"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.

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.

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.

Redefining nursing solidarity.

The idea of solidarity is in vogue, especially since the eruption of the COVID-19 pandemic. However, the term "solidarity," as used in nursing, is imprecise and vague, lacking clear definition and connoting a variety of general meanings. Based on the original meaning of "solidarity" in ancient Roman law, this article captures the archetypical idea of solidarity from a historical and interdisciplinary perspective. This archetypical or primary meaning comes before the development of any other meanings of the word, and it is therefore authentic and genuine because it does not derive from something else. After establishing the archetypical meaning of solidarity, the article translates this meaning into the area of nursing and demonstrates a deep connectivity between healthcare and solidarity. The second part of the article offers and develops a new definition of nursing solidarity as the responsibility for the healthcare of a person (unit) shared as a whole (entirety) by that person and a nurse or a nursing team (plurality). This new definition has some implications for nursing practice and education, since the definition emphasizes the idea that solidarity helps to (a) foster respect and avoid discrimination, (b) promote cohesion in health communities, (c) increase individual responsibility and a spirit of service, (d) stimulate motivation, (e) improve communication, (f) create an engaging workplace, and (g) develop leadership.

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.

Nursing and spirituality: A discussion paper on intertwining metaparadigms.

AIM: To explore connections between spiritual metaparadigm and the nursing metaparadigm and advocate for a progressive spiritualization of nursing management. BACKGROUND: Relationship between the spiritual holistic metaparadigm of love, communion and gift and the holonic nursing metaparadigm of care, relationship and practice is not completely understood. METHOD: The construction of a theoretical explanation on the basis of accumulated knowledge in the fields of nursing and spirituality (especially Christian spirituality) for the purpose of constructing a meaningful description. RESULTS: Deep connectivity between the elements of both metaparadigms: love and care, communion and relationship, and gift and practice. CONCLUSION: The connection between the spiritual and nursing metaparadigms is real in nursing education, practice and management because of the holistic character of spirituality. In collective intentions and cultural values are the main channels of interaction between the nursing and the spiritual metaparadigms. IMPLICATIONS FOR NURSING MANAGEMENT: Spirituality influences nursing management by, among other things, (a) providing meaning and purpose; (b) promoting cohesion in health communities; (c) fostering respect for ethics; (d) stimulating innovation; (e) encouraging leadership; and (f) illuminating the workplace.

Are Nursing Students Trained to Meet the Needs of Cancer Survivors and Their Families? New Challenges, New Opportunities

Current cancer treatments, along with more effective prevention measures, are producing increased cancer survival globally;(1) becoming ­ in many cases ­ a chronic disease.(2) Care of patients and families, living with a chronic disease, like cancer, constitutes one of the principal challenges for most health systems because they represent a heavy burden in terms of morbidity and mortality and carry a high percentage of the public expenditure in health.(3) Above all, the impact of cancer entails suffering and represents an important limitation in the quality of life, productivity, and functional state of the sick individuals and those living with them, that is, their family. More so, with evidence of the progressive increase of the number of older people with cancer, who are more prone to having comorbidities and other problems associated with their age, like dementia, depression, cerebrovascular accident, and diabetes.(4)