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Women with a pathogenic mutation in the BRCA1 or BRCA2 genes have an elevated lifetime risk of developing breast and ovarian cancer. To address this risk, women are managed with a combination of surveillance and/or risk-reduction strategies. Decisions about risk management strategies can be complex, personal and multifactorial. Women often struggle with the decision-making process. In addition, within the clinical environment, there may be variations in recommendations between clinicians that can leave women uncertain and less able to choose a risk management pathway. The overall aim of this project is the development of a web-based patient decision aid toolkit for BRCA mutation carriers that will improve the decision-making process by providing the user with information about their cancer risk, options for risk management and potential benefits and side effects. Development of the patient decision aid was guided by the International Patient Decision Aid Standards (IPDAS). With appropriate ethical approval, a mixed methods approach was used to identify suitable content for the decision aid. A decision-making needs assessment was conducted to identify the information needs of women with a BRCA mutation. Semi-structured interviews were held with cancer unaffected BRCA mutation carriers (n = 16) and key stakeholders including healthcare professionals, policy makers and patient group representatives (n= 10). Data were analysed by thematic analysis. Systematic scoping reviews were conducted to synthesise relevant evidence on risk-management options, benefits, harms and the development and testing of patient decision aids in general. Content for the decision aid was refined using a Delphi process to build consensus on items for inclusion in the decision aid amongst a diverse panel of experts (n=13). A prototype patient decision aid was developed which included written information as well as visual depictions of risk, videos and photographs to enhance the patient’s information experience. A ‘values clarification’ activity was included to enable women to work through their own values and preferences relating to risk management interventions and their associated benefits and side-effects. Initial ‘sandpit’ testing of the decision aid prototype was performed by the research team and advisory group. Usability testing was conducted with BRCA mutation carries (n = 8) and healthcare professionals (n = 8) using both qualitative interviews and quantitative surveys. The research team made final revisions to the decision aid based on participant feedback and committee consensus. This evidence-based patient decision aid can be used by BRCA mutation carriers unaccompanied or during a clinical consultation. We envisage that this decision aid will improve the decision-making process by assisting women and clinicians during shared decision-making regarding cancer risk management. Citation Format: Sarah A. McGarrigle, Carol Spillane, Niamh Byrne, Manria Polus, Geraldine Prizeman, Amanda Drury, Elizabeth Connolly, Anne-Marie Brady, Yvonne Hanhauser. A web-based Patient Decision Aid Toolkit for unaffected BRCA mutation carriers [abstract]. In: Proceedings of the 2022 San Antonio Breast Cancer Symposium; 2022 Dec 6-10; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2023;83(5 Suppl):Abstract nr P1-08-10.

To establish an understanding of the unmet needs of people living with or beyond a lymphoma diagnosis. Survivors of lymphoma are at increased risk of unmet needs due to cancer, treatment-related toxicities and extended survivorship. Despite the rapidly growing numbers of lymphoma survivors, their needs and research priorities are underserved and undervalued, therefore left largely unaddressed.A rapid review method and reflexive thematic analysis approach assimilated current knowledge. Eligibility criteria included quantitative, qualitative, or mixed approaches employing cross-sectional, longitudinal, cohort or review designs focused on the needs of adult lymphoma survivors (any subtype or stage of disease). Five databases: CINAHL, EMBASE, Medline, PsycInfo and Scopus, were systematically searched.Forty-seven studies met the inclusion criteria via a stringent screening process facilitated by NVivo. Almost 60 per cent of articles were published within the last five years and investigated a homogenous lymphoma sample. Most studies employed quantitative approaches (77%) and cross-sectional designs (67%). Studies were of high methodological quality. Five major themes were identified: disparity in health service delivery, the psychological impact of cancer, impactful and debilitating concerns, the monetary cost of survival and insufficient provision of survivorship information. A meta-analytical approach was not feasible due to the breadth of methodologies of included studies.This review shows that lymphoma survivors experience a myriad of unmet needs across multiple domains, reinforcing the need for lymphoma-specific research. However, more research is needed to advance and achieve informed decision-making relating to survivorship care, placing due attention to the needs and research priorities of lymphoma survivors.

