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Globally, cancer represents an increasing proportion of child mortality as progress against infectious causes is made. Approximately 400,000 children will develop cancer, each year, around the world. Only about half of these cancers will ever be diagnosed. In high-resource settings, 80% of children will survive, but only about 30% will survive in low-resource settings. Digital solutions have a valuable role in increasing health professional knowledge, skills and empowerment to diagnose, treat and otherwise care for children and adolescents with cancer. This review sought to identify digital resources that support the training and development of the paediatric oncology workforce in resource -poor settings.

This paper presents a narrative descriptive review of peer-reviewed publications and digital platforms that contribute to health professionals' education and training regarding paediatric oncology, particularly in rural and other low-resource settings.

Digital solutions were identified for building communities of practice, facilitating access to information and support and providing access to training, education and supervision specifically for paediatric oncology health professionals. A total of 33 resources are discussed in depth. A quality assessment of the digital resources is provided using the Currency, Relevance, Authority, Accuracy and Purpose (CRAAP) tool and suggestions to improve the quality of resources are discussed.

The authors anticipate that this summary of digital resources for the global paediatric oncology professional community will inform digital health investments and design of digital innovations to meet emerging needs and will have an impact on the workforce in the real world. Ultimately, this work will contribute to an improvement in the diagnosis and treatment of children and adolescents with cancer in resource-poor settings.

This is the first discussion and summary of digital education platforms which educate, train and offer support to health professionals with respect to paediatric oncology. These digital platforms are often aimed at, and are essential for, health professionals in rural and other low-resource settings.

The potential of current awareness services (CAS) for oncology nurses is considered with special reference to the spectrum of WWW CAS that are available, their benefits and problems, and how these can be linked to the dynamic health environments in which oncology nurses may find themselves. The intention with the article is to show the need for exploring the value of WWW CAS for dynamic professional fields such as oncology nursing, and to offer a point of departure for research on their information behaviour. The WWW CAS that were identified might be used to get oncology nurses interested in using such services, as well as in participating in research on their information behaviour.

A literature study on the nature and value of CAS is combined with a cursory analysis of the literature of oncology nursing to provide insight into the professional demands that oncology nurses need to cope with, and the potential value of CAS for oncology nurses. Based on this a selection of WWW CAS suitable for oncology nurses is identified. Insight into the potential of WWW CAS for oncology nurses and the CAS that are available are combined with what can be learned from studies on information‐seeking behaviour to offer some suggestions on how the need for oncology nurses to use CAS available via the WWW can be further explored. In general the suggestions to explore the use of CAS would also apply to other professional fields.

It seems as if oncology nurses can benefit substantially from WWW CAS. To successfully implement such CAS, extensive research on the information‐seeking behaviour, information use and information communication of oncology nurses is, however, necessary. The article could be used as an instrument to gain oncology nurses' interest in WWW CAS, and willingness to participate in further research on their information needs and information behaviour.

Oncology nurses' interest in CAS can be stimulated, and the article can be used as point of departure for further research. The article can also offer new opportunities for library and information (LIS) professionals to offer CAS in the health and other professional sectors, by reconsidering how one can use CAS available via the WWW.

No reports on CAS for oncology nurses could be traced, and there are also very few reports on the information needs and information behaviour of oncology nurses. The article hopes to pave the way for renewed interest in using CAS in demanding professional environments, and especially the health sciences, as well as to stimulate interest in research in information‐seeking behaviour in the health sciences.

The psycho-oncology and social work services recognised that a cancer diagnosis and treatment can result in considerable emotional consequences for patients, yet the referral rate to both services was extremely low. Only very visibly distressed patients were being referred to the service. The “Distress Thermometer” (DT), a distress screening tool, was introduced as a pilot project with day care and inpatient oncology patients of St Vincent ' s University Hospital, Dublin, in an effort to improve the identification, management and treatment of psychological distress in oncology patients. The purpose of this paper is to evaluate the effectiveness of this new intervention.

The Psycho-oncology service in conjunction with the Medical Social Work Department and Nursing Management at St Vincent ' s University Hospital, Dublin, initiated a Distress Education Management and Training Programme (DEMP). The initiative involved providing a training programme for oncology nursing staff and the introduction of a distress-screening tool for patients. In 1998, the DT was developed and validated for evaluation of distress (and depression) in cancer. It was adopted into recommendations made by the US National Comprehensive Cancer Network. The DT is a simple, self-report, pencil and paper measure consisting of a line with a 0-10 scale anchored at the zero point with “No distress” and at scale point ten with “Extreme distress”. Patients are given the instruction, “How distressed have you been during the past week on a scale of 0-10”? Patients indicated their level of distress with a mark on the scale. Patients scoring 4 or above were regarded as requiring intervention. The DT includes a problem checklist. The patient is asked to identify those problems from the checklist which are contributing to their score. The use of the DT was evaluated through interviews with patients and professionals.

