ABSTRACT
Cancer survivors participating in supervised exercise programs learn to exercise safely with oversight from care providers who monitor and facilitate their progress. This study investigated the long-term exercise participation levels and identified exercise barriers for graduates from a specialized cancer exercise and education program. Subjects were graduates from a 12-week supervised exercise program (www.canwellprogram.ca) who participated in a, prospective, long-term evaluation. Measures included: six-minute walk test (6-MWT), STEEP treadmill test, Functional Assessment Cancer Therapy-General (FACT-G), Edmonton Symptom Assessment System (ESAS), Godin Leisure-Time Exercise Questionnaire, and exercise barriers survey. Analysis was performed using the paired t -test. Fifty-seven (55% of eligible cohort) CanWell participants (mean age= 60; 74% females) were included in this study. Post program changes included statistically significant reductions in total min on the treadmill and a trend towards improvements in 6-MWT distance. No significant changes were recorded in total FACT-G or ESAS score, however functional well-being approached statistical significant improvements. The most commonly reported exercise barriers included fatigue, cost, and return to work. While most participants (86%) believed they were able to exercise, only 63% reported being able to progress their exercise. These finding demonstrated that although CanWell graduates have substantial support from exercise specialists and most have early success with exercise, environment-related factors diminish long-term independent adherence to exercise. Providing cancer survivors with the skills needed to monitor and progress their exercise routines, or access to "tune-ups" may increase exercise adherence and maximize benefits.
ABSTRACT
This paper describes a clinical nurse specialist/clinical nurse specialist-nurse practitioner (CNS/CNS-NP) internship program in a tertiary care teaching hospital Hamilton Health Sciences, located in south-central Ontario, Canada. The goal of the program is to increase the number of fully qualified CNS/CNS-NPs in the organization. With this program, Hamilton Health Sciences (HHS) is able to recognize and reward nurses already employed within the hospital. The program assists nurses in transition to the CNS/CNS-NP role while they are completing the required educational requirements. The authors describe the components of the internship program, responsibilities of participants and the infrastructure required to support the program. Overall the internship program is a valuable mechanism for supporting the development of advanced practice roles in the hospital setting.
