Amir Z, Scully J, Borrill C
Macmillan Practice Development Unit, School of Nursing, Midwifery and Health Visiting, University of Manchester, Gateway House, Piccadilly South, Manchester M60 7LP, UK.
Eur J Oncol Nurs. 2004 Dec;8(4):306-14. doi: 10.1016/j.ejon.2003.12.011.
Since the 1970s breast cancer services have witnessed considerable changes in the management of patients. One significant change was the introduction of specialist core personnel, including the breast care nurse (BCN). The role of the BCN has been gaining credence rapidly in the British NHS and this service is perhaps the paradigm of care for other services. With the lack of specific evidence of the role of specialist nurses in the breast care team, the current study aims to explore this area by in-depth interviews with core team members, and observations of 16 multi-disciplinary teams in England. The study explores the following themes: Nurses' unique informal management leadership role in ensuring the co-ordination, communication and planning of the team work; nurses' innovatory role in making the bureaucracy respond to patients and their relatives needs; nurses supportive role in the provision of expert advice and guidance to other members of the team; nurses confidence and humour in well-performing teams; and the limitations of the professional role of the breast cancer nurse. This study indicates that there is evidence that the BCN is practicing at an advanced level of practice. However, there is a severe lack of evidence-based description of that advanced practice. Cancer nurses including the BCNs should develop and participate in programmes of research in line with cancer legislation in order to build an evidence base that ultimately supports their unique role.
自20世纪70年代以来，乳腺癌服务在患者管理方面发生了显著变化。一个重大变化是引入了专业核心人员，包括乳腺护理护士（BCN）。BCN的角色在英国国民医疗服务体系（NHS）中迅速得到认可，这项服务或许是其他服务的护理典范。由于缺乏乳腺护理团队中专科护士角色的具体证据，本研究旨在通过对核心团队成员进行深入访谈以及对英格兰16个多学科团队的观察来探索这一领域。该研究探讨了以下主题：护士在确保团队工作的协调、沟通和规划方面独特的非正式管理领导角色；护士在促使官僚机构回应患者及其亲属需求方面的创新角色；护士在为团队其他成员提供专业建议和指导方面的支持角色；护士在表现出色的团队中的自信和幽默感；以及乳腺癌护士专业角色的局限性。本研究表明，有证据显示BCN的实践处于高级实践水平。然而，严重缺乏对这种高级实践基于证据的描述。包括BCN在内的癌症护士应根据癌症相关法规制定并参与研究项目，以建立最终支持其独特角色的证据基础。
