Research Grants Awarded
CANO/ACIO is pleased to announce the following research were funded:
“Exploring the relationship between Family Caregiver Distress and Burden in
Anita Mehta, RN, PhD, CFT
McGill University Health Centre, Psychosocial Oncology Program, Montreal, QC
“An interpretive description of moral distress in oncology nursing”
Brenda Peters-Watral, RN(NP), MN, AGD: ANP, PhD(c)
University of Manitoba, Winnipeg, MB
“Examining parents’ online accounts of caring for a child with cancer”
School of Nursing, University of Saskatchewan, Saskatoon, Saskatchewan
“Promoting Self-Management and Patient Activation through E-Health: A Systematic Literature Review and Meta-Analysis of Clinical Trials”
Saeed Moradian, PhD
Post-doctoral Research Fellow
University Health Network, Princess Margaret Cancer Centre Toronto, Ontario
“Internet cancer information use by newly diagnosed individuals: A mixed
methods study of interactions with the health care system”
Kristen Haase, RN, BN, MA, PhD(c)
School of Nursing, University of Ottawa
Using an interpretive descriptive approach, this qualitative study explored how patients newly diagnosed with cancer use cancer-related internet information (CRII). Patients (n=19) described CRII as an important resource to process information, make decisions about their illness, make sense of their disease, and complement or reinforce information provided by healthcare professionals. Healthcare professionals’ (n=21) supported patient use of CRII to manage pragmatic concerns and priorities, navigate the healthcare system, and modulate interactions with the healthcare system; but also expressed concern about patients using untrustworthy information. Proactive communication about CRII may strengthen areas for patient education and lend insight into patients’ key concerns regarding their diagnosis.
“Exploring the perspectives of early-discharge breast cancer survivors during the transition to primary care follow-up: A qualitative descriptive study”
Marian Luctkar-Flude, RN, MScN, PhD(c)
Queen’s University, School of Nursing
A qualitative descriptive study was conducted to explore perspectives of breast cancer survivors following their transition to follow-up in primary care. Four positive themes emerged from interviews with 14 survivors indicating that many were coping well and receiving desired survivorship care: (1) self-management; (2) keeping active; (3) back to normal; and (4) satisfaction with care. However, five themes also emerged revealing the ongoing challenges faced by these women: (1) ongoing side effects; (2) lack of confidence/dissatisfaction with primary care provider; (3) survivorship issues ignored; (4) uncertainty; and (5) interest in alternative therapy. Implications for oncology and primary care nurses include need to be familiar with evidence-based recommendations for breast cancer survivorship care, encourage/support self-management, and promote physical activity amongst breast cancer survivors.
“Experiences of first year nursing students in an outpatient oncology setting”
Tracy L. Powell, BScN, RN, MN
School of Nursing and Midwifery - Faculty of Health, Community and Education
Mount Royal University
The purpose of this qualitative study was to understand the experiences of first year nursing students who participated in an experiential learning opportunity with a Registered Nurse (RN) at an outpatient oncology center. Guided by hermeneutic phenomenology, this study used semi-structured individual interviews to collect data from 10 participants. Two main themes were identified and included Circles of Relationships and the Many Sides of Cancer. Based on the experience of these participants, the learning opportunity was beneficial in fostering gained understandings about cancer care and individuals who are diagnosed with cancer. It also enabled these students to adjust their perceptions of health and illness and to develop greater awareness of the impact of oncology nurses’ roles on individuals and family’s experiences.
“Fear of Cancer Recurrence among Survivors of Adult Cancer”
Jacqueline Galica, RN, CON(C), PhD
University of Toronto, Ontario
A cross-sectional survey was conducted with 1002 cancer survivors who completed the survey (50% response rate). Nearly 58% had a level of fear of cancer recurrence (FCR) that required professional intervention. Cancer survivors who had the highest FCR were women and having a younger age. Type of cancer diagnosis, time since diagnosis, and receipt of cancer treatment did not influence FCR. However, survivors who reported a higher number of symptoms to which they attributed to cancer had higher FCR. Those who knew someone with a cancer recurrence had significantly lower FCR; while survivors who believed that knowing someone with a recurrence affected their FCR had higher levels of FCR. Compared to survivors who had been discharged from the survivorship clinic, those who continued on active follow-up at the clinic had higher FCR. Survivors with a higher self-esteem and who were more optimistic had a lower FCR.
