Seminars in Oncology Nursing最新文献_第8页

Innovative Cancer Follow-Up with Telehealth: A New Method for Oncology Nurses 利用远程医疗进行创新性癌症随访：肿瘤科护士的新方法。

IF 2.2 4区医学 Q1 Nursing

Seminars in Oncology Nursing

Pub Date : 2024-06-01 DOI: 10.1016/j.soncn.2024.151649

Elif Donmez , Bulent Kilic , Zeynep Dulger , Turkan Ozdas

Objectives

Telenavigation (TN) is an innovative cancer follow-up method for oncology nurses. Little is known about the effectiveness of tele-navigation on cancer patients. This study investigated the opinions of healthcare providers (HCPs) and colorectal cancer patients’ experience regarding patient follow-up with TN.

Data Sources

This is a phenomenological qualitative study. Semistructured interviews were conducted with fifteen patients and eight healthcare providers. Participants were selected by purposive sampling. Data were collected from March to October 2022 and analyzed by thematic content analysis.

Conclusion

Six themes emerged that described the experiences of TN: (1) beneficial; (2) psychological state; (3) level of knowledge, (4) technology, (5) health care system, and (6) recommendations. Patients and HCPs found TN practice helpful and reassuring and they recommended expanding these practices within the health system. As a result of the research, the TN program is described as beneficial to patients and healthcare providers.

Implications for Nursing Practice

The TN follow-up is a beneficial implication for colorectal cancer patients undergoing treatment, and it deserves to be more widely deployed. It brings reassurance regarding psychological, reliable data access, and home follow-up. Patients and HCPs reported positive views on telephone follow-up. There is a recommendation that the innovative follow-up technique should be disseminated to the healthcare system and that cancer nurses should be more familiar with this method.

目的：远程导航（TN）是为肿瘤科护士提供的一种创新的癌症随访方法。人们对远程导航对癌症患者的效果知之甚少。本研究调查了医疗服务提供者（HCPs）的意见以及结直肠癌患者使用 TN 随访的经验：这是一项现象学定性研究。对 15 名患者和 8 名医疗服务提供者进行了半结构化访谈。参与者是通过有目的抽样选出的。数据收集时间为 2022 年 3 月至 10 月，采用主题内容分析法对数据进行分析：描述 TN 体验的六个主题是：（1）有益；（2）心理状态；（3）知识水平；（4）技术；（5）医疗保健系统；（6）建议。患者和医疗保健人员认为 TN 实践很有帮助，让人放心，他们建议在医疗系统内推广这些实践。研究结果表明，TN 项目对患者和医疗服务提供者都是有益的：TN随访对正在接受治疗的结直肠癌患者有益，值得更广泛地推广。它为患者带来了心理安慰、可靠的数据访问和家庭随访。患者和医疗保健人员对电话随访持积极态度。建议向医疗系统推广这种创新的随访技术，并让癌症护士更加熟悉这种方法。

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引用次数: 0

Reliability and Validity of the Arabic Version of the Short Form Supportive Care Needs Survey Questionnaire (SCNS-SF34-A) 阿拉伯语版支持性护理需求调查简表（SCNS-SF34-A）的可靠性和有效性。

IF 2.2 4区医学 Q1 Nursing

Seminars in Oncology Nursing

Pub Date : 2024-06-01 DOI: 10.1016/j.soncn.2024.151646

Hanan Abdelrahman , Mohammad Al Qadire , Hamada Zehry

Objective

This study aimed to assess the psychometric properties of the Arabic version of the Supportive Care Needs Survey Short Form 34 (SCNS-SF34-A) among heterogonous group of cancer patients.

Method

This was a multicenter, prospective, descriptive-correlational survey that included 297 cancer patients recruited from two hospitals. The tool construct validity, internal consistency, and test-retest reliability were evaluated.

Results

The participants comprised 60.6% females, with ages ranging from 18 to 82 years. The majority were married (71.7%) and had mainly breast cancer (28.3%). Exploratory factor analysis supported a four-factor structure that are: health system information and patient support domain, psychological domain, physical and daily living domain, and sexuality domain. This tool explained 64.2% of the variance. The SCNS-SF34-A demonstrated excellent internal consistency for the whole scale (Cronbach's alpha = 0.954) and high test-retest reliability (ICC = 0.954) for the subscales (Cronbach's alpha ranged from 0.82 to 0.95 and ICC ranged from 0.950 to 0.960.

