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Achieving Comprehensive, Patient-Centered Cancer Services: Optimizing the Role of Advanced Practice Nurses at the Core of Precision Health 实现以患者为中心的综合癌症服务:实现以患者为中心的综合癌症服务:优化高级执业护士在精准医疗中的核心作用。
IF 2.2 4区 医学 Q1 NURSING Pub Date : 2024-06-01 DOI: 10.1016/j.soncn.2024.151629
Sara Colomer-Lahiguera , Jenny Gentizon , Melissa Christofis , Célia Darnac , Andrea Serena , Manuela Eicher

Objectives

The field of oncology has been revolutionized by precision medicine, driven by advancements in molecular and genomic profiling. High-throughput genomic sequencing and non-invasive diagnostic methods have deepened our understanding of cancer biology, leading to personalized treatment approaches. Precision health expands on precision medicine, emphasizing holistic healthcare, integrating molecular profiling and genomics, physiology, behavioral, and social and environmental factors. Precision health encompasses traditional and emerging data, including electronic health records, patient-generated health data, and artificial intelligence-based health technologies. This article aims to explore the opportunities and challenges faced by advanced practice nurses (APNs) within the precision health paradigm.

Methods

We searched for peer-reviewed and professional relevant studies and articles on advanced practice nursing, oncology, precision medicine and precision health, and symptom science.

Results

APNs’ roles and competencies align with the core principles of precision health, allowing for personalized interventions based on comprehensive patient characteristics. We identified educational needs and policy gaps as limitations faced by APNs in fully embracing precision health.

Conclusion

APNs, including nurse practitioners and clinical nurse specialists, are ideally positioned to advance precision health. Nevertheless, it is imperative to overcome a series of barriers to fully leverage APNs’ potential in this context.

Implications for Nursing Practice

APNs can significantly contribute to precision health through their competencies in predictive, preventive, and health promotion strategies, personalized and collaborative care plans, ethical considerations, and interdisciplinary collaboration. However, there is a need to foster education in genetics and genomics, encourage continuous professional development, and enhance understanding of artificial intelligence-related technologies and digital health. Furthermore, APNs’ scope of practice needs to be reflected in policy making and legislation to enable effective contribution of APNs to precision health.

目标在分子和基因组分析技术进步的推动下,精准医疗在肿瘤学领域掀起了一场革命。高通量基因组测序和非侵入性诊断方法加深了我们对癌症生物学的了解,从而产生了个性化治疗方法。精准医疗是对精准医疗的拓展,强调整体医疗保健,整合了分子剖析和基因组学、生理学、行为学以及社会和环境因素。精准医疗涵盖传统数据和新兴数据,包括电子健康记录、患者生成的健康数据以及基于人工智能的医疗技术。本文旨在探讨高级执业护士(APNs)在精准健康范式中面临的机遇和挑战。方法我们搜索了同行评议和专业相关的高级执业护士、肿瘤学、精准医学和精准健康以及症状科学方面的研究和文章。结果高级执业护士的角色和能力符合精准健康的核心原则,可以根据患者的综合特征进行个性化干预。我们发现教育需求和政策差距是全科护士在全面接受精准医疗方面所面临的限制。结论全科护士,包括执业护士和临床专科护士,是推进精准医疗的理想人选。对护理实践的启示APN通过其在预测、预防和健康促进策略、个性化和协作性护理计划、伦理考虑以及跨学科协作方面的能力,可以为精准健康做出重大贡献。然而,有必要促进遗传学和基因组学方面的教育,鼓励持续的专业发展,并加强对人工智能相关技术和数字健康的了解。此外,全科护士的执业范围需要反映在政策制定和立法中,以使全科护士能够为精准健康做出有效贡献。
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引用次数: 0
Central Venous Access Device–Associated Skin Complications in Adults with Cancer: A Prospective Observational Study 癌症成人中与中心静脉通路设备相关的皮肤并发症:前瞻性观察研究
IF 2.2 4区 医学 Q1 NURSING Pub Date : 2024-06-01 DOI: 10.1016/j.soncn.2024.151618
Nicole C. Gavin , Sarah Northfield , Gabor Mihala , Margarette Somerville , Tricia Kleidon , Nicole Marsh , Emily Larsen , Jill Campbell , Claire M. Rickard , Amanda J. Ullman

Objectives

To identify the prevalence and type of central venous access device–associated skin complications for adult cancer patients, describe central venous access device management practices, and identify clinical and demographic characteristics associated with risk of central venous access device–associated skin complications.

