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AnteayerInternacionales

Exploring the Service Features of Telephone Cancer Information and Support Services From Callers' Experiences: A Qualitative Evidence Synthesis

ABSTRACT

Aim

This study aims to synthesise evidence on users' experiences of telephone cancer information and support services (CISS) to identify important service features and inform service development.

Design

A qualitative evidence synthesis.

Methods and Data Sources

OVID MEDLINE, EMBASE, CINAHL, PsycINFO and SocINDEX databases were searched for peer-reviewed qualitative literature fitting the inclusion criteria from database inception to 30 March 2023. The included articles were double-screened, and quality appraised using the CASP checklist. GRADE-CERQual was used as a tool to assess the confidence of review findings. Content synthesis combined the qualitative data with the Loiselle cancer experience measurement framework guiding analysis. This paper is reported as per the equator network recommended SRQR checklist.

Results

Of the 607 articles screened, seven studies were included. Four main themes and 14 sub-themes about CISS aspects were identified: psychological well-being (managing emotions/coping, hope/reassurance, supporting close others and a reluctance to call the CISS); knowledge is power (information seeking, the burden of knowledge and empowerment); truth and clarity (adjunct support, credible source and improved understanding and confidence); and service adequacy (operators' ability to connect with users, convenience, service provision and awareness, and the cancer journey).

Conclusion

Findings suggest people with cancer and their carers accessing a CISS value emotional support combined with trusted information, topic expertise and a connection with the service operator. future service provision should address the lack of awareness regarding the range of services and the convenience extended operating hours may offer.

Implications for Patient Care

The results add to our understanding of CISS service provision. However, knowledge gaps remain regarding preferences among service features and the hierarchy of CISS characteristics to be prioritised to enhance services.

Impact

Focused CISS awareness campaigns will inform communities and healthcare professionals of the available resources to improve the lives of those affected by cancer. Ongoing service review will enable resources to be tailored to callers' needs, potentially easing the burden on existing services that are overwhelmed and under-resourced.

Patient or Public Contribution

This qualitative evidence synthesis did not directly involve patient or public contribution to the manuscript.

Trial Registration

Systematic Review Registration Number (PROSPERO): CRD42023413897

Patient Preferences for Cancer Nurses as Care Providers: A Systematic Review of Discrete Choice Experiments

ABSTRACT

Background

Limited literature has focused on people with cancers' preference for care providers in scenarios where trade-offs may have to be made.

Aim

To report the results of a comprehensive search and synthesis of discrete choice experiments or best-worst scaling studies (± willingness to pay estimates) in scenarios involving cancer nurses, with a focus on: (1) preferred care provider; and (2) relative importance of attributes of care provision for people with cancer.

Methods

A search was conducted across: CINAHL, Cochrane Central Register of Controlled Trials, EconLit, Medline, PsycINFO, Scopus, Web of Science Core Collection, and Google Scholar for discrete choice experiments published between January and July 2025. Data were extracted and appraised by two authors. Results were narratively synthesised.

Results

Of 461 studies screened, 11 were included, published in Australia (n = 3), UK (n = 3), and China (n = 5) including people with breast (n = 4), gastric (n = 4), prostate (n = 1), or mixed cancers (n = 2). In six studies exploring scenarios of follow-up care (i.e., survivorship/surveillance), cancer medical specialists were the preferred care provider, followed by cancer nurses, and then general practitioners. In four of the five studies of supportive care scenarios (i.e., diet and exercise advice, anxiety and depression screening), cancer nurses were the preferred care provider, followed by allied health professionals, then cancer medical specialists. The highest WTP estimate was $US226.15 for a medical specialist to provide follow-up care. For supportive care, the highest WTP was $US137.52 for a cancer nurse to provide diet-based lifestyle advice post-treatment for breast cancer.

Conclusion

Cancer nurses are highly valued by people with cancer, particularly for supportive care provision. Opportunities exist for an increase in cancer nurse specialists with expanded scope of practice, to support the preference of people with cancer to have cancer medical specialists, or cancer nurse specialists provide expert cancer follow-up care.

Patient or Public Contribution

Employees of a cancer patient advocacy group were involved in the design of the study, interpretation of the data, and the preparation of the manuscript. No patients were involved in this work. However, this systematic review prioritized patient voices by including studies that reported on the preferences of people with cancer.

