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Medical nurses’ experiences of the care-needs of adult patients with a primary brain tumour
Annals of Oncology 30 (Supplement 5): v846–v850, 2019 doi:10.1093/annonc/mdz277
CANCER NURSING: TRANSLATING RESEARCH INTO PRACTICE CN107
Work related empowerment and collaboration in multiprofessional cancer centre
Background: The present and future health care is increasingly complex work environment. Cancer care setting has been identified as a challenging work environment in relation to occupational well-being and safety. Work empowerment is associated with job satisfaction, commitment and intention to stay at work. Another determinant is the multiprofessional collaboration in working contexts. It is important to enhance both empowerment of professionals and interprofessional collaboration. Aims of this study is to: recognize a need for work related empowerment (WEP) and interprofessional collaboration (IPC); understand WEP and IPC care; find ways to increase WEP and IPC. Methods: Cross-sectional survey, in a network based cancer center in Western Finland. The number of inhabitants in the area is 870 765. The estimated number of health care professionals working with cancer patients in three hospitals is 1050. WEP was evaluated by a validated instrument (Kuokkanen 2003) and IPC with instrument (MONAMI) developed for the study. Sample consists of 350 professionals in cancer care (nurses 66%, physicians 11 %, allied health professionals 13%). Statistical methods were used in analysis. Results: Work empowerment was evaluated positively; most critical the respondents were on their activeness on participating to positions of trust, and solving problems in their unit. From the impeding factors of WEP, respondents were most critical on the support by management. Empowerment was highest among physicians. Interprofessional collaboration was evaluated positively; most critical respondents were on the support by the management. Conclusions: The results indicate a need for developing organizational and management support for WEP and IPC. On the contrary to other professionals, medical professionals evaluate having good possibilities to lead, manage and make decisions. To decrease the difference between professional groups, enhancement on IPC is needed, that should acknowledge all professionals and aim for shared decision-making in work processes especially in situations not focusing solely on medical issues. Legal entity responsible for the study: Turku University of Applied Sciences. Funding: The Finnish Work Environment Fund. Disclosure: All authors have declared no conflicts of interest.
CN108
Engaging cancer survivors, healthcare providers and advocates in the development of a colorectal cancer survivorship information resource: A participatory action research study
A. Drury1, N. de Zeeuw2, D. Flannery3, A. McNamara4, A. Nolan5, C. O’Brien5, K. O’Connor3, S. Payne6, A-M. Brady1 1 School of Nursing and Midwifery, Trinity College Dublin, Dublin, Ireland, 2Colorectal Surgery, Tallaght University Hospital, Dublin, Ireland, 3GEMS Directorate, St. James’s Hospital, Dublin, Ireland, 4Information Development, Irish Cancer Society, Dublin, Ireland, 5HOPe Directorate, St. James’s Hospital, Dublin, Ireland, 6International Observatory on End of Life Care, Division of Health Research, Faculty of Health and Medicine, Lancaster University, Lancaster Background: Up to three-quarters of colorectal cancer (CRC), survivors may experience one or more physical, psychological or social issues after treatment. Individuals with a cancer diagnosis report appropriate support and information from healthcare professionals during treatment. However, many are unprepared for the chronic effects of cancer and its treatment and lack the resources to devise self-management skills. This study aims to design and develop an evidence-based Cancer Survivorship Information Resource (CSIR) to support the education of people with CRC about potential survivorship issues. Methods: The CSIR is being developed with key stakeholders via a three-phase participatory action research (PAR) approach. In Phase 1, chronic effects of CRC were explored in a mixed methods study (n ¼ 304). In Phase 2, a 3-round modified Delphi was undertaken with key stakeholders, including CRC survivors, healthcare professionals and advocates to gain consensus on topics to be included in the CSIR (n ¼ 36). Phase 3 will focus on the design, development and evaluation of the CSIR.