Conclusion

SCNS-SF34-A exhibits robust psychometric properties and holds promise for enhancing cancer care in the Arab world, contributing to a more tailored and effective approach to addressing patients' supportive care needs. The four-factor structure aligns with international studies, emphasizing the nuanced nature of variations. Further validation in diverse Arabic-speaking populations and the exploration of additional forms of validity are recommended.

Implications for Nursing Practice

The SCNS-SF34-A presents a reliable, culturally adapted, and sensitive assessment tool for the diverse supportive care needs of cancer patients in Oman and the Arab world. It contributes to the improvement of the quality of cancer care and patient-centered approach in clinical practice.

研究目的本研究旨在评估阿拉伯语版支持性护理需求调查简表 34（SCNS-SF34-A）在不同癌症患者群体中的心理测量特性：这是一项多中心、前瞻性、描述性相关调查，包括从两家医院招募的 297 名癌症患者。对该工具的建构效度、内部一致性和重测可靠性进行了评估：参与者中女性占 60.6%，年龄从 18 岁到 82 岁不等。大多数人已婚（71.7%），主要患有乳腺癌（28.3%）。探索性因素分析支持四因素结构，即：医疗系统信息和患者支持领域、心理领域、身体和日常生活领域以及性生活领域。该工具解释了 64.2% 的方差。SCNS-SF34-A 整个量表的内部一致性极佳（Cronbach's alpha = 0.954），各分量表的测试-再测可靠性也很高（ICC = 0.954）（Cronbach's alpha 为 0.82 至 0.95，ICC 为 0.950 至 0.960）：SCNS-SF34-A具有强大的心理测量特性，有望加强阿拉伯世界的癌症护理工作，有助于采用更有针对性、更有效的方法来满足患者的支持性护理需求。四因素结构与国际研究一致，强调了差异的细微差别。建议在讲阿拉伯语的不同人群中进行进一步验证，并探索其他形式的有效性：SCNS-SF34-A 为阿曼和阿拉伯世界癌症患者的不同支持性护理需求提供了一种可靠的、适应不同文化且敏感的评估工具。它有助于在临床实践中提高癌症护理质量和以患者为中心的方法。

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引用次数: 0

The Role of Researcher for Advanced Practice Nurses in Oncology: Challenges and Lessons Learned 肿瘤学高级实践护士的研究者角色：挑战与经验教训。

IF 2.2 4区医学 Q1 Nursing

Seminars in Oncology Nursing

Pub Date : 2024-06-01 DOI: 10.1016/j.soncn.2024.151634

Ann Van Hecke , Elsie Decoene , Annelies Courtens , Annemarie Coolbrandt , Ine Decadt , Eva Pape

Objectives

To reflect on current practice analyses regarding the role of advanced practice nurse (APN) researcher in oncology, and report on the challenges that were faced and lessons we have learned when intensively working with APNs on doing research within the domain of oncology.

Methods

Discussions with APNs supervised by or who collaborated with academics in nursing science during the past 10 years on doing research within the domain of oncology.

Results

Several misconceptions exist regarding the role of APNs as researchers. During the research process, APNs are confronted with a wide range of topics based on evidence gaps and unmet needs, challenges linked to specific research designs, and ethical issues. APNs also face challenges related to the dissemination of research. This step in the research process is often overlooked due to APNs’ lack of time, limited financial resources, insufficient support for academic writing, or lower priority for APNs and other healthcare providers.

Conclusion

The APN role of researcher in oncology is fundamental for the advancement of oncology nursing care, implementation of evidence‐based practice and innovations in oncology patient care, and further development of the nursing profession and nursing science. Participation in research is considered a main function that differentiates APNs from nurses in other clinical roles, such as specialized nurses. By embracing the role of researcher, oncology APNs can achieve professional growth that will stimulate them as an APN, open new opportunities, and keep them challenged.

