"Opportunistic Care": A Focus Group Study of Nurses' Perspective on Caring for Long-term Cancer Survivors and Their Families.

BACKGROUND: The global population of long-term cancer survivors is increasing, thanks to advances in treatments and care. Healthcare systems are working to address the unique needs of these individuals. However, there remains a knowledge gap concerning nurses' view on cancer survivorship care. OBJECTIVE: To identify nurses' perspective of care for long-term cancer survivors and their families. METHODS: This qualitative descriptive study used 5 focus groups comprising 33 nurses from primary healthcare and specialized oncology care. Data analysis was conducted through thematic analysis, and the study received ethical approval. RESULTS: Long-term cancer survivors and their families often remained unrecognized as a distinct group within the healthcare system. Consequently, nurses provide what can be termed as "opportunistic care" during nurse-survivor encounters, addressing health needs beyond the purpose of the initial healthcare visit. This absence of a systematic or structured approach for this patient group has prompted nurses to seek the establishment of a comprehensive framework through survivorship care plans, thus ensuring a continuum of care for this specific population. CONCLUSION: The lack of a structured approach to caring for long-term cancer survivors and their families, often invisible as a distinct population group, results in nurses providing care on an opportunistic basis. IMPLICATIONS FOR PRACTICE: It is crucial to develop and implement survivorship care plans tailored to this population's needs. Simultaneously, it is important to advance research in this area and establish an educational framework for nurses, enabling them to effectively address the care of long-term cancer survivors and their families.

[Translation and transcultural adaptation of the Person-Centred Practice Inventory Staff (PCPI-S) for health professionals in Spain].

BACKGROUND: Person-centred practices - following national and international developments in health-care policies - have become a key approach in healthcare. The Person-Centred Practice Inventory - Staff is an instrument based on the theoretical framework Person-Centred Practice that focuses on the staff's perspective and how they experience person-centred practices. Here, the aim of this study is to obtain the first Spanish version of the PCPI-S translated and adapted into the Spanish context. METHODS: The translation and adaptation of the instrument followed the Translation and Cultural Adaptation of Patient Reported Outcomes Measures - Principles of Good Practice, which included a consulting session with experts. Content validation measures on clarity and relevance were assessed for every item (I-CVI) and the survey as a whole (S-CVI/Ave). RESULTS: No major difficulties were registered to reach an agreement on the 12 items that needed to be clarified. Regarding clarity and relevance. The validity index per item (I-CVI) obtained excellent scores for clarity in 53 items and for relevance in 59; the S-CVI/Ave showed excellent results (=90). CONCLUSIONS: This first version of the Person-Centred Practice Inventory - Staff instrument adapted to the Spanish context is conceptually and semantically equivalent to the original one. This valuable tool will be of great help to identify the perception of healthcare professionals on person-centred practices.

Traducción y adaptación transcultural al contexto español del Person-Centred Practice Inventory-Staff (PCPI-S) para profesionales de la salud / Translation and transcultural adaptation of the Person-Centred Practice Inventory Staff (PCPI-S) for health professionals in Spain

Fundamento: El Cuidado Centrado en la Persona (CCP) se haconvertido en un tema central dentro del ámbito sanitario acorde con las políticas de salud nacionales e internacionales. ElPerson Centred Practice Inventory Staff (PCPI-S) es un instrumentobasado en el modelo teórico Person-Centred Practice Frameworkque evalúa la percepción que tienen los profesionales de la salud sobre una práctica centrada en la persona. El objetivo delestudio es obtener la primera versión española del PCPI-S traducido y adaptado a nuestro contexto español.Método: Se llevó a cabo una traducción y adaptación culturaldel instrumento utilizando la guía Translation and Cultural Adaptation of Patient Reported Outcomes Measures – Principles of GoodPractice (PGP) que incluyó una sesión con expertos. También serealizó una validación de contenido de la claridad y relevanciade cada ítem (I-CVI), así como del cuestionario total (S-CVI/Ave).Resultados: No se encontraron dificultades para llegar a unconsenso en los doce ítems que necesitaron ser clarificados. Elíndice de validez de contenido por ítem (I-CVI) obtuvo una puntuación excelente para claridad en 53 ítems, y para relevanciaen 59; el índice de validez de contenido del cuestionario (S-CVI/Ave) mostró resultados excelentes (≥90).Conclusiones: Se ha obtenido la primera versión del PCPI-Sadaptada al español, conceptual y semánticamente equivalenteal cuestionario original. Este instrumento permitirá identificarla percepción que tienen los profesionales de la salud sobre unapráctica centrada en la persona.(AU)