CN109
Medical nurses’ experiences of the care-needs of adult patients with a primary brain tumour
J. Mohammed Oncology, The Royal Wolverhampton Hospitals NHS Trust New Cross Hospital, Wolverhampton, UK Background: Adult primary malignant brain tumours are rare; however, they have a devastating impact and a poor prognosis (Ford et al., 2012). For the past seven years the National Cancer Patient Experience Survey (Quality Health, 2014) has reported the care of brain tumour patients as being less positive compared to other cancer sites, possibly due to unmet care needs. The Aims of this research were: - To explore registered medical nurses’ experiences of the care needs of adult patients with a primary brain tumour. - To identify possible gaps in knowledge and skills that limit the provision of optimal care. Methods: The project adopted a qualitative methodological approach using semistructured interviews to collect and analyse data to reflect the experiences of medical nurses’ in the aforementioned care context. Three participants volunteered, who met the inclusion/exclusion criteria. Participants were registered nurses who had worked on the oncology/haematology Triage Unit for 12 months or more so that they had meaningful reflection. Results: Themes emerged from the collection and analysis of data. Three main themes emphasised that the experience was: challenging; involved holistic care and depended on nurses’ knowledge and experience. Published literature identified that brain tumour patients were different to other cancer patients because they require more nursing time to address their complex care needs. The findings highlighted that senior nurses were significantly more knowledgeable, holistic and aware of patient needs. Conclusions: Junior nurses felt they had very limited experience, confidence or knowledge to care for adult patients with a primary brain tumour. They acknowledged that education and training was essential to allow staff involved in the care of adult patients with a primary brain tumour to feel confident enough to be able to assess and care for the complex needs of this group of patients. Legal entity responsible for the study: Birmingham City University. Funding: Has not received any funding. Disclosure: The author has declared no conflicts of interest.
CN110
Feasibility and acceptability of a mHealth intervention to increase colonoscopy uptake among Chinese first-degree relatives: A pilot cluster randomized controlled trial
Y. Bai, S. Winnie, K.W., C.L. Wong The Nethersole School of Nursing, Chinese University of Hong Kong, Hong Kong, China Background: Colonoscopy is recommended as preferred test for first-degree relatives (FDRs) of colorectal cancer (CRC) patients. However, colonoscopy screening rate remains low. A systematic review and meta-analysis conducted by the research team show that tailored communication is an effective approach to increase uptake of colonoscopy. However, the decision rules that guide the tailored process remain unclear. Based on the identified evidences, a mHealth intervention with an integrated tailoring
C European Society for Medical Oncology 2019. Published by Oxford University Press on behalf of the European Society for Medical Oncology. V
All rights reserved. For permissions, please email: [email protected].
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V. Sulosaari1, P. Ahonen2, H. Heikkil€a3, A. Jekunen4, H. Leino-Kilpi5, P. Rautava6, M. Rekunen7, M. Siekkinen7, M. Stolt5, T. Vahlberg8, L. Walta1 1 Health and Well-Being, Turku University of Applied Sciences, Turku, Finland, 2Doctoral School, Turku University of Applied Sciences, Turku, Finland, 3Research and Development, Finnish Institute of Occupational Health, Tyo¨terveyslaitos, Finland, 4 Oncology, Vaasa Oncology Clinic, Vaasa, Finland, 5Department of Nursing Science, University of Turku, Turku, Finland, 6Research Services, Turku University Hospital, Turku, Finland, 7Western Finland Cancer Centre, Turku University Hospital, Turku, Finland, 8 Department of Clinical Medicine, University of Turku, Turku, Finland
Results: In phase 1, CRC survivors reported symptoms including sexual dysfunction (66%), fatigue (64%), bowel dysfunction (57%) and fear of recurrence (60%). Seventeen survivorship information topics were identified in Phase 1; six further topics were proposed by Phase 2 participants. Seventeen items achieved agreement (80%) for inclusion in the CSIR, including fatigue, bowel function, sexual function, coping, and returning to work. Conclusions: Stakeholder consensus and engagement has the potential to effect sustainable change and innovation in practice. Phase 2 participants will be engaged in Phase 3 to develop and evaluate the content of the CSIR. PAR methodology facilitates the development of interventions which are person-centred and appropriate to the stage of treatment. Once developed, the CSIR will form part of a larger complex intervention, which aims to address the unmet information and supportive care needs of cancer survivors; supporting them to develop self-management skills to cope with the chronic effects of CRC and its treatment. Legal entity responsible for the study: Trinity College Dublin. Funding: The Health Research Board Research Training Fellowship for Healthcare Professionals (Grant#: HPF.2014.715). Disclosure: All authors have declared no conflicts of interest.
