Pia Riis Olsen

Keeping their world together--meanings and actions created through network-focused nursing in teenager and young adult cancer care.

In the transition between dependent childhood and independent young adulthood, teenagers and young adults (TYAs) are extremely vulnerable when diagnosed with cancer and while undergoing treatment. Nurses working on a youth unit for patients aged 15 to 22 years developed a nursing program that aims at supporting these young patients and their significant others to maintain, establish, and strengthen their social network during the treatment period. This article presents a grounded theory study that explored how the network-focused program was perceived by TYAs with cancer and their significant others. A theoretical account is presented on the meanings and actions that the inherent processes and interactions created. Twelve TYAs and 19 significant others participated. Data were generated through interviews, observations, and informal conversations. Embracing the program and building strength were the 2 subcategories that linked to a core concept of keeping their world together. The findings show that nurses are in a unique position to enhance and support the efforts of these young patients and their significant others in connecting with the social network that extends beyond the family and includes the wider social network.

Role of the nurse in patient education and follow-up of people receiving oral chemotherapy treatment: an International survey

PurposeThe aim of this study was to explore the nursing role in education and follow-up of patients who were taking oral chemotherapy (CT) and to identify the worldwide gap in patient education about oral CT.Materials and methodsMultinational Association of Supportive Care in Cancer members were invited to participate in a survey on oral CT. Nurse coordinators collected data via a 16-item questionnaire. Respondents totaled 1115 oncology nurses from 15 countries.ResultsFindings showed that about half of subjects work in outpatient/ambulatory clinics and had given at least two or more oral CT drugs. Although 52% had some type of guidelines/protocols, 47% reported not having received any education about oral CT drugs. While 64% report being involved in patient education, 58% of subjects indicated lack of patient education materials that are specific for oral CT agents. Only 27% stated that they gave all necessary information such as when and how to take the drugs, drug safety and storage, side effects, and symptom management. Reasons for not being involved in oral CT education and follow-up included beliefs that the physician plans the oral CT and gives patients necessary instructions (34%), that nurses only see patients who receive intravenous chemotherapy (16%), that nurses have lack of knowledge about oral agents (15%), and belief that physicians are responsible for patient follow-up. The nurses suggested better education and follow-up of patients to include the written patient education materials (33%) and professional education for nurses (30%).ConclusionsFindings revealed the need for professional education for nurses to ensure comprehensive, consistent patient education and development of written materials for patients receiving oral CT treatment.

Network-focused nursing development of a new concept.

Network-focused nursing—a new concept—was generated in a grounded theory study of nurses, teenager and young adults with cancer and their significant others. This article explores and clarifies the concept to prevent it from being normalized and taken for granted in everyday clinical practice and in the literature, and from being limited in growth and meanings. The integrated approach by Meleis combined with the Hybrid Model by Schwartz-Barcott and Kim are used for analysis. Antecedents, attributes and consequences are identified. Network-focused nursing has potential to advance nursing science and to be implemented in other areas of patient care.

Under the same umbrella: A model for knowledge and practice development

This article describes the development, organisation and significant elements of an Umbrella Model, which has been demonstrated to support knowledge and practice development in a large Danish hospital department. The aim is to inspire, support and guide implementation of the Umbrella Model in other settings. A shared theme overarching several minor projects is the core of the model and is exemplified in three completed programmes: Young people with cancer, Relatives and the cancer patient’s social network and Future cancer care – short but high quality. Commitment is achieved through close dialogue, supervision and programmes dealing with local needs and complex problems in clinical practice. The model unites clinical and academic competencies, has produced new knowledge and developed nursing care, and it has directed nurse leaders’ attention to the pivotal role they play in supporting a learning environment.

Using a knowledge utilization framework to explore how findings from one study can be applied to other nursing contexts.

AIM To discuss the complexities of moving research into practice and through a case example, explore how empirical findings from one specific study could be applied to nursing in other contexts. BACKGROUND The processes of moving research findings into practice are complex and multidimensional. In this paper, an innovative approach to social support, network-focused nursing (NFN), is used as a case example to illustrate these complexities. Social support is associated with better recovery and survival after illness and based on this, a NFN programme was developed in a Danish oncology youth unit. Subsequently, a research study was undertaken to investigate the programme and based on the findings, the concept NFN was developed. METHODS A knowledge utilization framework is used to explore how empirical findings from the NFN study could be applied to nursing more generally. Aligned with this, the specific considerations for implementing NFN are explicated. DISCUSSION Strong leadership, education, management support and effective communication are critical factors for research utilization. Moving research into practice requires openness to new ideas. Nursing and healthcare policies therefore need to support environments in which creativity and innovation can flourish. NFN was developed in teenager and young adult cancer care, but its principles may be transferable to other clinical environments. CONCLUSIONS It is important that nurse managers and policy makers ensure that support and education are available to nurses to facilitate moving research into practice. Moreover, resources need to be considered, particularly in countries where financial and organizational infrastructures may be weak.

