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Evaluation of a Specialized Oncology Nursing Supportive Care Intervention in Newly Diagnosed Breast and Colorectal Cancer Patients Following Surgery: A Cluster Randomized Trial

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Better coordination of supportive services during the early phases of cancer care has been proposed to improve the care experience of patients

Surgical practices were cluster randomized to a control group involving usual care practices or a standardized nursing intervention consisting of an in-person supportive care assessment with ongoing support to meet identified needs, including linkage to community services.

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In LMICs, insufficient nurse-to-patient ratios contribute to lower quality patient care, nursing burnout, and poor outcomes highlighting the need for efforts to expand the nursing workforce. Nurses working in LMICs, however, face many challenges that make nursing an unattractive profession: low pay, poor working conditions, poor career structures, a lack of opportunities for professional development, conflicts with other professionals, and a feeling of inadequacy or stigma related to their work

Consequently, LMICs suffer from continuous nurse migration to HICs to find better pay and work conditions, exacerbating already dire local human resource shortages. By highlighting the ways nurses can contribute to improving oncology care in LMICs, this report addresses the issues facing the workforce and includes recommendations to illustrate how health and educational systems can be used to strengthen the expertise and expand the role of oncology nurses in LMICs. Nursing education, the nursing practice environment, and opportunities for role expansion and research are not keeping pace with the growing need. It is our intention that this paper serves as a call to action to focus attention and resources on the need for education and training of oncology nurses in LMICs. In all aspects of the fight against cancer, nurses participate dynamically as part of an interdisciplinary team. A well-prepared oncology nursing workforce includes: generalist nurses who are prepared at the basic level and provide health promotion, risk assessment and care for people receiving cancer treatment in their general practice.

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The transition from an initial diagnosis of cancer through entry into the formal cancer system has been identified as a time of significant emotional distress, physical morbidity, and uncertainty for patients (Carey M, Lambert S, Smits R et al

, 2012). Despite efforts to improve transitions in care and reduce waiting times for cancer diagnosis and treatments, meeting the supportive care needs of patients and families remains a significant challenge. Newly diagnosed cancer patients report discontinuities in their care due to increasingly complex treatments involving multiple providers at different locations. We and others have found that discontinuities experienced by cancer patients/families can worsen stress and anxiety since they already feel threatened by a difficult disease and uncertain future. Indeed, a recent review found that cancer patients’ need for informational support to be prevalent, along with emotional care. Supportive care issues continue to be a priority area for research and policy in the USA, Canada, Australia, and elsewhere, with the aim to lessen the negative burden of care experience (Harrison J, Young J, Price M et al., 2009). Supportive care to meet the psychological, social, physical (symptom control), informational, and practical needs of patients is an essential component of cancer treatment. Active coordination of supportive care is proposed as one method to address care discontinuity and barriers to accessing these resources, but evaluations of its effectiveness, beyond assessments of patient satisfaction, are lacking.

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In the long run, it is imperative for nurses to educate the community on the importance of undergoing the cancer-screening process

The process gives nurses an opportunity to educate individuals on the necessary behaviors in reducing risks, and the symptoms to watch out for. Thus, giving nurses greater chances of detecting cancer-related disease in its early stages and warranting better chances of outliving the disease as opposed to the later stages, thus, lowering cancer death rate. Additionally, nurses and physicians should have a clear line of communication to avoid misinforming the patients on their prognosis and finally, patients and families should be educated on health promotion strategies

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Gilbert JE, Green E, Lankshear S et al. Nurses as patient navigators in cancer diagnosis: review, consultation and model design. Eur J Cancer Care (Engl ) 2011; 20: 228-36.

Harrison J, Young J, Price M et al. What are the unmet supportive care needs of people with cancer? A systematic review. Supportive Care in Cancer 2009; 17: 1117-28.

Case MA. Oncology nurse navigator. Clin J Oncol Nurs 2011; 15: 33-40.

Wagner EH, Aiello Bowles EJ, Greene SM et al. The quality of cancer patient experience: perspectives of patients, family members, providers and experts. Qual Saf Health Care 2010; 19: 484-9.

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