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AnteayerJournal of Clinical Nursing

Development and Psychometric Testing of a Comprehensive Cancer Nurse Self‐Assessment Tool (CaN‐SAT) for Identifying Cancer Nursing Skills

ABSTRACT

Aim

To develop and psychometrically test a comprehensive Cancer Nurse Self-Assessment Tool (CaN-SAT).

Design

Modified Delphi to assess content validity and cross-sectional survey to assess reliability and validity.

Methods

Phase 1: An expert group developed the tool structure and item content. Phase 2: Through a modified Delphi, cancer nursing experts rated the importance of each element of practice and assessed the relevance and clarity of each item. Content Validation Indexes (CVI) were calculated, and a CVI of ≥ 0.78 was required for items to be included. Phase 3: Cancer nurses participated in a survey to test internal consistency (using Cronbach's alpha coefficients) and known-group validity (through Mann–Whitney U tests). This study was reported using the Guidelines for Reporting Reliability and Agreement Studies (GRRAS) checklist.

Results

The CaN-SAT underwent two rounds of Delphi with 24 then 15 cancer nursing experts. All elements of practice were rated as important. Only three items achieved a CVI < 0.78 after round one; however, based on open-ended comments, 26 items were revised and one new item added. After round two, all items received a CVI above 0.78. The final tool consisted of 93 items across 15 elements of practice. Cronbach's alpha coefficients were between 0.92 and 0.98 indicating good reliability. Mann–Whitney U tests demonstrated significant differences between clinical nurses and advanced practice nurses across 13 out of 15 elements of practice.

Conclusion

The CaN-SAT is a comprehensive, valid and reliable tool that can be used for cancer nurses to self-assess current skill levels, identify their learning needs and inform decisions about educational opportunities to optimise cancer care provision.

Patient or Public Contribution

The research team included three patient advocates from Cancer Voices NSW, who were actively involved in all aspects of the study and are listed as authors.

The Effectiveness of Telehealth Self‐Management Interventions to Improve the Health Outcomes of Adults Undergoing Haemodialysis: A Systematic Review and Meta‐Analysis

ABSTRACT

Background

Haemodialysis is a life-sustaining treatment for patients suffering from advanced chronic kidney disease that persists without respite. Adherence to complex haemodialysis regimens demands rigorous self-management. Current literature has suggested the potential of novel telehealth technologies in supporting the self-management of haemodialysis patients, but this remains inconclusive.

Aim

To synthesise available evidence to determine the effectiveness of telehealth self-management interventions on the health outcomes of adults undergoing haemodialysis.

Design

A systematic review and meta-analysis (reported according to the PRISMA Guidelines).

Methods

Nine electronic databases (PubMed, EMBASE, Cochrane Central Register of Controlled Trials, MEDLINE, CINAHL, PsycINFO, Scopus, Web of Science and ProQuest Dissertations & Theses Global), trial registries and grey literature were searched from inception till 1 December 2023 for randomised controlled trials on the effectiveness of telehealth self-management interventions for haemodialysis patients. Two independent reviewers performed screening, data extraction and risk-of-bias appraisal using Cochrane RoB tool-1. Meta-analyses using Review Manager Web synthesised the interventional effects. Cochrane GRADE assessed the overall quality of evidence.

Results

Fifteen randomised controlled trials (involving 1003 participants) were included. Telehealth self-management interventions had a medium statistically significant effect on improving self-efficacy (SMD = 0.54, 95% CI [0.25, 0.83], Z = 3.69, p = 0.0002). Additional meta-analyses for the outcomes of knowledge, treatment adherence, health-related quality of life, inter-dialytic weight gain and serum electrolyte levels were non-statistically significant but appeared promising to be improved by telehealth self-management. The overall certainty of evidence for all outcomes was very low.

Conclusions

This review provided insights into the clinical importance of telehealth self-management interventions in self-efficacy enhancement among haemodialysis patients. Future researchers are encouraged to optimise telehealth components relevant to the worldwide needs and cultural diversity of adults undergoing haemodialysis.

Implication for Professional Care

Adoption of technological healthcare delivery is vital in establishing positive health outcomes and sustainability of routine patient care pathways.

Patient or Public Contribution

None.

Registration: PROSPERO CRD42024438860

Nursing practices on sexual health for people with neurological disorders: A narrative review

Abstract

Aims

To identify and describe nursing practices on the sexual health of people with neurological disorders.

Design

Narrative review.

Methods

Data were extracted from 1 January 2002, to 20 May 2021. Inclusion criteria were nursing practices, sexual health and people with neurological disorders. The main outcome measures were: context of nursing practice implementation (assumptions, knowledge, strategies and skills), facilitators of and barriers to addressing and treating the sexual health of people with neurological disorders, and benefits of nursing practices in sexual health. PRISMA reporting guidelines were used.

Data Sources

PubMed, Embase, ScienceDirect and CINAHL.

Results

In total, 926 articles were identified and nine were included. The involvement of nurses was recommended in most studies. Assumptions about the impact of neurology on sexuality and nurse's role in sexual healthcare, biopsychosocial knowledge, and skills (ethical, interpersonal, and technical) were highlighted. We found that the modes of knowledge proposed by Carper were mobilized in an unequal way. Sexual difficulties were the key focus and eroticization concerns were not addressed in any of the articles.

Conclusion

Several studies advocate nursing intervention; however, few accurately present, detail and evaluate sexual health nursing practices of patients with neurological pathologies. Literature describes practices structured around disorders rather than the potentials, fails to address the brake of eroticism and provides little information on the results of interventions.

Implications for the Profession and/or Patient Care

Developing teaching programs on sexual health in nursing programs may be necessary if nurses are to support a diverse range of patients in an inclusive and positive manner. These programs should highlight the domain-specific knowledge that is mobilized.

Impact

Sexual health is a fundamental human right. Alterations in the nervous system have shown to affect sexual health, however, it is not often discussed among patients with neurological disorders, who are rarely provided with sexual health counselling. Our findings may impact healthcare professionals engaged in care with these patients.

Reporting Method

PRISMA.

No patient or public contribution.

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