Multidisciplinary team meetings and shared decision-making are potential means of delivering patient-centred care. Not much is known about how those two paradigms fit together in cancer care. This ...study aimed to investigate how decisions are made in multidisciplinary team meetings and whether patient perspectives are incorporated in these decisions.
A qualitative study was conducted using non-participant observation at multidisciplinary team meetings (also called tumor boards) at the University Cancer Center Hamburg-Eppendorf, Germany. Two researchers recorded structured field notes from a total of N = 15 multidisciplinary team meetings. Data were analyzed using content analysis and descriptive statistics.
Physicians mainly exchanged medical information and based their decision-making on this information. Individual patient characteristics or their treatment preferences were rarely considered or discussed. In the few cases where patient preferences were raised as a topic, this information did not seem to be taken into account in decision-making processes about treatment recommendations.
The processes in multidisciplinary team meetings we observed did not exhibit shared decision-making. Patient perspectives were absent. If multidisciplinary team meetings wish to become more patient-centred they will have to modify their processes and find a way to include patient preferences into the decision-making process.
PROBLEM IDENTIFICATION: Adolescents and young adults (AYAs) with cancer commonly report future fertility as an important issue in care. Despite long-standing guidelines on fertility counseling and ...the trusting relationship between nurses and patients, little is known about the nurse's role in fertility preservation (FP) for AYAs with cancer. LITERATURE SEARCH: The authors conducted a literature search of articles published through 2020 focused on nursing involvement in FP for AYAs with cancer. DATA EVALUATION: 85 studies were identified. In total, 11 articles met inclusion criteria and were critically appraised in the review. SYNTHESIS: Although well positioned to improve FP care among AYAs with cancer, nurses currently have a minimal role because of provider, institutional, and patient-related barriers. IMPLICATIONS FOR PRACTICE: Interventions to enhance nurses' knowledge about FP, improvements in electronic health record documentation, and facilitation of institutional support are needed to support the nurse's role in FP for AYAs with cancer. KEYWORDS oncology; adolescent and young adult; fertility preservation; oncology nursing; oncofertility
Cancer prevention and screening is a significant part of the cancer care continuum. Nurses are trusted professionals who can bring stakeholders together and serve diverse groups.
This article ...describes how nurses can advance cancer prevention and screening initiatives in industry, education, legislative advocacy, research, survivorship, and program development and support.
An online search and collaborative knowledge revealed examples of nurses leading the way in cancer prevention and screening efforts.
Nurse-driven cancer prevention and screening collaborations advance care farther and faster. By creating maximum impact and mobilizing individual passion for a project, any nurse can find collaborative niche opportunities in clinical practice.
A long-term partnership among the Butaro Cancer Center of Excellence (BCCOE) in Rwanda, Partners in Health (PIH)/Inshuti Mu Buzima, and Dana-Farber Cancer Institute (DFCI) supports the development of ...oncology nurses through a clinical nurse educator role. Two senior Rwandan oncology nurses at BCCOE were hired as nurse educators and were mentored by a PIH/DFCI oncology nurse educator using the accompaniment approach. The formalized mentorship process included long-term accompaniment for all educator projects spanning staff training, quality improvement, research, and clinical practice, as well as development of nurse educator competencies and creation of a repository of resources.
Innovative and student-centered teaching methods are required to improve critical thinking and clinical reasoning skills. The objective of this study was to determine the impact of an oncology ...internship training on learning outcomes of nursing students using an integrated teaching-learning method.
A pre- and post-test quasi-experimental study was conducted among 107 undergraduate nursing students in fourth year who were allocated to two groups (intervention group = 51 and control group = 55) to receive an integrated teaching-learning method and routine method respectively. Data was collected using the Clinical Decision Making in Nursing Scale (CDMNS) and the students' cognitive learning test.