Purpose This study aims to explore the prevalence of CRC survivorship issues and their impact on survivors’ quality of life (QoL). Methods This study utilised a mixed methods sequential explanatory design. Adult CRC survivors between 6- and 60-months post-diagnosis (n = 304) were purposively recruited from three hospitals and twenty-one cancer support centres in Ireland. QoL was evaluated using the EuroQol and FACT-C questionnaires and results compared to population norms. 22 survey participants took part in semi-structured interviews exploring the impact of survivorship issues on their daily lives. Results While CRC survivors reported QoL outcomes comparable to or better than normative populations, 54% were dissatisfied with their QoL. The most common survivorship issues reported included negative body image (74%), fatigue (68%), sexual dysfunction (66%) and sleep disturbance (59%). Thematic analysis of the qualitative data illustrated survivors’ attempts to live with the impact of cancer and its treatment (loss, fear, impact) and striving to contextualise, reframe and understand the consequences of cancer and its treatment (control, vigilance, benefit). Within these themes, the cross-domain impact of less prevalent symptoms including bowel dysfunction (28–57%) and peripheral neuropathy (47%) were widely discussed. Conclusions Although cancer survivors report positive QoL outcomes, many experience distressing physical, psychological and social effects. The findings suggest less common and difficult to manage symptoms are the greatest source of distress and unmet need. Support and information must be tailored to address survivors’ individual needs and preferences for support, informed by holistic person-centred assessment.

Background Cancer can be distressing for patients and families. eHealth interventions have the potential to lessen this distress by creating opportunities for providing supportive care resources to patients at home. Objectives This article reviews supportive care eHealth interventions in cancer and emerging opportunities to optimize these interventions for diverse populations across the cancer trajectory. Methods A narrative literature review was conducted to evaluate eHealth supportive care for patients with cancer, including effective interventions, accessibility and interactivity issues, patient-reported outcomes, and strategies to improve care for older adults. Findings To ensure that patients with cancer and their family members benefit from supportive care eHealth interventions, nurses need to understand how to leverage such interventions to improve care.

Background: Specialist nursing care is a core indicator of quality care for people living with advanced breast cancer. However, access to and quality of nurse education programmes in advanced breast cancer is variable. Objectives: This study aims to define the topics for inclusion in an international curriculum for an advanced breast cancer education programme.Methods: A modified four-round Delphi study was undertaken with experts by profession and experience in advanced breast cancer. Thirty-four topics related to advanced breast cancer and six online teaching and learning methods were pre-selected following a systematic review. Between September 2021 and March 2022, the expert panel determined the importance of topics for inclusion in the education programme. Consensus was defined by at least 80 % agreement on the highest three points on a 9-point Likert scale. Results: A total of 31 experts participated in rounds 1-3 of this study, and 156 experts by profession and expe-rience participated in an additional fourth round, including people living with advanced breast cancer (n = 72, 46 %), healthcare professionals (n = 46, 29 %), family members or caregivers of a person diagnosed with advanced breast cancer (n = 30, 19 %) and advocacy professionals working in the area of advanced breast cancer (n = 8, 5 %). In round 4, 36 topics and five of six learning methods reached consensus.Conclusions: The results of this study provide a framework to develop education programmes in advanced breast cancer, defining the essential elements of curriculum content for such programmes. The results highlight the need for advanced breast cancer education programmes to use multiple teaching and learning methods to pro-mote nurses' understanding of person-centred supportive care and the physical, psychosocial and spiritual issues experienced by people living with advanced breast cancer.

Breathlessness support services have demonstrated benefits for breathlessness mastery, quality of life and psychosocial outcomes for people living with breathlessness. However, these services have predominantly been implemented in hospital and home care contexts. This study aims to evaluate the adaptation and implementation of a hospice-based outpatient Multidisciplinary Breathlessness Support Service (MBSS) in Ireland. A sequential explanatory mixed methods design guided this study. People with chronic breathlessness participated in longitudinal questionnaires ( n = 10), medical record audit ( n = 14) and a post-discharge interview ( n = 8). Caregivers ( n = 1) and healthcare professionals involved in referral to ( n = 2) and delivery of ( n = 3) the MBSS participated in a cross-sectional interview. Quantitative and qualitative data were integrated deductively via the pillar integration process, guided by the RE-AIM framework. Integration of mixed methods data enhanced understanding of factors influencing the reach, adoption, implementation and maintenance of the MBSS, and the potential outcomes that were most meaningful for service users. Potential threats to the sustainability of the MBSS related to potential preconceptions of hospice care, the lack of standardized discharge pathways from the service and access to primary care services to sustain pharmacological interventions. This study suggests that an adapted multidisciplinary breathlessness support intervention is feasible and acceptable in a hospice context. However, to ensure optimal reach and maintenance of the intervention, activities are required to ensure that misconceptions about the setting do not influence willingness to accept referral to MBSS services and integration of services is needed to enable consistency in referral and discharge processes.

