Nurses working with dying people are exposed to numerous stress factors. Their occupational stress may be so important as to lead to burnout. The aim of the present study is to examine the relationship among occupational stress, burnout, and professional support in nurses working with patients dying from cancer. The study has taken place in four palliative care and three medical oncology units of the Montreal metropolitan region. In all, seventy-six nurses of the N nurses fitting the entrance criteria of the study were selected. Participants completed a French version of the following instruments: the Occupational Stress of Nurses Working with Dying Patients, the Jones Staff Burnout Scale for Health Professionals and the Professional Support Scale. Results indicate that there is a significant relationship between occupational stress and burnout ( r = 0.462, p < 0.001) and between professional support and burnout ( r = −0.449, p < 0.001). Further, the results showed that the level of occupational stress and burnout was significantly lower for the palliative care nurses who received significantly more professional support than their colleagues working in medical oncology units. Professional support and training for nurses working with patients dying from cancer should be implemented in order to minimize the development of burnout.
BackgroundA regional integrated cancer network has implemented a program (educational workshops, reflective and mentoring activities) designed to support the uptake of evidence-informed interprofessional collaborative practices (referred to in this text as EIPCP) within cancer teams. This research project, which relates to the Registered Nurses' Association of Ontario (RNAO) Best Practice Guidelines and other sources of research evidence, represents a unique opportunity to learn more about the factors and processes involved in the translation of evidence-based recommendations into professional practices. The planned study seeks to address context-specific challenges and the concerns of nurses and other stakeholders regarding the uptake of evidence-based recommendations to effectively promote and support interprofessional collaborative practices.AimThis study aims to examine the uptake of evidence-based recommendations from best practice guidelines intended to enhance interprofessional collaborative practices within cancer teams.DesignThe planned study constitutes a practical trial, defined as a trial designed to provide comprehensive information that is grounded in real-world healthcare dynamics. An exploratory mixed methods study design will be used. It will involve collecting quantitative data to assess professionals' knowledge and attitudes, as well as practice environment factors associated with effective uptake of evidence-based recommendations. Semi-structured interviews will be conducted concurrently with care providers to gather qualitative data for describing the processes involved in the translation of evidence into action from both the users' (n = 12) and providers' (n = 24) perspectives. The Graham et al. Ottawa Model of Research Use will serve to construct operational definitions of concepts, and to establish the initial coding labels to be used in the thematic analysis of the qualitative data. Quantitative and qualitative results will be merged during interpretation to provide complementary perspectives of interrelated contextual factors that enhance the uptake of EIPCP and changes in professional practices.DiscussionThe information obtained from the study will produce new knowledge on the interventions and sources of support most conducive to the uptake of evidence and building of capacity to sustain new interprofessional collaborative practice patterns. It will provide new information on strategies for overcoming barriers to evidence-informed interventions. The findings will also pinpoint critical determinants of 'what works and why' taking into account the interplay between evidence, operational, relational micro-processes of care, uniqueness of patients' needs and preferences, and the local context.
The oncology patient navigator role was developed to ensure both continuity and consultation in the delivery of care to cancer patients and their families. In Québec, this role is filled by a nurse. This first article in a series of two, aims to explain why nurses were selected as patient navigators and to describe how this new role has been integrated in the Montérégie Region. The Québec Cancer Control Program, the definition established for the oncology nurse navigator role and the implementation of an integrated care network based on the Montérégie experience will be discussed.
Quebec's Oncology Nurse Navigators (or "IPOs" after their French acronym) have been integrated in the entire Montérégie health care region. They have been agents of change mandated with implementing a philosophy of care that centres on the patients and their families, and is delivered by oncology teams. The goal of this second article is to describe the role of IPOs in practice, the problems encountered in the various contexts and the solutions brought forward to facilitate their integration. The training of IPOs, the support they receive from administrators, the deployment of interdisciplinary teams dedicated to oncology, the holding of regular structured interdisciplinary meetings and the training of professionals, and development of standardized work instruments are discussed. The observed impacts of introducing IPOs will also be examined.
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