Implications for Nursing Practice

In addition to APN, organizational and structural related factors, support by relevant stakeholders, partnering with (nursing) research units and professional and patient organizations, and dedicated time for research can positively influence uptake of the APN researcher role.

方法在过去 10 年中，与接受护理科学学者指导或与护理科学学者合作的高级实践护士讨论在肿瘤学领域开展研究的问题。结果关于高级实践护士作为研究人员的角色，存在一些误解。在研究过程中，全科护士会面临各种基于证据差距和未满足需求的课题、与特定研究设计相关的挑战以及伦理问题。全科护士还面临与传播研究成果有关的挑战。由于全科护士缺乏时间、财政资源有限、学术写作支持不足，或者全科护士和其他医疗服务提供者的优先级较低，研究过程中的这一步骤往往被忽视。结论全科护士在肿瘤学中的研究者角色对于推进肿瘤学护理、实施循证实践和肿瘤学患者护理创新，以及进一步发展护理专业和护理科学至关重要。参与研究被认为是全科护士区别于其他临床角色护士（如专科护士）的主要职能。对护理实践的启示除全科护士外，与组织和结构相关的因素、相关利益方的支持、与（护理）研究单位及专业和患者组织的合作以及专门用于研究的时间都会对全科护士担任研究员这一角色产生积极影响。

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引用次数: 0

The Nurse Practitioner Role in Complex Malignant Hematology: A Qualitative Descriptive Study 复杂恶性血液病中的执业护士角色：定性描述研究。

IF 2.2 4区医学 Q1 Nursing

Seminars in Oncology Nursing

Pub Date : 2024-06-01 DOI: 10.1016/j.soncn.2024.151625

Margaret F. Forbes , Nancy Carter , Kristi L. MacKenzie , C. Tom Kouroukis , Kerry S. Balonjan , Denise E. Bryant-Lukosius

Objectives

Internationally, there is limited evidence about the role and impact of nurse practitioners (NPs) in complex malignant hematology (CMH). In one Canadian CMH program, NPs have existed for 20 years but not been evaluated. This study aimed to understand stakeholder perceptions of CMH NP role structures, processes, and outcomes and the extent to which the role meets patient and health service needs.

Methods

A qualitative descriptive study was conducted, guided by the PEPPA-Plus framework. Purposive sampling was used to recruit stakeholders who participated in focus groups and interviews. Content analysis was used to analyze the data.

Results

Participants included patients (n = 8) and healthcare professionals (n = 27). Themes about structures related to evolution of the CMH Program, model of care, and need for strategic vision. Process themes related to provision of accessible, comprehensive, and holistic care and NP workload. Positive and negative outcomes and lack of outcome measurement were identified.

Conclusion

Structures related to patient and NP characteristics, organizational change, staffing, and how NP work is organized impacts on NP role implementation and outcomes. Organizational structures can be strengthened to improve the model of care and NP role implementation and workload. Value-added NP contributions related to providing comprehensive care with attention to safety and social determinants of health. Research is needed to evaluate NP role outcomes in CMH.

Implications for Nursing Practice

The results can inform role design and organization policies and strategies to promote the recruitment, retention, and optimization of NP roles in CMH settings. Priorities for future research are also identified.

目的：在国际上，有关执业护士（NPs）在复杂恶性血液病（CMH）中的作用和影响的证据十分有限。在加拿大的一个 CMH 项目中，NP 已存在了 20 年，但尚未进行评估。本研究旨在了解利益相关者对 CMH NP 角色结构、流程和结果的看法，以及该角色在多大程度上满足了患者和医疗服务需求：方法：在 PEPPA-Plus 框架的指导下开展了一项定性描述性研究。在招募参与焦点小组和访谈的利益相关者时采用了有目的的抽样。研究采用内容分析法对数据进行分析：参与者包括患者（8 人）和医护人员（27 人）。关于结构的主题涉及到 CMH 项目的演变、护理模式以及对战略愿景的需求。过程主题涉及提供方便、全面和综合的护理以及 NP 的工作量。研究还发现了积极和消极的结果，以及缺乏对结果的衡量：与患者和 NP 特征、组织变革、人员配备和 NP 工作组织方式有关的结构对 NP 角色的实施和结果产生了影响。组织结构可以得到加强，以改善护理模式、护士角色的实施和工作量。护士的增值贡献与提供全面护理有关，同时关注安全和健康的社会决定因素。需要开展研究以评估 NP 在 CMH 中的角色成果：研究结果可为角色设计、组织政策和策略提供参考，以促进 CMH 环境中 NP 角色的招募、保留和优化。研究还确定了未来研究的重点。