CANCER NURSING: TRANSLATING RESEARCH INTO PRACTICE CN107
Work related empowerment and collaboration in multiprofessional cancer centre
Background: The present and future health care is increasingly complex work environment. Cancer care setting has been identified as a challenging work environment in relation to occupational well-being and safety. Work empowerment is associated with job satisfaction, commitment and intention to stay at work. Another determinant is the multiprofessional collaboration in working contexts. It is important to enhance both empowerment of professionals and interprofessional collaboration. Aims of this study is to: recognize a need for work related empowerment (WEP) and interprofessional collaboration (IPC); understand WEP and IPC care; find ways to increase WEP and IPC. Methods: Cross-sectional survey, in a network based cancer center in Western Finland. The number of inhabitants in the area is 870 765. The estimated number of health care professionals working with cancer patients in three hospitals is 1050. WEP was evaluated by a validated instrument (Kuokkanen 2003) and IPC with instrument (MONAMI) developed for the study. Sample consists of 350 professionals in cancer care (nurses 66%, physicians 11 %, allied health professionals 13%). Statistical methods were used in analysis. Results: Work empowerment was evaluated positively; most critical the respondents were on their activeness on participating to positions of trust, and solving problems in their unit. From the impeding factors of WEP, respondents were most critical on the support by management. Empowerment was highest among physicians. Interprofessional collaboration was evaluated positively; most critical respondents were on the support by the management. Conclusions: The results indicate a need for developing organizational and management support for WEP and IPC. On the contrary to other professionals, medical professionals evaluate having good possibilities to lead, manage and make decisions. To decrease the difference between professional groups, enhancement on IPC is needed, that should acknowledge all professionals and aim for shared decision-making in work processes especially in situations not focusing solely on medical issues. Legal entity responsible for the study: Turku University of Applied Sciences. Funding: The Finnish Work Environment Fund. Disclosure: All authors have declared no conflicts of interest.
CN108
Engaging cancer survivors, healthcare providers and advocates in the development of a colorectal cancer survivorship information resource: A participatory action research study
A. Drury1, N. de Zeeuw2, D. Flannery3, A. McNamara4, A. Nolan5, C. O’Brien5, K. O’Connor3, S. Payne6, A-M. Brady1 1 School of Nursing and Midwifery, Trinity College Dublin, Dublin, Ireland, 2Colorectal Surgery, Tallaght University Hospital, Dublin, Ireland, 3GEMS Directorate, St. James’s Hospital, Dublin, Ireland, 4Information Development, Irish Cancer Society, Dublin, Ireland, 5HOPe Directorate, St. James’s Hospital, Dublin, Ireland, 6International Observatory on End of Life Care, Division of Health Research, Faculty of Health and Medicine, Lancaster University, Lancaster Background: Up to three-quarters of colorectal cancer (CRC), survivors may experience one or more physical, psychological or social issues after treatment. Individuals with a cancer diagnosis report appropriate support and information from healthcare professionals during treatment. However, many are unprepared for the chronic effects of cancer and its treatment and lack the resources to devise self-management skills. This study aims to design and develop an evidence-based Cancer Survivorship Information Resource (CSIR) to support the education of people with CRC about potential survivorship issues. Methods: The CSIR is being developed with key stakeholders via a three-phase participatory action research (PAR) approach. In Phase 1, chronic effects of CRC were explored in a mixed methods study (n ¼ 304). In Phase 2, a 3-round modified Delphi was undertaken with key stakeholders, including CRC survivors, healthcare professionals and advocates to gain consensus on topics to be included in the CSIR (n ¼ 36). Phase 3 will focus on the design, development and evaluation of the CSIR.