Background: Patient-reported outcomes (PROs) are key indicators of health status and functioning, coming directly from the patient. Comprehensive monitoring of PROs enables implementation of person-centred care. Currently, the PROs that patients with advanced renal cell carcinoma (RCC) or hepatocellular carcinoma (HCC) consider of greatest importance remains unknown. Methods: A rapid literature review was carried out to identify PROs commonly reported in clinical studies of patients with advanced RCC/HCC. We searched MEDLINE, CINAHL & PsycInfo for relevant peer-reviewed publications in the period from 2000 to 2021. Pre-specified selection criteria were applied to all retrieved records. Findings were integrated into a narrative synthesis. Results: Eighty-one studies met our selection criteria and were retained. Most research was on advanced RCC (n = 64, 79%); 46 studies (57%) were drug trials. Only twenty-six studies (32%) employed PROs as their primary endpoint. Most PROs concerned physical symptoms (45% RCC, 54% HCC) and emotional wellbeing (19% RCC, 16% HCC). The most common outcome measured was quality of life (65% of the total), followed by fatigue (62%) and pain (54%). Whether selection of these PROs was patient-driven was not reported. Conclusions: A wide range of PROs were assessed. Deficits in PROs often cause patients to seek out help; however, which PROs matter the most to people with advanced RCC/HCC must be further clarified. Targeting, monitoring, and responding to the ‘right’ PROs can enhance provision of person-centred care in advanced RCC/HCC and augment the clinical efficacy of established and emerging targeted therapies.

Objectives: This article provides practical guidance on developing a comprehensible abstract, including those required for funding applications, conferences, and publication. In addition, we discuss and demonstrate the practicalities of editing and revising an abstract for conference or peer review and identify emerging formats that may be more relevant to nurses and researchers. Data Sources: This article has been informed by literature and the coauthors' respective experiences of preparing and reviewing abstracts for publication and conference presentation. Conclusion: Abstracts are a valuable tool to communicate the most important elements of the methods and results of a research project for a conference, manuscript, or even a research funding application. However, abstracts may often be an overlooked part of the dissemination process. An abstract determines whether or not a piece of research is relevant for presentation at a conference or valuable enough to be considered for peer review and subsequent publication. A strong and clearly written abstract positively predisposes reviewers of grant applications. Implications for Nursing Practice: Writing an abstract is arguably the most challenging component of academic writing, summarizing the results of a substantive research project in three to five sentences and positioning them concisely within the background and implications for future practice, policy, and research. A well-written abstract is clear, concise, and critical and requires time and revision to ensure success. © 2023 The Author(s)

Purpose Identifying cancer nursing research priorities is central to influencing the direction of cancer care research. The aim of this rapid review was to explore research priorities identified by oncology nurses for cancer care delivery between 2019-2022. Methods The Preferred Reporting Items for Systematic Reviews and Meta-Analysis informed the design of the rapid review. MEDLINE, CINAHL, PUBMED, Web of Science, and Cochrane databases were searched for studies published between December 1st, 2018, and September 30th, 2022. This timeframe was chosen to account for the latest relevant evidence synthesis, as well as changes in cancer care necessitated by the COVID-19 pandemic. The Quality Assessment of Diverse Studies tool was used to appraise quality. Results Four studies met the inclusion criteria. Many of the research priorities identified were influenced by the COVID-19 pandemic. The top cancer nursing research priority identified was the role of technology in improving patient and caregiver symptoms and health outcomes. Other most prevalent research priorities were focused on symptom management, culturally sensitive palliative and psychosocial care, early/integrated palliative care, financial toxicity, modifiable risk factors related to social determinants of health, public and patient involvement in research, and oncology nurses' well-being and scope of practice. Conclusion The findings indicate a need to steer a strategic programme of cancer nursing research towards digitalisation in cancer care to meet the current needs of people living with cancer and their caregivers. However, cancer nurses' burnout, staff shortages and disparities in specialist education will hinder the implementation of certain models of care.

Cancer nursing has evolved to meet the demands of rising cancer incidence, newer and more complex treatment options, and the emergence of specialist roles supporting patients from pre-diagnosis, through treatment, survivorship and end of life care. Nurses are involved in direct and in-direct care of people at risk of, and living with and after cancer in diverse contexts. As a result, nurses are positioned to have a significant influence on the processes and outcomes of cancer care, through education, research, policy, practice and leadership. However, nursing and cancer care face challenges, arising from workforce shortages, under-investment in services and under-representation in decision-making. This paper discusses the evolution of cancer nursing across education, policy, research, profession and practice, and sets an agenda for innovation and disruption across these domains to ensure sustainability of cancer care services and care for people living with and after cancer. We argue for the continued advancement of cancer nursing with critical focus on identifying and addressing inequities in role recognition and access to specialist cancer nursing education throughout Europe. Partnership, exchange of learning, and co-design will be central to progressing education, evidence and policy to support future growth in the cancer nursing workforce and embed cancer nurses in research and policy setting at local, national and international levels.

