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O'Connor Power F, Beatty S, Dunne N, O'Connell L, O’ Riordan N, Sloane H, Prizeman G, O'Sullivan K, Butler É, Howlin C, Byrne G. “I'm not being serviced; I'm being cared for”: A mixed methods' study of patients' and nurses' perceptions of community oncology nursing delivered by a Community Intervention Team. Eur J Oncol Nurs 2022; 60:102146. [DOI: 10.1016/j.ejon.2022.102146] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2021] [Revised: 03/01/2022] [Accepted: 04/22/2022] [Indexed: 11/25/2022]
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Humphreys P, Spratt B, Tariverdi M, Burdett RL, Cook D, Yarlagadda PKDV, Corry P. An Overview of Hospital Capacity Planning and Optimisation. Healthcare (Basel) 2022; 10:healthcare10050826. [PMID: 35627963 PMCID: PMC9140785 DOI: 10.3390/healthcare10050826] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2022] [Revised: 04/18/2022] [Accepted: 04/27/2022] [Indexed: 02/04/2023] Open
Abstract
Health care is uncertain, dynamic, and fast growing. With digital technologies set to revolutionise the industry, hospital capacity optimisation and planning have never been more relevant. The purposes of this article are threefold. The first is to identify the current state of the art, to summarise/analyse the key achievements, and to identify gaps in the body of research. The second is to synthesise and evaluate that literature to create a holistic framework for understanding hospital capacity planning and optimisation, in terms of physical elements, process, and governance. Third, avenues for future research are sought to inform researchers and practitioners where they should best concentrate their efforts. In conclusion, we find that prior research has typically focussed on individual parts, but the hospital is one body that is made up of many interdependent parts. It is also evident that past attempts considering entire hospitals fail to incorporate all the detail that is necessary to provide solutions that can be implemented in the real world, across strategic, tactical and operational planning horizons. A holistic approach is needed that includes ancillary services, equipment medicines, utilities, instrument trays, supply chain and inventory considerations.
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Affiliation(s)
- Peter Humphreys
- School of Mathematical Sciences, Queensland University of Technology, Brisbane, QLD 4000, Australia; (B.S.); (R.L.B.); (P.K.D.V.Y.); (P.C.)
- Correspondence: ; Tel.: +61-07-448-963-844
| | - Belinda Spratt
- School of Mathematical Sciences, Queensland University of Technology, Brisbane, QLD 4000, Australia; (B.S.); (R.L.B.); (P.K.D.V.Y.); (P.C.)
| | | | - Robert L. Burdett
- School of Mathematical Sciences, Queensland University of Technology, Brisbane, QLD 4000, Australia; (B.S.); (R.L.B.); (P.K.D.V.Y.); (P.C.)
| | - David Cook
- Princess Alexandra Hospital, Brisbane, QLD 4000, Australia;
| | - Prasad K. D. V. Yarlagadda
- School of Mathematical Sciences, Queensland University of Technology, Brisbane, QLD 4000, Australia; (B.S.); (R.L.B.); (P.K.D.V.Y.); (P.C.)
| | - Paul Corry
- School of Mathematical Sciences, Queensland University of Technology, Brisbane, QLD 4000, Australia; (B.S.); (R.L.B.); (P.K.D.V.Y.); (P.C.)