Difference in mean scores of cognitive learning test post-intervention was significant between the two groups (p < 0.001). Total CDMNS scores and its dimensions increased significantly for the intervention group post-intervention (p < 0.001). Analysis of covariance (ANCOVA) showed that when the effect of confounding variables, such as the student's Grade Point Average (GPA) and the pre-test scores of cognitive learning and decision-making scale were held constant, the effect of the independent variable (group) on students' cognitive learning test (p = 0.002) and CDMNS (p = 0.004) was significant.
Nursing students' cognitive learning and clinical decision-making scores were improved as a result of the integrated teaching-learning method. Nursing educators can use this method in clinical education to improve students' cognitive and meta-cognitive skills, thereby improving nursing care quality.
Lung cancer traditionally has a high morbidity and mortality rate because of late diagnosis. Use of a tumor board has been noted as one way to improve patient care and quality of life.
This article ...aimed to determine the contributions of an oncology nurse navigator (ONN) related to physician adherence to guidelines and streamlined patient care in an interprofessional lung cancer tumor board.
Retrospective chart review was performed for 18 months prior to and following implementation of the lung cancer tumor board.
After implementation of the lung cancer tumor board and the creation of clinical pathways by the ONN, diagnosis of early-stage non-small cell lung cancer and the use of diagnostic workups increased.
To compare the outcomes of robotic partial nephrectomy (RPN) with those of open PN (OPN) in patients with highly complex renal tumors defined as RENAL nephrometry score ≥ 10.
We analyzed clinical ...data from a total of 149 patients who underwent OPN or RPN for a highly complex renal mass at our institution between 2003 and 2017. Perioperative data, complication profiles, functional outcomes, pathologic variables, and oncologic outcomes were evaluated in both groups.
The median (interquartile range, IQR) patient age was 52.0 (42.0-59.0) years, and the median (IQR) follow-up period was 30.0 (7.0-54.0) months. Among the patients, 64 (43.0%) and 85 (57.0%) underwent OPN and RPN, respectively. The RPN group showed higher rates of clinical T1b and ≥ T2 than the OPN group (p = 0.019). There were no significant differences between the groups in terms of intraoperative outcomes such as operation time, estimated blood loss, warm ischemic time, and transfusion. Notably, the RPN group showed significantly shorter length of hospital stay than the OPN group (p < 0.001). Regarding the complication profiles and renal functional outcomes, no significant differences were reported between the groups. The estimated glomerular filtration rate decline from baseline at the last follow-up showed no significant differences between the two groups (p = 0.351). Kaplan-Meier survival analysis also showed no significant differences in survival outcomes between the groups (log-rank test, all p > 0.05).
RPN performed in patients with highly complex renal tumors offers perioperative, functional, and oncologic outcomes comparable to those associated with OPN.
To maintain and improve the quality of the cancer nursing workforce, it is crucial to understand the factors that influence retention and job satisfaction. We aimed to investigate the characteristics ...of cancer nurses in Australia and identify predictors of job satisfaction.
We analysed data from an anonymous cross-sectional survey distributed through the Cancer Nurses Society Australia membership and social media platforms from October 2021 to February 2022. The survey was compared to national nursing registration data. Data were analysed with non-parametric tests, and a stepwise, linear regression model was developed to best predict job satisfaction.
Responses were received from 930 cancer nurses. Most respondents (85%) described themselves as experienced nurses, and more than half had post-graduate qualifications. We identified individual, organizational, and systemic factors that contribute to job satisfaction and can impact in workforce shortages. The findings include strategies to address and prioritize workforce challenges. There were 89 different titles for advanced practice nursing roles. Managing high workload was a reported challenge by 88%. Intention to stay less than 10 years was reported by nearly 60%; this was significantly correlated with job satisfaction and age. Significantly higher scores for job satisfaction were associated with those who had career progression opportunities, career development opportunities, adequate peer support and a clearly defined scope of role. Conversely, job satisfaction scores decreased the more people agreed there was a lack of leadership and they had insufficient resources to provide quality care.
Cancer nurses are critical to the delivery of cancer care however, the workforce faces multiple challenges. This study provides an understanding of the Australian cancer nursing workforce characteristics, their roles and activities, and highlights important considerations for retaining nurses in the profession.
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