Objectives: There is little research to help health care professionals understand what patient outcomes are considered a priority in advanced liver or kidney cancer. Knowing what is important to patients can help promote person-centered approaches to treatment and disease management. The aim of this study was to identify those patient-reported outcomes (PROs) that patients, carers, and health care professionals consider as “core” when providing care to those with advanced liver or kidney cancer. Data sources: A three-round Delphi study was undertaken to ask experts by profession or experience to rank PROs identified from a previous literature review. Fifty-four experts, including people living with advanced liver or kidney cancer (44.4%), family members and caregivers (9.3%), and health care professionals (46.8%), reached consensus on 49 PROs including 12 new items (eg, palpitations, hopefulness, or social isolation). Items with the highest rate of consensus included quality of life, pain, mental health, and capacity to do daily activities. Conclusion: People living with advanced liver or kidney cancer experience complex health care needs. Some important outcomes were not actually captured in practice in this population and were suggested as part of this study. There are discrepancies between the views of health care professionals, patients, and family in what is important, highlighting the need of using measures to facilitate communication. Implications for Nursing Practice: Identification of priority PROs reported here will be key to facilitate more focused patient assessments. The actual use of measures in cancer nursing practice to allow monitoring of PROs must be tested for feasibility and usability.

Mixed methods research offers a unique opportunity to advance understanding of a phenomenon. However, practical guidance on the use of mixed methods to develop theoretical frameworks is limited. We present a novel adaptation of the Pillar Integration Process (PIP) to support development and refinement of a theoretical framework explaining the processes by which healthcare factors influence cancer survivors’ quality of life. Deductive integration of quantitative and qualitative data, guided by an a priori conceptual model, illuminates the nuances of the relationship between the concepts of interest, producing a theoretical framework, the Model of Healthcare factors influencing Quality of Life in Cancer Survivorship (MoHaQ-CS).

Access to comprehensive, integrated, multidisciplinary care is one of the most urgent and actionable recommendations of the Advanced Breast Cancer Global Alliance. However, access to specialist breast care units, and specialist breast cancer nurses is variable, influenced by access to specialist education and role recognition. To date, there has not been a synthesis of evidence regarding educational programmes related to advanced breast cancer education for nurses.The aim of this review was to determine the content, mode of delivery, assessment and outcomes of education programmes related to advanced breast cancer for nurses.A systematic review was undertaken, according to the Joanna Briggs Institute's mixed methods review methodology.MEDLINE, PUBMED, CINAHL, Scopus, PsycInfo, Joanna Briggs Institute, Web of Science and grey literature sources were systematically searched. Eleven publications met the inclusion criteria. Data relating to programme content, mode of delivery, assessment and outcomes were extracted and analysed.This review identifies a limited number of educational programmes within this specialist area of nursing practice. Shortcomings in the development, implementation and evaluation of advanced breast cancer education programmes included limited use of educational standards, theoretical frameworks and patient and public involvement to inform programme development. Evaluation of education programmes related to advanced breast cancer relied predominantly on self-reported learning, with limited consideration of the impacts of education on service delivery, patient experience or quality of care.Future development of advanced breast cancer education programmes must consider the alignment of programme content and learning outcomes with existing educational and competency standards. Evaluation of educational programmes in this field must endeavour to enhance rigour of methods, incorporating standardised questionnaires, and multiple methods and sources of data to evaluate the broader impacts of advanced breast cancer education for nurses.

IntroductionWomen who inherit a pathogenic mutation in Breast Cancer Susceptibility Genes 1 or 2 (BRCA1 or BRCA2) are at substantially higher risk of developing breast and ovarian cancer than the average woman. Several cancer risk management strategies exist to address this increased risk. Decisions about which risk management strategies to choose are complex, personal and multifactorial for these women. This scoping review will map evidence relevant to cancer risk management decision making in BRCA mutation carriers without a personal history of cancer. The objective is to identify and describe the features of patient decision aids that have been developed for BRCA mutation carriers. This information may be beneficial for designing new decision aids or adapting existing decision aids to support decision making in this population.Methods and analysisThis scoping review will be conducted according to the Joanna Briggs Institute’s scoping review methodological framework. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews checklist will be used for guidance. Studies on decision aids for women with a BRCA mutation who are unaffected by breast or ovarian cancer will be considered for inclusion. Five electronic databases will be searched (MEDLINE, EMBASE, Cochrane Library, CINAHL, Web of Science) with no restrictions applied for language or publication date. Studies for inclusion will be selected independently by two review authors. Data will be extracted using a predefined data extraction form. Findings will be presented in tabular form. A narrative description of the evidence will complement the tabulated results.Ethics and disseminationEthical approval for conducting this scoping review is not required as this study will involve secondary analysis of existing literature. Findings will be published in a peer-reviewed journal and presented at relevant conferences.

