Patients with cancer are expected to call an oncological emergency unit when they are unable to manage symptoms of their disease and side effects from treatment at home. Responding to calls from patients with different problems in a team of registered nurses and medical doctors requires interprofessional collaboration and learning. Therefore, this study aimed to explore conditions for team-based collaboration and learning when responding to calls from patients diagnosed with cancer in a specific setting of an oncological emergency unit. Using a frame of qualitative description three focus groups with 16 healthcare professionals from an oncological emergency unit at a Danish University Hospital were conducted. The verbatim transcribed text was analyzed using content analysis, and reported according to the COREQ guidelines. Two main themes emerged: 1) ‘Availability – a precondition for learning and collaboration’ and 2) ‘Sense of responsibility and distribution of roles’. The study demonstrated that interprofessional collaboration and learning were affected by intra and interprofessional and contextual factors. In addition to an awareness of personal attitudes, the environment and the distribution of responsibility and roles as essential preconditions for accomplishing teamwork need to be explicitly articulated if the team-based learning and collaboration are to succeed.

Nurses are imperative for healthcare systems’ ability to effectively function during pandemics, yet multiple factors may affect their willingness and preparedness to work. The aim of the present cross-sectional survey was to identify factors associated with registered nurses’ (RN) willingness and preparedness to work during the novel coronavirus disease (COVID-19) pandemic. The study was reported following the STROBE guidelines. A total of 358 nurses completed a self-administered online questionnaire. The participants were a part of a COVID-19 task force at a Danish university hospital during spring 2020. The results showed that the majority of RNs felt a professional obligation to engage in clinical work during the pandemic; however, their willingness and preparedness to work were affected by multiple factors, such as being relocated voluntarily, being prepared for the task and feeling safe. This study highlights that these factors are essential for the hospital management and nurse leaders to take responsibility for.

Relatives are an important resource to hospitalised patients and hence to nursing. During the COVID-19 pandemic, visiting restriction policies were implemented in healthcare settings globally, unwillingly excluding relatives from visiting the bedsides of their loved ones. The aim of the present study was to explore how the visiting restrictions influenced relatives’ relationships with patients and collaboration with registered nurses at non-pandemic hospital wards. In total, 13 relatives were interviewed. The study was reported following the COREQ guidelines and checklist. Content analysis led to three themes: 1) being excluded from providing care and support; 2) being excluded from conveying person-centred and situational relevant knowledge to registered nurses; and 3) being excluded from assessing the health status of the hospitalised loved one. Together they describe relatives feeling worried and powerless regarding the health of their hospitalised loved one and the performed nursing care. Findings from studies such as this are pivotal to any future national or global health crisis, where visiting restriction policies are implemented.

COVID-19 restrictions prevented relatives from visiting and accompanying patients to hospital and required that nurses wore personal protective equipment. These changes affected patients’ relationships with relatives and challenged their ability to connect with nurses. Individual, semi-structured interviews with 15 patients were carried out to explore patients’ experiences of their relationships with relatives and their collaboration with nurses during in- and outpatient contacts in non-COVID-19 hospital wards. The analysis of data was guided by phenomenological hermeneutic frame of reference and the study was reported according to the COREQ checklist. The findings illustrated that patients felt lonely and insecure when separated from relatives, caught between relatives and professionals during information exchange, and experienced the absence of relatives as both beneficial and burdening. Visitor restrictions provided patients with time to heal but prevented provision of informal care. Patients had to take responsibility for maintaining contact with relatives independent of their health condition. COVID-19 restrictions created distance with nurses, which potentially led to insufficient physical and psychosocial care.

This study aims to explore how a changed COVID-19 work environment influences nurses' clinical decision-making. Data were collected via three focus groups totaling 14 nurses working in COVID-19 pandemic wards at a Danish university hospital. The factors influencing decision-making are described in three themes; navigating in a COVID-19 dominated context, recognizing the importance of collegial fellowship, and the complexities of feeling competent. A strong joint commitment among the nurses to manage critical situations fostered a culture of knowledge-sharing and drawing on colleagues' competencies in clinical decision-making. It is important for nurse leaders to consider multiple factors when preparing nurses not only to work in changing work environments, but also when nurses are asked to work in environments and specialties that deviate from their usual routines.

