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Introduction: International and national guidelines highlight the need for general practitioner involvement during and after active cancer treatment and throughout long-term follow-up care. This paper aimed to evaluate patients' acceptance of radiation oncology shared follow-up care using the Theoretical Framework of Acceptability (TFA). Methods: This cross-sectional study was conducted at two cancer care centres in the Illawarra Shoalhaven region of Australia. A sample of patients scheduled for a radiation oncology follow-up consultation in 2021 were sent a 32-point self-complete paper-based survey. Data were analysed using descriptive, parametric and non-parametric statistical analysis. This paper followed the Checklist for Reporting of Survey Studies (CROSS). Results: Of the 414 surveys returned (45% response rate), the acceptance for radiation oncology shared cancer follow-up care was high (80%). Patients treated with only radiotherapy were 1.7 times more likely to accept shared follow-up care than those treated with multiple modalities. Patients who preferred follow-up care for fewer than three years were 7.5 times more likely to accept shared care than those who preferred follow-up care for five years. Patients who travelled more than 20 minutes to their radiation oncologist or to the rural cancer centre were slightly more likely to accept shared care than those who travelled less than twenty minutes to the regional cancer centre. A high understanding of shared care (Intervention Coherence) and a positive feeling towards shared care (Affective Attitude) were significant predictive factors in accepting shared radiation oncology follow-up care. Conclusion: Health services need to ensure patient preferences are considered to provide patient-centred cancer follow-up care. Shared cancer follow-up care implementation should start with patients who prefer a shorter follow-up period and understand the benefits of shared care. However, patients' involvement needs to be considered alongside other clinical risk profiles and organisational factors. Future qualitative research using the TFA constructs is warranted to inform clinical practice change. [ABSTRACT FROM AUTHOR]

Objectives: To examine in a sample of nurses working in acute-care wards, self-reported perceptions of the: 1) patient; family; nurse; doctor; and health system-related barriers to the provision of optimal end-of-life care to people who are dying in hospital; and 2) five barriers which, if removed, would lead to the greatest improvements in hospital-based end-of-life care. Background: Nurses play a central role in caring for dying patients and can offer a unique perspective about the factors that impact the quality of end-oflife care delivered in hospitals. Study design and methods: Two hundred and fifteen registered and enrolled nurses from three metropolitan and three rural hospitals across three health services completed a questionnaire-based, cross-sectional study between April 2016 and June 2017. Results: Nurses perceive that doctors continue to treat for too long (79% ranked as a large barrier); families have unrealistic expectations about a patient's prognosis (73%); junior doctors are unwilling to alter the decision of senior doctors (67%); doctors do not adequately explain the dying process (66%); and doctors have inadequate training in end-of-life care (66%). Nurses indicated that doctors reducing the length of active treatment and families having a more realistic expectation about life-expectancy would lead to the greatest improvement in end-oflife care in hospitals. Discussion: In this study of nurses working in a wide range of acute care settings across rural and metropolitan locations, substantial barriers to the provision of high-quality end-of-life care were perceived across all facets of healthcare provision. Important barriers included the continuation of potentially futile treatment, inadequacy of symptom control, and poor communication between doctors, patients and their families. Conclusion: Nurses perceive a range of patient; family; provider; and health system-related challenges to the provision of optimal end-of-life care in hospital. Findings highlight potential areas for improvement as part of a coordinated approach to optimising the provision of end-of-life care in hospitals. Future goals should include larger-scale, longitudinal studies across various states and territories to inform the development of interventions that can help to address the identified gaps in service provision. Implications for research, policy, and practice: This study has highlighted the need to involve all stakeholders when designing interventions to improve end-of-life care. Nurses can provide valuable insight into the factors that can make the greatest impact in improving care provision. It suggests that the provision of high-quality end-oflife care in hospitals is complex, and that there is substantial overlap between items nurses perceive to be barriers in each of the five domains of care provision. To achieve sustainable improvement in the quality of end-of-life care provided in hospitals, a multi-factorial, and collegial, approach to designing interventions will be needed. What is already known about the topic? • End-of-life care is increasingly being provided in hospital settings. • Nurses are an important source of information and support for dying patients and their families. • Few studies have explored nurses' perceptions of the barriers to the provision of high-quality end-oflife care across all domains of healthcare provision. What this paper adds: • Important barriers include continuation of potentially futile treatment, adequacy of symptom control, and poor communication between doctors, patients, and their families. • Findings can support the design of more effective intervention strategies to mitigate identified barriers and achieve improvements in the quality of end-of-life care delivered in hospital. [ABSTRACT FROM AUTHOR]

Objective The main aim of this study was to explore any association between colorectal cancer (CRC) and rotating shift work in nurses and midwives. The secondary aim of this study was to identify risk factors for CRC in nurses and midwives who are rotating shift workers. Design Cross-sectional study. Setting Electronic survey of participants from Australia, New Zealand and the United Kingdom. Subjects A sample of 8,199 male and female nurses and midwives from Australia, New Zealand and the United Kingdom invited through their registration papers or newsletter advertisement. Main outcome measure Prevalence of CRC in participants who have worked rotating shifts for 1-14 years or ≥15 years compared to participants who have never worked rotating shifts. In addition, risk factors for CRC in the rotating shift work population were analysed in a multivariate logistic regression model in order to obtain odds ratio of CRC. Results No statistically significant difference was found in the prevalence of CRC between those who have never worked rotating shift work, worked 1-14 years and worked 15 or more years. Among rotating shift workers, diabetes was associated with a 123-fold (95% CI 39-392; p<0.001) increased odds of CRC, while Inflammatory Bowel Disease (IBD) was associated with a 190-fold (95%CI 68-526; p<0.001) increased odds of CRC. Screening colonoscopy or sigmoidoscopy for CRC was associated with a 10-fold (95% CI 3-35; p<0.001) increased odds of being diagnosed with CRC. Conclusion No significant association was found between rotating shift work and colorectal cancer in nurses and midwives. In nurses and midwives who are rotating shift workers, diabetes, IBD and CRC screening significantly increased the odds of CRC. [ABSTRACT FROM AUTHOR]