Methods

A prospective cohort study of 369 patients (626 central venous access devices; 7,682 catheter days) was undertaken between March 2017 and March 2018 across two cancer care in-patient units in a large teaching hospital.

Results

Twenty-seven percent (n = 168) of participants had a central venous access device–associated skin complication. In the final multivariable analysis, significant (P < .05) risk factors for skin complications were cutaneous graft versus host disease (2.1 times greater risk) and female sex (1.4 times greater risk), whereas totally implanted vascular access device reduced risk for skin complications by two-thirds (incidence risk ratio 0.37).

Conclusion

Central venous access device–associated skin complications are a significant, potentially avoidable injury, requiring cancer nurses to be aware of high-risk groups and use evidence-based preventative and treatment strategies.

Implications for Practice

This study has confirmed how common these potentially preventable injuries are. Therefore, the prevalence of these complications could be reduced by focusing on improvements in skin assessment, reductions in central venous access device dressing variation and improving clinician knowledge of this injury.

目的 确定成年癌症患者中心静脉通路装置相关皮肤并发症的发生率和类型,描述中心静脉通路装置管理实践,并确定与中心静脉通路装置相关皮肤并发症风险相关的临床和人口学特征。方法2017年3月至2018年3月期间,在一家大型教学医院的两个癌症护理住院部对369名患者(626个中心静脉通路装置;7682个导管天数)进行了前瞻性队列研究。在最终的多变量分析中,皮肤并发症的重要风险因素(P < .05)是皮肤移植物抗宿主疾病(风险高出 2.1 倍)和女性(风险高出 1.4 倍),而完全植入式血管通路装置则将皮肤并发症的风险降低了三分之二(发病风险比为 0.37)。结论中心静脉通路装置相关的皮肤并发症是一种严重的、潜在的、可避免的损伤,要求癌症护士了解高风险人群,并采用循证预防和治疗策略。因此,可以通过改善皮肤评估、减少中心静脉通路装置敷料的变化以及提高临床医生对这种损伤的认识来降低这些并发症的发生率。
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引用次数: 0
Advanced Practice Pediatric Oncology Nursing as Imagined or In Place in Four Lower- and Upper-Middle-Income Countries 四个中低收入国家的儿科肿瘤高级护理实践。
IF 2.2 4区 医学 Q1 NURSING Pub Date : 2024-06-01 DOI: 10.1016/j.soncn.2024.151631
Remziye Semerci , Vera Larfi Samba , Dorian René Navarro Diaz , Rehana Punjwani , Julia Challinor

Objectives

The implementation of pediatric oncology advanced practice nurse (s) roles in low- and middle-income countries (LMICs) presents opportunities and challenges. The authors explore the implications of pediatric oncology advanced practice nursing roles in Pakistan, Cameroon, Turkey, and Mexico. Potential benefits and drawbacks of advanced practice nursing roles, impacts on nursing care, and strategies for advanced practice nursing role development in LMIC settings are considered.

Methods

Information from scholarly articles, policy documents, and four LMIC pediatric oncology nurse expert perspectives on existing and imagined advanced practice nursing roles in pediatric oncology in LMIC were synthesized.

Results

Current literature and policies point to efforts across LMICs to establish a wide variety of advanced nursing practices, not necessarily aligned with internationally accepted advanced practice nursing standards of practice or education. The LMIC nurses describe a wide range of national general nurse education and government advanced practice nurse recognition/licensing. Challenges to achieving or strengthening advanced practice nursing roles include, for example, healthcare professional resistance, government unwillingness to recognize/license advanced practice nurses, and lack of advanced practice nursing faculty. To promote a pediatric oncology advanced practice nursing role in LMICs requires navigating the national nursing scope of practice and nursing culture.

