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M. Eicher



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    OA14 - Nurses in Care for Lung Cancer and in Research (ID 398)

    • Event: WCLC 2016
    • Type: Oral Session
    • Track: Nurses
    • Presentations: 1
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      OA14.01 - Acceptability of an Advanced Practice Nurse in Lung Cancer by Health Professionals and Patients: A Qualitative Exploration (ID 4379)

      16:00 - 17:30  |  Author(s): M. Eicher

      • Abstract
      • Presentation
      • Slides

      Background:
      The advanced practice nurse in lung cancer (APNLC) has shown to play a key role in meeting the complex supportive care needs of patients with lung cancer. Nurses working in novel advanced practice nursing (APN) roles encounter a range of barriers to effective practice particularly in countries without an existing regulation of these novel roles. Being accepted by patients and healthcare professionals (HCPs) is fundamental for successful role implementation. The University Hospital of Lausanne (CHUV) was the first comprehensive cancer center in Switzerland to integrate an APNLC into the specialized multidisciplinary team (MDT) of the thoracic cancer center. To overcome barriers to implementing the APNLC role and promote its long-term viability, we aimed to explore the acceptability of this novel APNLC role from the perspective of the MDT and the patients cared for by the APNLC.

      Methods:
      This qualitative study was part of a larger implementation study (ClinicalTrials.gov, Number: NCT02362204). During summer 2015, we conducted focus groups and semi-structured interviews in the thoracic cancer center of CHUV. Participants were purposefully sampled and included patients with lung cancer (n=4) and HCPs from the MDT [physicians (n=6), nurses (n=5)], a social worker and the APNLC. Semi-structured individual interviews were conducted to examine the perspectives of patients and the APNLC alike. Focus groups were employed to gather perspectives from the MDT. Data were analyzed using thematic content analysis.

      Results:
      Three main themes emerged describing the acceptability of the APNLC: “role identification”, “role-specific contribution” and “flexible service provision”. Physicians and patients identified the specific APNLC role within the MDT. In particular, they valued specific contributions to continuity of care, psychosocial support and self-management of symptoms. Nurses perceived the APNLC role as overlapping with the traditional oncology nurse role. They were concerned about losing part of their traditional role. Flexibility in service provision was seen as strength of the APNLC role yet also posed organizational challenges related to the work-load.

      Conclusion:
      The new APNLC role appears to be well-accepted by patients and physicians. Barriers identified during the implementation of the APNLC role were primarily related to intra-professional and organizational challenges. The intra-professional role tension could challenge effective role implementation. To maximize the acceptability of a new APNLC role - particularly in countries that are in an early stage of APN role development - we recommend formalizing nursing role expectations, providing appropriate support/resources and promoting a national plan for APN accreditation and certification.

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