Background: Healthcare services have responded to the challenges of service delivery during COVID-19 with telehealth and hybrid models of care. However, there is limited understanding of the experiences of care among people affected by cancer and how their experiences may change and evolve against the shifting landscape of COVID-19 incidence, mortality, vaccination and refinements in service delivery. Objectives: This study explores the experiences of cancer care among people affected by cancer in Ireland during the COVID-19 pandemic. This paper presents the results of the initial cross-sectional semi-structured interviews and the longitudinal qualitative research design which will be employed in this study. Design: A longitudinal descriptive qualitative study. Setting: Ireland. Participants: People living with and after cancer or caring for someone with cancer during the COVID-19 pandemic. Methods: Participants were recruited to the study via social media advertisements and consented to participate in up to three semi-structured interviews between January and July 2021. Initial semi-structured interviews were conducted with 16 participants in January 2021. Participants completed measures of resilience (2-item Connor-Davidson Resilience Scale) and distress (The National Comprehensive Cancer Network Distress Thermometer). Interviews were recorded, transcribed and analyzed thematically. Results: Participants reported low levels of distress and moderate to high levels of resilience on average. Three themes were generated from analysis of the first phase of cross-sectional interviews. Participants described a counterbalance of being cautious of infection and keeping safe through prevention and shielding strategies. Although hospitals felt safe and were working efficiently, some participants felt COVID-19 had compromised person-centredness and empathy in care. While participants valued the restrictions being taken to minimize infection risk, substitution of face-to-face appointments with telehealth services and attending essential face-to-face appointments alone restricted participants' access to professional and social support. Despite this, many participants felt public health measures to reduce transmission of COVID-19 had created a sense of not missing out, feeling safe and reduced difficult social interactions requiring explanation of their diagnosis. Conclusions: There is an opportunity to learn from the experiences of healthcare delivery from the perspectives of people affected by cancer during the COVID-19 pandemic. The results highlight the complexities and dualities of living with, after or caring for someone with cancer during the COVID-19 pandemic. Opportunities for longitudinal qualitative research to explore the evolving experiences, concerns and persistent and emerging unmet information and clinical needs within the rapidly changing socio-political, socio-cultural and healthcare contexts of the COVID-19 pandemic are highlighted.

Purpose Quality supportive care during cancer survivorship contributes to positive physical and psychosocial health. However, the potential positive impacts are influenced by survivors' perceptions of and ability to access the supportive care services that they deem important to their well-being. The purpose of this integrative review was to examine cancer survivors’ preferences for the organization and delivery of supportive care services in the post-treatment period. Methods We conducted a systematic search for relevant quantitative, qualitative and mixed methods studies. Included studies were analyzed using directed content analysis, focused on models of care and type of provider, site of care, specialized services, structural supports through transitions, and sources of information. Results Sixty-nine studies were included. Overall, survivors' preferences are not static and fluctuate over time based on their perceived health needs, concerns and points of transition in care. While specialist supportive care led by consultant oncologists is often identified as the preferred model of care, survivors’ also express preferences for integrated and shared models of care, involving oncology nurses , primary care and multidisciplinary professionals to optimise coordination and impact of supportive care. Flexibility in care delivery, leveraging technology and expertise, was preferred to ensure convenient and timely access to supportive care. Conclusions Cancer survivors express preferences for the organization and delivery of supportive care in the post-treatment phase that fluctuate based on their perceived health needs. The development of novel survivorship health services must consider survivors’ preferences and allow flexibility in care delivery to facilitate engagement, uptake, and effectiveness.

