Coombs Lorinda A, Hunt Lauren, Cataldo Janine
University of California San Francisco, San Francisco, California.
Cancer Med. 2016 Aug;5(8):1908-16. doi: 10.1002/cam4.769. Epub 2016 Jun 5.
The quality of cancer care may be compromised in the near future because of work force issues. Several factors will impact the oncology health provider work force: an aging population, an increase in the number of cancer survivors, and expansion of health care coverage for the previously uninsured. Between October 2014 and March 2015, an electronic literature search of English language articles was conducted using PubMed(®) , the Cumulative Index to Nursing and Allied Health Sciences (CINAHL(®) ), Web of Science, Journal Storage (JSTOR(®) ), Google Scholar, and SCOPUS(®) . Using the scoping review criteria, the research question was identified "How much care in oncology is provided by nurse practitioners (NPs)?" Key search terms were kept broad and included: "NP" AND "oncology" AND "workforce". The literature was searched between 2005 and 2015, using the inclusion and exclusion criteria, 29 studies were identified, further review resulted in 10 relevant studies that met all criteria. Results demonstrated that NPs are utilized in both inpatient and outpatient settings, across all malignancy types and in a variety of roles. Academic institutions were strongly represented in all relevant studies, a finding that may reflect the Accreditation Council for Graduate Medical Education (ACGME) duty work hour limitations. There was no pattern associated with state scope of practice and NP representation in this scoping review. Many of the studies reviewed relied on subjective information, or represented a very small number of NPs. There is an obvious need for an objective analysis of the amount of care provided by oncology NPs.
由于劳动力问题，癌症护理质量在不久的将来可能会受到影响。几个因素将影响肿瘤医疗服务提供者的劳动力：人口老龄化、癌症幸存者数量增加以及为以前未参保者扩大医疗保健覆盖范围。在2014年10月至2015年3月期间，使用PubMed(®)、护理及相关健康科学累积索引（CINAHL(®)）、科学引文索引、期刊全文数据库（JSTOR(®)）、谷歌学术和Scopus(®)对英文文章进行了电子文献检索。根据范围综述标准，确定研究问题为“执业护士（NP）在肿瘤学中提供了多少护理服务？”关键检索词范围较宽泛，包括：“NP”、“肿瘤学”和“劳动力”。在2005年至2015年期间对文献进行检索，根据纳入和排除标准，确定了29项研究，进一步审查后得到10项符合所有标准的相关研究。结果表明，NP在住院和门诊环境中均有使用，涉及所有恶性肿瘤类型且担任多种角色。在所有相关研究中，学术机构的代表性很强，这一发现可能反映了研究生医学教育认证委员会（ACGME）对工作时间的限制。在本次范围综述中，未发现与州执业范围和NP代表性相关的模式。许多被审查的研究依赖主观信息，或者所涉及的NP数量非常少。显然需要对肿瘤学NP提供的护理量进行客观分析。
