FreshRSS

🔒
❌ Acerca de FreshRSS
Hay nuevos artículos disponibles. Pincha para refrescar la página.
AnteayerInternacionales

Guidance for Specialised Cancer Nursing of People With Gynaecological Cancers: A Scoping Review

ABSTRACT

Background

Gynaecological cancer nurses are crucial to the delivery of quality, specialised care to meet the needs of people with these cancers. The extent of evidence-based guidance to support nursing care is unknown.

Aim

To identify and describe existing international guidance for specialised gynaecological cancer nursing care.

Design

Scoping review.

Methods

This scoping review utilised the participants, concept, context framework with narrative synthesis.

Data Sources

Databases including MEDLINE (Ovid), CINAHL Ultimate (EBSCO), Proquest Central (Alumni) and Google Scholar were searched on 4 April 2025 along with relevant websites and reference lists of included sources. Included sources referred to the nurse's role and provided clinical guidelines, practice recommendations or equivalent guidance on how nurses provide specialised care. Sources were limited to those published in English from 2009 to present.

Results

Of 1905 sources identified, 12 met the inclusion criteria. Sources were published by authors in seven countries between 2014 and 2024. Most sources related to one specific gynaecological cancer type and/or one aspect or time point of care. Sources varied in the volume of nurse relevant content. No individual source provided comprehensive nursing guidance across all gynaecological cancer types.

Conclusions

Internationally published guidance for specialised gynaecological cancer nursing presents gaps in available evidence for care. We recommend comprehensive guidance resource development to meet clinical nurses' needs and improve translation of evidence-based nursing practice.

Implications for the Profession and/or Patient Care

The current lack of comprehensive published guidance for specialised gynaecological cancer nursing does not meet reported needs of nurses working in clinical practice and may be contributing to variation in nursing care delivery.

Trial Registration: https://osf.io/ntdzj; registered 24 March 2025; Open Science Framework

Changing the global narrative: raising awareness of implicit and explicit weight bias in healthcare professions

Por: Cook · J.

Commentary on: Bradford, H.M., Puhl, R.M., Phillippi, J.C., et al. Implicit and Explicit Weight Bias among Midwives: Variations Across Demographic Characteristics. J Midwifery Womens Health 2024;0:1: doi:10.1111/jmwh.13616.

Implications for practice and research

  • This study has implications for raising awareness on weight bias in practice highlighting a need for further inquiry exploring undergraduate education and continuing professional development.

  • This study has the potential to prompt further qualitative research focusing on the experiences and perspectives of health care professionals and weight bias.

  • Methods

    An online survey was used to measure weight bias of midwives. The survey included demographic questions about age, years since certification, body mass index (BMI), race and ethnicity and state of residence. Participants completed measures of implicit and explicit weight bias including the Implicit Association Test, the Anti-Fat Attitudes questionnaire, the Fat Phobia Scale-Short Form and the Preference for Thin People. Data...

    Using a Modified Delphi Process to Develop an Intervention to Support Care Coordination of Patient Social Needs in Primary Care

    ABSTRACT

    Aims

    To identify implementation strategies that effectively facilitate the adoption of social needs care coordination activities using enabling technologies among care management teams serving patients in community-based health centres.

    Design

    Modified Delphi process.

    Methods

    Discrete, feasible implementation strategies were identified through literature review and semi-structured interviews with care management staff and subject matter experts in clinical informatics, workflow redesign, and product engineering. A modified Delphi was conducted with eight subject matter experts and nine health centre care management staff. Iterative rounds of online surveys were used to achieve consensus on the most relevant implementation strategies and their delivery methods.

    Results

    The modified Delphi process achieved consensus on nine discrete implementation strategies needed to advance care management teams' ability to screen, refer and track social needs. Prioritised strategies included developing champions, enhancing quality improvement capacity, training staff on using enabling technologies and providing tailored technical assistance for workflow refinement. Consensus was also reached on a monthly cadence for most of the implementation strategies.

    Conclusions

    Consensus was reached on strategies to enhance care management teams' implementation of social needs screening, referrals and tracking using enabling technologies. These strategies will comprise an intervention to be pilot tested, refined and assessed in a cluster randomised clinical trial.

    Implications for the Profession and/or Patient Care

    Findings from this study will inform the development of strategies to further the adoption of enabling technologies to support social needs care coordination.

    Impact

    This work is key to the design of a type 2 hybrid implementation-effectiveness trial that will assess whether user-informed, evidence-based implementation strategies can improve care management teams' adoption of enabling technologies to facilitate social needs care coordination for patients.

    Patient or Public Contribution

    The research team includes a patient advisor with community-based nursing expertise and a nurse practitioner-clinical informaticist leader who was involved in data collection and interpretation of findings.

    Trial registration: Clinicaltrials.gov registration # NCT06489002. Registered July 5, 2024, https://clinicaltrials.gov/study/NCT06489002?term=NCT06489002&rank=1.

    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.

    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.

    ❌