Background: Person-centred practices – following nationaland international developments in health-care policies – havebecome a key approach in healthcare. The Person-CentredPractice Inventory – Staff is an instrument based on the theo -retical framework Person-Centred Practice that focuses onthe staff’s perspective and how they experience person-centred practices. Here, the aim of this study is to obtain the firstSpanish version of the PCPI-S translated and adapted into theSpanish context. Methods: The translation and adaptation of the instrumentfollowed the Translation and Cultural Adaptation of PatientReported Outcomes Measures – Principles of Good Practice,which included a consulting session with experts. Content validation measures on clarity and relevance were assessed forevery item (I-CVI) and the survey as a whole (S-CVI/Ave).Results: No major difficulties were registered to reach an agreement on the 12 items that needed to be clarified. Regarding clarity and relevance. The validity index per item (I-CVI) obtainedexcellent scores for clarity in 53 items and for relevance in 59;the S-CVI/Ave showed excellent results (≥90).Conclusions: This first version of the Person-Centred PracticeInventory – Staff instrument adapted to the Spanish context isconceptually and semantically equivalent to the original one.This valuable tool will be of great help to identify the perceptionof healthcare professionals on person-centred practices.(AU)

Educational Intervention for Family Nursing Students in Long-Term Cancer Survivorship: A Randomized Pilot Trial.

A randomized pilot study was conducted involving 69 third-year nursing students (ClinicalTrials.gov ID: NCT05270252). Students were randomly assigned to the CG (n = 34) or the intervention group (n = 35), using computer-generated randomization. The CG completed the third-year nursing, and the intervention group received in addition the Learning & Care educational intervention. The aim of this study was to determine the effectiveness, feasibility, and acceptability of the Learning & Care for students to acquire the knowledge, skills, and attitudes necessary to care for survivors and their families. The intervention group significantly improved in knowledge (p = .004; -1.15, 95% confidence interval [CI] [-1.94, -0.37]), skills (p ≤ .0001; -13.51, 95% CI [-15.19, -11.83]), and attitudes (p = .006; -5.61, 95% CI [-8.81, -2.42]). The students' satisfaction was found to be high (93.75%). Offering a family nursing approach improves students' competence to care for long-term cancer survivors and their families.

The relationship competencies guiding tool: A development, content validation and implementation study.

AIM: The aims of this paper are (1) to present the results of the development, content validation and implementation study of the Relationship Competencies Guiding Tool; (2) to provide examples of how each item in the tool is reflected in clinical narratives written by nurses and justify the corresponding scores after the evaluation; (3) to present how the language and content of the narratives are interpreted with the tool and to describe an exemplar; and (4) to present barriers to and facilitators of the application of the tool. BACKGROUND: From a person-centered care approach, the fostering of authentic relationships with patients is key to achieving therapeutic benefits. Therefore, it is essential to help nurses establish meaningful relationships with patients and help them acquire these abilities. Clinical narratives can be used as a way to promote reflective practice and professional competency development among nurses. A tool to evaluate the knowledge, skills, attitudes and values necessary for developing authentic encounters with patients through clinical narratives was developed, validated and implemented. DESIGN: An instrument-development study comprised of three steps: (1) conceptualization; (2) item generation and content validity; and (3) implementation of the tool and linguistic evaluation. METHODS: This study was conducted in three major steps. Step one entailed conceptualization. Step two included the generation of items and content validation. In step three, the tool was used to independently evaluate 25 narratives. One of these narratives was also linguistically analysed to provide a comprehensive view of the interpretative strategies deployed by evaluators. RESULTS: The Relationship Competencies Guiding Tool was developed, validated and implemented. It could help nurses work on nursing relationship-based professional competencies, guided the evaluators in the process of assigning scores to the corresponding items and helped the researchers identify certain barriers and facilitators before and during the narrative evaluation process. CONCLUSIONS: The tool has been shown to be clear, relevant and conceptually and linguistically suitable for evaluating clinical narratives. The Relationship Competencies Guiding Tool could be applied to interpret how nurses reflect professional competencies in a clinical narrative as a preliminary step in the construction of a measurement tool. TWEETABLE ABSTRACT: From a person-centered relationship-based care approach, clinical narratives can be used to promote professional competencies between nurses. The Relationship Competencies Guiding Tool may help evaluate the knowledge, skills, attitudes and values necessary for developing authentic encounters with persons/families, as reflected by nurses' clinical narratives.

