Regional Cancer Centre, Stockholm Gotland, 10239, Stockholm, Sweden.
Regional Cancer Centre, Stockholm Gotland, 10239, Stockholm, Sweden; Karolinska University Hospital, Theme Cancer, Patient Area Airway, Lung and Skin Cancer, 17176, Stockholm, Sweden; Umeå University, Department of Nursing, 90187, Umeå, Sweden.
Eur J Oncol Nurs. 2019 Aug;41:41-48. doi: 10.1016/j.ejon.2019.05.009. Epub 2019 Jun 1.
Extensive research results show quality improvements associated with advanced cancer nursing roles. Despite this, these roles are not implemented in many countries. The aim of this cross-sectional, population-based study was to compare patients' perception of care, before and after the introduction of a new advanced nursing role, the coordination contact nurse (CCN), in a region in Sweden.
All patients (with gynaecological, haematological, Head & Neck, upper gastrointestinal cancers) diagnosed in the region the year prior and one-year post introducing the new CCN role were identified from the Swedish Cancer Register. Data were collected using the European Organization of Research and Treatment of Cancer [EORTC] Quality of Life Questionnaire (QLQ-C30 and QLQ-INFO25) and a study specific questionnaire.
The results, based on baseline (n = 869) and follow-up data (n = 1003), show statistically significant patient-reported improvements after the introduction of the CCN role, regarding health-related patient information (EORTC QLQ- INFO25 global mean score increased from 41.23 to 44.16, p = 0.0006). We found statistically significant improvements related to availability of supportive care resources, e.g. increased reported access to contact nurse (from 53% to 66%, p ≤ 0.0001) and individual written care plans (from 40% to 54%, p < 0.0001). We also found some improvements related to patient involvement and care coordination, but also room for further developments.
The implementation of the new advanced cancer nursing role may have contributed to important improvements, but it has also identified areas in need of development. Further research with long-term evaluations of CCN roles in other contexts, are both needed and on-going.
大量研究结果表明，高级癌症护理角色与质量的提高有关。尽管如此，这些角色在许多国家并未得到实施。本横断面、基于人群的研究旨在比较瑞典某一地区引入新的高级护理角色（协调联络护士）前后患者对护理的感知。
从瑞典癌症登记处确定了该地区前一年和引入新协调联络护士角色后一年诊断出的所有（妇科、血液科、头颈部、上消化道癌）患者。使用欧洲癌症研究与治疗组织（EORTC）生活质量问卷（QLQ-C30 和 QLQ-INFO25）和专门的研究问卷收集数据。
基于基线（n=869）和随访数据（n=1003），结果显示，在引入协调联络护士角色后，患者报告的健康相关患者信息有统计学显著改善（EORTC QLQ-INFO25 全球平均评分从 41.23 增加到 44.16，p=0.0006）。我们发现与支持性护理资源的可用性相关的统计显著改善，例如，报告的联络护士（从 53%增加到 66%，p≤0.0001）和个人书面护理计划（从 40%增加到 54%，p<0.0001）的可获得性增加。我们还发现了一些与患者参与和护理协调相关的改进，但也有进一步发展的空间。
新的高级癌症护理角色的实施可能有助于重要的改进，但也发现了需要发展的领域。在其他背景下对协调联络护士角色进行长期评估的进一步研究是必要的，并且正在进行中。