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引用次数: 0

Nutritional Management of Lung Cancer Patients Undergoing Chemotherapy: A Qualitative Exploration of Patients' and Healthcare Professionals' Perspectives. 接受化疗的肺癌患者的营养管理：对患者和医护人员观点的定性研究。

IF 2.2 4区医学 Q1 Nursing

Seminars in Oncology Nursing

Pub Date : 2024-05-29 DOI: 10.1016/j.soncn.2024.151657

Huan Rong, Fangyi Li, Chunmei Liu, Linyu Zhou, Hongyue Zhong, Li Li, Tian Xiao, Ruihan Xiao, Xiaoju Chen

Objectives: To describe the experiences of lung cancer patients undergoing chemotherapy in nutrition management and the problems in the process of implementing nutrition management for patients by healthcare professionals.

Methods: This is a qualitative descriptive study. Qualitative data were collected through semistructured interviews with lung cancer patients undergoing chemotherapy (N = 16) and healthcare professionals (N = 24) from the oncology department at three tertiary grade A hospitals.

Results: Three themes emerged from the patients' interviews: deficiency in nutritional management capabilities; barriers to implementing nutritional management; incentives to implementing nutritional management. Five themes emerged from the healthcare professionals' interviews: insufficient attention to nutritional management of lung cancer patients undergoing chemotherapy; lack of standardization in nutritional management; inadequate support for nutritional management; weak multidisciplinary awareness; poor compliance from patients and their families.

Conclusions: The nutritional management of lung cancer patients undergoing chemotherapy is a complicated and vital process that requires the joint efforts of healthcare professionals and patients. Formulating corresponding strategies from multiple perspectives is suggested to provide targeted nutritional guidance for patients.

Implication for nursing practice: This study can help nurses better understand the nutritional management needs and challenges of patients to provide individualized nutritional guidance to patients. Meanwhile, the study also found the existing problems of nutrition management in clinical work, which can help nurses to reflect on and better participate in the nutrition management of patients.

目的描述接受化疗的肺癌患者在营养管理方面的经验，以及医护人员对患者实施营养管理过程中存在的问题：这是一项定性描述性研究。通过对三家三级甲等医院肿瘤科接受化疗的肺癌患者（16 人）和医护人员（24 人）进行半结构化访谈，收集定性数据：患者访谈中提出了三个主题：营养管理能力不足；实施营养管理的障碍；实施营养管理的激励措施。医护人员访谈中提出了五个主题：对肺癌化疗患者的营养管理重视不够；营养管理缺乏标准化；营养管理支持不足；多学科意识薄弱；患者及其家属依从性差：肺癌化疗患者的营养管理是一个复杂而重要的过程，需要医护人员和患者的共同努力。建议从多角度制定相应的策略，为患者提供有针对性的营养指导：本研究有助于护士更好地了解患者的营养管理需求和面临的挑战，为患者提供个体化的营养指导。对护理实践的启示：本研究有助于护士更好地了解患者的营养管理需求和面临的挑战，为患者提供个体化的营养指导，同时也发现了临床工作中营养管理存在的问题，有助于护士反思并更好地参与患者的营养管理。

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引用次数: 0

Oncology Nurses’ Experiences of Using Health Information Systems in the Delivery of Cancer Care in a Range of Care Settings: A Systematic Integrative Review 肿瘤科护士在不同护理环境中使用医疗信息系统提供癌症护理的经验：系统整合综述》。

IF 2.2 4区医学 Q1 Nursing

Seminars in Oncology Nursing

Pub Date : 2024-04-01 DOI: 10.1016/j.soncn.2023.151579

Delilah Shelley , Deborah Davis , Kasia Bail , Rebecca Heland , Catherine Paterson

Objectives

This systematic review aimed to identify oncology nurses’ experiences of using health information systems (HIS) in the delivery of cancer care.

