Department of Public Health, Ashkelon Academic College, Ashkelon 78211, Israel.
Oncology Institute, Shaare Zedek Medical Center, Jerusalem 91031, Israel.
Curr Oncol. 2023 Aug 5;30(8):7425-7438. doi: 10.3390/curroncol30080538.
The role of a clinical nurse specialist in oncology varies greatly between healthcare systems, and implementing this healthcare role with its multifaceted and co-existing responsibilities may prove challenging. While already integrated into healthcare systems and services in several European countries, Asia, Canada, and the United States, other countries are just beginning to develop clinical nursing specialties. The current study aims to provide healthcare policymakers with up-to-date evidence that focuses on the diverse modes of oncology clinical nurse specialist role implementation across several healthcare systems and pertinent implementation challenges as described in the literature. A rapid evidence assessment was carried out in order to provide policymakers with a rigorous review in a condensed timescale. Initially, only items in the English language were included, and "grey literature" was excluded. We searched PubMed between 1 January 2022 and 28 February 2022 and two independent scholars reviewed items. Based on 64 papers, both non-scientific and papers that met the initial criteria of the rapid review, we describe the modes of implementation of the oncology clinical nurse specialist in the United States, Canada, United Kingdom, Japan, Brazil and Australia. Barriers to implementation include conflicts around role boundaries, skepticism and lack of organizational support, as well as fears that oncology clinical nurse specialists will "encroach" on doctors' powers. In contrast, an oncology clinical nurse specialist is found to be universally more accessible to patients and their families and can help physicians deal with difficult workloads, among other advantages. Conclusions: This role offers a myriad of gains for cancer patients, oncology physicians, and the healthcare system. The literature demonstrates that it is a necessary role, albeit one that brings specific implementation challenges.
肿瘤学临床护理专家的角色在不同医疗体系之间差异很大，要实施这一具有多方面和共存职责的医疗角色可能具有挑战性。虽然该角色已经在一些欧洲国家、亚洲、加拿大和美国的医疗体系和服务中得到整合，但其他国家才刚刚开始发展临床护理专业。本研究旨在为医疗保健政策制定者提供最新的证据，重点关注跨越多个医疗体系的肿瘤学临床护理专家角色实施的不同模式，以及文献中描述的相关实施挑战。为了在短时间内为政策制定者提供严格的审查，我们进行了快速证据评估。最初，仅纳入英文项目，且排除“灰色文献”。我们于 2022 年 1 月 1 日至 2 月 28 日在 PubMed 上进行了检索，两位独立学者对项目进行了审查。基于 64 篇论文，包括非科学论文和符合快速审查初始标准的论文，我们描述了美国、加拿大、英国、日本、巴西和澳大利亚实施肿瘤学临床护理专家的模式。实施的障碍包括角色边界的冲突、怀疑和缺乏组织支持，以及对肿瘤学临床护理专家会“侵犯”医生权力的担忧。相比之下，肿瘤学临床护理专家普遍更容易为患者及其家属所接触，并且可以帮助医生处理繁重的工作量等。结论：该角色为癌症患者、肿瘤学医生和医疗体系带来了诸多益处。文献表明，这是一个必要的角色，尽管它带来了具体的实施挑战。
