Programa de acompañamiento a personas diagnosticadas con cáncer de cabeza y cuello, liderado por la enfermera de práctica avanzada con mención en oncología / Support program for people with head and neck cancer, led by an oncology advanced practice nurse

Se presenta una propuesta de intervención de enfermería de práctica avanzada (EPA) en oncología. OBJETIVO: Implementar un programa de acompañamiento para pacientes con cáncer de cabeza y cuello. PROPUESTA: Realizar un levantamiento del proceso y descripción del flujo que debe transitar el paciente oncológico desde la sospecha, diagnóstico, tratamiento, seguimiento y derivación a cuidados paliativos. En segunda instancia, crear e implementar una consulta de enfermería que pueda responder a las necesidades de atención de salud en forma holística de la persona con diagnóstico oncológico de cáncer de cabeza y cuello, tanto en las personas que se encuentran en fase sospecha y confirmación diagnóstica (consulta de ingreso) y en el proceso de seguimiento del sobreviviente (después de finalizado el tratamiento oncológico), a través de una puesta en marcha escalonada, con períodos de evaluación en cada uno de ellos. CONCLUSIONES: La heterogeneidad de la persona diagnosticada con cáncer de cabeza y cuello representa un desafío y se considera a la EPA un profesional para manejar casos complejos. El camino hacia este nuevo rol será paulatino, y requiere una transición tanto por el equipo de salud, los pacientes y las propias enfermeras dentro del marco legal vigente.

This paper presents a proposal for an advanced practice nursing intervention (APN) in oncology. OBJECTIVE: To implement a support program for patients with head and neck cancer. PROPOSAL: To carry out a survey of the process and description of the flow that the oncology patient must go through from suspicion, diagnosis, treatment, follow-up and referral to palliative care. Secondly, to create and implement a nursing consultation that can respond to the health care needs in a holistic manner of the person with an oncological diagnosis of head and neck cancer, both in people who are in the suspicion and diagnostic confirmation phase (admission consultation) and in the follow-up process of the survivor (after the end of oncological treatment), through a staggered implementation, with evaluation periods in each of them. CONCLUSIONS: The heterogeneity of the person diagnosed with head and neck cancer represents a challenge and the APN is considered a professional to manage complex cases. The journey towards this new role will be gradual, and requires a transition both by the health team, the patients and the nurses themselves within the current legal framework.

Programa integral de apoyo a personas con cáncer de mama en tratamiento con quimioterapia para mejorar resultados en salud y calidad de vida, con perspectiva de autocuidado / Comprehensive support program for people with breast cancer undergoing chemotherapy treatment to improve health outcomes and quality of life, with a self-care perspective

El rol de la Enfermería de Práctica Avanzada (EPA) se incorpora a los equipos de salud en la década de los 60 en Estados Unidos y su contribución se expande a otros países. En Chile es un rol incipiente. El rol de EPA contribuye a implementar un modelo de atención centrado en la persona, que brinda atención integral y atiende necesidades específicas y relevantes a diversos grupos de población. OBJETIVO: Diseñar una intervención dirigida a personas en tratamiento con quimioterapia (QT) por un profesional de enfermería con formación avanzada. PROPUESTA: Como parte del diseño, se buscó evidencia para respaldo de la intervención. Se utilizaron las palabras claves: cáncer de mama, quimioterapia, enfermera de practica avanzada, enfermera practicante, sobreviviente; en las bases de datos Pubmed, Web of Science, ProQuest, Epistemonikos, Elsevier, Scielo. Un componente fundamental del programa propuesto es el seguimiento proactivo realizado por una EPA y dirigido a las mujeres con cáncer de mama en QT. Este permitirá: a) potenciar las habilidades de autocuidado, b) mejorar la tolerancia al tratamiento, c) hacer entrega de cuidado experto e individualizado, planificado de acuerdo a las necesidades de cada persona, promoviendo la recuperación de la autonomía y el bienestar. CONCLUSIONES: Como resultados complementarios se espera impactar en la satisfacción usuaria, y asimismo aportar a la implementación del nuevo rol EPA al promover el reconocimiento por el paciente y el equipo de salud como profesional experto en cuidado avanzado.

