Modified international e-Delphi survey to define healthcare professional competencies for working with teenagers and young adults with cancer

Abstract

ObjectivesTo provide international consensus on the competencies required by healthcare professionals in order to provide specialist care for teenagers and young adults (TYA) with cancer.DesignModified e-Delphi survey.SettingInternational, multicentre study.ParticipantsExperts were defined as professionals having worked in TYA cancer care for more than 12 months. They were identified through publications and professional organisations.MethodsRound 1, developed from a previous qualitative study, included 87 closed-ended questions with responses on a nine-point Likert scale and further open-ended responses to identify other skills, knowledge and attitudes. Round 2 contained only items with no consensus in round 1 and suggestions of additional items of competency. Consensus was defined as a median score ranging from 7 to 9 and strength of agreement using mean absolute deviation of the median.ResultsA total of 179 registered to be members of the expert panel; valid responses were available from 158 (88%) in round 1 and 136/158 (86%) in round 2. The majority of participants were nurses (35%) or doctors (39%) from Europe (55%) or North America (35%). All 87 items in round 1 reached consensus with an additional 15 items identified for round 2, which also reached consensus. The strength of agreement was mostly high for statements. The areas of competence rated most important were agreed to be: ‘Identify the impact of disease on young people's life’ (skill), ‘Know about side effects of treatment and how this might be different to those experienced by children or older adults’ (knowledge), ‘Honesty’ (attitude) and ‘Listen to young people's concerns’ (aspect of communication).ConclusionsGiven the high degree of consensus, this list of competencies should influence education curriculum, professional development and inform workforce planning. Variation in strength of agreement for some competencies between professional groups should be explored further in pursuit of effective multidisciplinary team working.

An analysis of the development of adolescent and young adult cancer care in the United Kingdom: A Foucauldian perspective

“…While emphasis may have been placed on the creation of the built environment and specialist staff by charities in the UK, there has also been development of multiprofessional AYA cancer teams driven by the additional discourses and values underpinning multidisciplinarity. Integral to this has been the influential role of nurses with leadership positions in AYA services, practice and research (Kelly & Gibson, ; Morgan & Soanes, ; Olsen & Smith, ; Smith et al., ; Taylor, Solanki, Aslam, Whelan, & Fern, ; Taylor, Feltbower et al., ). July 2014 marked the launch of the first nursing‐specific publication on practice competencies entitled Caring for Teenagers and Young Adults (TYAs) with Cancer: A Competence and Career Framework for Nursing (Teenage Cancer Trust, ).…”

“…(); Taylor, Feltbower et al. (); Taylor, Solanki et al. () have purposefully engaged AYAs with cancer in their recent national study evaluating specialist care models.…”

Issues experienced and support provided to adolescents and young adults at the end of active treatment for cancer: A rapid review of the literature

“…Young people face a number of challenges throughout their cancer experience: Diagnosis pathways are frequently protracted and complex, access to care and research is dependent on a number of chance events, and the journey through treatment to survivorship involves several transitions, which can be unsettling and distressing (Lethaby et al, ; Nathan, Hayes‐Lattin, Sisler, & Hudson, ; Taylor et al, ; Wilkins, D'Agostino, Penney, & Nathan, ). First, AYA face the challenging transition from a state of health to illness, and for many who begin treatment within children or AYA‐specific services, they will later be required to transition to adult cancer services (Nathan et al, ).…”

Transitioning adolescent and young adult cancer care research out of its adolescence

“…This has indeed required detailed characterisation of the specific similarities and differences between AYA and older/younger patients, over and above merely highlighting them, but much of that is now in place. For example Specific barriers to AYA entering clinical trials are now characterised (Fern, Lewandowski, Coxon, & Whelan, ) Patient and health service organisational factors that underpin advanced disease at AYA cancer presentation are increasingly understood (Herbert et al, ) Biological differences between apparently similar cancers in AYA and other age groups are described in some areas (Tricoli et al, ) The specific healthcare professional competencies required for working with AYA are characterised (Taylor et al, ) The social difficulties of AYA with cancer are specifically and systematically described (Warner et al, ). The unmet needs of AYA have been frequently described and differ relatively little during the cancer trajectory (Lea et al, ). In this edition, Darlington et al comprehensively describe how specific AYA needs can influence the quality of life (Sodergren et al, ). …”

“…Biological differences between apparently similar cancers in AYA and other age groups are described in some areas (Tricoli et al, 2016) 4. The specific healthcare professional competencies required for working with AYA are characterised (Taylor et al, 2016) 5. The social difficulties of AYA with cancer are specifically and systematically described (Warner et al, 2016).…”