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Nursing, psychotherapy and advanced cancer: A scoping review. Eur J Oncol Nurs 2021; 56:102090. [PMID: 35026499 DOI: 10.1016/j.ejon.2021.102090] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2021] [Revised: 12/17/2021] [Accepted: 12/19/2021] [Indexed: 02/06/2023]
Abstract
PURPOSE Many individuals with advanced cancer have unmet psychological needs and often lack access to supportive care. Psychotherapy for adults with advanced cancer is a promising way to address some of the challenges in meeting these care needs. Nurses are the largest cohort of healthcare workers who can practice as psychotherapists and are positioned ideally to integrate these interventions as part of routine care. The purpose of this scoping review is to map the literature on psychotherapeutic interventions among adults with advanced cancer and to explore the nursing role in this body of evidence. METHODS We conducted a scoping review for relevant quantitative, qualitative, and mixed methods studies. The content of included studies was analyzed and grouped based on two broad categories that describe how nursing's role was mentioned, described, and utilized: 1. Nurses are not the interventionist/psychotherapist and, 2. Nurses are mentioned as the interventionist/psychotherapist. RESULTS Eighty-six studies were included. Overall, majority of studies did not mention a role for nursing in any capacity. Some studies mentioned a non-interventionist role for nursing in the research study. Fourteen studies mentioned nurses as interventionists/psychotherapists. These studies focused on feasibility, acceptability and patient related outcomes of brief psychotherapies. Dignity therapy was the most common psychotherapy in studies where nurses were utilized as interventionists, followed by life review and supportive expressive therapies. Very few studies discussed nursing's role in this area and nursing's capacity to deliver this form of care. CONCLUSION There is paucity in nursing research focused on psychotherapy for adults with advanced cancer. It is feasible and acceptable for nurses to deliver brief psychotherapies to adults with advanced cancer, and the integration of these techniques in everyday practice has great potential that must be explored. The development of this knowledge base is needed to support future education, research, and practice policy agendas.
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A qualitative evaluation of community and acute hospital nursing oncology services in Ireland. Eur J Oncol Nurs 2021; 51:101912. [PMID: 33610929 DOI: 10.1016/j.ejon.2021.101912] [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] [Received: 07/31/2020] [Revised: 02/01/2021] [Accepted: 02/05/2021] [Indexed: 01/06/2023]
Abstract
PURPOSE Cancer patients are a particularly vulnerable population group, facing an increase in physical, mental, logistical and financial difficulties. This, as well as Ireland's increased focus on primary care with the Sláintecare health plan, led to the development of the Community Oncology Nursing Programme, where community nurses are trained to provide cancer care in the community. This paper sought to explore the lived experiences of the patients and nurses involved in this programme in order to examine its impact as well as determine facilitators and roadblocks for future development. METHODS A qualitative examination of the service was carried out by interviewing cancer patients receiving care as part of the programme as well as the nurses delivering care, both in the community and hospital day-ward. Thematic analysis was used. RESULTS Themes of improved patient experience, nurse-patient relationship, the importance of location and roadblocks to further implementation of the programme emerged. There was a universal belief that the programme offered benefits to the patient and improved their care in some manner. CONCLUSIONS The Community Oncology Nursing Programme has been well received by both nurses and patients. The service provided by community nurses as part of this programme offers benefits to patients and an improved cancer service.
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Murtagh S, McCombe G, Broughan J, Carroll Á, Casey M, Harrold Á, Dennehy T, Fawsitt R, Cullen W. Integrating Primary and Secondary Care to Enhance Chronic Disease Management: A Scoping Review. Int J Integr Care 2021; 21:4. [PMID: 33613136 PMCID: PMC7880002 DOI: 10.5334/ijic.5508] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2020] [Accepted: 10/28/2020] [Indexed: 11/20/2022] Open
Abstract
BACKGROUND In Ireland, as in many healthcare systems, health policy has committed to delivering an integrated model of care to address the increasing burden of chronic disease. Integrated care is an approach to healthcare systems delivery that aims to minimise fragmentation of patient services and improve care continuity. To this end, how best to integrate primary and secondary care is a challenge. This paper aims to undertake a scoping review of empirical work on the integration of primary and secondary care in relation to chronic disease management. METHODS A search was conducted of 'PubMed', 'Cochrane Library' and 'Google Scholar' for papers published between 2009-2019 using Arksey and O'Malley's framework for conducing scoping reviews. RESULTS Twenty-two studies were included. These reported research from a wide range of healthcare systems (most commonly UK, Australia, the Netherlands), adopted a range of methodologies (most commonly randomised/non-randomised controlled trials, case studies, qualitative studies) and among patients with a range of chronic conditions (most commonly diabetes, COPD, Parkinson's disease). No studies reported on interventions to address the needs of whole populations. Interventions to enhance integration included multidisciplinary teams, education of healthcare professionals, and e-health interventions. Among the effectiveness measures reported were improved disease specific outcomes, and cost effectiveness. CONCLUSION With healthcare systems increasingly recognising that integrated approaches to patient care can enhance chronic disease management, considerable literature now informs how this can be done. However, most of the research published has focussed on specific diseases and their clinical outcomes. Future research should focus on how such approaches may improve health outcomes for populations as a whole.