Data Sources

The electronic databases searched included CINAHL, MEDLINE (EBSCO host), SCOPUS, Web of Science Core Collection, Google Scholar, OVID, and ProQuest Central (using advanced search strategy) and hand searching of reference lists of the included articles and relevant systematic reviews. Studies published in English language were examined.

Conclusion

Twenty-six studies were included. Three themes emerged: (1) the transparency and application of the nursing process within HIS, (2) HIS enhancing and facilitating communication between nurses and patients, and (3) the impact of HIS on the elements of person-centered care. Nurses’ experiences with HIS were overall positive. However, digital systems do not fully capture all elements of the nursing processes; this was confirmed in this review, through the nurses’ lens. Most studies used HIS for symptom reporting and monitoring within non-inpatient settings and largely biomedical and lack insight into the person-centeredness and overall holistic care.

Implications for Nursing Practice

There are evidently varied views of HIS adoption across the globe. HIS can improve health-related quality of life and symptom burden, including self-reporting of symptoms among patients. However, there is a need for ongoing high-quality research, and clearer reporting than is evident in the current 26 studies, to fully understand the impact of HIS within the nursing processes and patient outcomes across all specialty cancer fields.

目的：本系统综述旨在了解肿瘤科护士在提供癌症护理时使用医疗信息系统（HIS）的经验：本系统综述旨在了解肿瘤科护士在提供癌症护理过程中使用医疗信息系统（HIS）的经验：检索的电子数据库包括：CINAHL、MEDLINE（EBSCO主机）、SCOPUS、Web of Science Core Collection、Google Scholar、OVID和ProQuest Central（使用高级检索策略），并对纳入文章的参考文献目录和相关系统综述进行了人工检索。结论：共纳入 26 项研究：共纳入 26 项研究。出现了三个主题：（1）护理流程在 HIS 中的透明度和应用；（2）HIS 加强和促进了护士与患者之间的沟通；（3）HIS 对以人为本的护理要素的影响。护士对 HIS 的体验总体上是积极的。然而，数字系统并不能完全捕捉到护理流程的所有要素；这一点在本综述中通过护士的视角得到了证实。大多数研究将 HIS 用于非住院环境下的症状报告和监测，主要是生物医学方面的研究，缺乏对以人为本和整体护理的深入了解：对护理实践的启示：在全球范围内，人们对采用 HIS 的看法显然各不相同。HIS 可以改善与健康相关的生活质量和症状负担，包括患者对症状的自我报告。然而，需要持续开展高质量的研究，并提供比目前 26 项研究更清晰的报告，以充分了解 HIS 在所有癌症专科领域的护理流程和患者预后中的影响。

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引用次数: 0

Determination of Nursing Care Times Based on the Perroca Patient Classification Instrument in the Inpatient Oncology Unit: A Mixed Method Study 根据佩罗卡病人分类工具确定肿瘤科住院病人的护理时间：混合方法研究。

IF 2.2 4区医学 Q1 Nursing

Seminars in Oncology Nursing

Pub Date : 2024-04-01 DOI: 10.1016/j.soncn.2024.151608

Güzin Ayan , Emine Türkmen , Esra Uğur , Elif Akbal , Banu Sarıtaş , Çiğdem Erbay , Özge Hayta

Objectives

The aim of this study was to determine the daily nursing care times of hospitalized inpatient oncology unit patients according to degree of acuity using the Perroca Patient Classification tool.

Data Sources

This study used a mixed method sequential explanatory design. The "Nursing Activity Record Form” and “Perroca Patient Classification Instrument” were used for quantitative data collection, and direct observation was performed for 175 hours via time-motion study. Descriptive statistics, between-group comparison, and correlation analysis were used for data analysis. Using a semistructured questionnaire, qualitative data were collected from individual in-depth interviews with seven nurses who participated in the quantitative part of the study. Qualitative data were analyzed by thematic analysis. The reporting of this study followed GRAMMS checklist.