Conclusion

The strategic introduction of pediatric oncology advanced practice nursing roles in LMICs has the potential to significantly enhance patient care by, for example, addressing healthcare workforce shortages and facilitating timely care delivery. However, challenges related to role complexity, resistance from traditional healthcare structures, and role overlap must be considered. Tailoring these roles to local contexts and fostering stakeholder collaboration are essential for successful implementation.

Implications for Nursing Practice

The adoption of advanced practice nursing roles can lead to improved quality of care for pediatric oncology patients and their families in LMICs, where cancer care is challenging. The positive impact of pediatric oncology advanced practice nurses on patient outcomes and healthcare delivery cannot be discounted but must align with local nursing and healthcare culture and expectations.

目标:在中低收入国家(LMICs)实施儿科肿瘤高级实践护士(S)角色既是机遇也是挑战。作者探讨了儿科肿瘤高级实践护士角色在巴基斯坦、喀麦隆、土耳其和墨西哥的影响。作者探讨了高级实践护理角色的潜在益处和弊端、对护理工作的影响以及在 LMIC 环境中发展高级实践护理角色的策略:方法:综合了学术文章、政策文件和四位低收入与中等收入国家儿科肿瘤护理专家对低收入与中等收入国家儿科肿瘤领域现有和设想的高级实践护理角色的观点:目前的文献和政策表明,低收入与中等收入国家正在努力建立各种高级护理实践,但这些实践不一定符合国际公认的高级实践护理实践或教育标准。低收入与中等收入国家的护士描述了广泛的国家普通护士教育和政府高级实践护士认可/许可。实现或加强高级实践护理角色所面临的挑战包括:医护人员的抵触情绪、政府不愿承认/颁发高级实践护士执照以及缺乏高级实践护理师资等。要在低收入和中等收入国家推广儿科肿瘤高级实践护理的角色,就必须在国家护理实践范围和护理文化方面取得进展:结论:在低收入和中等收入国家战略性地引入儿科肿瘤高级实践护理角色,有可能通过解决医护人员短缺问题和促进及时提供护理服务等方式,显著提高患者护理水平。然而,必须考虑到与角色复杂性、传统医疗结构的阻力和角色重叠有关的挑战。根据当地情况调整这些角色并促进利益相关者的合作对于成功实施至关重要:对护理实践的启示:在癌症护理面临挑战的低收入和中等收入国家,采用高级实践护理角色可提高儿科肿瘤患者及其家属的护理质量。儿科肿瘤高级实践护士对患者预后和医疗服务的积极影响不容忽视,但必须符合当地的护理和医疗文化及期望。
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引用次数: 0
Building Career Pathways for Cancer Nurses: Ensuring Cancer Nursing's Future 为癌症护理人员建立职业途径:确保癌症护理的未来。
IF 2.2 4区 医学 Q1 NURSING Pub Date : 2024-06-01 DOI: 10.1016/j.soncn.2024.151633
Gemma McErlean , Catherine Paterson , Carla Thamm

Objectives

It is well established that cancer nurses and advanced practice nurses (APN) are critical to the delivery of high-quality, accessible, safe, and affordable cancer care globally. Specialized cancer nurses and APNs with a strong foundation in the pillars of nursing practice (clinical, leadership, education, and research) are essential to optimize patient outcomes, create increased cost-efficiencies through innovative models of care delivery, and can further leverage interprofessional collaboration in cancer care. To address the existing shortcomings in cancer control, Australian cancer nurses, including APNs, and cancer nurses and APNs globally, need an evidence-informed consensus drive framework to harmonize clinical, educational and career pathways leading to specialization, advanced practice, promotion, and equitable and accessible education.

Methods

Critical perspective.

Results

Scoping work has begun to build on the 2009 seminal Australian EdCaN framework, with ambitions to develop a contemporary practice and career framework for all cancer nurses which details clear pathways to specialized and APN roles inclusive of navigating to and through direct clinical care, research, academia, education, and management or executive leadership.

Conclusions

A revised framework that is cognizant of the changing landscape of contemporary cancer care, and the growing diversity of nursing roles is needed to address the imminent nursing workforce crisis.