Co-Design and Validation of a Family Nursing Educational Intervention in Long-Term Cancer Survivorship Using Expert Judgement.

The number of cancer survivors is increasing exponentially thanks to early screening, treatment, and cancer care. One of the main challenges for healthcare systems and professionals is the care of cancer survivors and their families, as they have specific needs that are often unmet. Nursing students, as future healthcare professionals, need education to face these new health demands. They will need to develop specific competencies to help them care for and empower this emerging population. The aim of the study was to co-design and validate an educational intervention on long-term cancer survivorship for nursing, through a multidisciplinary panel of experts. Group interviews were conducted with a panel of 11 experts, including eight professionals from different backgrounds (oncology, cancer nursing, pharmacology, and education), a long-term cancer survivor, a family member of a cancer survivor, and a nursing student. The experts validated a pioneer educational intervention to train nursing students in long-term cancer survival. The co-design and validation of the intervention from an interdisciplinary perspective and with the participation of long-term cancer survivors and their families was considered relevant as it included the vision of all the stakeholders involved in long-term cancer survivorship.

[Translation and transcultural adaptation of the theoretical Person-Centred Practice Framework to the Spanish context].

BACKGROUND: Person-centered care has become a key global approach that seeks to provide answers to all factors of the complex health care-related processes. This has led to the development of theoretical frameworks that represent the components of person-centered care. The internationally recognized Person-Centred Practice Framework (PCPF) (McCormack and McCance) allows multidisciplinary teams to understand and operationalize the dimensions for the development of person-centered care. The aim of this study was to obtain the first Spanish version of the PCPF translated and adapted to the Spanish context. METHODS: We translated the PCPF following the Translation and cultural adaptation process for Patient-Reported Outcomes (PRO) Measures guidelines. A consulting session with experts was part of the process and content validation on clarity and relevance for each domain was performed. RESULTS: We encountered no significant difficulties to reach agreements on most of the terms except for Having a sympathetic presence. Not only was a complex term to translate but also to trans-culturally adapt. Regarding relevance and clarity, the content index by construct (I-CVI) and the global framework (S-CVI/Ave) were consistent with their original counterparts (>0.90). CONCLUSIONS: The adapted Spanish version is clear, significant, and conceptually equivalent to the original PCPF. It will allow a better comprehension of the person-centered practice framework in the Spanish context and facilitate the implementation of this approach in clinical practices.

Traducción y adaptación transcultural al contexto español del marco teórico Person-Centred Practice Framework / Translation and transcultural adaptation of the theoretical Person-Centred Practice Framework to the Spanish context

Fundamento: El cuidado centrado en la persona se ha convertido en un enfoque esencial a nivel global que pretende dar respuesta a todas las dimensiones que afectan a los complejos procesos de la atención sanitaria. El Person-Centred Practice Framework (PCPF), desarrollado por McCormack y McCance facilita que los equipos multidisciplinares puedan entender y operativizar todas las dimensiones que participan en el desarrollo de una atención centrada en la persona. El objetivo del estudio fue obtener la primera versión española del marco PCPF traducida y adaptada a nuestro contexto español. Método: La traducción y adaptación transcultural del PCPF se acometió utilizando la guía Translation and cultural adaptation process for Patient-Reported Outcomes (PRO) Measures, que incluye una sesión con expertos. Además, se realizó una validación de contenido de la claridad y la relevancia de cada dominio. Resultados: No se encontraron dificultades relevantes para llegar a un acuerdo en la mayoría de los términos que necesitaron ser clarificados, a excepción del término Estar presente con pleno reconocimiento del otro, que fue el más complejo de traducir y adaptar culturalmente. Respecto a la relevancia y claridad, el índice de validez de contenido por constructo (I-CVI) y del marco global (S-CVI/Ave) mostraron excelentes resultados (≥0,90). Conclusiones: Se ha obtenido una versión adaptada al español clara, relevante y conceptualmente equivalente al marco PCPF original. La disponibilidad de este marco en español facilitará una mejor comprensión de la práctica centrada en la persona y favorecerá la implementación de este enfoque en la práctica clínica.(AU)

