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Donmez E, Kilic B, Dulger Z, Ozdas T. Innovative Cancer Follow-Up with Telehealth: A New Method for Oncology Nurses. Semin Oncol Nurs 2024:151649. [PMID: 38734572 DOI: 10.1016/j.soncn.2024.151649] [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: 02/19/2024] [Revised: 03/31/2024] [Accepted: 04/14/2024] [Indexed: 05/13/2024]
Abstract
OBJECTIVES Telenavigation (TN) is an innovative cancer follow-up method for oncology nurses. Little is known about the effectiveness of tele-navigation on cancer patients. This study investigated the opinions of healthcare providers (HCPs) and colorectal cancer patients' experience regarding patient follow-up with TN. DATA SOURCES This is a phenomenological qualitative study. Semistructured interviews were conducted with fifteen patients and eight healthcare providers. Participants were selected by purposive sampling. Data were collected from March to October 2022 and analyzed by thematic content analysis. CONCLUSION Six themes emerged that described the experiences of TN: (1) beneficial; (2) psychological state; (3) level of knowledge, (4) technology, (5) health care system, and (6) recommendations. Patients and HCPs found TN practice helpful and reassuring and they recommended expanding these practices within the health system. As a result of the research, the TN program is described as beneficial to patients and healthcare providers. IMPLICATIONS FOR NURSING PRACTICE The TN follow-up is a beneficial implication for colorectal cancer patients undergoing treatment, and it deserves to be more widely deployed. It brings reassurance regarding psychological, reliable data access, and home follow-up. Patients and HCPs reported positive views on telephone follow-up. There is a recommendation that the innovative follow-up technique should be disseminated to the healthcare system and that cancer nurses should be more familiar with this method.
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Affiliation(s)
- Elif Donmez
- Department of Oncology Nursing, Hamidiye Nursing Faculty, University of Health Sciences, Üsküdar, Istanbul, Turkiye.
| | - Bulent Kilic
- Department of Public Health, Medical Faculty, Dokuz Eylul University, Izmir, Turkiye
| | - Zeynep Dulger
- Department of Oncology Nursing, Hamidiye Nursing Faculty, University of Health Sciences, Üsküdar, Istanbul, Turkiye
| | - Turkan Ozdas
- Department of Oncology Nursing, Hamidiye Nursing Faculty, University of Health Sciences, Üsküdar, Istanbul, Turkiye
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Soumerai TE, Mulvey TM, Jackson VA, Lennes IT. Supportive Care for Cancer Patients Via Telehealth: Breaking Bad News and Providing Palliative Care Virtually. Cancer J 2024; 30:27-30. [PMID: 38265923 DOI: 10.1097/ppo.0000000000000699] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2024]
Abstract
ABSTRACT Delivering oncologic care via telemedicine has presented a unique set of benefits and challenges. Discussions of sensitive topics between patients and providers can be difficult on a virtual platform. Although it was imperative to utilize telemedicine to keep cancer patients safe during the height of the pandemic, its continued use in the postvaccination era has provided important conveniences to both providers and patients. In the case of breaking bad news and end-of-life discussions, however, in-person care has remained the overwhelming preference of both groups. If face-to-face consultation is not possible or feasible in these situations, virtual visits are a viable option to connect oncologists with their patients.
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Affiliation(s)
- Tara E Soumerai
- From the Massachusetts General Hospital Cancer Center, Boston, MA
| | - Therese M Mulvey
- From the Massachusetts General Hospital Cancer Center, Boston, MA
| | - Vicki A Jackson
- From the Massachusetts General Hospital Cancer Center, Boston, MA
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Scotté F, Taylor A, Davies A. Supportive Care: The "Keystone" of Modern Oncology Practice. Cancers (Basel) 2023; 15:3860. [PMID: 37568675 PMCID: PMC10417474 DOI: 10.3390/cancers15153860] [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: 07/07/2023] [Revised: 07/24/2023] [Accepted: 07/27/2023] [Indexed: 08/13/2023] Open
Abstract
The Multinational Association of Supportive Care in Cancer (MASCC) defines supportive care as "the prevention and management of the adverse effects of cancer and its treatment. This includes management of physical and psychological symptoms and side effects across the continuum of the cancer journey from diagnosis through treatment to post-treatment care. Supportive care aims to improve the quality of rehabilitation, secondary cancer prevention, survivorship, and end-of-life care". This article will provide an overview of modern supportive care in cancer, discussing its definition, its relationship with palliative care, models of care, "core" service elements (multi-professional/multidisciplinary involvement), the evidence that supportive care improves morbidity, quality of life, and mortality in various groups of patients with cancer, and the health economic benefits of supportive care. The article will also discuss the current and future challenges to providing optimal supportive care to all oncology patients.