Implications for Nursing Practice

The revised framework may support the implementation of the newly released Australian Cancer Plan and provide a career pathway model that may be adopted internationally, including in low- and middle-income countries.

目标:癌症护士和高级执业护士(APN)对于在全球范围内提供优质、便捷、安全和负担得起的癌症护理至关重要,这一点已得到公认。在护理实践支柱(临床、领导力、教育和研究)方面具有坚实基础的癌症专科护士和高级实践护士对于优化患者治疗效果、通过创新护理服务模式提高成本效益以及进一步促进癌症护理中的跨专业合作至关重要。为解决癌症控制方面的现有不足,澳大利亚癌症护士(包括全科护士)以及全球癌症护士和全科护士需要一个以证据为基础的共识驱动框架,以协调临床、教育和职业发展途径,从而实现专业化、高级实践、晋升以及公平和可获得的教育:方法:批判性视角:已开始进行范围界定工作,以 2009 年澳大利亚 EdCaN 重要框架为基础,为所有癌症护士制定一个当代实践和职业框架,详细说明通往专科和 APN 角色的明确途径,包括直接临床护理、研究、学术、教育、管理或行政领导:结论:为应对迫在眉睫的护理人员危机,有必要修订框架,使其认识到当代癌症护理不断变化的形势以及护理角色日益多样化的特点:修订后的框架可支持新发布的《澳大利亚癌症计划》的实施,并提供一个可在国际上(包括中低收入国家)采用的职业途径模型。
{"title":"Building Career Pathways for Cancer Nurses: Ensuring Cancer Nursing's Future","authors":"Gemma McErlean ,&nbsp;Catherine Paterson ,&nbsp;Carla Thamm","doi":"10.1016/j.soncn.2024.151633","DOIUrl":"10.1016/j.soncn.2024.151633","url":null,"abstract":"<div><h3>Objectives</h3><p>It is well established that cancer nurses and advanced practice nurses (APN) are critical to the delivery of high-quality, accessible, safe, and affordable cancer care globally. Specialized cancer nurses and APNs with a strong foundation in the pillars of nursing practice (clinical, leadership, education, and research) are essential to optimize patient outcomes, create increased cost-efficiencies through innovative models of care delivery, and can further leverage interprofessional collaboration in cancer care. To address the existing shortcomings in cancer control, Australian cancer nurses, including APNs, and cancer nurses and APNs globally, need an evidence-informed consensus drive framework to harmonize clinical, educational and career pathways leading to specialization, advanced practice, promotion, and equitable and accessible education.</p></div><div><h3>Methods</h3><p>Critical perspective.</p></div><div><h3>Results</h3><p>Scoping work has begun to build on the 2009 seminal Australian EdCaN framework, with ambitions to develop a contemporary practice and career framework for all cancer nurses which details clear pathways to specialized and APN roles inclusive of navigating to and through direct clinical care, research, academia, education, and management or executive leadership.</p></div><div><h3>Conclusions</h3><p>A revised framework that is cognizant of the changing landscape of contemporary cancer care, and the growing diversity of nursing roles is needed to address the imminent nursing workforce crisis.</p></div><div><h3>Implications for Nursing Practice</h3><p>The revised framework may support the implementation of the newly released Australian Cancer Plan and provide a career pathway model that may be adopted internationally, including in low- and middle-income countries.</p></div>","PeriodicalId":54253,"journal":{"name":"Seminars in Oncology Nursing","volume":"40 3","pages":"Article 151633"},"PeriodicalIF":2.2,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S074920812400072X/pdfft?md5=5cf7d5b70f78d8ac20194f1101cc05f4&pid=1-s2.0-S074920812400072X-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140913115","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
The Relationship Between Attitudes Toward Death, Rumination, and Psychological Resilience of Oncology Nurses 肿瘤科护士对死亡的态度、反刍和心理复原力之间的关系。
IF 2.2 4区 医学 Q1 NURSING Pub Date : 2024-06-01 DOI: 10.1016/j.soncn.2024.151645
Yeter Sinem Üzar-Özçetin , Simay Ezgi Budak

Objectives

The study aimed to examine the relationship between attitudes toward death, rumination, and psychological resilience of oncology nurses.

