With a clear definition of their role, professional navigators may be more efficient and less challenged in terms of setting priorities and making decisions while having to face demands from the health system and patients. The integrative framework could improve the effectiveness of cancer navigation programs.

Some healthcare organizations recommend adopting open visiting policies. These organisations are working towards the end goal of promoting the idea that patients and families can be true partners in care. An essential step in this culture shift involves openness to family presence and their engagement in the patient's care. Among other things, their recommendations are based on data from studies that assessed the impacts of different types of visiting policies on patients, families and healthcare staff. In order to inform and guide an organizational reflection on possible changes to our hospital center's visiting policies, our team undertook a systematic review that focussed on the advantages and disadvantages of open/flexible visiting policies, as perceived by patients, families and staff. Review articles and original articles were assessed and synthesized following a rigorous review process. Results of the reviewed studies suggest that flexible visiting policies lead to greater patient satisfaction with care and to positive impacts for both patients and families, and that these stakeholders have clear preferences for open/flexible policies. Nevertheless, policies including some guidelines to safeguard rest and sleep periods were deemed necessary by patients, rather than an unqualified open policy. Results also suggested that flexible visiting hours were not associated with an increased risk in hospital-acquired infections or septic complications in intensive care units (ICUs), where the majority of the reviewed studies were carried out. Authors recommended taking the specific context of care units into account when implementing new visiting policies, as needs may be different according to different health issues. Staff preferences over a model or the other were somewhat mixed. Some staff see the presence of families and visitors as an obstacle to the provision of care and a reason to fear increased workloads. In order to overcome this resistance, the importance of adequately preparing staff and supporting them throughout the policy change to ensure its success is highlighted.

The objective of this exploratory study was to evaluate the impact of advanced parental cancer on adolescents' psychological status. A sample of 28 adolescents, having a parent with advanced cancer, was recruited and compared with a sample from the general population (N = 2,346). Late adolescents (age 15 to 18) experienced significantly more psychological distress than early adolescents (age 12 to 14). Moreover, late adolescents experienced significantly higher psychological distress than the general population for the same age group, which was not the case for early adolescents. Implications for adolescents living in families touched by advanced cancer are discussed.

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