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Affiliation(s)
| | - Amy Taylor
- Our Lady’s Hospice & Care Services, D6W RY72 Dublin, Ireland
- School of Medicine, Trinity College Dublin, D02 PN40 Dublin, Ireland
| | - Andrew Davies
- Our Lady’s Hospice & Care Services, D6W RY72 Dublin, Ireland
- School of Medicine, Trinity College Dublin, D02 PN40 Dublin, Ireland
- School of Medicine, University College Dublin, D04 V1W8 Dublin, Ireland
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Ma L, Wang X, Zou S, Lin M, Qiu S, Li W. A structural equation modelling analysis: interprofessional team collaboration, organizational career management, and post competency of community nurses. BMC Health Serv Res 2023; 23:327. [PMID: 37005581 PMCID: PMC10067220 DOI: 10.1186/s12913-023-09303-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2022] [Accepted: 03/17/2023] [Indexed: 04/04/2023] Open
Abstract
BACKGROUND With the advent of an ageing society and an increase in the prevalence of chronic diseases, the role of primary health care has become increasingly important and reliant on multidisciplinary collaboration. As members of this interprofessional cooperative team, community nurses play a dominant role. Thus, the post competencies of community nurses study deserve our attention. In addition, organizational career management can affect nurses in some ways. This study aims to examine the current situation and relationship among interprofessional team collaboration, organizational career management and post-competency of community nurses. METHODS A survey was conducted among 530 nurses in 28 community medical institutions from November 2021 to April 2022 in Chengdu, Sichuan Province, China. Descriptive analysis was used for analysis, and a structural equation model was used to hypothesize and verify the model. A total of 88.2% of respondents met the inclusion criteria and did not meet the exclusion criteria. The main reason nurses gave for not participating was that they were too busy. RESULTS Among the competencies on the questionnaire, ensuring quality and helping roles scored the lowest. The teaching-coaching and diagnostic functions played a mediating role. Nurses with greater seniority and those who were transferred to administrative departments had lower scores, and the difference was statistically significant (p < 0.05). In the structural equation model, CFI = 0.992 and RMSEA = 0.049, which shows that the model fit well, suggesting that organizational career management had no statistically significant effect on post competency (β = -0.006, p = 0.932) but that interprofessional team collaboration had a statistically significant effect on post competency (β = 1.146, p < 0.001) and organizational career management had a statistically significant effect on interprofessional team collaboration (β = 0.684, p < 0.001). CONCLUSIONS Attention should be given to the improvement of community nurses' post competency in ensuring quality and performing helping, teaching-coaching, and diagnostic roles. Moreover, researchers should focus on the decline in community nurses' abilities, particularly for those with greater seniority or in administrative roles. The structural equation model shows that interprofessional team collaboration is a complete intermediary between organizational career management and post competency.
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Affiliation(s)
- Li Ma
- Institute of Hospital Management, Outpatient Department, West China School of Nursing, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Xinwei Wang
- School of Business, Sichuan University, Chengdu, Sichuan, China
| | - Shiyue Zou
- The First People's Hospital of Longquanyi District, Chengdu, Sichuan, China
| | - Min Lin
- The First People's Hospital of Longquanyi District, Chengdu, Sichuan, China
| | - Shi Qiu
- West China Biomedical Big Data Center, West China Hospital, Sichuan University, Chengdu, Sichuan, China.
| | - Weimin Li
- Department of Respiratory and Critical Care Medicine, Institute of Respiratory Health, Frontiers Science Center for Disease-Related Molecular Network/Precision Medicine Research Center, West China Hospital, Sichuan University, Chengdu, Sichuan, China.
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Huepenbecker SP, Meyer LA. Our dual responsibility of improving quality and questioning the metrics: Reflections on 30-day readmission rate as a quality indicator. Gynecol Oncol 2022; 165:1-3. [PMID: 35346424 DOI: 10.1016/j.ygyno.2022.03.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Affiliation(s)
- Sarah P Huepenbecker
- Department of Gynecologic Oncology and Reproductive Medicine, The University of Texas, MD Anderson Cancer Center, Houston, TX, USA
| | - Larissa A Meyer
- Department of Gynecologic Oncology and Reproductive Medicine, The University of Texas, MD Anderson Cancer Center, Houston, TX, USA.