Methods

The study design was cross-sectional. Data were collected from 118 oncology nurses using the Demographic Data Form, Work-Related Rumination Scale, Connor-Davidson Resilience Scale Short Form, and Death Attitude Profile-Revised Scale. For data analysis, correlation and regression analyses were performed.

Results

The study findings showed that oncology nurses` work related rumination score was moderate, while psychological resilience score was severely high. More than two-thirds of the work-related ruminations of oncology nurses were explained by psychological resilience and attitudes toward death. Even though there is a negative correlation between negative attitudes toward death and psychological resilience, the acceptance of death scores showed positive relations with psychological resilience.

Conclusion

Nurses with positive attitudes toward death can also develop psychological resilience and experience fewer work-related ruminations. This result reveals the necessity of determining oncology nurses' attitudes toward death in order to protect their psychological resilience and reduce work-related ruminations. It is also evident that the results are valuable in presenting how nurses' work-related ruminations relate to psychological resilience and attitudes toward death.

Implications for Nursing Practice

Nurses are the main care providers in oncology settings, and they are witnessing the suffering process of their patients and experiencing the loss of their patients. These challenges bring work-related ruminations that lower the psychological resilience of nurses and affect attitudes toward death. Therefore, nurses can build an awareness of their ruminations and develop coping skills with intrusive ruminations.

研究目的:本研究旨在探讨肿瘤科护士对死亡的态度、反刍和心理复原力之间的关系。 研究方法:本研究采用横断面设计。使用人口统计学数据表、工作相关反刍量表、康纳-戴维森复原力量表简表和死亡态度档案-修订版量表收集了 118 名肿瘤科护士的数据。研究结果表明,肿瘤科护士的工作相关遐想得分中等,而心理复原力得分严重偏高。超过三分之二的肿瘤科护士的工作相关反刍是由心理复原力和对死亡的态度所解释的。尽管对死亡的消极态度与心理复原力之间呈负相关,但对死亡的接受度得分与心理复原力呈正相关。这一结果揭示了确定肿瘤科护士对死亡的态度以保护其心理复原力和减少工作相关反刍的必要性。对护理实践的启示护士是肿瘤科环境中的主要护理人员,她们见证了病人的痛苦过程,也经历了病人的离去。这些挑战带来了与工作相关的反思,降低了护士的心理承受能力,影响了她们对死亡的态度。因此,护士可以建立对自己反思的意识,并发展应对侵入性反思的技能。
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引用次数: 0
Advanced Practice Nursing Titles and Roles in Cancer Care: A Scoping Review 癌症护理中的高级实践护理职称和角色:范围审查。
IF 2.2 4区 医学 Q1 NURSING Pub Date : 2024-06-01 DOI: 10.1016/j.soncn.2024.151627
Maura Dowling , Eva Pape , Franziska Geese , Ann Van Hecke , Denise Bryant-Lukosius , M. Consuelo Cerón , Paz Fernández-Ortega , Francisca Marquez-Doren , Ashleigh Ward , Cherith Semple , Tracy King , Manela Glarcher , Amanda Drury

Objectives

Advanced practice nursing roles in cancer care are diverse and exist across the cancer care continuum. However, the titles used and the scope of practice differ across countries. This diversity is likely to be misleading to patients and influence nurses’ contribution to health care. An understanding of the current state of advanced practice nursing roles in cancer care internationally is needed to inform opportunities for future role development and enhance cancer nursing career pathways.

Methods

This scoping review included a systematic search of four databases: MEDLINE, CINAHL, PsycINFO, and Academic Search Complete. Independent screening for papers meeting the review's inclusion criteria was undertaken using online screening software. Data extraction, coding, and mapping were undertaken in NVivo 12.

Results

Of the 13,409 records identified, 108 met the review's inclusion criteria. A variety of roles in cancer care settings were described. The United States and the United Kingdom had the most titles for advanced practice nursing roles. Tumor-specific roles were described and integrated into different phases of the cancer care continuum. Trends in continuing professional development for advanced practice nurses in cancer care included the rise in Fellowship programs in the United States and practice-based education in the United Kingdom.

