Nurse-led cancer care: A scope review of the past years (2003-2016).
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ABSTRACT:
SUBMITTER: Lai XB
PROVIDER: S-EPMC6626125 | biostudies-literature | 2017 Apr
REPOSITORIES: biostudies-literature
Publications
Nurse-led cancer care: A scope review of the past years (2003-2016).
Lai Xiao Bin XB Ching Shirley Siu Yin SSY Wong Frances Kam Yuet FKY
International journal of nursing sciences 20170306 2
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Project description:AimsTo investigate the scope of practice of nurse-led services for people experiencing homelessness, and the influence on access to healthcare.DesignA scoping review.Data sourcesOn 20 November 2020, the following databases were searched: CINAHL, Embase, MEDLINE, PubMed and Scopus.Review methodsIncluded studies focused on people experiencing homelessness aged 18 years and over, nurse-led services in any setting and described the nursing scope of practice. Studies were peer-reviewed primary research, published in English from the year 2000. Three authors performed quality appraisals using the mixed methods assessment tool. Results were synthesized and discussed narratively and reported according to the PRISMA-ScR 2020 Statement.ResultsNineteen studies were included from the United States (n = 9), Australia (n = 4), United Kingdom (n = 4) and Canada (n = 2). The total participant sample size was n = 6303. Studies focused on registered nurses (n = 10), nurse practitioners (n = 5) or both (n = 4), in outpatient or community settings. The nursing scope of practice was broad and covered a range of skills, knowledge and attributes. Key skills identified include assessment and procedural skills, client support and health education. Key attributes were a trauma-informed approach and building trust through communication. Important knowledge included understanding the impact of homelessness, knowledge of available services and the capacity to undertake holistic assessments. Findings suggest that nurse-led care facilitated access to healthcare through building trust and supporting clients to access services.ConclusionOptimized nursing scope of practice can facilitate access to healthcare for people experiencing homelessness. Key factors in enabling this include autonomy in nursing practice, organizational support and education.ImpactThe broad range of skills, knowledge and attributes reported provide a foundation from which to design an educational framework to optimize the nursing scope of practice, thereby increasing access to healthcare for people experiencing homelessness.
| S-EPMC9795912 | biostudies-literature
Project description:ObjectiveAging can introduce significant changes in health, cognition, function, social status, and emotional status among older adults affected by cancer. Little is known about how existing nurse-led interventions address the needs of older adults. The objective was to identify existing nurse-led interventions among older adults to optimize recovery and survivorship needs.MethodsA integrative systematic review was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) 2020 Guidelines. Electronic databases (APA PsycINFO, CINAHL, MEDLINE, Scopus, and Google Scholar databases) were searched using key search terms. Articles were assessed for inclusion according to a pre-determined eligibility criterion. Data extraction and quality appraisal were conducted. Findings were integrated into a narrative synthesis.ResultsTwenty-one studies were included, and a total of 4253 participants were represented. There were a range of study designs: quantitative (n = 10), randomised controlled trials (n = 6), mixed methods studies (n = 3), qualitative (n = 1), and a non-randomized controlled study (n = 1). Most participants had prostate cancer, with some representation in colorectal, lung, head and neck, renal, esophageal, and mixed cancer patient populations.ConclusionsThis review shows a lack of evidence on the inclusion of geriatric assessments for older people with cancer within existing nurse-led interventions. Further research is needed to test nurse-led interventions with the inclusion of geriatric assessments and their contribution to the multidisciplinary team across the cancer care continuum for various cancer patient populations.