Background: There is limited understanding of how the experiences of people with cancer may change and evolve against the shifting landscape of COVID-19 incidence, mortality, vaccination and healthcare delivery. This study aimed to explore the experiences of cancer care among people affected by cancer during the COVID-19 pandemic using a longitudinal qualitative study design. Methods: Participants were recruited to this longitudinal descriptive qualitative study via social media advertisements. Sixteen semi-structured interviews were conducted with people living with, after or caring for someone with cancer at three timepoints over a six-month period during the COVID-19 pandemic. Interviews were recorded, transcribed and analysed thematically. Results: Participants described feeling afraid and keeping safe through prevention and shielding strategies. Some had been vaccinated by phase 2 but many had not. Although hospitals felt safe and efficient, some participants felt COVID-19 restrictions were being used an excuse for compromised care. Substitution of face-to-face appointments with telehealth services restricted participants' access to professional and social support and reliable information. In phase one participants felt public health measures to reduce transmission of COVID-19 had created a sense of not missing out, but this feeling had largely shifted by phase 2 and the continued restrictions on social interactions amplified feelings of isolation. Conclusions: This study highlights opportunities for longitudinal qualitative research to explore evolving experiences of people with cancer in the context of changing socio-cultural and healthcare provision during the COVID-19 pandemic. Legal entity responsible for the study: The authors. Funding: National University of Ireland, Galway, Ireland;Promotions Project Phase 2 Research Consolidation Grant. Disclosure: All authors have declared no conflicts of interest.

Purpose To conduct an integrative scoping review of the physical, psychological and social experiences of women who have experienced chemotherapy-induced alopecia (CIA). Method An integrative review was undertaken. A systematic search of MEDLINE, CINAHL and PsycInfo identified 23 studies meeting the inclusion criteria. Data relating to women's experiences of alopecia was extracted and synthesized thematically. Results Four analytical themes were formed; ‘the physical and psychological effect of alopecia’, ‘more than the loss of hair’, ‘the complexities of a visual cancer identity’ and ‘coping with new internal and external relationships’. CIA involves a public and private representation of illness which disrupts women's identity and their acceptance in public, yet this is a highly individualised experience. There is disparity in current evidence regarding the experience of CIA for women among older age groups, with rarer forms of cancer, haematological malignancies and those receiving palliative care or targeted treatment modalities. Conclusions This review highlights the continued pervasive psychosocial implications arising from CIA, however this is not exclusive to scalp hair as alopecia from the face and body has also been found to require adaptation and effective coping. Limited knowledge exists on the experience of alopecia induced by treatment for haematological cancers and rarer-tumour groups and emerging systemic anti-cancer treatment modalities. Healthcare professionals must endeavour to support and discuss the potential risks of alopecia, and provide patients with an opportunity to voice their fears, concerns, and experiences of CIA. Future research should incorporate the identified underserved populations and the experience of newer therapies.

ObjectiveCancer survivors’ perceptions of healthcare have been identified as a predictor of quality of life (QoL) outcomes. This study aims to explore colorectal cancer (CRC) survivors’ perceptions of how cancer-related healthcare affects their QoL.MethodsSemistructured interviews were conducted with 22 CRC survivors receiving follow-up care between 1 and 5 years post diagnosis. Interviews were recorded, transcribed and analysed thematically.ResultsFive themes described the impact of healthcare experiences on CRC survivors’ QoL. While cancer survivors spoke positively of their relationships with healthcare professionals, many experienced a range of unmet information and supportive care needs. Participants described a range of positive and negative experiences, as power dynamics and navigation of healthcare systems had implications for their QoL. Where negative healthcare events aligned, survivors’ autonomy, dignity and confidence were undermined, and survivorship issues could be inadequately addressed. To address persistent unmet needs, survivors developed a safety net(work) of supports to bridge the gap of unmet needs in healthcare with varying outcomes.ConclusionsCancer survivors’ experience of follow-up and healthcare can positively or negatively affect their QoL. Preparation for cancer survivorship must be incorporated into the acute phase of diagnosis and treatment and interlinked with clear pathways of survivorship care and accessible supportive care, which support survivors to be equal partners in their healthcare. Understanding cancer survivors’ knowledge, expertise and mastery of their condition is essential to ensure delivery of person-centred supportive care that adequately addresses the survivor’s unmet needs.

The European Academy of Nursing Science (EANS) is an independently organised body comprising individuals who have made significant contributions to the advancement of nursing science in Europe through scholarship and research (European Academy of Nursing Science, 2015). Established in 1998, EANS aims to be the leading nursing academy providing inspiration, collaboration and academic leadership in Europe. The academy provides a forum for established and early nurse researchers to develop a European perspective and collaborations to their work. One of its central activities is an annual doctoral summer school, where nurse doctoral candidates from across Europe gain exposure to a common European perspective on nursing research. Participants attend three consecutive summer schools held across Europe. A two day EANS conference is held during the summer school, attended by members of EANS, and second year students are expected to prepare and present a formal debate as part of the conference proceedings. Students work in six randomly allocated multistate groups where three groups prepare material in support of a motion, three against it. The 2015 EANS summer school and conference were held in Barcelona, Spain. Debate is a unique opportunity to prepare an argument for or against a motion based on evidence – whether or not they subscribe to the position they are asked to support. Preparation within teams where for most English is not the first language and coming from a wide range of nursing and geographical backgrounds presents opportunities and challenges in equal measure. Debate allows important issues to be explored thoroughly in