Conclusions

The differences in advanced practice nursing roles in cancer care allow regional and institutional variation to meet the needs of patient populations and health care system demands. However, a lack of clarity surrounding titles and roles results in confusion and underutilization of these nurses’ highly specialized skill sets.

Implications for Nursing Practice

Incongruence in titles and scope of practice internationally will ultimately result in a merging of roles. There is a need for international agreement on education requirements for advanced practice nursing roles to promote career pathways.

目标:癌症护理中的高级实践护理角色多种多样,存在于整个癌症护理过程中。然而,各国使用的称谓和实践范围各不相同。这种多样性可能会误导患者,影响护士对医疗保健的贡献。我们需要了解国际上癌症护理中高级实践护理角色的现状,以便为未来的角色发展提供信息,并加强癌症护理的职业发展途径:本次范围界定综述包括对四个数据库的系统检索:方法:本范围综述包括对四个数据库的系统检索:MEDLINE、CINAHL、PsycINFO 和 Academic Search Complete。使用在线筛选软件对符合综述纳入标准的论文进行独立筛选。使用 NVivo 12 进行数据提取、编码和绘图:结果:在已确定的 13,409 条记录中,有 108 条符合综述的纳入标准。这些记录描述了癌症护理环境中的各种角色。美国和英国的高级实践护理角色最多。对特定肿瘤的角色进行了描述,并将其纳入癌症护理的不同阶段。癌症护理中高级实践护士的持续专业发展的趋势包括美国研究员计划的增加和英国以实践为基础的教育:癌症护理中高级实践护士角色的差异允许地区和机构的差异,以满足患者群体的需求和医疗保健系统的要求。然而,由于职称和角色不明确,导致这些护士的高度专业化技能组合被混淆和利用不足:对护理实践的影响:国际上职称和执业范围的不一致最终将导致角色的合并。国际社会有必要就高级实践护理角色的教育要求达成一致,以促进职业发展途径。
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引用次数: 0
Patient-Reported Outcome and Experience Measures in Advanced Nursing Practice: What Are Key Considerations for Implementation and Optimized Use? 高级护理实践中的患者报告结果和体验测量:实施和优化使用的主要考虑因素是什么?
IF 2.2 4区 医学 Q1 NURSING Pub Date : 2024-06-01 DOI: 10.1016/j.soncn.2024.151632
Amanda Drury , Vanessa Boland , Maura Dowling

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.

目的 讨论在癌症护理的高级实践护理服务中实施患者报告的结果测量(PROMs)和患者报告的体验测量(PREMs)的机遇和挑战。结果高级执业护士完全有能力评估和应对 PROMs 和 PREMs 数据;多项研究强调,在护士主导的服务中,患者在生活质量、症状困扰和功能状态方面的预后均有所改善。然而,PROMs 和 PREMs 在癌症护理和护士主导服务中的实施情况各不相同。以往的研究强调了实施方面的挑战,这些挑战可能会阻碍 PROMs 和 PREMs 工具的可比性和通用性。高级实践护士应考虑这些挑战,包括如何使用标准化的 PROM 工具。电子 PROM 虽然高效,但可能会将面临不公平风险的个体排除在外。复杂、冗长、频繁地使用 PROMs 也可能会给癌症患者或癌症术后患者带来过重的负担,在一些研究中,癌症患者表示更倾向于灵活使用 PROMs。因此,让癌症患者参与计划 PROMs/PREMs 的实施可能会克服这一难题。最后,实施过程中的组织考虑因素应涉及资金投入,包括技术和培训的初始成本,以及在现有基础设施内考虑 PROMs 的可操作性,以实现 PROMs 数据的无缝利用。在护士主导的服务中计划实施 PROMs 和 PREMs 时,可通过制定明确的使用指南、投资于所需基础设施的开发、用户教育和严格的实施流程(包括患者参与 PROMs/PREMs 的选择)来降低实施风险。
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引用次数: 0
Corrigendum to ‘The Effect of Psychosocial Support Videos Provided by the Community on Disease Attitudes and Symptoms of Pediatric Oncology Patients: Randomized Controlled Study’ [Seminars in Oncology Nursing 40 (2024) 151570] 社区提供的社会心理支持视频对儿科肿瘤患者疾病态度和症状的影响:随机对照研究》[Seminars in Oncology Nursing 40 (2024) 151570]。
IF 2.2 4区 医学 Q1 NURSING Pub Date : 2024-06-01 DOI: 10.1016/j.soncn.2024.151653
Remziye Semerci , Eyşan Hanzade Savaş , Ezgi Gizem Gürbüz , Nazlı Başegen , Münevver Erkul , Kübra Alki , Ezgi Paslı Uysalol
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引用次数: 0
A Future-Oriented Perspective on Advanced Practice Nursing Roles in Cancer Care: Pushing the Boundaries to Promote Innovation and Achieve Equitable, Patient-Centered Care 面向未来的视角:高级实践护理在癌症护理中的作用:推动创新,实现以患者为中心的公平护理。
IF 2.2 4区 医学 Q1 NURSING Pub Date : 2024-06-01 DOI: 10.1016/j.soncn.2024.151635
Denise Bryant-Lukosius , Eva Pape , Maura Dowling
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引用次数: 0
Nursing Considerations for Cytokine Release Syndrome in Relapsed/Refractory Multiple Myeloma: Experience with Teclistamab from the MajesTEC-1 Study 复发性/难治性多发性骨髓瘤细胞因子释放综合征的护理注意事项:MajesTEC-1研究中使用泰克司他单抗的经验。
IF 2.2 4区 医学 Q1 NURSING Pub Date : 2024-06-01 DOI: 10.1016/j.soncn.2024.151621
Donna Catamero , Patricia Blázquez Benito , Samantha Shenoy , Margaret Doyle , Jessica Fowler , Rachel Kobos , Arnob Banerjee , Sandy Kruyswijk

