Resilience at Work among Healthcare Professionals in Oncology during and beyond the Pandemic: Report from A Deliberative Multi-Stakeholder Reflexive Symposium.

The chronic distress faced by healthcare professionals (HCPs) in oncology was exacerbated by the COVID-19 pandemic, heightening the need to improve their resilience. The Entretiens Jacques Cartier symposium provided an opportunity for participants from France and Quebec to share perspectives on resilience at work and discuss interventions at individual and organizational levels to support HCP health and well-being. Fifty-eight stakeholders were invited to the symposium, including HCPs, government decision-makers, researchers, and patient representatives. The symposium began with presentations on the nature of professional resilience at work in oncology and promising interventions developed in France and Quebec. Participants were then engaged in deliberation on how evidence and experiential knowledge could contribute to workplace strategies to strengthen resilience. Small-group reflexive sessions using the photovoice method, and an intersectoral roundtable, elicited the expression and deliberation of multiple perspectives on the nature and building blocks of resilience. Four main themes emerged from the discussions: (1) that resilience remains a muddy concept and can be associated pejoratively with "happycracy"; (2) that resilience must contend with bounded autonomy and captors; (3) that it relies on a sense of coherence at work; and (4) that patients play a role in improving HCP resilience. Stakeholders from healthcare systems in different countries view resilience at work as a means of equipping teams to handle chronic and punctual stresses in cancer care. The symposium emphasized the importance of better defining what resilience at work means and pursuing explorations of multicomponent interventions to support oncology HCPs and the patients they care for. The themes raised by participants at the symposium suggest pathways for furthering this exploration.

[Management of patients treated with immunotherapy through city-hospital coordination]. / Prise en charge des patients traités par immunothérapie grâce à la coordination ville-hôpital.

The evolution of therapies and practices in oncology has made exchanges and city-hospital coordination in the patient's care pathway essential. As part of the system introduced by Article 51 of the Social Security Financing Act for 2018, the Léon-Bérard Center in Lyon (69), supported by its supervisory authorities, is experimenting with a new organizational method via its home immunotherapy project. An initial review, conducted two years after its launch, demonstrates the benefits for patient quality of life and safety.

The Ambulatory Medical Assistance (AMA) programme during active-phase treatment in patients with haematological malignancies: A cost-effectiveness analysis.

CONTEXT: The need for patient navigator is growing, and there is a lack of cost evaluation, especially during survivorship. OBJECTIVE: The objective of this study is to evaluate the cost-effectiveness of an Ambulatory Medical Assistance (AMA) programme in patients with haematological malignancies (HM). DESIGN: A cost-effectiveness analysis of the AMA programme was performed compared to a simulated control arm. SETTING: An interventional, single-arm and prospective study was conducted in a French reference haematology-oncology centre between 2016 and 2020. PARTICIPANTS: Adult patients were enrolled with histologically documented malignant haematology, during their active therapy phase, and treated either by intravenous chemotherapy or oral therapy. METHODS: An extrapolation of the effectiveness was derived from a similar nurse monitoring programme (CAPRI study). Cost effectiveness of the programme was evaluated through adverse events of Grade 3 or 4 avoided in different populations. RESULTS: Included patient (n = 797) from the AMA programme were followed during 125 days (IQR: 0-181), and adverse events (Grade 3/4) were observed in 10.1% of patients versus 13.4% in the simulated control arm. The overall cost of AE avoided was estimated to €81,113, leading to an ICER of €864. CONCLUSION: The AMA programme was shown to be cost-effective compared to a simulated control arm with no intervention.

[Post-treatment, a delicate and insufficiently structured period]. / L'après-traitement, une période délicate et insuffisamment structurée.

In France, the number of cancer survivors is expected to increase significantly in the coming years. However, there seems to be a lack of identification and management of complications after treatment. Coordination nurses and advanced practice nurses play a fundamental and complementary role to physicians in responding to this problem.

[Ensuring continuity of cancer treatment despite the COVID-19 epidemic]. / Assurer la continuité des traitements anticancéreux malgré l'épidémie de Covid-19.

A real organisational challenge for the teams working alongside people being treated for cancer, the continuity of treatment and care has mobilised all those involved in care since the beginning of the COVID-19 epidemic. To ensure the safety of these patients, who are more vulnerable due to their illness, and to ensure that they do not lose any chances against their cancer, the care providers of the Lyon Regional Cancer Centre have innovated and adapted their practices, both in the city and in the hospital.

[Therapeutic education and pathway of the allograft patient]. / Éducation thérapeutique et parcours du patient allogreffé.

After intensive chemotherapy followed by an allograft of haematopoietic stem cells, patients are immunocompromised for several months, or even years. They are vulnerable to bacteria and viral and fungal infections, and they must be made aware of the strict hygiene precautions to follow before they return home. Working alongside these patients in a therapeutic education approach, the nurse informs and guides them on the practices to adopt and the warning signs to look out for in the event of complications.

[Virtual reality and palliative care, a complement in the care provision]. / Réalité virtuelle et soins palliatifs, un complément dans la prise en charge.

Commonplace in the world of gaming or the cinema, virtual reality headsets have made their appearance in the hospital over recent years. A nursing team in Lyon shares its feedback regarding the benefit of these tools as a complement to the care provided to patients in a palliative care unit.