Gaps and delays in survivorship care in the return-to-work pathway for survivors of breast cancer-a qualitative study.

Introduction: The number of survivors of breast cancer (bca) in Canada has steadily increased thanks to major advances in cancer care. But the resulting clientele face new challenges related to survivorship. The lack of continuity of care and the side effects of treatment affect the resumption of active life by survivors of bca, including return to work (rtw). The goal of the present article was to outline gaps and delay in survivorship care in the rtw pathway of survivors of bca. Methods: This qualitative interpretative descriptive study recruited 9 survivors of bca in the province of Quebec. Interviews were conducted at the end of cancer treatments (n = 9), 1 month before rtw (n = 9), and after rtw (n = 5). In an iterative process, a content analysis was performed. Results: The interviews highlighted gaps in survivorship care and the paucity of dedicated resources for cancer survivors. Participants received neither a survivorship care plan nor information about cancer survivorship (for example, transition to a new normal, side effects, rtw). Conclusions: Support for survivors of bca resuming their active lives has to be optimized. We suggest that health professionals have to intervene at 1, 3, and 6 months after cancer treatment. At those points, survivors of bca need support for side-effects management, the rtw decision, resource navigation, and reintegration of daily activities. Also, delay in clinical pathways seems to be longer, and much attention is needed to accompany the transition to a "normal life" after cancer.

Factors associated with critical thinking among nurses.

The ability to think critically is increasingly hypothesized to play an important role in a nurse's ability to function competently in complex health care settings. This cross-sectional exploratory survey used secondary data (Gendrop, 1989) to assess the critical thinking ability of a convenience sample of 160 nurses from two urban hospitals. Four variables hypothesized to be associated with critical thinking ability were explored: age, level of education, years of nursing experience, and area of expertise in nursing. Critical thinking was assessed using the Watson Glaser Critical Thinking Appraisal Tool (WGCTA). Study findings suggest that age and years of experience were negatively correlated with critical thinking ability. However, the level of education was positively related to critical thinking. Future needs for research were identified and implications for nursing education and practice were provided.