Objectives

Cytokine release syndrome (CRS) is a systemic inflammatory response that is commonly observed as a class effect of T-cell–redirecting therapies. This article provides important practical guidance for nurses relating to the diagnosis, monitoring, and management of CRS in patients receiving teclistamab, based on experience from the MajesTEC-1 clinical trial and real-life nursing practice.

Methods

MajesTEC-1 is a phase 1/2 study of teclistamab in heavily pretreated patients with relapsed/refractory multiple myeloma. To mitigate the risk of high-grade CRS, patients were carefully monitored for early signs and symptoms of CRS (including fever, which must have fully resolved before teclistamab administration).

Results

A survey of nurses from several of the study sites provided additional real-life insights into nursing best practices for managing CRS from four academic institutions in three countries.

Conclusions

In MajesTEC-1, 72% of patients treated with teclistamab experienced CRS, the majority of which was low grade. All cases resolved and none led to treatment discontinuation. Real-life supportive measures for CRS are generally aligned with those outlined in the study.

Implications for Nursing Practice

Because nurses are on the frontline of patient care, they play a crucial role in promptly recognizing the signs and symptoms of CRS and responding with timely and appropriate supportive treatment. This review provides important practical guidance for nurses on diagnosis, monitoring, and management of CRS in patients receiving teclistamab, based on experience from the MajesTEC-1 trial and real-life nursing practice.

目的细胞因子释放综合征(CRS)是一种全身性炎症反应,是T细胞重定向疗法常见的一类效应。本文根据MajesTEC-1临床试验的经验和现实生活中的护理实践,就接受替卡司他单抗治疗的患者CRS的诊断、监测和管理为护士提供了重要的实用指导。为了降低高级别CRS的风险,对患者进行了仔细监测,以发现CRS的早期症状和体征(包括发热,发热必须在替卡单抗用药前完全退去)。结果对几个研究机构的护士进行了调查,结果显示,三个国家的四家学术机构在管理CRS方面的最佳护理实践为我们提供了更多真实的见解。所有病例均得到缓解,无一例导致治疗中断。对护理实践的启示由于护士处于患者护理的第一线,他们在及时识别CRS的体征和症状并采取及时、适当的支持治疗方面发挥着至关重要的作用。本综述基于MajesTEC-1试验的经验和现实生活中的护理实践,为护士诊断、监测和管理接受替卡司他单抗治疗的患者的CRS提供了重要的实用指导。
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Seminars in Oncology Nursing
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