Aim of the research and why it is important:  Existing research evidence has identified that people affected by brain cancer and their family and/or caregiver can experience distressing unmet supportive care needs which are not always adequately addressed in routine follow-up clinical care.   Therefore, this clinical trial will bring together different healthcare professionals (doctors, nurses, psychologists, exercise physiologists and dietitians) and researchers with expertise in cancer care to deliver a “timely needs-based” model of supportive care to improve function, physical and psychological well-being, and overall quality of life.

Affiliations: University of Canberra and ACT Health 

Nurses are the highest users of health information systems (HIS) within hospitals. Emergent evidence suggests that HIS may afford a solution for efficient, reliable, and safe care delivery. However, evidence specific to oncology nurses’ experiences of using HIS are limited.
 
 Aim

The systematic review was aimed to identify oncology nurses’ experiences of using HIS in the delivery of cancer care.
 
 Review Question

What are the experiences of oncology nurses using HIS in the delivery of cancer care?
 
 Method

An integrative systematic review was conducted using the PRIMSA guidelines. Electronic databases included: CINAHL, MEDLINE, SCOPUS, Web of Science Core Collection, Google scholar, OVID, ProQuest Central and hand searching of reference lists. Titles, abstracts and full-texts were reviewed independently by two reviewers using eligibility criteria. Methodological quality assessment on included studies, and narrative synthesis were performed.

Results: 26 studies were included and represented 1464 nurse participants. Three themes emerged: 1) transparency and application of nursing process within HIS, 2) HIS enhancing and facilitating communication between nurses and patients, 3) the impact of HIS on elements of person-centred care. The HIS focused on assessment, diagnosis, and planning. However, insight into intervention and patient outcome were limited.
 
 Conclusion 

Digital systems don’t fully capture all elements of the nursing process, and this has been confirmed in this review. Future research need to focus on the impact of HIS on nursing processes and patient outcome.
 
 Significance

The findings can contribute to the growing work around HIS. Importantly, increase awareness among health care leaders of the current challenges from HIS to ensure better support for nurses.

 

Delilah M Shelley1, Catherine Paterson3,5, Deborah Davis2,5, Kasia Bail4, Rebecca Heland6
 
 

1.     University of Canberra, Bruce, ACT, 2617

2.     Midwifery Faculty of Health, University of Canberra, Bruce, ACT, 2617

3.     Nursing Faculty of Health, University of Canberra, Bruce, ACT, 2617

4.     Nursing and Midwifery Faculty of Health, University of Canberra, Bruce, ACT, 2617

5.     Synergy Nursing and Midwifery Research, Garran, ACT, 2605 

6.     ACT Health Directorate, Phillip, ACT, 2606

Uro-oncology multidisciplinary teams (MDTs) deliver comprehensive cancer care across Australia although a multitude of individuals do not receive a timely MDT discussion and little is known about the clinical decision-making among MDTs or how patients’ needs, and preferences are embedded. 

 

To understand the clinical decision-making process among the uro-oncology MDT and how patients are engaged in the process.

 

This study was conducted in a Metropolitan Cancer Regional Hospital in Australia. Semi-structured interviews were conducted with healthcare professionals of a uro-oncology MDT from June 2022 to July 2022. The cognitive continuum theoretical model of clinical decision-making along with Braun and Clark’s six-steps of thematic analysis were applied, and a narrative synthesis undertaken.

 

Three themes emerged, 1) the ‘role and scope of the uro-oncology MDT’, 2) ‘lack of person-centred clinical decision-making’ and 3) the ‘barriers and facilitators.’ Individuals do not attend, nor are they able to attend MDT discussions. The reasons for patient exclusion include logistics, time constraints, medical jargon and privacy reasons. Identified barriers included: incomplete referral documentation and a lack of attendance from all members of the MDT.

 

The MDT had a prominent biomedical focus which lacked person-centred considerations. Psycho-social issues (including urinary, bowel and sexual dysfunction) are scantly discussed, however, patients’ preferences for treatments are considered in the clinical decision-making process.

 

This study provides further evidence to indicate that uro-oncology MDTs continue to have a biomedical focus which impedes holistic care. Evidently the whole person is not being treated which likely results in reduced quality of life and compounds unmet care needs.

 

Blake Askelin1, Alicia Hind2,3, Catherine Paterson4,5,6
 
 

1.     Canberra Health Services, Garran, ACT, 2605

2.     School of Nursing, Midwifery and Public Health, University of Canberra, Bruce ACT 2617

3.     Faculty of Health, University of Canberra, Bruce, ACT 2617

4.     ACT Health, Phillip, ACT 2605

5.     PACES Research Group, University of Canberra, Bruce ACT 2617

6.     Icon Cancer Centre, Bruce ACT 2617

Ecological Momentary Assessment (EMA) methodology captures real-time, real-world, self-reports in participants naturalistic environments. EMA is a highly-specialised research method and knowledge of its implementation in the cancer context is in its infancy. 

 

To critically synthesise and describe the use of EMA in cancer research.