The Advanced Practice Nurse (APN) joined health teams in the 1960s in the United States and her contribution spread to other countries. In Chile it is an incipient role. APN's role contributes to implementing a person-centered care model that provides comprehensive care and attends to specific and relevant needs of various population groups. OBJECTIVE: To design an intervention aimed at people undergoing chemotherapy treatment (CT) by a nursing professional with advanced training. PROPOSAL: As part of the design, evidence was sought to support the intervention. The keywords were used: breast cancer or neoplasm cancer, chemotherapy, advanced practice nurse or nurse practitioner. Survivorship in the Pubmed, Web of Science, ProQuest, Epistemonikos, Elsevier, Scielo databases. A fundamental component of the proposed program is the proactive follow-up carried out by an APN and aimed at women with breast cancer in QT. This will allow: a) to enhance self-care skills, b) to improve tolerance to treatment, c) to deliver expert and individualized care, planned according to the needs of each person, promoting the recovery of autonomy and well-being. CONCLUSIONS: As complementary results, it is expected to impact user satisfaction, and also contribute to the implementation of the new APN role by promoting recognition by the patient and the health team as an expert professional in advanced care.

Validação de questionário sobre a assistência do enfermeiro de práticas avançadas à idosos / Validation of questionnaire on advanced practice nurse assistance for elderly / Validación de cuestionario de prácticas avanzadas asistencia de enfermería para ancianos

Objetivo: Construir e validar instrumento para avaliar o grau de satisfação dos usuários idosos no modelo de atuação do enfermeiro navegador, clínico e de práticas avançadas em serviços de oncologia. Métodos: Estudo metodológico embasado no processo de construção e validação de instrumento que contemplou a estrutura conceitual; definição dos objetivos e população; construção dos itens e escala de resposta; seleção e organização dos itens; estruturação do instrumento; opinião de especialistas; pré-teste e validação de conteúdo. Resultados: Construiu-se instrumento com 13 itens, distribuídos em dois blocos temáticos: aspectos socioeconômicos, composto por oito itens, e cinco perguntas fechadas. Evidenciado por dois métodos estatísticos: correlação não paramétrica e coeficiente de concordância. Conclusão: Conclui-se que o instrumento de avaliação sobre o grau de satisfação de usuários idosos com um modelo de atuação do enfermeiro navegador, enfermeiro clínico e enfermeiro de práticas avançadas tem validade de conteúdo e aparência. (AU)

Objective: To construct and validate an instrument to evaluate the degree of satisfaction of elderly users in the nurse navigator, clinical and advanced practice models in oncology services. Methods: Methodological study based on the process of construction and validation of an instrument that included the conceptual structure; definition of objectives and population; construction of items and response scale; selection and organization of items; structuring of the instrument; expert opinion; pre-test and content validation. Results: An instrument with 13 items was constructed, distributed in two thematic blocks: socioeconomic aspects composed of eight items, and five closed questions. Evidenced by two statistical methods: non-parametric correlation and agreement coefficient. Conclusion: It is concluded that the assessment instrument on the degree of satisfaction of elderly users with a nurse navigator, nurse practitioner and advanced practice nurse performance model has content and appearance validity. (AU)

Objetivo: Construir y validar un instrumento para evaluar el grado de satisfacción de los usuarios mayores en los modelos de enfermera navegante, clínica y de práctica avanzada en los servicios de oncología. Métodos: Estudio metodológico basado en el proceso de construcción y validación de un instrumento que incluyó la estructura conceptual; la definición de los objetivos y la población; la construcción de los ítems y la escala de respuesta; la selección y organización de los ítems; la estructuración del instrumento; la opinión de expertos; el pre-test y la validación del contenido. Resultados: Instrumento construido con 13 ítems, distribuidos en dos bloques temáticos: aspectos socioeconómicos compuestos por ocho ítems, y cinco preguntas cerradas. Lo demuestran dos métodos estadísticos: la correlación no paramétrica y el coeficiente de acuerdo. Conclusión: Se concluye que el instrumento de aval sobre el grado de satisfacción de los usuarios idosos con un modelo de actuación del enfermero navegador, enfermero clínico y enfermero de prácticas avanzadas tiene validez de contenido y apariencia. (AU)

A qualitative study on the working status of outpatient nurses in general practice departments in general hospitals in Beijing / 中华全科医师杂志

