Bernier Pascal, Desjardins Leandra, Charette Marie-Claude, Latour Marie-Paule, Bastien Marie-Pierre
Mental health nurse clinician with the Department of Pediatric Hematology-Oncology, CHU Sainte-Justine, and associate researcher with the Immune Diseases and Cancer Axis, Centre de recherche Azrieli du CHU Sainte-Justine.
Psychologist and clinical researcher with the Immune Diseases and Cancer Axis, Centre de recherche Azrieli du CHU Sainte-Justine.
Can Oncol Nurs J. 2024 Jul 1;34(3):267-280. doi: 10.5737/23688076343274. eCollection 2024 Summer.
Pediatric hematological and oncological illnesses present many coping challenges. Mental health issues can arise during and after treatment, in both patients and their families. The current model of care does not always seem to meet the needs identified by some young patients. In Quebec, nurses are allowed to assess and care for patients experiencing physical and mental health difficulties (Ordre des infirmières et infirmiers du Québec, 2016). Therefore, a mental health nurse clinician (MHNC) with experience in pediatric hematology/oncology could provide care that is complementary to that offered by psychologists, social workers, and other psychosocial professionals in the pediatric hematology/oncology unit in order to meet any needs that remain unmet. The MHNC project has three stages: (1) role development, (2) role implementation, and (3) role assessment one year after implementation. In this first article, we explain how the MHNC role was developed.
We used the participatory, evidence-based, patient-focused process for advanced practice nursing (APN) role development, implementation, and evaluation (PEPPA Framework; Bryant-Lukosius & Dicenso, 2004) to develop this model. The first five steps in the PEPPA Framework were applied in the creation of the MHNC role to (1) select the target population, (2) identify the stakeholders to be involved, (3) ascertain needs, (4) determine and prioritize problems and set goals, and (5) define a new model of care.
After multiple meetings involving numerous health professionals and managers, the MHNC role was developed with a versatile, transdisciplinary perspective to address better the needs of young cancer patients (especially those in their teens) and their families. The role was developed around four main areas of practice: (1) interventions offered to patient-family, (2) interventions offered to health professionals, (3) psychiatric consultation-liaison, and (4) education and research.
The next steps are to use a strategic plan to implement the role and then to evaluate the impact of the role one year after implementation.
儿科血液学和肿瘤学疾病带来了诸多应对挑战。在治疗期间及之后，患者及其家属都可能出现心理健康问题。当前的护理模式似乎并不总能满足一些年轻患者所确定的需求。在魁北克，护士被允许对有身心健康困难的患者进行评估和护理（魁北克护士协会，2016年）。因此，一位在儿科血液学/肿瘤学方面有经验的心理健康护士临床医生（MHNC）可以提供与心理学家、社会工作者及其他心理社会专业人员在儿科血液学/肿瘤学科室所提供的护理互补的护理，以满足任何未得到满足的需求。MHNC项目有三个阶段：（1）角色发展，（2）角色实施，以及（3）实施一年后的角色评估。在这第一篇文章中，我们解释了MHNC角色是如何发展而来的。
我们使用了参与式、基于证据、以患者为中心的高级实践护理（APN）角色发展、实施和评估过程（PEPPA框架；Bryant-Lukosius & Dicenso，2004年）来开发这个模式。PEPPA框架的前五个步骤被应用于创建MHNC角色，以（1）选择目标人群，（2）确定要参与的利益相关者，（3）确定需求，（4）确定并优先处理问题并设定目标，以及（5）定义一种新的护理模式。
在多次有众多卫生专业人员和管理人员参与的会议之后，MHNC角色从一个通用的跨学科视角得以发展，以便更好地满足年轻癌症患者（尤其是十几岁的患者）及其家庭的需求。该角色围绕四个主要实践领域得以发展：（1）为患者-家庭提供的干预措施，（2）为卫生专业人员提供的干预措施，（3）精神科会诊-联络，以及（4）教育与研究。
接下来的步骤是使用一项战略计划来实施该角色，然后在实施一年后评估该角色的影响。