Conclusions

As a result of the integration of quantitative and qualitative data, daily nursing care duration was determined as 2 to 2.5 hours for Type 1 patients, 2.6 to 3.5 hours for Type 2 patients, 3.6 to 4.75 hours for Type 3 patients, and 4.76 to 5.5 hours for Type 4 patients. The findings showed that in an inpatient oncology unit, nursing care hours increased as patients' Perroca Patient Classification Instrument acuity grade increased; thus, the instrument was discriminative in determining patients' degree of acuity.

Implications for Nursing Practice

Nurse managers can utilize this study's results to plan daily assignments that are sensitive to patient care needs. The results can also help nurse managers to identify relationships between nurse staffing and patient outcomes at the unit level, as well as to develop ways to analyze such relationships.

研究目的本研究旨在使用佩罗卡患者分类工具，根据病情严重程度确定肿瘤科住院患者的日常护理时间：本研究采用混合法顺序解释设计。采用 "护理活动记录表 "和 "佩罗卡病人分类工具 "进行定量数据收集，并通过时间运动研究进行 175 小时的直接观察。数据分析采用了描述性统计、组间比较和相关分析。通过半结构化问卷，对参与定量研究的 7 名护士进行了个别深入访谈，收集了定性数据。定性数据采用主题分析法进行分析。本研究的报告遵循 GRAMMS 核对表：综合定量和定性数据后，确定 1 型患者的每日护理时间为 2 至 2.5 小时，2 型患者为 2.6 至 3.5 小时，3 型患者为 3.6 至 4.75 小时，4 型患者为 4.76 至 5.5 小时。研究结果表明，在肿瘤科住院病房中，随着患者的佩罗卡患者分级工具（Perroca Patient Classification Instrument）严重程度等级的增加，护理时间也随之增加；因此，该工具在确定患者严重程度方面具有鉴别性：对护理实践的启示：护士管理者可以利用本研究的结果来规划日常任务，以满足患者的护理需求。研究结果还有助于护士管理者在科室层面确定护士人员配备与患者治疗效果之间的关系，并制定分析这种关系的方法。

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引用次数: 0

Qualitative Analysis of School Re-Entry Experiences of Turkish Survivors of Childhood and Adolescent Cancer: Parental Perspective 土耳其儿童和青少年癌症幸存者重返校园经历的定性分析：父母的视角。

IF 2.2 4区医学 Q1 Nursing

Seminars in Oncology Nursing

Pub Date : 2024-04-01 DOI: 10.1016/j.soncn.2024.151613

Tuba Arpaci , Naime Altay

Objective

This study aimed to explore the school re-entry experiences of Turkish survivors of childhood and adolescent cancer.

Data Sources

In this qualitative study, semistructured in-depth interviews were undertaken with parents of childhood cancer survivors who had completed treatment for at least 2 years (n = 20). Interviews were conducted via telephone or video conferencing. The study was conducted and reported according to the COREQ (Consolidated Criteria for Reporting Qualitative Research) guidelines. The components of qualitative rigor were considered to ensure confidence in the methods and data.

Conclusions

The average age of parents was 43.20 ± 4.66 years (range 37-55) (n = 20). The mean age of survivors was 8.45 ± 2.03 years at diagnosis and 15.05 ± 2.08 years during the study. The diagnosis of most of the survivors was lymphoma (35%). Four main themes were developed: worry; challenging situations; negative effects of the disease process; and facilitating situations. Parents stated that both children and parents need support during the school re-entry process.

Implication for Nursing Practice

This study revealed that survivors may experience problems that make school re-entry difficult. With cooperation between the health team and the school, arrangements should be made to ensure survivors have a positive experience on school re-entry. Pediatric oncology nurses should know survivors' requirements and take action to deliver school re-entry adjustment programs.