| S-EPMC10597832 | biostudies-literature
Project description:Dietary problems are frequently reported in cancer patients and survivors which may reduce quality of life and cancer survival. Nurses' role in dietary management is recognized as important, but review evidence on nurse-led dietary interventions for cancer patients and survivors is lacking. This review aims to summarize evidence on nurse-led dietary interventions for cancer patients and survivors. Ten electronic databases (PubMed, CINAHL, CENTRAL, EMBASE, Web of Science, Ovid, CNKI, Wan Fang, CQVIP, Index to Taiwan Periodical Literature System) were searched from inception dates to November 11, 2021, using the key search terms "cancer/nutrition/nurse-led/intervention." Eligible studies were experimental studies on nurse-led dietary interventions for improving dietary intake in cancer patients and survivors published in peer-reviewed journals in English or Chinese. The methodological quality of the included studies was evaluated using the revised Cochrane risk-of-bias assessment tool. Data were extracted and summarized descriptively. Three randomized controlled trials on nurse-led dietary counseling published between 2005 and 2018 were included, with an overall high risk of bias. Two studies found positive intervention effects in improving fruit and vegetable intake, while the other study demonstrated an increase in energy intake. This is the first systematic review to summarize the evidence on nurse-led dietary interventions for cancer patients and survivors. Although available studies are limited, a positive trend was identified in that nurse-led dietary interventions are effective in increasing dietary intake in cancer patients and survivors. Additional studies in this field are required to further explore nurses' role in the development of nutritional oncology care.
| S-EPMC9072171 | biostudies-literature
Project description:BackgroundThe evolving nature of nursing practice necessitates the development and implementation of contemporary models of care; however, inconsistent definitions hinder this. With the increasing demand for nurse-led models of care, it is crucial to establish a consistent understanding to ensure the efficacy of implemented models.AimWe aim to provide a working definition for nursing models of care, then using this, present the key features that nurse-led models of care should consider.Sources of evidenceAn unstructured literature review was used to explore the research aim.DiscussionWe propose that nursing models of care be defined as involving three interrelated domains: (1) a theoretical basis that underpins conceptualisation of care, (2) organisational work methods that direct task delegation, organisational governance, and care responsibility and (3) practical methods for care delivery that describes practical care methodologies. Extrapolating from this framework, nurse-led models of care are defined as having an evidence-based and person-centred theoretical basis, an organisational work method driven by nurses, and practical methods of care delivery supported by the creation of holistic care plans.ConclusionAs the design and implementation of a model of care is influenced by unique contextual considerations, the definitions provided in this paper should be considered as a starting point for further refinement, consideration and discussion.Implications for nursing policyStandardisation in how models of care are defined enables greater understanding and improved comparability between disparate sources of evidence and can aid stakeholders by providing a common language. Creating standardisation in the terminology of nurse-led models of care specifically supports the continued advocacy efforts for these models of care and assists policymakers and health providers in their design and implementation.
| S-EPMC11865630 | biostudies-literature
Project description:ObjectivesThis study sought to assess the effectiveness of nurse-led care (NLC) in patients with rheumatoid arthritis (RA).MethodsWe conducted a comprehensive search of the Cochrane Library, Web of Science, PubMed, Embase, CINAHL, ClinicalTrials.gov databases and the references from relevant literature published prior to May 2023. Two independent reviewers assessed the studies using population/intervention/comparison/outcome/study criteria, and quantitative tools were used to gauge the methodological quality of the included studies. Independent quality assessments were carried out using the Cochrane Collaboration's risk-of-bias tool. Effect sizes were determined using mean difference (MD) or standardised mean difference (SMD) with corresponding 95% CIs.ResultsUltimately, 14 articles were included, encompassing a total of 3369 RA patients. NLC exhibited significant advantages in the primary outcome, disease activity (MD =-0.09, 95% CI (-0.17 to -0.01)), and the secondary outcome, self-efficacy (MD=0.40, 95% CI (0.03, 0.77)). In subgroup analysis, NLC was more effective in reducing disease activity compared with usual care (MD=-0.15, 95% CI (-0.26 to -0.04)), and there was no significant difference in disease activity reduction between NLC and rheumatologist-led care (MD=-0.02, 95% CI (-0.14, 0.10)). In terms of self-efficacy, no significant difference was observed between NLC and usual care (SMD=0.56, 95% CI (-0.09, 1.21)) or between NLC and rheumatologist-led care (SMD=0.20, 95% CI (-0.19, 0.59). When comparing other secondary outcomes (pain, satisfaction, quality of life, fatigue, stiffness, physical function and psychological status), the effectiveness of NLC for RA patients was similar to that of the control group, with no statistically significant differences.ConclusionsNLC proves highly effective in managing RA patients, surpassing usual care and equating to rheumatologist-led care in primary and some secondary outcomes. It may be feasible to allow nurses to participate in the disease management of some RA patients instead of doctors.Prospero registration numberCRD42022362071.