The (Under) Valued Contribution of Doctorally Prepared Clinical Nurses to Healthcare—A Qualitative Study

ABSTRACT

Aim

Although the majority of doctorally prepared nurses work in academia, a percentage choose clinical work. Knowledge about the contribution of doctorally prepared clinical nurses (DPCNs) is growing, but further exploration is required. This research explored the value that DPCNs provide to nursing practice and healthcare.

Design and Methods

Using an interpretive descriptive approach, individual interviews were conducted with 18 DPCNs. Data was collected between 2021 and 2022. Reflexive thematic analysis informed the data analysis.

Results

Five key mechanisms drive DPCNs' value: being a knowledge expert; an enhanced approach to practice; increased credibility/prestige of the doctorate; valuable conversations; and new opportunities and collaborations. Challenges to value contribution were also highlighted, including identity issues; negative external perceptions; fragmented mentorship; no post-doctoral pathway; and little recognition from nursing leaders.

Conclusion

Doctorally prepared clinical nurses bring significant value to nursing and healthcare through distinct mechanisms that should be nurtured and strengthened.

Implications for Practice

Doctorally prepared clinical nurses add important value to healthcare. However, these nurses are under-utilised and require support to enhance their value contribution.

Impact

Identifying the mechanisms driving value provides a unique opportunity to acknowledge, support and enhance the value provided by DPCNs. The research will be impactful for nurses considering doctoral study, nursing leaders and healthcare managers.

Reporting Method

This research is reported following SRQR guidelines.

Patient or Public Involvement

This study did not include patient or public involvement in its design, conduct or reporting.

Structural Resilience Across the Life Course: Perspectives From Older Adults Racialized as Black

ABSTRACT

Aim(s)

This study explored perceptions of older adults racialised as Black on structural resilience across the life course.

Design

A qualitative descriptive study.

Methods

Using purposive sampling, we recruited 15 Black adults aged 50 and older residing in Baltimore, Maryland, including individuals possessing historical or current knowledge of the community. Semi-structured interviews were conducted to elicit participants' experiences with structural resources during childhood, adulthood and late adulthood. Interviews were audio-recorded, transcribed verbatim and analysed using content analysis.

Results

Of the 15 participants, three identified as male (20.0%) and 12 as female (80.0%), with an average age of 70.9 ± 8.2 years. The analysis identified nine categories of structural resilience, confirming its multifaceted and dynamic nature. Common categories present across all life stages included: Built environment, civic engagement, food and housing, healthcare, and social capital and cohesion. Life stage–specific categories included child and family services, educational supports, and workforce development supports during childhood and adulthood, and financial support during adulthood and late adulthood.

Conclusion

These categories were interdependent and spanned across life stages, illustrating the dynamic, cumulative and relational qualities of structural resilience. Furthermore, structural resources were identified as key to safeguarding, empowering and restorative responses to adversity.

Impact

These findings contribute to the development of a nuanced, life course–informed framework of structural resilience and highlight the need for ecological strategies that address structural forces shaping health and well-being, particularly among older adults racialised as Black.

Reporting Method

This study was reported in accordance with the Consolidated Criteria for Reporting Qualitative Research checklist.

Patient or Public Contribution

No patient or public contribution.

When Words Fail: ICU Nurses' Experiences Caring for Patients With Limited English Proficiency in the United States

ABSTRACT

Aims

To explore the lived experiences of intensive care nurses caring for patients with limited English proficiency.

Design

A hermeneutic, interpretive phenomenological design was used.

Methods

Semi-structured interviews were conducted with intensive care nurses recruited through purposive sampling. Data collection included Qualtrics screening surveys and semi-structured Zoom interviews. The research team, comprising linguistically diverse faculty and undergraduate research assistants, employed reflexivity techniques to minimise bias and enhance interpretive rigour. Data were analysed via inductive analysis using the hermeneutic circle.

Results

Five main themes emerged organically from the data: Complications of Care Relating to Verbal Communication Challenges. Benefits and Barriers of Nursing Informatics in Linguistic Care. The Universal Language: Nursing Effort Builds Trust. The Ripple Effect: Chronological Considerations for Patient Care. Moving Forward: Where Do We Go From Here?

Based on these findings, a four-phase model was developed to guide individual and system-level interventions to reduce nurse moral distress and improve language equity in critical care.

Conclusion

Language barriers in the intensive care unit hinder communication, increase stress for patients and nurses, and impact care quality. While nurses' efforts to bridge these gaps are valued, systemic changes (such as expanded interpreter availability and improved cultural safety training) are necessary to support culturally, linguistically, and medically appropriate care.