Objective:To survey the working status of outpatient nurses in general practice departments of general hospitals.Methods:From March to April 2021, personal in-depth interviews were conducted with outpatient nurses from general practice residency training bases in Beijing. The thematic framework analysis method was used to analyze the interview data and refine the themes.Results:Fourteen nurses working in general practice outpatient clinics were interviewed in this study. Four themes were extracted from the interview data: (1) inadequate staffing of full-time outpatient nurses in general practice departments of comprehensive hospitals; (2) unclear job functions for outpatient nurses in general practice departments; (3) no standardized patient health education in the department; (4) no relevant training received systematically.Conclusion:General practice departments in general hospitals should setup full-time general practice nurse positions, clarify the job responsibilities, strengthen the relevant training and enhance core competency for nurses working in general practice department.

Effects of feedback teaching based on dynamic cases on teaching quality of practice nurses in the department of neurosurgery / 中华医学教育探索杂志

Objective:To explore the effects of feedback teaching based on dynamic cases on teaching quality of practice nurses in the department of neurosurgery.Methods:A total of 69 practice nurses from the Department of Neurosurgery in the First Affiliated Hospital of Nanjing Medical University were enrolled as the research subjects between January 2019 and August 2020, of which 33 practice nurses between January and October 2019 were selected as the control group and the other 36 practice nurses between November 2019 and August 2020 were selected as the observation group. The control group used routine teaching, while the observation group adopted feedback teaching based on dynamic cases. The assessment scores, practice effect, nursing job satisfaction, and the incidence of nursing errors after teaching were compared between the two groups. SPSS 24.0 was used for Chi-square test and t-test. Results:After teaching, the scores of each assessment (teaching rounds, health education, specialist nursing operations, morning questions, basic operations, and theoretical assessment) in the observation group were significantly higher than those in the control group, and the scores of disease change recognition ability, independent work ability, communication ability and teamwork ability were significantly higher than those in the control group ( P<0.05). After 1 week, 2 weeks, 3 weeks and 4 weeks of teaching, the teaching satisfaction in the observation group was significantly higher than that in the control group ( P<0.05). The total incidence of nursing errors in the observation group 2.78%(1/36) was significantly lower than that in the control group 27.27(9/33)( P<0.05). Conclusion:Feedback teaching based on dynamic cases can effectively improve the teaching quality of practice nurses in the department of neurosurgery, improve nursing job satisfaction, and reduce the risk of nursing errors.

The application of advanced practice nurse-led transitional caring in chronic obstructive pulmonary disease / 中国实用护理杂志

With the increasing prevalence of chronic obstructive pulmonary disease (COPD) and the extremely high mortality, disability, symptom burden and dysfunction, as well as the need for continuous drug management and care and increased rehospitalization rate, it brings patients, families and even society huge economic burden. The transitional care model provides non-drug treatment method to help patients get through the transition period safely and steadily, it also improves patients' self-care ability, quality of life and reduce hospital readmission. This review will start from the concept of disease management in transitional period, elaborate on the problems and core elements of transitional caring, then discuss the application of advanced practice nurse-dominated transitional caring mode in COPD, so as to provide theoretical and practical basis for improving the quality of chronic diseases management in China.

The Current Status of Professional Medical Support Staffs in General Hospitals less than 500 Beds / 임상간호연구

PURPOSE: This study aimed to investigate the current statistics of professional medical support staffs(PMSSs) working in general hospitals with less than 500 beds. METHODS: This study was conducted on 35 general hospitals with less than 500 beds from September 11th to October 27th, 2017. RESULTS: Four hundred fifty one PMSSs were currently providing medical support. The number of clinical nurse experts was the highest among the roles, followed by Physician Assistants(PA) and Advanced Practice Nurses. The mean job satisfaction score was 3.07 out of 5. In the case of PA group, most of the delegated prescriptions were performed, however the delegated roles were not much documented in written format. The paucity of documentation requires a development of a committee for PMSSs, including a development of selection criteria and a scope of practice in each institution. CONCLUSION: The results of this study suggested the composition of a committee for PMSSs in the medical institutions and renaming the specified titles of PMSSs.

