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Sezgin MG, Bektas H. The effect of nurse-led remote telephone triage on symptom management of patients with cancer: A systematic review and meta-analysis. Worldviews Evid Based Nurs 2024. [PMID: 38530162 DOI: 10.1111/wvn.12721] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2023] [Revised: 02/20/2024] [Accepted: 02/22/2024] [Indexed: 03/27/2024]
Abstract
BACKGROUND Cancer patients experience many symptoms. Nurse-led remote telephone triage can improve their quality of life by contributing to the management of these symptoms. AIMS This study aimed to investigate the effects of nurse-led remote telephone triage on symptom management of patients with cancer. METHODS The searches were conducted in 10 databases and gray literature from May 2023 to July 2023 without any year limitations. A fixed-effects model was used in the meta-analysis. Cochran's Q chi-squared test and I2 statistics were used for heterogeneity. The PRISMA checklist was used. Data obtained from the included studies were analyzed using CMA 3 software. RESULTS Six relevant studies (1671 patients) were included. Nurse-led remote telephone triage was found to have a positive and moderate effect on parameters such as pain (Hedge's g = 0.21, p < .001), fatigue (Hedge's g = 0.28, p < .001), and depression (Hedge's g = 0.24, p < .001) in patients with cancer. Also, the remote telephone triage had a positive and low effect on outcomes such as anxiety (Hedge's g = 0.17, p = .001), nausea (Hedge's g = 0.17, p = .004), and vomiting (Hedge's g = 0.16, p = .007) but did not affect diarrhea results. LINKING EVIDENCE TO ACTION This study showed that nurse-led remote telephone triage considerably improved the symptoms of patients with cancer. This study will increase oncology nurses' awareness that nurse-led remote telephone triage of patients with cancer can improve their symptoms. Remote symptom triage developed using evidence-based guidelines and protocols can significantly contribute to the regular follow-up of patients' symptoms, providing quality care, and establishing appropriate symptom management programs and systems with high levels of evidence.
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Affiliation(s)
- Merve Gozde Sezgin
- Department of Internal Medicine Nursing, Akdeniz University Faculty of Nursing, Antalya, Turkey
| | - Hicran Bektas
- Department of Internal Medicine Nursing, Akdeniz University Faculty of Nursing, Antalya, Turkey
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Ayivi-Vinz G, Bakwa Kanyinga F, Bergeron L, Décary S, Adisso ÉL, Zomahoun HTV, Daniel SJ, Tremblay M, Plourde KV, Guay-Bélanger S, Légaré F. Use of the CPD-REACTION Questionnaire to Evaluate Continuing Professional Development Activities for Health Professionals: Systematic Review. JMIR MEDICAL EDUCATION 2022; 8:e36948. [PMID: 35318188 PMCID: PMC9112082 DOI: 10.2196/36948] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/31/2022] [Revised: 03/11/2022] [Accepted: 03/21/2022] [Indexed: 05/19/2023]
Abstract
BACKGROUND Continuing professional development (CPD) is essential for physicians to maintain and enhance their knowledge, competence, skills, and performance. Web-based CPD plays an essential role. However, validated theory-informed measures of their impact are lacking. The CPD-REACTION questionnaire is a validated theory-informed tool that evaluates the impact of CPD activities on clinicians' behavioral intentions. OBJECTIVE We aimed to review the use of the CPD-REACTION questionnaire, which measures the impact of CPD activities on health professionals' intentions to change clinical behavior. We examined CPD activity characteristics, ranges of intention, mean scores, score distributions, and psychometric properties. METHODS We conducted a systematic review informed by the Cochrane review methodology. We searched 8 databases from January 1, 2014, to April 20, 2021. Gray literature was identified using Google Scholar and Research Gate. Eligibility criteria included all health care professionals, any study design, and participants' completion of the CPD-REACTION questionnaire either before, after, or before and after a CPD activity. Study selection, data extraction, and study quality evaluation were independently performed by 2 reviewers. We extracted data on characteristics of studies, the CPD activity (eg, targeted clinical behavior and format), and CPD-REACTION use. We used the Mixed Methods Appraisal Tool to evaluate the methodological quality of the studies. Data extracted were analyzed using descriptive statistics and the Student t test (2-tailed) for bivariate analysis. The results are presented as a narrative synthesis reported according to the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. RESULTS Overall, 65 citations were eligible and referred to 52 primary studies. The number of primary studies reporting the use of CPD-REACTION has increased continuously since 2014 from 1 to 16 publications per year (2021). It is available in English, French, Spanish, and Dutch. Most of the studies were conducted in Canada (30/52, 58%). Furthermore, 40 different clinical behaviors were identified. The most common CPD format was e-learning (34/52, 65%). The original version of the CPD-REACTION questionnaire was used in 31 of 52 studies, and an adapted version in 18 of 52 studies. In addition, 31% (16/52) of the studies measured both the pre- and postintervention scores. In 22 studies, CPD providers were university-based. Most studies targeted interprofessional groups of health professionals (31/52, 60%). CONCLUSIONS The use of CPD-REACTION has increased rapidly and across a wide range of clinical behaviors and formats, including a web-based format. Further research should investigate the most effective way to adapt the CPD-REACTION questionnaire to a variety of clinical behaviors and contexts. TRIAL REGISTRATION PROSPERO CRD42018116492; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=116492.