Purpose Previous conceptualizations of cancer survivorship have focused on heterogeneous cancer survivors, with little consideration of the validity of conclusions for homogeneous tumour groups. This paper aims to examine the concept of cancer survivorship in the context of colorectal cancer (CRC). Method Rodgers’ (1989) Evolutionary Method of Concept Analysis guided this study. A systematic search of PUBMED, CINAHL, PsycINFO and The Cochrane Library was conducted in November 2016 to identify studies of CRC survivorship. The Braun and Clarke (2006) framework guided the analysis and interpretation of data extracted from eighty-five publications. Results Similar to general populations of cancer survivors, CRC survivors experience survivorship as an individual, life-changing process, punctuated by uncertainty and a duality of positive and negative outcomes affecting quality of life. However, CRC survivors experience specific concerns arising from the management of their disease. The concept of cancer survivorship has evolved over the past decade as the importance of navigating the healthcare system and its resources, and the constellation of met and unmet needs of cancer survivors are realised. Conclusions The results highlight core similarities between survivorship in the context of CRC and other tumour groups, but underlines issues specific to CRC survivorship. Communication and support are key issues in survivorship care which may detrimentally affect CRC survivors' well-being if they are inadequately addressed. Healthcare professionals (HCP’s) therefore have a duty to ensure cancer survivors’ health, information and supportive care needs are met in the aftermath of treatment.

Background Follow-up care and surveillance are essential components of colorectal cancer survivorship. However, the relative contribution of healthcare experiences to quality of life in cancer survivorship is poorly understood. Objectives This study explores associations between colorectal cancer survivors’ healthcare experiences and quality of life. Design Cross-sectional survey study. Settings Participants were recruited from medical oncology and colorectal cancer surgery departments in three hospitals, and twenty-one cancer support centres providing psycho-social care to cancer patients and survivors in Ireland. Participants 304 colorectal cancer survivors between 6 and 60 months post-diagnosis. Methods Participants completed a cross-sectional questionnaire, including the Functional Assessment of Therapy–Colorectal Cancer Survey and the Patient Continuity of Care Questionnaire. Multivariate logistic regression analysis was undertaken to identify associations between quality of life outcomes and healthcare-related variables including continuity of care, access to care, information needs and perceptions of support from health and advocacy services. Results Most participants (80%) had access to a named healthcare professional and were more frequently satisfied with support received in hospital (95%) compared to primary care (76%) or community (61%) settings. More than two-thirds of participants reported unmet information needs (68%) or social difficulties (66%). 40% reported some dissatisfaction with continuity of care. Greater social difficulty was consistently associated with poorer quality of life in all domains (OR range: 2.9–9.7). Lower satisfaction with continuity of care predicted poorer physical (OR=2.6), social (OR=2.1), functional (OR=2.9) and overall quality of life (OR=2.0). Unmet information needs (OR=2.9) and absence of access to a named nurse (OR=3.8) were associated with lower levels of emotional well-being. Survivors who were living with active malignant disease (OR=3.8), had undergone reversal of a temporary ostomy (OR=4.0) or had accessed advocacy-led cancer support were more likely to experience lower quality of life overall (OR=2.6). Conclusions Colorectal cancer survivors relied on oncology professionals for cancer-related support and experienced quality of life issues and unmet needs, which were not addressed by oncology, primary care or advocacy professionals. This study suggests there is scope to optimise the contribution of primary care, community care and advocacy services to cancer survivorship care; these services were often overlooked or provided insufficient support when accessed by survivors. The recurring associations between quality of life outcomes and continuity of care and social difficulties suggest these may be meaningful variables to target in the development of interventions to improve survivors’ quality of life in the context of healthcare.