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Affiliation(s)
- Sara Murtagh
- School of Medicine, University College Dublin, Ireland
| | - Geoff McCombe
- School of Medicine, University College Dublin, Ireland
| | - John Broughan
- School of Medicine, University College Dublin, Ireland
| | - Áine Carroll
- School of Medicine, University College Dublin, Ireland
| | - Mary Casey
- School of Nursing Midwifery and Health Systems, University College Dublin, Ireland
| | - Áine Harrold
- School of Medicine, University College Dublin, Ireland
| | | | - Ronan Fawsitt
- School of Medicine, University College Dublin, Ireland
- Ireland East Hospital Group, Dublin, Ireland
| | - Walter Cullen
- School of Medicine, University College Dublin, Ireland
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Abstract
Objectives To determine whether the shared care model during the follow-up of cancer survivors is effective in terms of patient-reported outcomes, clinical outcomes, and continuity of care. Methods Using systematic review methods, studies were searched from six electronic databases-MEDLINE (n = 474), British Nursing Index (n = 320), CINAHL (n = 437), Cochrane Library (n = 370), HMIC (n = 77), and Social Care Online (n = 210). The review considered all health-related outcomes that evaluated the effectiveness of shared care for cancer survivors. Results Eight randomised controlled trials and three descriptive papers were identified. The results showed the likelihood of similar effectiveness between shared care and usual care in terms of quality of life, mental health outcomes, unmet needs, and clinical outcomes in cancer survivorship. The reviewed studies indicated that shared care overall is highly acceptable to cancer survivors and primary care practitioners, and shared care might be cheaper than usual care. Conclusions The results from this review suggest that the patient satisfaction of shared care is higher than usual care, and the effectiveness of shared care is similar to usual care in cancer survivorship. Interventions that formally involve primary care and improve the communication between primary care and hospital care could support the PCPs in the follow-up.
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Chaar EA, Hallit S, Hajj A, Aaraj R, Kattan J, Jabbour H, Khabbaz LR. Evaluating the impact of spirituality on the quality of life, anxiety, and depression among patients with cancer: an observational transversal study. Support Care Cancer 2018; 26:2581-2590. [PMID: 29453604 DOI: 10.1007/s00520-018-4089-1] [Citation(s) in RCA: 45] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2017] [Accepted: 01/30/2018] [Indexed: 02/03/2023]
Abstract
OBJECTIVE Spiritual well-being was found to have some protective effect against end-of life despair in cancer patients. We aimed at assessing the impact of spirituality on the quality of life, depression, and anxiety of Lebanese cancer patients. METHODS Our observational transversal monocentric study was conducted between January and April 2016 among a convenient sample of 115 Lebanese cancer patients admitted to Hôtel-Dieu de France Hospital (HDF), Beirut-Lebanon. In addition to socio-demographic and clinical data, three questionnaires were used: EORTC QLQ-C30 (European Organization for Research and Treatment of Cancer Quality of Life Questionnaire, 3rd version), FACIT-Sp-12 (Functional Assessment of Chronic Illness Therapy-Spiritual Well-Being; The 12-item Spiritual Well-Being Scale, 4th version), and HADS (Hospital Anxiety and Depression Scale). Eighteen patients taking anxiolytic and/or antidepressants were not included in the analysis. The remaining 97 patients were analyzed. RESULTS Better emotional and cognitive functioning was seen in patients with higher meaning, peace, faith, and total FACIT scores. Meaning, peace, and total FACIT scores were also higher among patients with better global health status and quality of life. Anxiety as well as depression was significantly associated to all spiritual well-being factors. CONCLUSION Spirituality can improve quality of life and decrease the incidence of anxiety and depression in cancer patients. Our results highlight the need to incorporate spiritual care in healthcare systems.