Perspectives: European Academy of Nursing Science debate

The European Academy of Nursing Science (EANS) is an independently organised body comprising individuals who have made significant contributions to the advancement of nursing science in Europe through scholarship and research (European Academy of Nursing Science, 2015). Established in 1998, EANS aims to be the leading nursing academy providing inspiration, collaboration and academic leadership in Europe. The academy provides a forum for established and early nurse researchers to develop a European perspective and collaborations to their work. One of its central activities is an annual doctoral summer school, where nurse doctoral candidates from across Europe gain exposure to a common European perspective on nursing research. Participants attend three consecutive summer schools held across Europe. A two day EANS conference is held during the summer school, attended by members of EANS, and second year students are expected to prepare and present a formal debate as part of the conference proceedings. Students work in six randomly allocated multistate groups where three groups prepare material in support of a motion, three against it. The 2015 EANS summer school and conference were held in Barcelona, Spain. Debate is a unique opportunity to prepare an argument for or against a motion based on evidence – whether or not they subscribe to the position they are asked to support. Preparation within teams where for most English is not the first language and coming from a wide range of nursing and geographical backgrounds presents opportunities and challenges in equal measure. Debate allows important issues to be explored thoroughly in

Communication with Young People with Cancer About Sensitive Topics

This chapter will focus on communicating with young people with cancer. It will start with a general introduction of different understandings of the concept of youth as this influences the approach nurses may take in communicating with young people with cancer. The chapter will highlight important aspects in communication with young people with cancer with particular focus around sensitive topics such as fear, anxiety and death.

Network-Focused Nursing and Network Meetings in AYA Cancer Care

The chapter describes network-focused nursing, a new concept and approach in caring for adolescents and young people with cancer. It demonstrates how nurses can facilitate social support from the young persons’ social network and in this way help the AYA and the family navigate and get through the difficult experience of cancer and treatment.

Introduction: Beyond No Man’s Land: The Development of AYA Cancer Nursing

Recognition of adolescents as a distinct group in healthcare has been documented since the 1930s. Historically, there has been little attention to the specific needs of the adolescent and young adult (AYA) cancer population, and age-appropriate care and practice changes have been slow to occur. The AYA patient population has traditionally been treated with younger children or much older adults and was once described ‘at the edge of no man’s land’ [1]. However, attention and focus to AYA cancer has gained increasing momentum internationally, and alongside this, the experience and expertise of the nursing profession has grown significantly over time. AYA cancer care and AYA cancer nursing are now gaining recognition as a distinct subspeciality in the UK, across Europe and further afield internationally. In many countries, they are now being cared for by specialist teams who are experts in the delivery of AYA care, often within purpose-built environments [2].

Pathways to Diagnosis for Teenagers and Young Adults with Cancer in European Nations: A Pilot Study

PURPOSE The diagnosis of cancer is often prolonged in teenagers and young adults (TYA). There may be lessons in improving this from international comparisons. However, international studies are complex and so we conducted a pilot study to examine the key barriers to large-scale research in this field. METHODS We provided translated questionnaires covering key aspects of presentation and clinical management within 60 days of a confirmed cancer diagnosis, to patients 13-29 years of age inclusive, to their primary care physicians and to the cancer specialists managing their cancer. We conducted descriptive analyses of the data and also the process of study implementation. RESULTS For our pilot, collecting triangulated data was feasible, but varying regulatory requirements and professional willingness to contribute data were key barriers. The time of data collection and the method for collecting symptom reports were important for timely and accurate data synthesis. Patients reported more symptoms than professionals recorded. We observed substantial variation in pathways to cancer diagnosis to explore definitively in future studies. CONCLUSION Focused research upon the mechanisms underpinning complex cancer pathways, and focusing that research upon specific cancer types within TYA may be the next key areas of study.