Implications for the Profession and/or Patient Care

Findings highlight the need for increased institutional support, additional resources for night-shift staff, and the integration of cultural humility education into intensive care training. The Limited English Proficiency Moral Distress Action Cycle for Critical Care Nursing, developed from this study, offers a flexible framework to guide the implementation of these improvements and reduce nurse moral distress. Future research should explore interventions to promote cultural and linguistic competence in multilingual patient populations.

Impact

Q: What problem did the study address?

A: The nurse-identified clinical, ethical, and workflow risks created when interpreters or translation tools are inadequate for critical care.

Q: What were the main findings?

A: Language barriers jeopardise teaching, informed consent, and symptom reporting. Video and phone interpreters or translation apps are vital but are often scarce, unreliable, or impersonal, particularly during night shifts. Nurses bridge these gaps by building trust through empathy, non-verbal communication, and learning key phrases. Yet, effective care for patients with limited English proficiency requires extra time, increasing workloads and fuelling moral distress related to language-discordant care. Nurses consistently called for 24/7 interpreter coverage; more reliable devices and cultural humility training must be implemented system-wide.

Q: Where and on whom will the research have an impact?

A: Findings can guide nurses, managers, leaders, and administrators to improve both language concordant and discordant nursing care and train nurses in cultural and linguistic competencies for a multilingual patient population. Ultimately, these efforts have been shown to improve the quality, outcomes, and cost-effectiveness of patient care. The study also identifies moral-distress triggers and introduces the Limited English Proficiency Moral Distress Action Cycle (LEP-MDAC). This model is proposed for use in other high-acuity settings worldwide that seek to provide language-concordant or language-discordant care effectively.

Reporting Method

SRQR.

Patient or Public Contribution

None.

Development and Psychometric Testing of a Comprehensive Cancer Nurse Self‐Assessment Tool (CaN‐SAT) for Identifying Cancer Nursing Skills

ABSTRACT

Aim

To develop and psychometrically test a comprehensive Cancer Nurse Self-Assessment Tool (CaN-SAT).

Design

Modified Delphi to assess content validity and cross-sectional survey to assess reliability and validity.

Methods

Phase 1: An expert group developed the tool structure and item content. Phase 2: Through a modified Delphi, cancer nursing experts rated the importance of each element of practice and assessed the relevance and clarity of each item. Content Validation Indexes (CVI) were calculated, and a CVI of ≥ 0.78 was required for items to be included. Phase 3: Cancer nurses participated in a survey to test internal consistency (using Cronbach's alpha coefficients) and known-group validity (through Mann–Whitney U tests). This study was reported using the Guidelines for Reporting Reliability and Agreement Studies (GRRAS) checklist.

Results

The CaN-SAT underwent two rounds of Delphi with 24 then 15 cancer nursing experts. All elements of practice were rated as important. Only three items achieved a CVI < 0.78 after round one; however, based on open-ended comments, 26 items were revised and one new item added. After round two, all items received a CVI above 0.78. The final tool consisted of 93 items across 15 elements of practice. Cronbach's alpha coefficients were between 0.92 and 0.98 indicating good reliability. Mann–Whitney U tests demonstrated significant differences between clinical nurses and advanced practice nurses across 13 out of 15 elements of practice.

Conclusion

The CaN-SAT is a comprehensive, valid and reliable tool that can be used for cancer nurses to self-assess current skill levels, identify their learning needs and inform decisions about educational opportunities to optimise cancer care provision.

Patient or Public Contribution

The research team included three patient advocates from Cancer Voices NSW, who were actively involved in all aspects of the study and are listed as authors.

Development and Pilot Psychometric Testing of the Cancer Nurse Self‐Assessment Tools for Early and Metastatic Breast Cancer

ABSTRACT

Aim

To develop and psychometrically test two newly developed Cancer Nurse Self-Assessment Tools for early and metastatic breast cancer (CaN-SAT-eBC and CAN-SAT-mBC).

Design

Instrument development and psychometric testing of content validity, reliability and construct validity.

Methods

A three-phase procedure was conducted. Phase 1: An expert working group was formed to design and develop each tool using Benner's Model of Clinical Competence. Phase 2: The Content Validation Index (CVI) was used to assess the relevance and clarity of each item on the tools with breast cancer nurse experts and nursing educators. A CVI ≥ 0.78 was required for an item to be included in each tool. Phase 3: The tools were tested for internal consistency using Cronbach's alpha and construct validity using principal component analysis (PCA). The Guidelines for Reporting Reliability and Agreement Studies were followed in reporting this study.