Background: Person-centered care has become a key global approach that seeks to provide answers to all factors of the complex health care-related processes. This has led to the development of theoretical frameworks that represent the components of person-centered care. The internationally recognized Person-Centred Practice Framework (PCPF) (McCormack and McCance) allows multidisciplinary teams to understand and operationalize the dimensions for the development of person-centered care. The aim of this study was to obtain the first Spanish version of the PCPF translated and adapted to the Spanish context. Methods: We translated the PCPF following the Translation and cultural adaptation process for Patient-Reported Outcomes (PRO) Measures guidelines. A consulting session with experts was part of the process and content validation on clarity and relevance for each domain was performed. Results: We encountered no significant difficulties to reach agreements on most of the terms except for Having a sympathetic presence .Not only was a complex term to translate but also to trans-culturally adapt. Regarding relevance and clarity, the content index by construct (I-CVI) and the global framework (S-CVI/Ave) were consistent with their original counterparts (≥0.90). Conclusions: The adapted Spanish version is clear, significant, and conceptually equivalent to the original PCPF. It will allow a better comprehension of the person-centered practice framework in the Spanish context and facilitate the implementation of this approach in clinical practices.(AU)

Are Nursing Interventions Effective in Improving Quality of Life in Cancer Survivors? A Systematic Review.

BACKGROUND: Cancer survivors (CSs) have needs that can negatively impact their quality of life (QoL). Oncology nurses play a key role in providing comprehensive care in cancer survivorship, although little is known about their impact on health outcomes. OBJECTIVE: The aim of this study was to determine the effectiveness of nursing interventions to improve QoL and satisfaction with care of CSs. METHODS: A systematic review was conducted. PubMed, CINAHL, PsycINFO, and Cochrane databases were searched for experimental studies. The Joanna Briggs Institute Checklist for Randomized Controlled Trials was used to verify the quality of the studies (Prospero reference: CRD42020148294). RESULTS: Of the 8 clinical trials eligible for inclusion, 5 demonstrated that interventions conducted by nurses improved the overall QoL or some of its domains in CSs. The included studies focused on short-term survival; no studies in long-term CSs were identified. Two studies assessed satisfaction with care of survivors, obtaining positive results. CONCLUSIONS: Nursing interventions seem to improve the QoL of short-term CSs. However, because of the low number of studies identified, the findings of this systematic review should be interpreted with caution. IMPLICATIONS FOR PRACTICE: Further studies are necessary to strengthen the implementation of effective nursing intervention in cancer practice. Research should particularly be conducted with long-term CSs as there is lack of data on this specific stage of cancer.

Role of the nurse in the design, delivery, monitoring and coordination of cancer survivorship care plans: An integrative review.

AIM: Survivorship care plans (SCPs) are recommended as a tool for the care of cancer survivors. SCPs have been implemented with a multidisciplinary approach; however, the specific role of nurses in the SCP is unknown. Our aim is to determine the role of nurses and their degree of participation in cancer SCPs. DESIGN: Integrative review of the literature with systematic methodology. DATA SOURCES: PubMed, CINAHL, PsycINFO, Web of Science, Cochrane and Cancerlit databases were reviewed. Articles published up to March 2021 were included. REVIEW METHOD: Of the 2,638 publications identified, 22 studies met our inclusion criteria. Quality of included studies was assessed using Joanna Briggs Institute quality assessment tools. RESULTS: The studies showed that nurses play a key role and participate in different phases of the SCP, including design, delivery, monitoring and coordination among different levels of care, with varying degrees of involvement and responsibility; design and delivery of the SCP are the phases with the highest nurse participation (18 out of 22 studies). The majority of SCPs are implemented in specialized, hospital-based care and focus on short-term cancer survivors, who are actively undergoing oncological treatments. CONCLUSION: This review shows that nurses actively participate in the design, implementation and coordination of SCPs. However, SCPs focus on the acute survival and treatment phases, and there is a gap in their use in long-term cancer survivorship. This gap may be one reason the needs of long-term cancer survivors are not covered. IMPACT: This review contributes to the current body of knowledge by addressing the role of nurses in cancer SCPs. We recommend the involvement of an advanced practice nurse as SCP coordinator to improve communication between cancer specialists and primary care providers and to promote continued care throughout the different phases of cancer survivorship, including long-term survival.