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Affiliation(s)
- Emile Abou Chaar
- Laboratoire de Pharmacologie, pharmacie clinique et contrôle de qualité des médicaments, Pôle technologie Santé, Faculté de Pharmacie, Université Saint-Joseph de Beyrouth, Beirut, Lebanon
- Faculty of Pharmacy, Saint-Joseph University, Beirut, Lebanon
| | - Souheil Hallit
- Faculty of Pharmacy, Saint-Joseph University, Beirut, Lebanon
- Faculty of Pharmacy, Lebanese University, Beirut, Lebanon
- Faculty of Medicine and Medical Sciences, Holy Spirit University of Kaslik, Kaslik, Lebanon
- Research Department, Psychiatric Hospital of the Cross, P.O Box 60096, Jal Eddib, Lebanon
- Occupational Health Environment Research Team, U1219 BPH Bordeaux Population Health Research Center Inserm, Université de Bordeaux, Bordeaux, France
- INSPECT-LB: Institut National de Sante Publique, Epidemiologie Clinique et Toxicologie, Faculty of Public Health, Lebanese University, Beirut, Lebanon
| | - Aline Hajj
- Laboratoire de Pharmacologie, pharmacie clinique et contrôle de qualité des médicaments, Pôle technologie Santé, Faculté de Pharmacie, Université Saint-Joseph de Beyrouth, Beirut, Lebanon
- Faculty of Pharmacy, Saint-Joseph University, Beirut, Lebanon
| | - Racha Aaraj
- Faculty of Pharmacy, Saint-Joseph University, Beirut, Lebanon
| | - Joseph Kattan
- Faculty of Medicine, Université Saint-Joseph de Beyrouth, Beirut, Lebanon
- Department of oncology, Hotel-Dieu de France de Beyrouth, Beirut, Lebanon
| | - Hicham Jabbour
- Faculty of Medicine, Université Saint-Joseph de Beyrouth, Beirut, Lebanon
- Department of anesthesia and reanimation, Hotel-Dieu de France de Beyrouth, Beirut, Lebanon
| | - Lydia Rabbaa Khabbaz
- Laboratoire de Pharmacologie, pharmacie clinique et contrôle de qualité des médicaments, Pôle technologie Santé, Faculté de Pharmacie, Université Saint-Joseph de Beyrouth, Beirut, Lebanon.
- Faculty of Pharmacy, Saint-Joseph University, Beirut, Lebanon.
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Cortis LJ, Ward PR, McKinnon RA, Koczwara B. Integrated care in cancer: What is it, how is it used and where are the gaps? A textual narrative literature synthesis. Eur J Cancer Care (Engl) 2017; 26. [PMID: 28426142 DOI: 10.1111/ecc.12689] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/13/2017] [Indexed: 11/30/2022]
Abstract
Integrated care is an underpinning concept of contemporary health care policy proffered as a strategy to overcome the fragmentations in care encountered by people with complex care needs (Shaw et al. [2011] What is Integrated Care? An Overview of Integrated Care in the NHS). Cancer patients have potential to benefit from such policy, often having needs that extend beyond cancer. This paper seeks to understand how the concept of integrated care is used in the cancer literature. A search of leading databases was conducted for original research relating to integrated care or an integration intervention aiming to improve outcomes of cancer patients, and analysed using textual narrative synthesis. 38 papers were included, each with a focus on improving cancer-specific aspects of care enhancing the capabilities of the cancer multidisciplinary team. Of the eight studies involving integration between the cancer service and other care providers, all focused on utilising the external provider to deliver aspects of cancer care or placed them in a passive role, as survey participant, a recipient of cancer-related clinical information or as the comparator "usual care" arm. Within the cancer literature, integration is predominantly used to describe initiatives to improve cancer-related aspects of care. Less attention is given to integration initiatives that enhance coordination across levels of the healthcare system or service providers.