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Affiliation(s)
- Gloria Ayivi-Vinz
- VITAM - Centre de Recherche en Santé Durable, Centre Intégré Universitaire de Santé et de Services Sociaux de la Capitale-Nationale, Université Laval, Quebec, QC, Canada
- Tier 1 Canada Research Chair in Shared Decision Making and Knowledge Translation, Université Laval, Quebec, QC, Canada
- Department of Social and Preventive Medicine, Faculty of Medicine, Université Laval, Quebec, QC, Canada
| | - Felly Bakwa Kanyinga
- VITAM - Centre de Recherche en Santé Durable, Centre Intégré Universitaire de Santé et de Services Sociaux de la Capitale-Nationale, Université Laval, Quebec, QC, Canada
- Tier 1 Canada Research Chair in Shared Decision Making and Knowledge Translation, Université Laval, Quebec, QC, Canada
- Department of Social and Preventive Medicine, Faculty of Medicine, Université Laval, Quebec, QC, Canada
| | - Lysa Bergeron
- Tier 1 Canada Research Chair in Shared Decision Making and Knowledge Translation, Université Laval, Quebec, QC, Canada
| | - Simon Décary
- School of Rehabilitation, Faculty of Medicine and Health Sciences, Université de Sherbrooke, Sherbrooke, QC, Canada
| | - Évèhouénou Lionel Adisso
- VITAM - Centre de Recherche en Santé Durable, Centre Intégré Universitaire de Santé et de Services Sociaux de la Capitale-Nationale, Université Laval, Quebec, QC, Canada
- Tier 1 Canada Research Chair in Shared Decision Making and Knowledge Translation, Université Laval, Quebec, QC, Canada
- Department of Social and Preventive Medicine, Faculty of Medicine, Université Laval, Quebec, QC, Canada
| | - Hervé Tchala Vignon Zomahoun
- VITAM - Centre de Recherche en Santé Durable, Centre Intégré Universitaire de Santé et de Services Sociaux de la Capitale-Nationale, Université Laval, Quebec, QC, Canada
- Unité de Soutien SSA Québec, Université Laval, Quebec, QC, Canada
| | - Sam J Daniel
- Direction du Développement Professionnel Continu, Fédération des Médecins Spécialistes du Québec, Montreal, QC, Canada
| | - Martin Tremblay
- Direction du Développement Professionnel Continu, Fédération des Médecins Spécialistes du Québec, Montreal, QC, Canada
| | - Karine V Plourde
- VITAM - Centre de Recherche en Santé Durable, Centre Intégré Universitaire de Santé et de Services Sociaux de la Capitale-Nationale, Université Laval, Quebec, QC, Canada
- Tier 1 Canada Research Chair in Shared Decision Making and Knowledge Translation, Université Laval, Quebec, QC, Canada
| | - Sabrina Guay-Bélanger
- VITAM - Centre de Recherche en Santé Durable, Centre Intégré Universitaire de Santé et de Services Sociaux de la Capitale-Nationale, Université Laval, Quebec, QC, Canada
- Tier 1 Canada Research Chair in Shared Decision Making and Knowledge Translation, Université Laval, Quebec, QC, Canada
| | - France Légaré
- VITAM - Centre de Recherche en Santé Durable, Centre Intégré Universitaire de Santé et de Services Sociaux de la Capitale-Nationale, Université Laval, Quebec, QC, Canada
- Tier 1 Canada Research Chair in Shared Decision Making and Knowledge Translation, Université Laval, Quebec, QC, Canada
- Unité de Soutien SSA Québec, Université Laval, Quebec, QC, Canada
- Department of Family Medicine and Emergency Medicine, Faculty of Medicine, Université Laval, Quebec, QC, Canada
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Ramos-Morcillo AJ, Harillo-Acevedo D, Ruzafa-Martinez M. Using the Knowledge-to-Action Framework to understand experiences of breastfeeding guideline implementation: A qualitative study. J Nurs Manag 2020; 28:1670-1685. [PMID: 32770811 DOI: 10.1111/jonm.13123] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2020] [Revised: 07/31/2020] [Accepted: 08/03/2020] [Indexed: 11/28/2022]
Abstract
AIM To examine the perceptions and experiences of health care professionals and mothers in relation to the implementation of a breastfeeding clinical practice guideline (CPG). BACKGROUND Breastfeeding CPG applications remain limited, and qualitative studies have indicated the need to overcome the perception by professionals of difficulties in applying recommendations. METHODS A qualitative study was conducted in a Spanish public hospital that implemented the Registered Nurses´ Association of Ontario breastfeeding CPG from 2012 through 2015. Between May and August 2017, 27 semi-structured interviews were conducted with managers, with professionals in maternity and paediatric departments and with mothers. Deductive content analysis was performed following the stages in the Knowledge-To-Action (KTA) Framework. RESULTS We obtained five main categories: (a) problem as opportunity; (b) adequate context and adapted recommendations; (c) extent of implementation; (d) impact of results; and (e) knowledge use normalization. CONCLUSIONS The KTA Framework assists understanding of the participation of the main actors in breastfeeding CPG implementation. IMPLICATIONS FOR NURSING MANAGEMENT The nature of the interventions and the participation of managers, different professionals and mothers in a multi-unit setting generate a complex implementation process that reveals key factors to be taken into account in future CPG implementations.