CN109
Medical nurses’ experiences of the care-needs of adult patients with a primary brain tumour
J. Mohammed Oncology, The Royal Wolverhampton Hospitals NHS Trust New Cross Hospital, Wolverhampton, UK Background: Adult primary malignant brain tumours are rare; however, they have a devastating impact and a poor prognosis (Ford et al., 2012). For the past seven years the National Cancer Patient Experience Survey (Quality Health, 2014) has reported the care of brain tumour patients as being less positive compared to other cancer sites, possibly due to unmet care needs. The Aims of this research were: - To explore registered medical nurses’ experiences of the care needs of adult patients with a primary brain tumour. - To identify possible gaps in knowledge and skills that limit the provision of optimal care. Methods: The project adopted a qualitative methodological approach using semistructured interviews to collect and analyse data to reflect the experiences of medical nurses’ in the aforementioned care context. Three participants volunteered, who met the inclusion/exclusion criteria. Participants were registered nurses who had worked on the oncology/haematology Triage Unit for 12 months or more so that they had meaningful reflection. Results: Themes emerged from the collection and analysis of data. Three main themes emphasised that the experience was: challenging; involved holistic care and depended on nurses’ knowledge and experience. Published literature identified that brain tumour patients were different to other cancer patients because they require more nursing time to address their complex care needs. The findings highlighted that senior nurses were significantly more knowledgeable, holistic and aware of patient needs. Conclusions: Junior nurses felt they had very limited experience, confidence or knowledge to care for adult patients with a primary brain tumour. They acknowledged that education and training was essential to allow staff involved in the care of adult patients with a primary brain tumour to feel confident enough to be able to assess and care for the complex needs of this group of patients. Legal entity responsible for the study: Birmingham City University. Funding: Has not received any funding. Disclosure: The author has declared no conflicts of interest.
CN110
Feasibility and acceptability of a mHealth intervention to increase colonoscopy uptake among Chinese first-degree relatives: A pilot cluster randomized controlled trial
Y. Bai, S. Winnie, K.W., C.L. Wong The Nethersole School of Nursing, Chinese University of Hong Kong, Hong Kong, China Background: Colonoscopy is recommended as preferred test for first-degree relatives (FDRs) of colorectal cancer (CRC) patients. However, colonoscopy screening rate remains low. A systematic review and meta-analysis conducted by the research team show that tailored communication is an effective approach to increase uptake of colonoscopy. However, the decision rules that guide the tailored process remain unclear. Based on the identified evidences, a mHealth intervention with an integrated tailoring
C European Society for Medical Oncology 2019. Published by Oxford University Press on behalf of the European Society for Medical Oncology. V
All rights reserved. For permissions, please email: [email protected].
Downloaded from https://academic.oup.com/annonc/article-abstract/30/Supplement_5/mdz277.002/5576713 by guest on 24 October 2019
V. Sulosaari1, P. Ahonen2, H. Heikkil€a3, A. Jekunen4, H. Leino-Kilpi5, P. Rautava6, M. Rekunen7, M. Siekkinen7, M. Stolt5, T. Vahlberg8, L. Walta1 1 Health and Well-Being, Turku University of Applied Sciences, Turku, Finland, 2Doctoral School, Turku University of Applied Sciences, Turku, Finland, 3Research and Development, Finnish Institute of Occupational Health, Tyo¨terveyslaitos, Finland, 4 Oncology, Vaasa Oncology Clinic, Vaasa, Finland, 5Department of Nursing Science, University of Turku, Turku, Finland, 6Research Services, Turku University Hospital, Turku, Finland, 7Western Finland Cancer Centre, Turku University Hospital, Turku, Finland, 8 Department of Clinical Medicine, University of Turku, Turku, Finland
Results: In phase 1, CRC survivors reported symptoms including sexual dysfunction (66%), fatigue (64%), bowel dysfunction (57%) and fear of recurrence (60%). Seventeen survivorship information topics were identified in Phase 1; six further topics were proposed by Phase 2 participants. Seventeen items achieved agreement (80%) for inclusion in the CSIR, including fatigue, bowel function, sexual function, coping, and returning to work. Conclusions: Stakeholder consensus and engagement has the potential to effect sustainable change and innovation in practice. Phase 2 participants will be engaged in Phase 3 to develop and evaluate the content of the CSIR. PAR methodology facilitates the development of interventions which are person-centred and appropriate to the stage of treatment. Once developed, the CSIR will form part of a larger complex intervention, which aims to address the unmet information and supportive care needs of cancer survivors; supporting them to develop self-management skills to cope with the chronic effects of CRC and its treatment. Legal entity responsible for the study: Trinity College Dublin. Funding: The Health Research Board Research Training Fellowship for Healthcare Professionals (Grant#: HPF.2014.715). Disclosure: All authors have declared no conflicts of interest.