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Nurse-led models of chemotherapy care: mixed economy or nurse–doctor substitution?

Nurse-led models of chemotherapy care: mixed economy or nurse–doctor substitution?
Nurse-led models of chemotherapy care: mixed economy or nurse–doctor substitution?
Aim: This paper reports a study exploring the perspectives of people affected by cancer (service users) and health care professionals' about current medical consultant-led services and the acceptability of a proposed nurse-led ambulatory chemotherapy service.

Background: A number of studies have evaluated a nurse-led model of cancer care delivery but little work has been undertaken in chemotherapy settings. Furthermore, many of these studies give little information on how the perspective of users was incorporated in the design and evaluation of these services.

Methods: Service users (n = 26) and health care professionals (n = 22) were recruited across the South East of England. A qualitative study was undertaken… Using a semi-structured interview schedule, participants were asked to give their perceptions of current chemotherapy services and the potential of a nurse-led service. A thematic analysis of data was undertaken.

Findings: This paper focuses on the theme of the current and future context of a chemotherapy service. Three sub-themes were identified: contextualizing roles, defining therapeutic outcomes, and demonstrating effectiveness. All interviewees saw this role as different but complementary to the role of medical staff. There were mixed opinions from service users and professionals on the acceptability of nurse-led chemotherapy provision. In defining potential outcomes of nurse-led care, service users described benefits in terms of service and economic outcomes. Professionals saw additional benefits in terms of patient-based outcomes. Professionals and service users expressed the need for appropriate education of nurses for this role and rigorous evaluation of any new service before widespread implementation.

Conclusions: Understanding the perspective of users is imperative when re-designing cancer nursing services. Implementation of nurse-led models in chemotherapy services should be preceded by staff education and followed by systematic evaluation.
cancer nursing, advanced practice, patient evaluation of care, chemotherapy, nurse-led services
0309-2402
244-252
Fitzsimmons, Deborah
4e282651-162f-48f0-bbf7-190c265279f2
Hawker, Sheila E.
e840ae96-7362-4d88-8390-92919131a66c
Simmonds, Peter
27d4c068-e352-4cbf-9899-771893788ade
George, Steve L.
bdfc752b-f67e-4490-8dc0-99bfaeb046ca
Johnson, Colin D.
e50aa9cd-8c61-4fe3-a0b3-f51cc3a6c74a
Corner, Jessica L.
eddc9d69-aa12-4de5-8ab0-b20a6b5765fa
Fitzsimmons, Deborah
4e282651-162f-48f0-bbf7-190c265279f2
Hawker, Sheila E.
e840ae96-7362-4d88-8390-92919131a66c
Simmonds, Peter
27d4c068-e352-4cbf-9899-771893788ade
George, Steve L.
bdfc752b-f67e-4490-8dc0-99bfaeb046ca
Johnson, Colin D.
e50aa9cd-8c61-4fe3-a0b3-f51cc3a6c74a
Corner, Jessica L.
eddc9d69-aa12-4de5-8ab0-b20a6b5765fa

Fitzsimmons, Deborah, Hawker, Sheila E., Simmonds, Peter, George, Steve L., Johnson, Colin D. and Corner, Jessica L. (2005) Nurse-led models of chemotherapy care: mixed economy or nurse–doctor substitution? Journal of Advanced Nursing, 50 (3), 244-252. (doi:10.1111/j.1365-2648.2005.03387.x).

Record type: Article

Abstract

Aim: This paper reports a study exploring the perspectives of people affected by cancer (service users) and health care professionals' about current medical consultant-led services and the acceptability of a proposed nurse-led ambulatory chemotherapy service.

Background: A number of studies have evaluated a nurse-led model of cancer care delivery but little work has been undertaken in chemotherapy settings. Furthermore, many of these studies give little information on how the perspective of users was incorporated in the design and evaluation of these services.

Methods: Service users (n = 26) and health care professionals (n = 22) were recruited across the South East of England. A qualitative study was undertaken… Using a semi-structured interview schedule, participants were asked to give their perceptions of current chemotherapy services and the potential of a nurse-led service. A thematic analysis of data was undertaken.

Findings: This paper focuses on the theme of the current and future context of a chemotherapy service. Three sub-themes were identified: contextualizing roles, defining therapeutic outcomes, and demonstrating effectiveness. All interviewees saw this role as different but complementary to the role of medical staff. There were mixed opinions from service users and professionals on the acceptability of nurse-led chemotherapy provision. In defining potential outcomes of nurse-led care, service users described benefits in terms of service and economic outcomes. Professionals saw additional benefits in terms of patient-based outcomes. Professionals and service users expressed the need for appropriate education of nurses for this role and rigorous evaluation of any new service before widespread implementation.

Conclusions: Understanding the perspective of users is imperative when re-designing cancer nursing services. Implementation of nurse-led models in chemotherapy services should be preceded by staff education and followed by systematic evaluation.

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More information

Published date: May 2005
Keywords: cancer nursing, advanced practice, patient evaluation of care, chemotherapy, nurse-led services

Identifiers

Local EPrints ID: 24334
URI: http://eprints.soton.ac.uk/id/eprint/24334
ISSN: 0309-2402
PURE UUID: 6d55738c-7a63-4154-9d55-461f573286e4

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Date deposited: 30 Mar 2006
Last modified: 08 Jan 2022 06:48

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Contributors

Author: Deborah Fitzsimmons
Author: Sheila E. Hawker
Author: Peter Simmonds
Author: Steve L. George
Author: Jessica L. Corner

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