 Methods

This systematic review has been reported according to the Preferred Reporting Items for Systematic Reviews and Meta-analysis (PRISMA) Guideline. Electronic databases were searched by an expert librarian, double screened by two reviewers, methodological quality assessed and data extracted. A narrative synthesis examined the rationale for EMA, characteristics of the study samples, EMA sampling procedures, EMA completion rates, outcome measures and implications of findings. 

21 EMA studies in cancer were included. The findings identified that EMA is an acceptable approach to real-time data collection among people affected by cancer. Studies were found significantly heterogeneous in method and approaches varied in design and self-reported measurements. No existing EMA study in cancer reported on validity or reliability of EMA questionnaires.

This is the first systematic review to describe the use of EMA in cancer research. The findings from this review have identified that EMA is an acceptable approach to real-time data collection among people affected by cancer. Further research is required to develop an outcome set for EMA in cancer care to refine the relevance and acceptability of EMA data collection protocols.

EMA in cancer research holds significant promise to advance cancer care and survivorship research through the attainment of real-time, real-world, self-reported data linking affect, thoughts, and behaviours in naturalistic environments.

 

Catherine Paterson1,2, Lucy Armitage1, Murray Turner1
 
 

1.     Faculty of Health, University of Canberra, Bruce, ACT, 2617, Australia

2.     Robert Gordon University, Aberdeen, AB10 7AQ, Scotland, UK

Canberra Health Services policy recommends Introduction, Subjective, Objective, Analysis, Plan (ISOAP) format for all clinical documentation. In 2021 there was no standard format in the documentation in written nursing clinical notes in the Neonatal Intensive and Special Care (NICU/SCN). Our team conducted a pre- implementation audit that showed only 2% used the ISOAP format.

To increase the use of ISOAP documentation format from 2% to 50% (Jan 22) and 90% (April 22) and 90% (May 23) post DHR rollout.

This study was designed on the Institute of Health Care Improvement Model, utilising PDSA cycles (CHS QI No 2342). The project included: development of templates, posters, lanyards, and examples of ISOAP documentation for use across NICU/SCN. Staff Education via in-service, email, and one-to-one education. Clinical Audits were undertaken post implementation.

Audits of clinical reports showed an increase from 2% (pre) to 78% (3 months post). These results were supported by the CHS Clinical Audit completed in March 2022, reporting 100% of were completed in ISOAP format. A post DHR audit reported 65% written in ISOAP and 20% in a Systemic format. We are currently updating templates to increase uptake of ISOAP format in DHR.

Implementation of ISOAP has assisted in standardised nursing documentation across NICU/SCN. ISOAP format provides nurses a format to document; neonatal observations and assessments, changes in condition, and daily care plan, while facilitating clear documentation of family needs and participation in their baby’s care. 

First project to develop ISOAP guidelines that meet the clinical documentation requirements for neonates admitted to a NICU/SCN.

 

Margaret M Broom1,2, Laura Briguglio1, Juby Joseph1, Heather Heslop1, Lori Grjl1, Clare O'Brien1

 
 

1.     Centenary Hospital for Women and Children, Department of Neonatology, Garran, ACT, 2606

2.     SYNERGY: Nursing and Midwifery Research Centre, UC and ACT Health 

Introduction: Cancer presents the largest clinical, social, and economical burden affecting humanity. As incidence continues to rise, more individuals are facing the ongoing psychological health effects of the disease. Exercise appears a positive intervention for improving psychological health. However, no comprehensive systematic reviews or meta-analysis have investigated the effects on psychological health in those living with cancer. 
 
 

Aims: Evaluate the effects of exercise on psychological health in those living with cancer and assess moderating variables of exercise to identify those with greatest effects.
 
 

Methods: Systematic review with meta-analysis. The initial search was conducted using six electronic databases in March 2022. Seventy-eight studies were identified to meet the inclusion criteria. Randomised control trials of physical exercise in adults living with cancer that included psychological health outcome measures. Additionally, sufficient details of the exercise prescription were required, this included exercise frequency, intensity, duration, and type. Meta-analysis completed with Meta-Essentials Workbook for meta-analysis, using a random-effects model. Subgroup analysis included moderators of exercise described by FITT principles: Frequency; Intensity; Time; and Type.
 
 

Results: Analysis of 183 individual effect sizes from 68 trials demonstrated that exercise has small to moderate effects (d = 0.30, 95%CI 0.20; 0.40) on psychological health. The subgroup analysis showed the greatest effects on psychological health were achieved with frequent aerobic exercise at light to moderate intensities. 
 
 

Conclusion: Exercise demonstrates small to moderate effects on psychological health among individuals with cancer. 
 
 

Significance: This research provides high-quality evidence to support exercise for addressing psychological health in individuals with cancer. Additionally, insight is provided into the respective effect of various exercise moderators.

 

Jay Calder

 

1. Faculty of Health, University of Canberra, Canberra, Australian Capital Territory, 2611

2. Prehabilitation, Activity, Cancer, Exercise and Survivorship (PACES) Research Group, University of Canberra, Bruce, Australian Capital Territory, 2611