Educational methods used in cancer training for health sciences students: An integrative review.

OBJECTIVE: To explore the educational methods used in the cancer training of undergraduate students in health sciences. DESIGN: Integrative review with a systematic methodology was performed to obtain a comprehensive picture of the variety of educational methods used in cancer training. DATA SOURCES: A search was performed in the PubMed, CINAHL, PsycINFO and Cochrane databases for the period 2008-2020. REVIEW METHODS: The Critical Appraisal Skills Program (CASP) was used to assess the quality of included studies. Three reviewers extracted data and did quality appraisal. RESULTS: A total of 40 articles referring to cancer training in medicine and nursing were included in the review; no articles referring to other health disciplines were found. The main educational methods used were expository methods, case studies, exercises and problems, problem-based learning, learning contracts and project-oriented learning. CONCLUSION: This review shows the need to combine educational methods so that health sciences students acquire competency (knowledge, skill, attitude) for comprehensive cancer care. There is a gap in the training of undergraduate nursing students to provide person/family centered care in oncology. To improve the training and professional practice of future health professionals, interprofessional education and the involvement of people with cancer in simulation education are recommended.

Implementation and evaluation of a training programme to promote the development of professional competences in nursing: A pilot study.

BACKGROUND: Clinical narratives may be used as a means to improve the acquisition of clinical competences. Even though there are studies that recognize the potential value of clinical narratives to promote nursing professional development, there is no evidence that shows their value as a tool to improve nurses' competences to provide person-centred nursing care. PURPOSE: To evaluate the preliminary efficacy of narratives for the development of three nursing professional competences -respect, intentional presence and knowing the person- for providing person-centred care. METHOD: Using a pre-post quasi-experimental design, a pilot study with a total of 34 nurses enrolled in a training course of nursing specialization was conducted between September 2016 and June 2017. All the nurses received a multi-component intervention based on the Critical Reflective Inquiry model. The strategies of this programme consisted of writing three narratives, attending two masterclasses, participating in a discussion group, and participating in a face-to-face interview. The NarratUN Evaluation tool was used to assess the outcomes. Changes among nurses were analysed using the Wilcoxon signed Rank test. RESULTS: The difference in the means between the pre- and post-intervention scores were statistically significant for respect [0.59 (95% CI 0.23-0.95; p = 0.001)], intentional presence [0.75 (95% CI 0.32-1.17; p < 0.0001)] and knowing the person [0.62 (95% CI 0.25-0.99; p = 0.001)]. The difference in the mean score for use of the narrative and reflection also increased significantly [0.65 (95% CI 0.32-0.98, p < 0.001)]. CONCLUSIONS: The use of narratives combined with other reflective strategies (masterclass sessions and discussion groups) proved to be effective for the development of professional competences of nurses.

Equity in health care.

It has long been known that a segment of the population enjoys distinctly better health status and higher quality of health care than others. To solve this problem, prioritization is unavoidable, and the question is how priorities should be set. Rational priority setting would seek equity amongst the whole population, the extent to which people receive equal care for equal needs. Equity in health care is an ethical imperative not only because of the intrinsic worth of good health, or the value that society places on good health, but because, without good health, people would be unable to enjoy life's other sources of happiness. This paper also argues the importance of the health care's efficiency, but at the same time, it highlights how any innovation and rationalization undertaken in the provision of the health system should be achieved from the consideration of human dignity, making the person prevail over economic criteria. Therefore, the underlying principles on which this health care equity paper is based are fundamental human rights. The main aim is to ensure the implementation of these essential rights by those carrying out public duties. Viewed from this angle, equity in health care means equality: equality in access to services and treatment, and equality in the quality of care provided. As a result, this paper attempts to address both human dignity and efficiency through the context of equity to reconcile them in the middle ground.