Results

Each tool underwent two rounds of content validation. Ten experts were involved in the content validation for the CaN-SAT-eBC and 12 experts involved for CaN-SAT-mBC. The final versions comprised 18 (CAN-SAT-eBC) and 22 elements (CaN-SAT-mBC). All items obtained a satisfactory CVI of 0.83–1.0. Data from 159 and 126 nurses were analysed to evaluate reliability for CaN-SAT-eBC and CaN-SAT-mBC, respectively. The Cronbach's alpha coefficients for all elements were between 0.83 and 0.98. The PCA supported that each element was unidimensional and composed of internally correlated items, with the exception of the ‘Diagnostics’ element of practice which has a two-component structure measuring basic and advanced diagnostic tasks.

Conclusions

The two CaN-SATs are comprehensive, valid and reliable. They can be used for self-assessment by nurses in relation to breast cancer care and for identifying learning needs for long-term professional development. The self-assessment tools can also be used to develop education initiatives for specialised breast cancer nurses.

Patient or Public Contribution

No patient or public contribution.

A Scoping Review of Observational Research on Cannabis Use for Symptom Management in HIV and Cancer: Implications for Cannabis Nursing

ABSTRACT

Background

People with HIV have a higher risk of developing non-AIDS-defining cancers in older age, leading to a significant population living with two conditions, HIV and cancer. There is an increasing interest in cannabis use for symptom management in people with chronic conditions; in 2023, the American Nurses Association officially recognised cannabis nursing as a specialty nursing practice focusing on the care of individuals seeking education/guidance in the therapeutic use of cannabis, supporting the urgency of its research. However, the scientific literature lacks a synthesised review in the focused populations.

Aim

To explore observational research on cannabis use for symptom management among people with HIV and/or cancer and identify gaps in current knowledge to inform future research and policy development.

Methods

Following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews (PRISMA-ScR) checklist, a literature search of relevant articles was conducted in the databases PubMed (n = 552), PsycInfo (n = 204), CINAHL (n = 164) and Embase (n = 976). Upon screening 1738 articles, 142 were identified for full-text review and 51 were retained for data extraction.

Results

There were more studies evaluating cannabis use among people with cancer than with HIV and no studies among people living with comorbid HIV and cancer. Most studies were cross-sectional with limited metrics on the perceived effectiveness and safety of cannabis use for symptom management and its dosing/mode of delivery for reducing symptoms. While studies focused on cannabis therapy under the provision of healthcare providers, individuals reported obtaining information about cannabis from friends/family/the Internet.

Implications for Cannabis Nursing

This body of research could be strengthened by rigorous longitudinal study designs to build causal relationships on the therapeutic effects of cannabis use and the inclusion of reliable and valid symptom assessment measures over time, which facilitates developing clinical practice guidance and policymaking in cannabis nursing.

Patient or Public Contribution

No patient or public contribution.

An mHealth application for chronic vascular access: A multi‐method evaluation

Abstract

Background

Healthcare consumers require diverse resources to assist their navigation of complex healthcare interactions, however, these resources need to be fit for purpose.

Aim

In this study, we evaluated the utility, usability and feasibility of children, families and adults requiring long-term intravenous therapy using a recently developed mobile health application (App), intravenous (IV) Passport.

Design

Multi-site, parallel, multi-method, prospective cohort study.

Methods

A multi-site, multi-method study was carried out in 2020–2021, with 46 participants (20 adults, 26 children/family) reporting on their experiences surrounding the use of the IV Passport for up to 6 months.

Results

Overall, utility rates were acceptable, with 78.3% (N = 36) using the IV Passport over the follow-up period, with high rates of planned future use for those still active in the project (N = 21; 73%), especially in the child/family cohort (N = 13; 100%). Acceptability rates were high (9/10; IQR 6.5–10), with the IV Passport primarily used for documenting new devices and complications. Thematic analysis revealed three main themes (and multiple subthemes) in the qualitative data: Advocacy for healthcare needs, Complexity of healthcare and App design and functionality.

Conclusion

Several recommendations were made to improve the end-user experience including ‘how to’ instructions; and scheduling functionality for routine care.

Implications for the Profession and/or Patient Care

The IV Passport can be safely and appropriately integrated into healthcare, to support consumers.

Impact

Patient-/parent-reported feedback suggests the Intravenous Passport is a useful tool for record-keeping, and positive communication between patients/parents, and clinicians.

Reporting Method

Not applicable.

Patient Contribution

Consumers reported their experiences surrounding the use of the IV Passport for up to 6 months.

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