研究目的本研究旨在探讨土耳其儿童和青少年癌症幸存者重返校园的经历：在这项定性研究中，我们对已完成至少两年治疗的儿童癌症幸存者的父母（n = 20）进行了半结构化深入访谈。访谈通过电话或视频会议进行。本研究根据 COREQ（定性研究综合报告标准）指南进行并报告。研究考虑了定性研究的严谨性，以确保研究方法和数据的可信度：父母的平均年龄为 43.20 ± 4.66 岁（37-55 岁不等）（n = 20）。幸存者确诊时的平均年龄为（8.45 ± 2.03）岁，研究期间的平均年龄为（15.05 ± 2.08）岁。大多数幸存者的诊断为淋巴瘤（35%）。研究形成了四大主题：担忧；具有挑战性的情况；疾病过程的负面影响；以及有利的情况。家长们表示，在重新入学的过程中，孩子和家长都需要支持：这项研究表明，幸存者可能会遇到一些问题，导致重新入学困难重重。在医疗团队和学校的合作下，应做出安排以确保幸存者在重新入学时有积极的体验。小儿肿瘤科护士应了解幸存者的要求，并采取行动提供重新入学调整方案。

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引用次数: 0

Navigating Transitions in Oncology Care: From Emergency Department to Outpatient Clinic 引导肿瘤治疗的过渡：从急诊科到门诊。

IF 2.2 4区医学 Q1 Nursing

Seminars in Oncology Nursing

Pub Date : 2024-04-01 DOI: 10.1016/j.soncn.2024.151585

Megan Roy, Katie Fanslau, Margaret Rummel, Shannon Maier, Yvette Bell, Eleanor Miller

Objective

This quality improvement project was a collaborative effort with Penn Medicine's emergency department (ED) and oncology nurse navigators (ONNs). The goal of the project was to streamline patient transitions from the ED to the outpatient oncology clinic by developing a standardized referral process. The main objectives were to simplify and automate the referral process using the electronic medical record, improve multidisciplinary communication across the care continuum, ensure timely follow-up, and address barriers to oncology care.

Methods

The ED providers placed a consult to ONNs. The ONNs reached out to the patient within 48 hours of the consult. They maintained a database of patient referrals and collected information such as patient demographics, reason for referral, insurance, and patient outcomes.

Results

The ED providers referred 204 patients to the ONNs from April 2022 to September 2023. The development of a standardized referral process from the ED to the outpatient oncology clinic proved successful. Of the patients referred, the ONNs facilitated 98 cancer diagnoses and 80 of those patients are receiving oncology care at Penn Medicine. The median time to the patient's first appointments was seven days, diagnosis was 15 days, and treatment initiation occurred within 32 days.

Conclusion

The project team achieved their goal of facilitating timely access to oncology care, ensuring continuity, and addressing patient-specific barriers.

Implications for Nursing Practice

This quality improvement initiative highlights the ONNs' role in enhancing access and equity in cancer care delivery. The success of the project underscores the ONN's expertise and leadership in addressing healthcare disparities in oncology care. Collaboratively, the teams created a new referral workflow improving care transitions from the ED to the outpatient oncology clinic. The project sets a precedent for optimizing patient care transitions, demonstrating the positive impact of ONNs as key members of the multidisciplinary healthcare team.

目标：该质量改进项目是宾夕法尼亚州立医院急诊科（ED）和肿瘤科护士导航员（ONNs）的一项合作项目。该项目的目标是通过制定标准化转诊流程，简化患者从急诊科到肿瘤门诊的转诊程序。主要目标是利用电子病历简化转诊流程并使之自动化，改善整个治疗过程中的多学科沟通，确保及时跟进，并解决肿瘤治疗的障碍：方法：急诊室医疗服务提供者向 ONNs 提供咨询。ONN 在会诊后 48 小时内与患者取得联系。他们建立了患者转诊数据库，并收集了患者人口统计学、转诊原因、保险和患者治疗结果等信息：结果：从 2022 年 4 月到 2023 年 9 月，急诊室医疗服务提供者向 ONNs 转介了 204 名患者。事实证明，制定从急诊室到肿瘤门诊的标准化转诊流程是成功的。在转诊的患者中，ONNs 协助确诊了 98 例癌症，其中 80 例患者正在宾夕法尼亚州立医院接受肿瘤治疗。患者首次就诊的中位时间为 7 天，诊断时间为 15 天，开始治疗的时间为 32 天：项目团队实现了促进及时获得肿瘤治疗、确保连续性和解决患者特定障碍的目标：这项质量改进计划凸显了 ONNs 在提高癌症护理的可及性和公平性方面的作用。该项目的成功凸显了 ONN 在解决肿瘤护理中的医疗差距方面的专业知识和领导力。各团队通力合作，创建了一个新的转诊工作流程，改善了从急诊室到肿瘤门诊的护理过渡。该项目开创了优化患者护理过渡的先例，展示了 ONN 作为多学科医疗团队重要成员的积极影响。

