'Bad news consultations' with oncology nurses: Impact on perceived stress and patient experience.

PURPOSE: 'Bad News Consultations' (BNC), conducted by nurses who are specialists in cancer, have been institutionally implemented in all French anti-cancer centres, to support the patient facing announcement-related stress. This study aimed to 1/describe the impact of the BNC on the patient's perceived stress and 2/determine the patient's benefits from the BNC. METHOD: This monocentric study, cross-sectional evaluation, used a mixed method, both quantitative and qualitative. During 8 months, 336 eligible participants who underwent a BNC were recruited by nurses. Perceived stress was self-assessed with a validated Visual Analogic Scale (VAS), at the beginning and at the end of the BNC. Stress resilience was self-assessed once using the CD-RISC2. Qualitative experiences were explored after the BNC, using a 25-item questionnaire. Multivariate analyses were conducted on perceived stress measures (on the VAS) to test mixed-effects models, including initial predispositions (e.g., stress resilience) and organisational constraints (e.g, interval between the medical consultation and the BNC). RESULTS: Analyses on the perceived stress measures revealed a significant and negative effect of Time (B = -1.91; p < .001), Gender (B = 0.72; p = .03), and Resilience score (B = -0.43; p < .001), without any significant effect of the other incorporated random effects (i.e., Type of cancer/treatment) nor fixed effects (i.e., Age, Organisational constraints). Patients mostly reported having received necessary information, having their addressed emotions with empathetic responses and respect, perceived benefits in the healthcare pathway, and heard of some supportive cares. CONCLUSION: Perceived stress was reduced after BNCs. According to the patients, the BNCs allowed a better patient-centered communication and a better care pathway.

Including administrators in curricular redesign: How the academic-practice relationship can bridge the practice-theory gap.

AIM: Health care administrators provided information through semi-structured interviews as to how one faculty of nursing (FoN) was preparing students for practice. BACKGROUND: There is a long-standing disconnect between the nursing education and the clinical arena known as the theory-practice gap. The FoN wanted to redevelop their curriculum to better prepare students for practice and bridge the gap. METHOD: Using developmental evaluation, 36 administrators were interviewed and asked about their expectations of newly graduated nurses, the FoN curriculum, and changes to be made. RESULTS: Four themes were identified: entry to programme; curricular content, delivery and structure; clinical recommendations; and stronger relationships. CONCLUSION: Strong academic-practice partnerships are still needed. The current lack of communication and partnership has compromised students' quality of education and their transition into the workforce. IMPLICATIONS FOR NURSING MANAGEMENT: Leaders in both the education and practice settings can better prepare newly graduated nurses and bridge the theory-practice gap by co-creating a joint committee and creating more touchpoints with one another. A joint committee can develop appropriate entry-to-programme guidelines, discuss relevant trends in practice and shape the curriculum. Clinical experiences for students may also act as extra touchpoints whereby the two groups can discuss clinical mentorship needs and build stronger academic-practice relationships.