School of Health Sciences, Faculty of Health & Medical Sciences, University of Surrey, Guildford GU2 7TX, UK.
University of Surrey, UK.
Int J Nurs Stud. 2016 Jan;53:85-94. doi: 10.1016/j.ijnurstu.2015.09.001. Epub 2015 Sep 9.
Cancer survival is increasing as patients live longer with a cancer diagnosis. This success has implications for health service provision in that increasing numbers of adults who have received cancer therapy are requiring monitoring and long-term health care by a wide range of practitioners. Given these recent trends there is a need to explore staff perceptions and confidence in managing the consequences of cancer diagnosis and treatment in cancer survivors to enhance an integrated cancer service delivery.
This study examines the self-reported perceptions of competence in nurses and professionals allied to medicine providing survivorship services caring for adults after cancer treatment in both secondary and primary care.
A cross sectional survey of the adult cancer workforce using a self-assessment tool for assessing confidence in providing long-term cancer patient management. This study was a health service evaluation.
The study was conducted within the United Kingdom.
Respondents were 618 health care professionals of these 368 were specialist adult cancer nurses in oncology and the community setting and 250 cancer allied health professionals.
The survey tool was developed with experts in cancer management, nurses professionals allied to medicine such as physiotherapists and dieticians, educationalists, patient groups as well as health service managers. Competence was assessed in 4 domains clinical practice, symptom management, care co-ordination and proactive management. Perceptions of training needs were also ascertained. Data were collected using an Internet survey distributed through cancer services, community settings and professional institutions.
In total 618 practitioners who responded were providing services for adults' 1-year post cancer therapy. Practitioners felt confident in managing psychosocial care and communicating with patients. Deficits in self-reported confidence were found in long-term medications management, care planning, long-term and complex symptom management, for those providing dimensions of care coordination and proactive care. Differences in confidence were seen between practitioner groups. Community nurses felt less skilled in managing adult cancer patients long-term.
Nurses and allied health professionals self-reported confidence, in managing all areas of care for adult cancer survivors, is variable with deficits in important areas of practice. Despite this being a small proportion of practitioners who are working in cancer care, those responding had perceived gaps in knowledge and educational needs. In providing cancer aftercare there is a requisite shift to proactive care, supported self-management and collaborative management if patient's long-term consequences of cancer and its treatment are to be addressed.
If health care providers are to transform cancer survivor services then investment is required in education and capability planning across nurses, allied health professionals in both the hospital and the community setting.
随着癌症患者的存活时间延长，癌症的生存状况有所改善。这对医疗服务的提供产生了影响，因为越来越多接受过癌症治疗的成年人需要由广泛的从业者进行监测和长期的健康护理。鉴于这些新趋势，有必要探索工作人员对癌症幸存者的诊断和治疗后果的管理的看法和信心，以增强癌症服务的综合提供。
本研究调查了在二级和初级保健中为接受癌症治疗后的成年人提供生存服务的护士和医学相关专业人员对自身在管理癌症相关长期后果方面的能力的自我报告认知和信心。
使用自我评估工具对护理人员和医学相关专业人员提供长期癌症患者管理的能力进行评估，对成人癌症工作者进行横断面调查。本研究为卫生服务评估。
该研究在英国进行。
共有 618 名卫生保健专业人员参与了这项研究，其中 368 名为在肿瘤学和社区环境中提供成人癌症护理的专科癌症护士，250 名为癌症相关健康专业人员。
该调查工具是由癌症管理专家、护理人员和医学相关专业人员（如物理治疗师和营养师）、教育工作者、患者群体以及卫生服务管理者共同制定的。在四个领域评估了能力：临床实践、症状管理、护理协调和主动管理。还确定了培训需求的认知。通过互联网调查在癌症服务、社区环境和专业机构中进行数据收集。
共有 618 名从事成人癌症治疗后 1 年服务的从业者对该研究进行了回复。从业者对管理心理社会护理和与患者沟通有信心。自我报告的信心不足表现在长期药物管理、护理计划、长期和复杂症状管理、护理协调和主动护理方面。不同的从业者群体之间存在信心差异。社区护士对管理成年癌症患者的长期护理技能不足。
护士和医学相关专业人员自我报告的管理成年癌症幸存者的所有方面的护理能力各不相同，在实践的重要领域存在不足。尽管这些是在癌症护理中工作的一小部分从业者，但参与调查的人员认为他们在知识和教育需求方面存在差距。在提供癌症康复护理时，需要积极主动地护理、支持自我管理和协作管理，如果要解决癌症及其治疗的长期后果，就需要从被动护理转变为积极主动地护理。
如果卫生保健提供者要改变癌症幸存者的服务，那么需要在医院和社区环境中的护士和医学相关专业人员中投入教育和能力规划。