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Lessons for Oncology From the COVID-19 Pandemic: Operationalizing and Scaling Virtual Cancer Care in Health Systems. Cancer J 2022; 28:125-133. [PMID: 35333498 PMCID: PMC9158540 DOI: 10.1097/ppo.0000000000000579] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
ABSTRACT After several decades of slow expansion, the use of virtual care in oncology rapidly expanded during the COVID-19 pandemic. Data from cancer centers across the country show that most patients and providers were satisfied with components of virtual care, and virtual care may be able to improve access to care. However, the rapid implementation of programs during the pandemic worsened disparities in access to virtual care. Health systems must develop strategies to monitor quality, support patients and providers, promote health equity, and overcome regulatory challenges to successfully deliver care in hybrid systems that combine in-person and virtual care.
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Passey D, Healy R, Qualls J, Hamilton CJ, Tilley E, Burningham Z, Sauer B, Halwani A. Development and implementation of a pharmacist-led telehealth medication management program for veterans receiving oral antineoplastic therapies through the MISSION Act. Am J Health Syst Pharm 2022; 79:835-843. [PMID: 35084462 DOI: 10.1093/ajhp/zxac023] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
DISCLAIMER In an effort to expedite the publication of articles related to the COVID-19 pandemic, AJHP is posting these manuscripts online as soon as possible after acceptance. Accepted manuscripts have been peer-reviewed and copyedited, but are posted online before technical formatting and author proofing. These manuscripts are not the final version of record and will be replaced with the final article (formatted per AJHP style and proofed by the authors) at a later time. PURPOSE Veterans prescribed oral antineoplastic therapies (OATs) by community providers outside the Veterans Health Administration (VA) may lack access to comprehensive medication management. To address this, our multidisciplinary team developed and implemented a pharmacist-led telehealth medication management program for veterans prescribed OATs by community providers. SUMMARY The program exclusively uses telehealth to connect veterans with a dedicated board-certified clinical oncology pharmacist who provides comprehensive medication management. The program is based on established pharmacy models found in the research literature. We developed a standard operating procedure, communication templates, patient education materials, and a suite of health information technology tools to help streamline pharmacy processes. The Consolidated Framework for Implementation Research was used to design implementation strategies to promote the adoption of the program. In the first year, 64 veterans from 3 VA medical centers were enrolled in the program. The oncology clinical pharmacist performed 342 encounters and 101 interventions. The program saved an estimated $200,724 in medication-related costs. The veterans we surveyed reported high levels of satisfaction with the pharmacy services provided by the program. CONCLUSION The delivery of comprehensive medication management through telehealth is feasible from a healthcare system perspective and beneficial for patients. The board-certified oncology clinical pharmacist provided remote pharmacy services to Veterans across three sites in a large and rural service area for the VA. The program realized several benefits, including positive clinical outcomes, high levels of patient satisfaction, and cost savings on medication-related costs.