Background Cancer survivors may live with an array of physical, psychological and social disabilities which impact their day-to-day lives. The literature exploring quality of life in cancer survivorship is predominantly quantitative in nature; with inconsistencies in symptom prevalence owing to the multiplicity of generic and disease-specific quality of life instruments. This study explores the quality of life outcomes and symptom experiences of colorectal cancer survivors using a mixed methods sequential explanatory research design. Methods A purposive sample of adult colorectal cancer survivors between six and 60 months post-diagnosis (n = 304) were recruited from three public and private hospitals and 21 cancer support centres in Ireland. Participants completed a cross-sectional questionnaire; quality of life was evaluated using the EuroQol and FACT-C questionnaires. A sub-sample of 22 survey participants selected using a maximum variety sampling strategy took part in semi-structured interviews to explore their quality of life and symptom experiences in greater depth. Results Quality of life scores reported by the sample were postive on average; however, more than half were dissatisfied with their quality of life, and more than three-quarters reported at least one physical, psychological or social survivorship issue. Negative body image (74%), sexual dysfunction (66%) and fatigue (64%) were the most common issues reported by survey participants. However, qualitative data suggest that less prevalent symptoms such as bowel dysfunction (28-57%) and peripheral neuropathy (47%) were associated with higher levels of unmet need and greatest distress, as they had the greatest potential to negatively impact social and psychological well-being. Conclusions The findings of this study demonstrate that although cancer survivors report positive quality of life outcomes, many may experience distressing physical, psychological and social effects. Given the finding that survivors associated greater unmet need and symptom-related distress with less common symptoms, it is imperative cancer survivors receive information and support that is based upon holistic person-centred evidence. Legal entity responsible for the study Amanda Drury. Funding Health Research Board. Disclosure All authors have declared no conflicts of interest.

Background Up to three-quarters of colorectal cancer (CRC), survivors may experience one or more physical, psychological or social issues after treatment. Individuals with a cancer diagnosis report appropriate support and information from healthcare professionals during treatment. However, many are unprepared for the chronic effects of cancer and its treatment and lack the resources to devise self-management skills. This study aims to design and develop an evidence-based Cancer Survivorship Information Resource (CSIR) to support the education of people with CRC about potential survivorship issues. Methods The CSIR is being developed with key stakeholders via a three-phase participatory action research (PAR) approach. In Phase 1, chronic effects of CRC were explored in a mixed methods study (n = 304). In Phase 2, a 3-round modified Delphi was undertaken with key stakeholders, including CRC survivors, healthcare professionals and advocates to gain consensus on topics to be included in the CSIR (n = 36). Phase 3 will focus on the design, development and evaluation of the CSIR. Results In phase 1, CRC survivors reported symptoms including sexual dysfunction (66%), fatigue (64%), bowel dysfunction (57%) and fear of recurrence (60%). Seventeen survivorship information topics were identified in Phase 1; six further topics were proposed by Phase 2 participants. Seventeen items achieved agreement (≥80%) for inclusion in the CSIR, including fatigue, bowel function, sexual function, coping, and returning to work. Conclusions Stakeholder consensus and engagement has the potential to effect sustainable change and innovation in practice. Phase 2 participants will be engaged in Phase 3 to develop and evaluate the content of the CSIR. PAR methodology facilitates the development of interventions which are person-centred and appropriate to the stage of treatment. Once developed, the CSIR will form part of a larger complex intervention, which aims to address the unmet information and supportive care needs of cancer survivors; supporting them to develop self-management skills to cope with the chronic effects of CRC and its treatment. Legal entity responsible for the study Trinity College Dublin. Funding The Health Research Board Research Training Fellowship for Healthcare Professionals (Grant#: HPF.2014.715). Disclosure All authors have declared no conflicts of interest.

Background: The Institute of Medicine report ‘From Cancer Patient to Cancer Survivor’ has drawn widespread attention to the experiences of cancer survivors. Research examining the symptom experiences of survivors are proliferative within the literature but limited by samples which include multiple tumor groups and varying inclusion criteria. This cross-sectional quantitative study seeks to examine pain and quality of life (QoL) in the context of colorectal cancer (CRC) survivorship, as defined by the Institute of Medicine. Material and methods: A purposive sample of CRC survivors (n = 252) attending hospitals and cancer support centers in the Republic of Ireland were recruited between September 2014 and January 2016. Self-rated health (SRH), QoL and pain were assessed in the sample using the EuroQOL questionnaire, the Functional Assessment of Therapy-Colorectal (FACT-C) questionnaire, and symptom experience items. Results: One hundred participants (40%) indicated they had pain on the day of the survey or in the past week. Of those with pain, many also experienced a lack of energy (95%), bowel dysfunction (74%), sleep disturbance (76%) or interference with their ability to enjoy life (75%). Pain was associated with younger age, female gender, current chemotherapy treatment, and previous radiotherapy treatment. Although participants reported positive QoL scores, statistical analysis revealed pain was linked to significantly poorer SRH and overall QoL, and poorer physical, emotional, functional, social/family and CRC-specific wellbeing, compared to those who did not indicate pain. Discussion: Pain was experienced by almost two fifths of CRC survivors up to five years after treatment and was associated with poorer SRH and QoL. In light of these findings, healthcare professionals must endeavor to manage cancer survivors’ needs in a manner which is cognizant of the burden of pain and in the context of other symptoms and morbidities experienced by long-term cancer survivors.