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引用次数: 0

Smoking Cessation Support: A Marathon, Not a Sprint; The Perspectives of Cancer Patients Who Smoke 戒烟支持：马拉松，而非短跑；吸烟癌症患者的观点

IF 2.2 4区医学 Q1 Nursing

Seminars in Oncology Nursing

Pub Date : 2024-04-01 DOI: 10.1016/j.soncn.2024.151584

Patricia Fox , Nancy Bhardwaj , Ailsa Lyons , Vikram Niranjan , Kate Frazer , Shiraz Syed , Amanda McCann , Sinead Brennan , Donal Brennan , Catherine Kelly , Michael Keane , Patricia Fitzpatrick

Objectives

Despite the unfavorable outcomes associated with continued smoking, a substantial proportion of patients with cancer continue to smoke after diagnosis. However, limited use of smoking cessation (SC) interventions has been reported. This study explored the perceptions of patients with cancer who continue to smoke/recently quit regarding SC.

Data Sources

Semistructured phone/Zoom/Webex interviews were conducted with 25 participants attending four Irish cancer hospitals who were current smokers or had quit at/after their cancer diagnosis. Thematic analysis was used to analyze the data.

Conclusion

A total of four key themes emerged: (1) Diagnosis was a shock and a cue to action. (2) Brief and variable SC support: most participants did not feel stigmatized and reported receiving verbal or written information from oncology healthcare providers (HCPs) on SC supports. However, use of SC services was limited and largely ineffective. Some participants reported that SC discussions occurred earlier in their treatment with limited/no discussion later. (3) Facilitators vs barriers: the presence or absence of willpower and motivation was perceived as important. Family and HCP support helped while stress hindered SC. (4) SC support is a “marathon,” not a “sprint.” Patients with cancer who continue to smoke or recently quit want a sustained, tailored, nonjudgmental approach to SC incorporating pharmacological and behavioral interventions that span hospital-/community-based settings.

Implications for Nursing Practice

While consultants have been identified as the key HCP to initiate the SC discussion, oncology nurses can support patients with cancer who smoke/recently quit by advocating for comprehensive SC services and by using positive messaging and encouragement.

目标尽管持续吸烟会带来不利的后果，但仍有相当一部分癌症患者在确诊后继续吸烟。然而，戒烟（SC）干预措施的使用却很有限。本研究探讨了继续吸烟/最近戒烟的癌症患者对戒烟干预的看法。数据来源对在爱尔兰四家癌症医院就诊的 25 名参与者进行了结构化电话/Zoom/Webex 访谈，这些参与者目前是吸烟者或在癌症确诊时/后戒烟。结论共出现了四个关键主题：(1) 诊断是一种冲击，也是采取行动的线索。(2) 简短而多变的戒烟支持：大多数参与者并不感到耻辱，并称从肿瘤医护人员（HCPs）那里获得了关于戒烟支持的口头或书面信息。但是，对 SC 服务的使用很有限，而且大多没有效果。一些参与者报告说，他们在治疗的早期就进行了 SC 讨论，但后期讨论有限/没有讨论。(3) 促进因素与障碍：意志力和动机的有无被认为很重要。家庭和医护人员的支持对 SC 有帮助，而压力则会阻碍 SC。(4) 支持戒烟是一场 "马拉松"，而不是 "短跑"。虽然咨询师被认为是发起戒烟讨论的关键 HCP，但肿瘤科护士可以通过倡导全面的戒烟服务以及使用积极的信息和鼓励来支持吸烟/近期戒烟的癌症患者。

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引用次数: 0