of supportive care resources, e.g. increased reported access to contact nurse (from 53% to 66%, p ≤ 0.0001) and individual written care plans (from 40% to 54%, p < 0.0001). We also found some improvements related to patient involvement and care coordination, but also room for further developments. CONCLUSION The implementation of the new advanced cancer nursing role may have contributed to important improvements, but it has also identified areas in need of development. Further research with long-term evaluations of CCN roles in other contexts, are both needed and on-going.
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Affiliation(s)
- B Westman
- Regional Cancer Centre, Stockholm Gotland, 10239, Stockholm, Sweden.
| | - H Ullgren
- Regional Cancer Centre, Stockholm Gotland, 10239, Stockholm, Sweden; Karolinska University Hospital, Theme Cancer, Patient Area Airway, Lung and Skin Cancer, 17176, Stockholm, Sweden; Umeå University, Department of Nursing, 90187, Umeå, Sweden
| | - A Olofsson
- Regional Cancer Centre, Stockholm Gotland, 10239, Stockholm, Sweden
| | - L Sharp
- Regional Cancer Centre, Stockholm Gotland, 10239, Stockholm, Sweden; Karolinska Institutet, LIME, Division of Innovative Care Research, 17177, Stockholm, Sweden
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Zibrik K, Laskin J, Ho C. Integration of a nurse navigator into the triage process for patients with non-small-cell lung cancer: creating systematic improvements in patient care. ACTA ACUST UNITED AC 2016; 23:e280-3. [PMID: 27330366 DOI: 10.3747/co.23.2954] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Nurse navigation is a developing facet of oncology care. The concept of patient navigation was originally created in 1990 at the Harlem Hospital Center in New York City as a strategy to assist vulnerable and socially disadvantaged populations with timely access to breast cancer care. Since the mid-1990s, navigation programs have expanded to include many patient populations that require specialized management and prompt access to diagnostic and clinical resources. Advanced non-small-cell lung cancer is ideally suited for navigation to facilitate efficient assessment in this fragile patient population and to ensure timely results of molecular tests for first-line therapy with appropriately targeted agents. At the BC Cancer Agency, nurse navigator involvement with thoracic oncology triage has been demonstrated to increase the proportion of patients receiving systemic treatment, to shorten the time to delivery of systemic treatment, and to increase the rate of molecular testing and the number of patients with molecular testing results available at time of initial consultation. Insights gained through the start-up process are briefly discussed, and a framework for implementation at other institutions is outlined.
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Affiliation(s)
| | | | - C Ho
- BC Cancer Agency, Vancouver, BC
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