Public's Perception of Reimbursement for Advanced Practice Nurses' Education and Counseling in Intensive Care Units by the National Health Insurance / 중환자간호학회지

PURPOSE: This study aimed to investigate the public's perception of reimbursement for the education and counseling services provided to advanced practice nurses in intensive care units.METHOD: This was a secondary data analysis study. The original data were collected utilizing an online panel. The sample comprised 615 individuals aged between 19 and 49 years nationwide. The study variables included the public's perception of reimbursement for education and counseling services, age, gender, education level, income, and health status. Variables such as past experience of being admitted to an intensive care unit by self, family, or relatives and the recognition of advanced practice nurses were also examined.RESULTS: The mean of the perception score was 3.15 on a 4-point scale ranging from 1 (strongly disagree) to 4 (strongly agree). Among the participants, 89.2% answered “somewhat agreed” or “strongly agreed” to the question about the education and counseling services being covered by the National Health Insurance. Moreover, education level, past experience of being admitted to an intensive care unit by self, family, or relatives, and recognition of advanced practice nurses were significantly associated with the perception score.CONCLUSION: Efforts should be made to publicize the need for the education and counseling services that are provided to advanced practice nurses in intensive care units.

A Study on the Mediating Effect of Emotional Intelligence between Perfectionism and Burnout in Advanced Practice Nurses (APN) / 간호행정학회지

PURPOSE: The aim of this study was to analyze relationships between perfectionism, burnout, and emotional intelligence in APN and to identify the mediating effect of emotional intelligence on the relationship between perfectionism and burnout. METHODS: A structured self-report questionnaire was used to measure perfectionism, burnout, and emotional intelligence. Data were collected from 121 APN working in five advanced general hospitals and two general hospitals. Data were analyzed using descriptive statistics, Independent t-test, One-way ANOVA, Mann-Whitney U test, Pearson correlation and Hierarchical multiple regression with the SPSS/WIN 22.0 program. RESULTS: Mean scores for each variable were: perfectionism 3.57 (on a 5-point scale), burnout 3.32 (on a 7-point scale), and emotional intelligence 5.00 (on a 7-point scale). Self-oriented perfectionism had a positive correlation with burnout, as did socially prescribed perfectionism. Emotional intelligence was a significant variable reducing burnout, as it also had a reverse buffering effect on the relationship between self-oriented perfectionism and burnout. Explanatory power of the final model based on variables was 34%. CONCLUSION: The results of this study suggest a mediating direction regarding burnout by demonstrating that emotional intelligence plays a direct and reverse buffering role to self-oriented perfectionism, which can be used to reduce burnout in APN.

Mediating effect of locus of control between career adaptability and vocational selection anxiety in ;practice nurses / 中国实用护理杂志

Objective To explore the relationship among vocational selection anxiety, career adaptability and locus of control in practice nurses. Methods Totally 408 practice nurses from five Tertiary A Hospitals in Liaoning Province were assessed with the Career Adaptability Scale, Locus of Control Scale and Vocational Selection Anxiety Questionnaire. All data were analyzed using the software SPSS 22.0 and AMOS 22.0. Results Career adaptability was negatively correlated with vocational selection anxiety (r=-0.44, P<0.01), chance and powerful others (r=-0.21,-0.21,P<0.01). Chance and powerful others were positively correlated with vocation selection anxiety (r=0.45, 0.44,P < 0.01). The career adaptability could negatively predict the vocational selection anxiety directly and indirectly via the mediating role of chance and powerful others. Conclusions Career adaptability and locus of control could influence the vocational selection anxiety. Chance and powerful others played a role of part-mediating variable in the relationship of career adaptability and vocational selection anxiety.

The current status of the development and enlightenment on nurse specialist in China: 1992 to 2013 survey of literature / 中国实用护理杂志

Objective To describe the current status and existing problems on the specialist nurse in China and provide references for nurse management.Methods The following databases were searched:Chinese Biomedical Literature Database (SinoMed),China Academic Journal database,Chinese Science and Technology journals database,using the key words specialty nurse,clinical nurse specialist and advanced practice nurse.Strict inclusion and exclusion criteria were applied.Results Seven hundred and eighteen papers were eligible for inclusion.The earliest paper was published in 1992,then the number increased yearly.Most of the papers were reviews or summaries of experience,and the hotspot were about the nurse specialist in ICU,operating room,emergency,oncology and diabetes department.Conclusions The attempt about nurse specialist have been carried out in the whole country,but further improvement and practice are needed to solve the existing problems such as the definition,training,certification and nurse management,and it is urgent for us to explore a suitable way for the development of specialist nurse in China.