“Supporting patient self-management of existential concerns within oncology nursing practice”
Virginia Lee, RN, PhD
Ingram School of Nursing, Faculty of Medicine, McGill University
MUHC Department of Nursing Research, Nurse Scientist, Cancer Care Mission
Finding effective ways to cope with the inherent uncertainty of cancer can be distressing. This study tested the self-administered workbook version of the Meaning Making Intervention©, offered as part of a group psychoeducational workshop. One month after receiving workshop, patients reported significantly improved self-efficacy, less sleep disturbance as well as improved emotional and spiritual wellbeing (more hopeful, less sad, less worry about dying). Our study findings advocate for greater integration of complementary therapies in cancer centres that can help patients to self-regulate the transient yet significant physical, emotional, social, or existential toll of cancer.
Received the CANO-ACIO Helene Hudson Lectureship Award (October 2016) and Best Student Oral Presentation Award (Jeremie Richard) at the McGill University Health Centre Research Institute Cancer Research Program Summer Student Research Day (August 2016).
“Exploring the Relationship between Social Determinants of Health and Symptom Burden in Cancer Populations”
Anna Santos Salas, RN, PhD
Faculty of Nursing
University of Alberta
This study explored cancer care practitioners’ perspectives regarding social disparity and symptom burden in socially vulnerable palliative care populations. Clinical strategies to enhance symptom relief in these groups were also identified. Findings indicated that individuals with income, education, housing, and other social disparities may experience increased symptom complexity. Individuals at risk of presenting a higher symptom burden include inner city residents, indigenous people, low income groups, non-English speaking individuals, and people with mental health conditions. Findings revealed the need to consider social disparity and adjust clinical interventions to improve symptom relief in these populations.
“Dimensions of Care in Radiation Therapy: Perspectives of Radiation Therapists and Radiation Therapy Patients”
Edith Pituskin, BSN, MN, PhD
Department of Oncology,
Faculty of Medicine & Dentistry
University of Alberta
After surgery, radiation therapy is the most common treatment for cancer, with over half of all patients receiving RT at some point of their disease trajectory. Similar to their relationships with oncology nurses, patients consistently report caring relationships with the RTT as a critical component of their overall experience. We aimed to concurrently study the experiences of both patients (n = 8) and radiation therapists (n =4) using qualitative method. Our findings will inform approaches in patient-informed quality care between oncology providers.
“L'étude portant sur le dépistage systematique de la détresse aupres de personnes atteintes de cancers hématologiques et de cancer du sein”
Nicole Tremblay inf., M.Sc., CSIO (C), ICSP (C)
Notre étude à devis mixte séquentiel exploratoire a poursuivi cinq objectifs distincts et a comporté 3 phases distinctes dont la dernière n'a pu être menée. Toutefois, les deux premières phases complètes en soi ont confirmé certains résultats d’études antérieures, notamment en ce qui concerne la prévalence de la détresse. En effet, près de 34 % de notre échantillon de la phase 1 (N=532) rencontre le seuil clinique de détresse et plus du quart des patients (26,6 %) atteignent le seuil clinique d’anxiété. De plus, ls présentent des fréquences élevées à l'égard de certains problèmes (la peur (50 %), le sommeil (42 %), la famille (35 %), la compréhension de la maladie et du traitement (31 %), l’adaptation face à la maladie (31 %) et la tristesse (31 %) Le temps 1 correspond pour les patients atteints de cancers hématologiques à l’admission à l’unité hospitalisation et que le temps 2 correspond le plus souvent au congé. Alors que pour les femmes atteintes de cancer du sein, le temps 1 correspond à une 2e ou 3e rencontre suivant l’annonce du diagnostic et le temps 2 correspond à un jour X dans la période des traitements. Par ailleurs nos résultats indiquent que le niveau de détresse de notre échantillon diminue dans le temps. Cependant, cette baisse survient peu importe que l’aide proposée ait été acceptée ou non. En fait, une vaste majorité de patients expriment qu’ils ne souhaitent pas être aidés pour des problèmes ou des préoccupations mentionnées sur l’ODD : 77,3 % au temps 1 et 85,3 % au temps 2.