| S-EPMC11751805 | biostudies-literature
Project description:BackgroundThe implementation of evidence-based interventions for people with dementia is complex and challenging. However, successful implementation might be a key element to ensure evidence-based practice and high quality of care. There is a need to improve implementation processes in dementia care by better understanding the arising challenges. Thus, the aim of this study was to identify recent knowledge concerning barriers and facilitators to implementing nurse-led interventions in dementia care.MethodsWe performed a scoping review using the methodological framework of Arksey and O'Malley. Studies explicitly reporting on the implementation process and factors influencing the implementation of a nurse-led intervention in dementia care in all settings were included. We searched eight databases from January 2015 until January 2019. Two authors independently selected the studies. For data analysis, we used an inductive approach to build domains and categories.ResultsWe included 26 studies in the review and identified barriers as well as facilitators in five domains: policy (e.g. financing issues, health insurance), organisation (e.g. organisational culture and vision, resources, management support), intervention/implementation (e.g. complexity of the intervention, perceived value of the intervention), staff (e.g. knowledge, experience and skills, attitude towards the intervention), and person with dementia/family (e.g. nature and stage of dementia, response of persons with dementia and their families).ConclusionsBesides general influencing factors for implementing nursing interventions, we identified dementia-specific factors reaching beyond already known barriers and facilitators. A pre-existing person-centred culture of care as well as consistent team cultures and attitudes have a facilitating effect on implementation processes. Furthermore, there is a need for interventions that are highly flexible and sensitive to patients' condition, needs and behaviour.
| S-EPMC7140366 | biostudies-literature
Project description:The "nurse-led" oral and maxillofacial (OMFS) head and neck (H&N) clinic has been introduced and developed over the last decade, and we are now close to a point that this endeavour can potentially be implemented nationwide. This paper is a systematic review of the proposed OMFS H&N nurse-led clinic model. Literature on the topic is limited: only eight eligible papers were identified and reviewed. These were appraised focusing on four domains: requirement/necessity, true cost, patient safety and outcomes, and education and training. Most of the advantages/proposed benefits of these clinics have previously been discussed. This current review has revealed that the available published evidence on the concept of OMFS H&N nurse-led clinics demonstrates that they might not be necessary. The alleged cost savings have not been described in detail and might not be as significant as expected, more intense collaboration is required to establish watertight quality assurance processes concerning patient safety, and the clinics might have an impact on the education and training of OMFS trainees. The nurse-led clinic concept is interesting and exciting, but more discussion and planning is needed prior to it being launched nationwide.
| S-EPMC7438999 | biostudies-literature
Project description:BackgroundComprehensive models of survivorship care are necessary to improve access to and coordination of care. New models of care provide the opportunity to address the complexity of physical and psychosocial problems and long-term health needs experienced by patients following cancer treatment.ObjectiveThis paper presents our expert-informed, rules-based survivorship algorithm to build a nurse-led model of survivorship care to support men living with prostate cancer (PCa). The algorithm is called No Evidence of Disease (Ned) and supports timelier decision-making, enhanced safety, and continuity of care.MethodsAn initial rule set was developed and refined through working groups with clinical experts across Canada (eg, nurse experts, physician experts, and scientists; n=20), and patient partners (n=3). Algorithm priorities were defined through a multidisciplinary consensus meeting with clinical nurse specialists, nurse scientists, nurse practitioners, urologic oncologists, urologists, and radiation oncologists (n=17). The system was refined and validated using the nominal group technique.ResultsFour levels of alert classification were established, initiated by responses on the Expanded Prostate Cancer Index Composite for Clinical Practice survey, and mediated by changes in minimal clinically important different alert thresholds, alert history, and clinical urgency with patient autonomy influencing clinical acuity. Patient autonomy was supported through tailored education as a first line of response, and alert escalation depending on a patient-initiated request for a nurse consultation.ConclusionsThe Ned algorithm is positioned to facilitate PCa nurse-led care models with a high nurse-to-patient ratio. This novel expert-informed PCa survivorship care algorithm contains a defined escalation pathway for clinically urgent symptoms while honoring patient preference. Though further validation is required through a pragmatic trial, we anticipate the Ned algorithm will support timelier decision-making and enhance continuity of care through the automation of more frequent automated checkpoints, while empowering patients to self-manage their symptoms more effectively than standard care.International registered report identifier (irrid)RR2-10.1136/bmjopen-2020-045806.