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Affiliation(s)
- Deborah Passey
- Division of Epidemiology, Department of Internal Medicine, University of Utah, Salt Lake City, UT, USA
| | - Regan Healy
- George E. Wahlen Department of Veterans Affairs Medical Center, Salt Lake City, UT, USA
| | - Joshua Qualls
- George E. Wahlen Department of Veterans Affairs Medical Center, Salt Lake City, UT, USA
| | - Clayton J Hamilton
- George E. Wahlen Department of Veterans Affairs Medical Center, Salt Lake City, UT, USA
| | - Elizabeth Tilley
- Division of Epidemiology, Department of Internal Medicine, University of Utah, Salt Lake City, UT, and George E. Wahlen Department of Veterans Affairs Medical Center, Salt Lake City, UT, USA
| | - Zach Burningham
- George E. Wahlen Department of Veterans Affairs Medical Center, Salt Lake City, UT, and Division of Epidemiology, Department of Internal Medicine, University of Utah, Salt Lake City, UT, USA
| | - Brian Sauer
- George E. Wahlen Department of Veterans Affairs Medical Center, Salt Lake City, UT, and Division of Epidemiology, Department of Internal Medicine, University of Utah, Salt Lake City, UT, USA
| | - Ahmad Halwani
- George E. Wahlen Department of Veterans Affairs Medical Center, Salt Lake City, UT; Division of Epidemiology, Department of Internal Medicine, University of Utah, Salt Lake City, UT; and Huntsman Cancer Institute, Salt Lake City, UT, USA
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Tele-neuro-oncology: Current Practices and Future Directions. Curr Oncol Rep 2022; 24:99-103. [PMID: 35059995 PMCID: PMC8773390 DOI: 10.1007/s11912-021-01176-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/28/2021] [Indexed: 11/25/2022]
Abstract
Purpose of Review The purpose of this review is to describe the current state of telemedicine within neuro-oncology. This article will address the development of tele-neuro-oncology over time with a focus on current use and applications of telemedicine within the field. Current modalities and practical considerations for tele-neuro-oncology visits and opportunities for growth will be highlighted. Recent Findings The use of telemedicine has expanded significantly during the COVID-19 pandemic, particularly within neuro-oncology. The use of telemedicine is widely accepted by neuro-oncologic patients and providers and continues to expand in utilization and scope. The use of tele-neuro-oncology is expected to develop further with opportunities for multidisciplinary and integrated care, clinical trials, research, and education. Summary Telemedicine provides a unique, patient-centered approach to neuro-oncologic care. Telehealth will remain a valuable tool, and its use and role are expected to expand within neuro-oncology.
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Flucke N, Sullivan-Moore C. Patient Assessment: Using the Oncology Nurse Navigator Patient Assessment for Rural and Other Resource-Poor Settings. Clin J Oncol Nurs 2021; 25:729-734. [PMID: 34800092 DOI: 10.1188/21.cjon.729-734] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Oncology nurse navigators (ONNs) rely on assessment tools to identify patient priorities so that care may be expedited along the cancer continuum. Few nonproprietary assessment tools exist for ONNs who work in rural and other resource-poor settings to reliably identify and track patient needs and barriers for seamless and timely oncology care.
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Carnahan LR, Abdelrahim R, Ferrans CE, Rizzo GR, Molina Y, Handler A. Rural Cancer Disparities: Understanding Implications for Breast and Cervical Cancer Diagnoses. Clin J Oncol Nurs 2021; 25:10-16. [PMID: 34533527 DOI: 10.1188/21.cjon.s1.10-16] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
BACKGROUND Rural populations experience several disparities, influenced by structural-, community-, and individual-level barriers, across the breast and cervical cancer continuum. OBJECTIVES This study seeks to identify structural-, community-, and individual-level barriers that affect rural populations across the cancer continuum, understand the role of nurses serving rural populations in breast and cervical cancer screening and diagnostics, and provide recommendations for working with rural patients. METHODS This is a secondary analysis of qualitative interviews conducted with public health nurses serving rural populations. FINDINGS Emergent themes indicate that rural populations experience barriers that affect disparities across the breast and cervical cancer continuum, including a changing healthcare landscape, access to cancer-focused care, access to insurance, collective poverty, and demographic factors. Nurses working with rural communities can address these disparities as they fulfill multiple roles and responsibilities.
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Marshall VK, Chavez MN, Mason TM, Martinez Tyson D. The Use of Telehealth to Provide Continuity of Cancer Care during the COVID-19 Pandemic: Advantages, Disparities, and Implications to Promote Health Equity. Hosp Top 2021; 100:166-176. [PMID: 34218752 DOI: 10.1080/00185868.2021.1942360] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
Perceptions of oncology health care providers use of telehealth to provide care to patients during the COVID-19 pandemic were explored. A qualitative study using semi-structured interviews and purposive sampling (N = 30) was conducted. Four themes emerged: 1) telehealth provided continuity of cancer care and used to decrease the risk of COVID-19 exposure; 2) advantages brought about convenience and inclusion of family caregivers; 3) telehealth revealed geographic, aging, and racial/ethnic disparities and digital illiteracy; and 4) rapid implementation was challenging. Telehealth provides a number of opportunities to support care for vulnerable cancer patients during this health crisis; however, disparities must be addressed.