De plus, les participants à l’étude sont nombreux à refuser les références proposées. Parmi les 46 % de l’échantillon se voyant offrir une référence au temps 1, celle-ci est acceptée
dans 40 % des cas. Sans compter qu’une certaine proportion de patients refusent de compléter le questionnaire parce qu’ils n’en ressentent pas le besoin (raison principale des refus de compléter l’outil en phase 1). De plus, l’étude a démontré que le motif le plus souvent indiqué par le patient lorsqu’il perçoit l’ODD comme étant non utile est qu'il n'en ressent pas le besoin. Alors, est-ce que le dépistage de la détresse demeure une pratique utile? Beaucoup de verbatim d’infirmières ont mentionné que les patients ne désirent pas être aidés, ce qui ne veut pas dire, d’une part, que le dialogue ou l’aide offerte par l’infirmière à ce moment-là n’est pas significatif pour eux. À la lumière de nos résultats et de notre expérience clinique, nous sommes enclins à penser que les personnes atteintes de cancer ont de nombreuses ressources internes et familiales qui contribuent à leur adaptation et à leur résilience dans le temps, et qui peuvent être renforcées et honorées. D’autre part, il faut aussi réaliser ici que la détresse aurait pu tout aussi bien augmenter dans le temps, car le temps 2 correspond pour un grand nombre de patients de notre échantillon à des périodes intenses de traitement (femmes atteintes de cancer du sein en radiothérapie ou chimiothérapie ou patients greffés à la veille du congé hospitalier, mais présentant toujours de nombreux symptômes). D’autre part, on constate que l’étude met en lumière le caractère introspectif du dépistage qui prédomine dans les thèmes concernant l’utilité de l’outil pour le patient et que cet aspect mérite d’être exploré davantage dans les recherches futures.
“Colorectal cancer screening behaviors of South Asian immigrants in Canada: An exploratory mixed methods study”
Joanne Crawford, RN, BScN, CON(C), MScN, PhD
This exploratory sequential mixed method study explored factors that influence colorectal cancer (CRC) screening, and resulted in the development of an empirically-based cross culturally adapted survey for average risk South Asian (SA) immigrants. The scoping study (Phase 1) findings revealed four themes: beliefs and attitudes such as centrality of family; lack of knowledge; barriers to access; and gender differences. The focus group study (Phase 2) thematic analysis revealed three themes: beliefs and attitudes such as benefits of screening; knowledge and awareness of CRC and screening; and support and accessibility to information and screening. In survey development (Phase 3), concept identification, a search for candidate measures, critical appraisal, and advisory group consultation were completed. Modifications were made to the Urdu survey during cross-cultural translation and adaptation, and cognitively pre-tested. This study enhanced understanding of factors that influenced cancer screening and provided insights on socio-cultural context, beliefs, attitudes, barriers, and strategies to promote CRC screening among SA immigrants in Canada. The scoping study, focus group study, and cognitive interview study were published in academic journals in 2015 and 2017.
“Acceptability and feasibility of an online, image-based patient education guide for women newly diagnosed with ovarian cancer”
Joanne Power, RN, MScN, CON(C)
Clinical Nurse Specialist, Gynaecology Oncology
McGill University Health Centre, Montreal, QC
A descriptive study using mixed methods was conducted to investigate the acceptability and usability of an online, image-based patient education guide for women newly diagnosed with ovarian cancer from the patients’ perspective. For patients who were familiar with using computers, the online format was an acceptable way of receiving information and patients found it easy to use. Having credible information sources was important to patients. As well, patients often used the guide with family members and appreciated practical, hospital specific information contained in the guide.
Recipient of CANO/Ovarian Cancer Canada Award for Excellence in Gynecology Oncology Nursing (October 2016)
Last Updated: August 14, 2018