Oncology Advanced Nurses' Use of Outcome Indicators and Perception of Outcome Evaluation / 간호행정학회지

PURPOSE: The purpose of this study was to explore the use of outcome indicators and perception of outcome evaluation of oncology advanced practice nurses (APNs). METHOD: A total of 111 oncology APNs from hospitals which have over 400 beds were surveyed. The participants' use of outcome indicators and perception of outcome evaluation were collected using a questionnaire including 84 outcome indicators for APNs developed by Sung et al. and 13 items on APNs' contribution to the hospitals developed by Kleinpell (2005). Data were analyzed using descriptive statistics, t-test, and chi2 test. RESULT: Twelve items out of 84 outcome indicators were used over 50% of the time and 57 items could be used in the future by the participants. Seven of the 10 top-ranking outcome indicators in use were education related and were also expected to be used frequently in the future. The score for participants' perception of outcome evaluation was average-high, 3.82 out of 5. CONCLUSIONS: The results of the study show that the main outcome indicator for oncology APNs is education related, and thus the use of education related outcome indicators is recommended to make oncology APNs' activities be more visible.

Experience of Belongingness at Apprentice Course for Advanced Practice Nurse: Learning-connected Process / 성인간호학회지

PURPOSE: This study was to explore the process of belongingness experienced during the apprentice course for advanced practice nurses. METHODS: Data were collected through in-depth interviews with 15 people, who attended the apprentice course for advanced practice nurse, from three schools in Seoul from Jan. 19 until Feb. 25, 2010. The constant comparative method was adapted for data analysis. RESULTS: The core category of this study was the 'learning-connected process' and this process was categorized into three stages. These stages were: going along with the atmosphere, exchanging, and integrating. During the course, the 'uncomfortable participation' as the central idea meant a sense of responsibility and a tension about practice learning of the participant and was influenced by the quality of interaction and the distinct instruction of learning contents. Belongingness was characterized by the Joyful and happy participation which linked to the motivation of new learning opportunities. CONCLUSION: The findings indicate that there is a process to belongingness and a close relationship between belongingness and learning. Further studies would suggest exploring the components of belongingness, a concept analysis and incorporating the belongingness scale with other qualitative research on this topic.

Educational Issues and Strategies to Improve APN Education / 간호학회지

PURPOSE: This study was aimed at exploring the current status of graduate programs for an advanced practice nurse(APN) to recommend future directions of APN education. METHODS: A total of 142 students enrolled in seven APN specialty programs, 67 professors who were involved in APN education, and nine nurse administrators participated in the study. Data was collected by questionnaires and focus group interviews. RESULTS: The current definition of APN was found not to be specific enough to represent expected roles of APN in regards to knowledge, attitudes, roles, and skills. Standard curricula employed regardless of the area of APN specialty, lack of qualified clinical practice settings, as well as prepared instructors were found to be problematic. CONCLUSION: The following needs to be addressed: 1. redefining of APN roles, 2. tailoring specialty areas of APN, 3. consolidating educational programs, and 4. ensuring APN role models and faculty. Suggesting a CNS role in Korean APN, areas of APN should be rearranged toclarify their roles and educational programs need to be further developed to meet the expectations and quality of APNs. It is necessary to ensure APN's employment in the health care system by laws and policies to perform advanced nursing roles.

Prevention from Needle-stab for Practice Nurses: An Investigation / 中华医院感染学杂志

OBJECTIVE To find out the knowledge and understanding level of prevention from needle-stab for practice nurses to train and educate their professional safety precautions. METHODS There were 105 practice nurses who practiced in the hospital from Jul 2003 to Apr 2004,and were asked for filling out the inquiry paper forms which made by ourselves. RESULTS We found that only 20 nurses were good at understanding their professional safety precautions which occupied 19.05%.Fifty nine nurses understood just so-so which occupied 56.19%.Twenty six nurses were poor-understood which occupied 24.76%. CONCLUSIONS The results are not satisfied with the practice nurses,so we suggested the medical school teachers and the hospital supervisors think highly of training and educating the practice nurses. Let them learn and understand the knowledge of the professional safety precautions.Restricted the training and education plan and countermeasures to avoid the blood infectious diseases.