Patients who scored four or above (38 per cent of patients), were seen by the Oncology Social Worker for psychosocial assessment and mental health triage. Patients who scored above a certain level (usually above 12/20) in the clinical range on the Hospital Anxiety and Depression scale (3 per cent) were referred to Psycho-oncology. That 38 per cent of oncology patients required intervention from a specialist service accurately reflects international findings on the rate of distress among cancer patients.

Assessment of cancer patients ' distress levels in a structured and planned manner with a Distress Thermometer, as recommended by best international practice, works very effectively and should be considered for all cancer out-patients This will have implications in terms of staff that will be required to manage such a service.

This was the first time that this internationally recognised tool was used to such an extent and to positive effect in an Irish context.

The purpose of this paper is to explore oncology nurses’ barriers to empathy-based care perceptions.

The authors used a descriptive qualitative method. In total, 18 oncology nurses were selected via purposive sampling. Data were collected through in-depth interviews and qualitative content analysis using an inductive approach.

Three main categories emerged from the data analysis: barriers related to nursing including: lacking compassion; disinterest in oncology nursing and self-criticism; psychological distress; barriers related to healthcare: job strain; task-centeredness; no formal training; poor manager support; nurse-patient gender imbalance; and barriers related to cancer care including: difficulty maintaining empathy with cancer patients; and inappropriate cancer patient

Oncology nurses provided insights into barriers to empathy-based care and the challenges they encountered while caring for cancer patients. Understanding these barriers is the first step to overcoming obstacles and creating an open and caring environment to provide an empathic care culture.

Given that oncology nurses experience several emotions, positive coping strategies for these distresses should be adopted. Healthcare systems should change cancer-caring culture from task-centered to patient-centered care. Compassion and empathy should become patient care values.

The aim of this paper is to empirically describe and analyze factors deemed to be relevant for the successful provision of coordinated paediatric oncology care by physicians and nurses involved.

A qualitative case study primarily consisting of interviews.

The paper's findings indicate that certain factors (i.e. distinct mission, clear treatment protocols and support from external stakeholders) relevant for the provision of coordinated paediatric oncology care have not received sufficient attention in previous research. In addition, emphasis is placed on the necessity of facilitating constructive working relationships and a bottom-up perspective when pursuing improved care coordination.

The factors described and analyzed may act as insights for how paediatric oncology might be improved in terms of care coordination and thus facilitate care integration. In addition, the paper's findings identify factors relevant for further empirical studies in order to delineate their generalizability.

Barriers to adequate healthcare in rural areas remain a grand challenge for local healthcare systems. In addition to patients' travel burdens, lack of health insurance, and lower health literacy, rural healthcare systems also experience significant resource shortages, as well as issues with recruitment and retention of healthcare providers, particularly specialists. These factors combined result in complex change management-focused challenges for rural healthcare systems. Change management initiatives are often resource intensive, and in rural health organizations already strapped for resources, it may be particularly risky to embark on change initiatives. One way to address these change management concerns is by leveraging socio-technical simulation models to estimate techno-economic feasibility (e.g., is it technologically feasible, and is it economical?) as well as socio-utility feasibility (e.g., how will the changes be utilized?). We present a framework for how healthcare systems can integrate modeling and simulation techniques from systems engineering into a change management process. Modeling and simulation are particularly useful for investigating the amount of uncertainty about potential outcomes, guiding decision-making that considers different scenarios, and validating theories to determine if they accurately reflect real-life processes. The results of these simulations can be integrated into critical change management recommendations related to developing readiness for change and addressing resistance to change. As part of our integration, we present a case study showcasing how simulation modeling has been used to determine feasibility and potential resistance to change considerations for implementing a mobile radiation oncology unit. Recommendations and implications are discussed.

Until now, it is not clear whether there are differences in patient perception between multi-bedded rooms with two and four beds. The purpose of this study was to investigate the effect of the physical (i.e. room type) and psychosocial (i.e. kindness of roommates and extraversion) aspects on the patients’ experience (i.e. pleasantness of the room, anxiety, sleep quality) in multi-bedded rooms in an oncology ward.

A group of 84 hospitalized oncology patients completed a questionnaire on the day of departure. Room types were categorized into two groups: two-person and four-person rooms.

