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Workforce characteristics and interventions associated with high-quality care and support to older people with cancer: a systematic review

Workforce characteristics and interventions associated with high-quality care and support to older people with cancer: a systematic review
Workforce characteristics and interventions associated with high-quality care and support to older people with cancer: a systematic review
Objectives: to provide an overview of the evidence base on the effectiveness of workforce interventions for improving the outcomes for older people with cancer, as well as analysing key features of the workforce associated with those improvements.

Design: systematic review.

Methods: relevant databases were searched for primary research, published in English, reporting on older people and cancer and the outcomes of interventions to improve workforce knowledge, attitudes or skills; involving a change in workforce composition and/or skill mix; and/or requiring significant workforce reconfiguration or new roles. Studies were also sought on associations between the composition and characteristics of the cancer care workforce and older people's outcomes. A narrative synthesis was conducted and supported by tabulation of key study data.

Results: studies (n=24) included 4555 patients aged 60+ from targeted cancer screening to end of life care. Interventions were diverse and two-thirds of the studies were assessed as low quality. Only two studies directly targeted workforce knowledge and skills and only two studies addressed the nature of workforce features related to improved outcomes. Interventions focused on discrete groups of older people with specific needs offering guidance or psychological support were more effective than those broadly targeting survival outcomes. Advanced Practice Nursing roles, voluntary support roles and the involvement of geriatric teams provided some evidence of effectiveness.

Conclusions: an array of workforce interventions focus on improving outcomes for older people with cancer but these are diverse and thinly spread across the cancer journey. Higher quality and larger scale research that focuses on workforce features is now needed to guide developments in this field, and review findings indicate that interventions targeted at specific subgroups of older people with complex needs, and that involve input from advanced practice nurses, geriatric teams and trained volunteers appear most promising.
2044-6055
Bridges, Jacqueline
57e80ebe-ee5f-4219-9bbc-43215e8363cd
Lucas, Grace
c26bafa2-1ccc-4bf9-bbf4-b43314339a3e
Wiseman, Theresa
e3ff42ae-97ef-4640-af3d-40eeae830df9
Griffiths, Peter
ac7afec1-7d72-4b83-b016-3a43e245265b
Bridges, Jacqueline
57e80ebe-ee5f-4219-9bbc-43215e8363cd
Lucas, Grace
c26bafa2-1ccc-4bf9-bbf4-b43314339a3e
Wiseman, Theresa
e3ff42ae-97ef-4640-af3d-40eeae830df9
Griffiths, Peter
ac7afec1-7d72-4b83-b016-3a43e245265b

Bridges, Jacqueline, Lucas, Grace, Wiseman, Theresa and Griffiths, Peter (2017) Workforce characteristics and interventions associated with high-quality care and support to older people with cancer: a systematic review. BMJ Open. (doi:10.1136/bmjopen-2017-016127).

Record type: Article

Abstract

Objectives: to provide an overview of the evidence base on the effectiveness of workforce interventions for improving the outcomes for older people with cancer, as well as analysing key features of the workforce associated with those improvements.

Design: systematic review.

Methods: relevant databases were searched for primary research, published in English, reporting on older people and cancer and the outcomes of interventions to improve workforce knowledge, attitudes or skills; involving a change in workforce composition and/or skill mix; and/or requiring significant workforce reconfiguration or new roles. Studies were also sought on associations between the composition and characteristics of the cancer care workforce and older people's outcomes. A narrative synthesis was conducted and supported by tabulation of key study data.

Results: studies (n=24) included 4555 patients aged 60+ from targeted cancer screening to end of life care. Interventions were diverse and two-thirds of the studies were assessed as low quality. Only two studies directly targeted workforce knowledge and skills and only two studies addressed the nature of workforce features related to improved outcomes. Interventions focused on discrete groups of older people with specific needs offering guidance or psychological support were more effective than those broadly targeting survival outcomes. Advanced Practice Nursing roles, voluntary support roles and the involvement of geriatric teams provided some evidence of effectiveness.

Conclusions: an array of workforce interventions focus on improving outcomes for older people with cancer but these are diverse and thinly spread across the cancer journey. Higher quality and larger scale research that focuses on workforce features is now needed to guide developments in this field, and review findings indicate that interventions targeted at specific subgroups of older people with complex needs, and that involve input from advanced practice nurses, geriatric teams and trained volunteers appear most promising.

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Accepted/In Press date: 10 April 2017
e-pub ahead of print date: 31 July 2017

Identifiers

Local EPrints ID: 414885
URI: https://eprints.soton.ac.uk/id/eprint/414885
ISSN: 2044-6055
PURE UUID: 96885375-ce35-44f1-a90b-878651953861
ORCID for Jacqueline Bridges: ORCID iD orcid.org/0000-0001-6776-736X
ORCID for Theresa Wiseman: ORCID iD orcid.org/0000-0002-3355-1269
ORCID for Peter Griffiths: ORCID iD orcid.org/0000-0003-2439-2857

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Date deposited: 13 Oct 2017 16:30
Last modified: 14 Mar 2019 01:37

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Contributors

Author: Grace Lucas
Author: Theresa Wiseman ORCID iD
Author: Peter Griffiths ORCID iD

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