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Stacey D, Ludwig C, Jolicoeur L, Carley M, Balchin K, Jibb L, Kelly F, Kuziemsky C, Madore S, Rambout L, Vickers MM, Martelli L. Quality of telephone-based cancer symptom management by nurses: a quality improvement project. Support Care Cancer 2020; 29:841-849. [PMID: 32495032 DOI: 10.1007/s00520-020-05551-5] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2019] [Accepted: 05/25/2020] [Indexed: 11/28/2022]
Abstract
PURPOSE To determine the quality of cancer symptom management when evidence from clinical practice guidelines are used in telephone-based oncology nursing services. METHODS Guided by the Knowledge to Action Framework, we conducted a quality improvement (QI) project focused on "monitoring knowledge use" (e.g., use of practice guides) and "measuring outcomes." In 2016, 15 Pan-Canadian Oncology Symptom Triage and Remote Support (COSTaRS) practice guides that synthesize evidence from guidelines were implemented with training for all oncology nurses at a regional ambulatory oncology program. Eighteen months post-implementation, Symptom Management Analysis Tool (SMAT) was used to analyze audio-recorded calls and related documentation of cancer symptom management. RESULTS Of 113 audio-recorded calls, 66 were COSTaRS symptoms (58%), 43 other symptoms (38%), and 4 medically complex situations (4%). Of 66 recorded calls, 63 (95%) were documented. Average SMAT quality score was 71% (range 21-100%) for audio-recordings and 63% (range 19-100%) for documentation of calls. COSTaRS practice guide use was documented in 33% calls. For these calls, average SMAT quality scores were 74% with COSTaRS versus 69% without COSTaRS for audio-recording and 73% (range 33-100%) with COSTaRS versus 58% without COSTaRS for documentation. Patient outcomes indicated symptom was resolved (38%), worse (25%), unchanged (3%), or unknown (33%). Eight patients (13%) had an ED visit within 14 days post that was related to the symptom discussed. CONCLUSIONS Only a third of nurses indicated use of COSTaRS practice guides. There were higher quality symptom management scores when COSTaRS use was reported. Nurses documented less than what they discussed.
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Affiliation(s)
- Dawn Stacey
- School of Nursing, Faculty of Health Sciences, University of Ottawa, Ottawa, Ontario, Canada. .,Ottawa Hospital Research Institute, 451 Smyth Road, Ottawa, Ontario, K1H 8M5, Canada.
| | - Claire Ludwig
- School of Nursing, Faculty of Health Sciences, University of Ottawa, Ottawa, Ontario, Canada
| | - Lynne Jolicoeur
- Regional Cancer Program, The Ottawa Hospital, Ottawa, Ontario, Canada
| | - Meg Carley
- Ottawa Hospital Research Institute, 451 Smyth Road, Ottawa, Ontario, K1H 8M5, Canada
| | - Katelyn Balchin
- Blood and Marrow Transplant Program, Regional Cancer Program, The Ottawa Hospital, Ottawa, Ontario, Canada
| | - Lindsay Jibb
- Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, Toronto, Ontario, Canada
| | - Freya Kelly
- University of Ottawa Heart Institute (Cardiac Virtual Care), Ottawa, Ontario, Canada
| | | | - Suzanne Madore
- Eye Care Program, The Ottawa Hospital, Ottawa, Ontario, Canada.,Acute and Chronic Pain, Substance Use Program and Medical Device Reprocessing, The Ottawa Hospital, Ottawa, Ontario, Canada
| | - Lisa Rambout
- Pharmacy, The Ottawa Hospital, Ottawa, Ontario, Canada
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