Multivariate logistic regression analyses with the minimum Akaike Information Criterion (AIC) showed no direct main effects of room type (two vs. four-person room), kindness of roommates and extraversion on pleasantness of the room, anxiety and sleep quality. However, the authors found an interaction effect between room type and extraversion on pleasantness of the room. Patients who score relatively high in extraversion rated the room as more pleasant when they stayed in a four-person rather than a two-person room. For patients relatively low in extraversion, room type was not related to pleasantness of the room.

The findings allow hospitals to better understand individual differences in patient experiences. Hospitals should inform patients about the benefits of the different room types and potential influences of personality (extraversion) so patients are empowered and can benefit from autonomy and the most appropriate place.

This study emphasizes the importance of including four-person rooms in an oncology ward, while new hospital facility layouts mainly include single-bed rooms.

This study aims to understand how healthcare social media offer nonmedical psycho-social support for pediatric oncology patients and their care community and how social media can be exploited for healthcare knowledge management.

Social media capabilities were identified and categorized based on psycho-social support services for pediatric oncology patients, caregivers and their community of care. Data were collected from 187 service sites representing more than 100 organizations. These broadly defined capabilities in trusted care organizations were analyzed to understand use of social media in providing psycho-social support.

Analysis revealed resource guides, stories and in-person support at clinics as the most prevalent forms of technology-guided psycho-social support. Privacy, security and information integrity rose as technical challenges for interactive social media platforms. Medical community trust is inconsistent, leading to immature adoption of critical psycho-social support as a knowledge management source. Findings further indicate the not-for-profit support sector provides robust social media capabilities compared to the healthcare sector.

Future research may extend to maturing healthcare and not-for-profit sector services and to private sector products such as mobile applications and other technologies.

Survivor and caregiver quality of life depend on psycho-social support communities and services delivered via social media.

Child protection social implications require significant attention due to sensitivity of security, privacy concerns and longevity of digital footprints for pediatric patients.

Research demonstrates opportunity for medical provider, healthcare organization, not-for-profit sector, patient and caregiver cooperation using social media. Data indicate healthcare technology systems leveraging social media can extend knowledge management capability beyond organization boundaries.

Although “satisfaction” is not easy to define, excellence in health care is impossible without professional/patient satisfaction, so this paper aims to report on a pilot study designed in order to evaluate the degree of nursing staff satisfaction with the implementation of measures to improve quality of care.

The project consisted of several phases: writing protocols of care; training of nursing staff in their management; and a cross‐sectional study to evaluate nursing staff satisfaction with them. The design of the survey consisted of a 16‐item Likert scale, which had to be auto filled. A factorial analysis to simplify and validate the tools was used, using statistical analyses with SPSS software 8.0.

The results are applicable to young small oncological units with high degree of variability in patient care. The study showed that nursing staff satisfaction with new improvement measures taken improves safety and finally quality of care.

The study obtained four dimensions (D) explaining 100 percent of variance. Each dimension with several items: D1: “Nursing job quality” explaining 48.4 percent of variance; D2: “Satisfaction with the knowledge”; D3: “Nursing job feelings/perceptions”; D4: “Nursing communication with doctors/patients”. It provided a direct point of view of each nurse, knowledge about problems encountered daily and demonstration of how a simple/convenient method is useful to engage the staff in decision‐making‐process and implementation of new strategies or to promote the integration of basic aspects of health management in daily clinical practice.

This is the first study evaluating nursing staff satisfaction with new improvement measures taken in a small medical unit, aiming at quality of care benefits. Very promising results were obtained although the sample size was small.

Modularity promises to relieve problems of complexity in service systems. However, limited evidence exists of its application in specialized hospital services. The purpose of this paper is to identify enablers, constraints, and outcomes of modularization in specialized hospital services.

A qualitative comparative study of a hematology unit with modular service architecture and an oncology unit with integral service architecture in a university hospital is performed to analyze the service architectures, enablers and constraints of modularization, and outcomes.

A framework and five propositions combining the characteristics of specialized hospital services, enabling activities, and outcomes of modularization were developed. Modular service architecture was developed through limiting the number of treatment components, reorganizing production of standardized components into a separate service unit, and standardizing communication and scheduling in interfaces. Modularization increased service efficiency but diluted ownership of services, decreased customization, and diminished informal communication. This is explained by the specific characteristics of the services: fragmented service delivery, professional autonomy, hierarchy, information asymmetry, and requirement to treat all.

Modularization can increase efficiency in specialized hospital services. However, specific characteristics of specialized care may challenge its application and limit its outcomes.

The study identifies enabling activities and constraints that hospital managers should take into account when developing modular service systems.

This is the first empirical study exploring the enablers, constraints, and outcomes of modularization in specialized hospital services. The study complements literature on service modularity with reference to specialized hospital services.