| S-EPMC10585445 | biostudies-literature
Project description:BackgroundA multidisciplinary approach is widely recommended for the effective management of chronic kidney disease (CKD), with the objective of improving both clinical and psychosocial outcomes. However, resource constraints and increasing demands on healthcare systems have emphasized the necessity for alternative models of care, such as nurse-led interventions. These interventions possess the potential to address critical challenges in CKD management by providing accessible, patient-centered care across diverse healthcare settings.ObjectiveThis systematic review and meta-analysis aims to compare the effects of nurse-led care with routine care in CKD management to determine its efficacy across diverse cultural backgrounds.MethodsFollowing PRISMA guidelines, a comprehensive search was conducted on PubMed, EMBASE, Scopus, and Cochrane databases, supplemented by manual searches and clinical trial registries. Inclusion criteria were randomized controlled trials (RCTs) involving nurse-led care for CKD patients aged 18 or older. Data extraction focused on study and baseline characteristics, and outcomes related to quality of life (symptoms/problems associated with kidney disease, sleep, energy/fatigue, patient satisfaction, overall health, depression, physical functioning, emotional well-being, role-physical, burden of kidney disease), depression, eGFR, and blood pressure. Statistical analysis used RevMan and STATA software, with results reported as standardized mean differences, along with their confidence intervals.ResultsThe analysis included 10 RCTs with a total of 964 participants. Nurse-led care significantly improved symptoms/problems associated with kidney disease, sleep quality, pain, energy/fatigue, overall health, and depression. However, no significant improvements were observed in the burden of kidney disease, physical functioning, role-physical, patient satisfaction and emotional well-being. Variability in outcomes related to depression highlights potential heterogeneity among studies. While some trials reported enhanced hospitalization rates and treatment adherence, others showed inconsistent findings, suggesting a need for more rigorous research.ConclusionNurse-led care provides notable benefits in managing certain aspects of CKD, including symptom control, sleep disturbances, energy levels, and overall health. However, its limited impact on kidney function and other clinical outcomes underscores the necessity for developing robust, standardized nurse-led care models and conducting long-term studies to evaluate their comprehensive efficacy.
| S-EPMC11837475 | biostudies-literature
Project description:AimThe study aimed to synthesize evidence comparing task-shifting interventions led by general practice nurses and mental health specialists in improving mental health outcomes of adults in primary care.DesignThis study used a systematic review of randomized controlled trials.Data sourcesArticles from the databases CINAHL, MEDLINE, APA PsycInfo, PubMed, EMBASE, Cochrane EBM Reviews, Web of Science Core Collection, and ProQuest Dissertation and Thesis published between 2000 and 2020 were included.Review methodsThe review was arranged based on the Cochrane Collaboration guidelines and reported using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA).ResultsTwelve articles met the eligibility criteria. Eight studies revealed that nurse-led intervention was significantly superior to its comparator. The review identified three major themes: training and supervision, single and collaborative care and psychosocial treatments.ConclusionNurses could be temporarily employed to provide mental health services in the absence of mental health specialists as long as appropriate training and supervision was provided. This finding should be interpreted with caution due to the high risk of bias in the studies reviewed and the limited generalisability of their findings.
| S-EPMC9786659 | biostudies-literature