Braun-Inglis Christa, Boehmer Leigh M, Zitella Laura J, Hoffner Brianna, Shvetsov Yurii B, Berenberg Jeffrey L, Oyer Randall A, Benson Al B
University of Hawaii School of Nursing and Dental Hygiene, Honolulu, Hawaii.
University of Hawaii Cancer Center, Honolulu, Hawaii.
J Adv Pract Oncol. 2022 Mar;13(2):107-119. doi: 10.6004/jadpro.2022.13.2.2. Epub 2022 Mar 25.
Oncology advanced practitioners (APs), including nurse practitioners, clinical nurse specialists, physician assistants, and clinical pharmacists contribute significantly to quality cancer care. Advanced practitioners enhance value across the spectrum of cancer care. Research is an underdeveloped component of quality care, as well as an underdeveloped component of AP practice. Understanding research-related attitudes and roles of APs could lead to enhanced clinical trial accrual, conduct, and protocol development.
A nationwide survey addressing attitudes, beliefs, and roles of APs regarding clinical research was distributed by the Association of Community Cancer Centers (ACCC) and Harborside in early 2020.
408 oncology APs completed the survey. Thirty-five percent practice in an academic setting and 62% in the community. Nearly all respondents believe clinical trials are important to improve care, and over 90% report clinical trials are available at their practice. About 80% report being comfortable discussing the topic of clinical trials with patients and are involved in the care of trial participants. Sixty percent are comfortable discussing available trials, and 38% routinely explore available trials with patients. While 70% report approaching eligible patients about trials, only 20% report doing so "a great deal" or "a lot." Ninety percent report that APs should play a role in clinical research, and 73% want to be more involved. Barriers identified to greater AP clinical trial involvement include lack of time, inadequate awareness of trial specifics, and a lack of a formal role in protocol development and leadership.
Advanced practitioners are engaged and interested in clinical trials and believe clinical research is important to improve cancer care. Multidisciplinary team integration, trials-related education, and policy change are needed to employ APs to their full potential within cancer clinical trials.
肿瘤学高级从业者（包括执业护士、临床护理专家、医师助理和临床药剂师）对优质癌症护理做出了重大贡献。高级从业者在癌症护理的各个方面提升了价值。研究是优质护理中一个未充分发展的组成部分，也是高级从业者实践中一个未充分发展的组成部分。了解高级从业者与研究相关的态度和角色可能会提高临床试验的入组率、实施情况和方案制定。
2020年初，社区癌症中心协会（ACCC）和港湾医疗公司开展了一项全国性调查，涉及高级从业者对临床研究的态度、信念和角色。
408名肿瘤学高级从业者完成了调查。35%在学术环境中工作，62%在社区工作。几乎所有受访者都认为临床试验对改善护理很重要，超过90%的人报告其所在机构有临床试验。约80%的人表示愿意与患者讨论临床试验话题，并参与试验参与者的护理。60%的人愿意讨论现有试验，38%的人会定期与患者探讨现有试验。虽然70%的人报告会向符合条件的患者提及试验，但只有20%的人报告“大量”或“频繁”这样做。90%的人报告高级从业者应在临床研究中发挥作用，73%的人希望更多地参与其中。确定的阻碍高级从业者更多参与临床试验的因素包括时间不足、对试验细节的认识不足，以及在方案制定和领导方面缺乏正式角色。
高级从业者参与并对临床试验感兴趣，认为临床研究对改善癌症护理很重要。需要进行多学科团队整合、与试验相关的教育和政策变革，以充分发挥高级从业者在癌症临床试验中的潜力。