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Affiliation(s)
| | - Melody N Chavez
- College of Public Health, University of South Florida, Tampa, FL, USA
| | - Tina M Mason
- H. Lee Moffitt Cancer Center & Research Institute, Tampa, FL, USA
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Ferrua M, Mathivon D, Duflot-Boukobza A, Abbas M, Charles C, Barrais A, Legendre J, Mendes C, Pons M, Merad M, Minvielle E, Mir O, Scotté F. Nurse navigators' telemonitoring for cancer patients with COVID-19: a French case study. Support Care Cancer 2021; 29:4485-4492. [PMID: 33462724 PMCID: PMC7813165 DOI: 10.1007/s00520-020-05968-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2020] [Accepted: 12/22/2020] [Indexed: 02/08/2023]
Abstract
Purpose The Gustave Roussy Cancer Institute implemented a patient-reported outcome platform (CAPRI-COVID) for cancer patients with coronavirus disease 2019 (COVID-19) to quarantine patients at home while ensuring monitoring of COVID-related symptoms and securing the care pathway. In this study, we described the CAPRI-COVID intervention, evaluated its use, and presented results of the tracking indicators with a focus on the nurse navigators’ (NNs) activities and the experience of patients. Methods Data of 130 cancer patients with COVID-19 diagnosed from March 23 to June 5, 2020, were collected. Six COVID-related symptoms were monitored daily, either by the patient via the CAPRI mobile application (CAPRI App) or by NNs via telemonitoring. In the cases of worsening or new-onset symptoms, an automated alert was sent to the platform, and NNs could immediately consult an emergency physician for future course of action. Results All 130 patients (median age: 59 years; 59.2% female) were monitored during the study period. There were no deaths or admissions to the intensive care unit attributable to COVID-19; 7.8% of patients were hospitalized (excluding scheduled hospitalization), and 17.1% were admitted to the emergency department at least once during the monitoring period. NNs carried out 1412 regular monitoring calls (average of 10.9 calls per patient), while 55% of the patients downloaded the CAPRI App. Conclusions Most patients monitored with CAPRI-COVID were quarantined during the first wave of the pandemic. In addition to the CAPRI App, which helped limit phone calls, NNs played an essential role in patient management.
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Affiliation(s)
- Marie Ferrua
- Research Department, Gustave Roussy, Villejuif, France.
| | - Delphine Mathivon
- Department of Ambulatory Cancer Care, Gustave Roussy, Villejuif, France
| | | | - May Abbas
- Interdisciplinary Cancer Pathways Division (DIOPP), Gustave Roussy, Villejuif, France
| | - Cécile Charles
- Interdisciplinary Cancer Pathways Division (DIOPP), Gustave Roussy, Villejuif, France.,Laboratory of Psychopathology and Health Processes (EA 4057), University of Paris Descartes, Sorbonne, Paris, France
| | - Amandine Barrais
- Department of Ambulatory Cancer Care, Gustave Roussy, Villejuif, France
| | - Jennifer Legendre
- Department of Ambulatory Cancer Care, Gustave Roussy, Villejuif, France
| | - Christine Mendes
- Department of Ambulatory Cancer Care, Gustave Roussy, Villejuif, France
| | - Magali Pons
- Interdisciplinary Cancer Pathways Division (DIOPP), Gustave Roussy, Villejuif, France
| | | | | | - Olivier Mir
- Department of Ambulatory Cancer Care, Gustave Roussy, Villejuif, France
| | - Florian Scotté
- Interdisciplinary Cancer Pathways Division (DIOPP), Gustave Roussy, Villejuif, France
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Hickey M. Championing eHealth in Clinical Care. Clin J Oncol Nurs 2020; 24:4-9. [PMID: 32441696 DOI: 10.1188/20.cjon.s1.4-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Since 1959, the rate of technological advancements, which has been buoyed by the evolution of microprocessors that stimulate innovation, has grown exponentially, doubling every 12 to 18 months (Roser & Ritchie, 2020). In 2020, it is impossible to walk down the street without seeing people checking their smartphones. However, it was only four decades ago that the personal computer was first introduced into the marketplace. It has been a little more than a decade since the first smartphone-the iPhone by Apple-was released in 2007, followed by the release of the iPad in 2010 (Zimmermann, 2017). As of 2019, an estimated 269 million people in the United States use smartphones (Holst, 2019). Increased technological advancements, as well as the widespread availability of these technologies and their application to Americans' daily lives, have become the norm. In the clinical nursing care of patients with cancer, the use of technology is also gaining momentum. This supplement to the Clinical Journal of Oncology Nursing explores how technology in health care can extend and enhance clinical oncology nursing care.
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