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Affiliation(s)
- L J Cortis
- Flinders Centre for Innovation in Cancer, Flinders University, Adelaide, SA, Australia
| | - P R Ward
- Discipline of Public Health, School of Health Sciences, Flinders University, Adelaide, SA, Australia
| | - R A McKinnon
- Flinders Centre for Innovation in Cancer, Flinders University, Adelaide, SA, Australia
| | - B Koczwara
- Flinders Centre for Innovation in Cancer, Flinders University, Adelaide, SA, Australia
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Cadet T, Davis C, Elks J, Wilson P. A Holistic Model of Care to Support Those Living with and beyond Cancer. Healthcare (Basel) 2016; 4:E88. [PMID: 27869728 PMCID: PMC5198130 DOI: 10.3390/healthcare4040088] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2016] [Revised: 10/14/2016] [Accepted: 11/11/2016] [Indexed: 12/04/2022] Open
Abstract
BACKGROUND Globally, the burden of cancer continues to increase and it is well-documented that while not a homogeneous population, cancer patients and cancer survivors face many physical, psychological, social, spiritual, and financial issues. Cancer care is shifting from a disease-focused to a patient-centered approach resulting in an increased need to address these concerns. METHODS Utilizing a quality improvement approach, this paper describes an integrated cancer care model at Bloomhill Cancer Center (BCC) in Queensland, Australia that demonstrates the ability to meet the holistic needs of patients living with and beyond cancer and to identify opportunities for better practice and service provision. RESULTS Survey results indicate that 67% and 77% of respondents were very satisfied and 27% and 17% were satisfied with their first contact and very satisfied with their first meeting with a nurse at BCC. Clients also reported being very satisfied (46%) or satisfied (30%) with the emotional support they received at BCC and over 90% were very satisfied or satisfied with the touch therapies that the received. CONCLUSION Due to the early success of the interventions provided by BCC, the model potentially offers other states and countries a framework for supportive cancer care provision for people living with and beyond cancer.
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Affiliation(s)
- Tamara Cadet
- School of Social Work, Simmons College, 300 The Fenway, Boston, MA 02115, USA.
- Oral Health Policy and Epidemiology, Harvard School of Dental Medicine, Boston, MA 02115, USA.
| | - Cindy Davis
- Faculty of Arts, Business & Law, University of the Sunshine Coast, Sunshine Coast, QLD 4556, Australia.
| | - Jacinta Elks
- School of Nursing, University of the Sunshine Coast, Sunshine Coast, QLD 4556, Australia.
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Transition journey from hospital to home in patients with cancer and their caregivers: a qualitative study. Support Care Cancer 2016; 24:4319-26. [PMID: 27178439 DOI: 10.1007/s00520-016-3269-0] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2016] [Accepted: 05/05/2016] [Indexed: 10/21/2022]
Abstract
BACKGROUND The National Cancer Institute Singapore initiated the NUH2 Home program in January 2014, referred to as "Caring Across the Cancer Continuum," a nurse-led cancer transitional care service (CTCS) that provides home care to patients with cancer and their caregivers. The study aimed to explore the transition experiences of patients with cancer and their caregivers. METHOD Using a purposive sampling, 12 patients with cancer and 12 caregivers were recruited. Audiotape interviews were conducted until data saturation was achieved. Each interview was transcribed verbatim, and thematic analyses were performed to extract significant themes and subthemes. RESULTS Four themes emerged from the data including (1) ongoing concerns, (2) needing timely help, (3) resuming control and normality of life, and (4) appreciating the transition care. The transition journey of patients and caregivers provided them with an ability to regain control and normality in their lives, be reassured and confident in being able to care for themselves and manage the physiological and psychological strains associated with the multiple vicissitudes associated with having cancer and its treatment while at home. CONCLUSION Our study addressed the nature, patterns, conditions, and responses to transition care. Our findings provided relevant contextual knowledge to further improve the transition care service based on the recommendations of the patients with cancer and their caregivers who first experienced the new service.
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