EONS leads the way to recognition of cancer nursing in Europe with the RECaN project
Mary Wells, Professor of cancer nursing research and practice at the NMAHP Research Unit, University of Stirling, former EONS board member and current co-chair of the EONS Research Working Group reported on progress with Phase 1 of this important project
We all know that nurses are central to the care of patients with cancer, but recognition of cancer nursing across Europe is highly variable. In particular, there is little consensus on cancer nursing roles, specialisation, training and education needs for the continued growth of the profession in today’s climate. Demonstrating how and to what extent cancer nurses influence patient experiences and outcomes is essential if we are to improve our own and others’ understanding of the true value of cancer nursing.
Mary said: “For these reasons, the ECCO Board has decided that one of its top priorities is to advance the recognition of oncology nursing across Europe. This led to the set-up of this very important and breakthrough project that EONS is leading, called ‘Recognising European cancer nursing’ (RECaN). Launched in March 2016, it is our main focus for the next three years.”
The RECaN project is being led by EONS President, Daniel Kelly. It involves EONS Board members and all four EONS Working Groups. The project is being conducted in three phases:
- Phase 1 – systematic review of the value and impact of cancer nursing on patient experiences and outcomes
- Phase 2 – case study of four contrasting countries in Europe where nursing is at different stages of development
- Phase 3 – engaging with the OncoPolicy community to find ways of supporting and promoting cancer nursing across Europe
The Research Working Group (RWG) is chiefly responsible for carrying out Phase 1 – the systematic review – which is nearing its conclusion. Its ambitious goals were:
- To systematically identify the roles and types of intervention activities currently undertaken by cancer nurses
- To determine the effectiveness and cost-effectiveness of interventions delivered by cancer nurses in improving the experience and outcomes of people with cancer
Mary is leading the systematic review, with colleagues from the NMAHP Research Unit in Scotland, Dr Pauline Campbell and Ms Claire Torrens. She explained that the team have applied strict standards to the conduct of the review, searching ten different databases for all randomised and non-randomised controlled trials of cancer nursing interventions. Following an assessment of study quality, members of the EONS RWG have classified each intervention using the Omaha classification system in order to understand the nature of the interventions delivered by cancer nurses. The next stage is to compare the effectiveness of these interventions with standard care or no intervention.
Mary explained: “Previous reviews have found that specialist nurse-led interventions are at least as effective as others, including medically-led interventions, and some have shown improvements in quality of life. We expect our review to endorse these findings but also to go further, as ours is the first review to synthesise the evidence underpinning the impact and contribution made by cancer nurses across the whole spectrum of cancer nursing practice.”
Some conclusions and recommendations
Phase one is well on the way to delivering some very interesting results. They show that:
- the nursing contribution to cancer care and cancer research is significant and varied
- nurses are producing high quality, innovative and cutting edge research in cancer care
- nurse-led interventions are increasing in frequency and complexity.
But, Mary explained, there are also some gaps in the evidence: “For example, certain cancer groups or intervention types have been researched more than others. Our mapping of the evidence will enable us to make a number of important recommendations about future research areas.
Mary concluded: “These results can be used to underpin an international effort to set research priorities for cancer nursing, and improve the design, standardisation and reporting of nursing interventions and trials.
“EONS is in prime position to facilitate and co-ordinate this effort and to use the findings of RECaN to influence policy and practice across Europe. Working in partnership with ECCO is crucial to realising this ambition to ensure better recognition of cancer nursing.”