This article discusses how existential phenomenology may serve as a frame in a mixed-methods study of changes in weight and body composition among women in adjuvant treatment for breast cancer. In accordance with ontologically and epistemologically fundamental assumptions in nursing, we link mixed-methods and existential phenomenology from the perspective of the French philosopher Maurice Merleau-Ponty and his notion of a unified body subject. Letting this perspective permeate our philosophy, methodology and issues at the method level in mixed-method research undermines the distinction between first- and third-person perspective when applying and integrating different data sources in a mixed-methods study. Applying Merleau-Ponty's third way, the women's bodily experiences appear as gestalt; a 'figure' against a ground of existential threats that are grasped through insight from data integrating in joint displays, which revealed the women's experiences on a deep existential level. Existential phenomenology as a frame in mixed-method studies can speak not only to nurses but also to a multidisciplinary audience in a shared attempt to deepen the understanding of a patient's healthcare problem.

Purpose To explore the essential meaning of how sensory disturbances caused by Oxaliplatin influence self-understanding and freedom to live an everyday life among survivors after colorectal cancer. Methods Data was generated by means of a semi-structured individual interview with eight survivors after colorectal cancer who continued to experience chemotherapy-induced peripheral neuropathy at least one year after completing chemotherapy with Oxaliplatin. Data analysis was guided by existential phenomenology and descriptive life-world research. Results The essential meaning was structured by four constituents. 1) An unpleasant fluctuating sensation which is impossible to ignore, 2) Breaking through of noise and pain despite struggling to keep them at bay, 3) Continuously feeling ill despite being cured, and 4) Bodily constraints that impact self-understanding and limit enjoyment of life. Conclusion The survivors used distraction to keep the sensory disturbances at bay but were forced to adapt to a new self-understanding as sufferers after chemotherapy despite being cured of their cancer disease. This way of being-in-the-world was understood by survivors, their families and healthcare professionals as a necessary price to pay to be alive. However, marked as sufferer after chemotherapy, the participants' everyday style of experience and life revealed as an ill health condition, which limited their ability to accomplish everyday activities as before and their freedom to realize their potential-the "I can".

The maintenance of physical distance, the absence of relatives and the relocation of registered nurses to COVID-19 units presumably affects nursing care at non-COVID-19 units. Using a qualitative design, this study explored registered nurses' experiences of how COVID-19 influenced nursing care in non-COVID-19 units at a Danish university hospital during the first wave of the virus. The study is reported using the COREQ checklist. The analysis offered two findings: (1) the challenge of an increased workload for registered nurses remaining in non-COVID-19 units and (2) the difficulty of navigating the contradictory needs for both closeness to and distance from patients. The study concluded that several factors challenged nursing care in non-COVID-19 units during the COVID-19 pandemic. These may have decreased the amount of contact between patients and registered nurses, which may have contributed to a task-oriented approach to nursing care, leading to missed nursing care.

Purpose: To deepen the understanding of how survivors' experience and give meaning to the embodied phenomenon of chronic sensory disturbances in everyday life after oxaliplatin treatment for colorectal cancer. Methods: Data was generated by means of a semi-structured interview guide and drawings with the aim to explore eight survivors' lifeworld experiences. Data was analyzed through a phenomenological approach. Results: The essential meaning of sensory disturbances emerged in two main themes and four sub-themes. Theme A: 'A peculiar experience that is difficult to logically understand' with the subthemes; 'An ambiguous perception in hands and feet' and 'Being alienated from one's own body'. Theme B: Losing touch with the world' with the subthemes: 'A lack of sensory contact with physical surfaces' and 'Breakdown of sensitivity in hands hampers fine motor skills and social contact'. Conclusion: Sensory disturbances contributed to an ambiguous and discordant perception of an alienated body that was difficult to describe and affected the ability to act and connect to things and other people. Metaphors and drawings were valuable as means to verbalize and illustrate the changed body perception where the 'I can' changed into 'I cannot'. To support the embodied connection to the world new usage patterns were required.

Background Cancer treatment is often given on an outpatient basis. An oncological emergency telephone line has been established to improve access to cancer care and prevent life-threatening side effects. However, healthcare professionals need to make clinical decisions without being able to assess patients face-to-face, which may be problematic. This study explores how healthcare professionals experience clinical decision-making in oncological emergency telephone consultations. Methods An exploratory qualitative approach applying three focus groups with healthcare professionals from a Danish university hospital were undertaken. Data were analysed using inductive content analysis. Results An overall theme elucidated how healthcare professionals ended up deciding during each call whether the problem could be solved on the phone or the patient had to come for a face-to-face consultation or to wait and see whether the condition changed. Some decisions were easy to make, while others were moderate or difficult. The decision was influenced by several factors that could be structured into three themes: reliance on one's own knowledge and experience, consideration of different perspectives and the influence of context. Conclusion This study demonstrated that clinical decision-making in oncological emergency telephone consultations includes three types of decisions that are intertwined with intra-personal, inter-professional and contextual factors such as personal knowledge, collaboration and workload. These factors are essential for the timely referral of patients to the right level of service.

BACKGROUNDTelephone consultations are common in supporting patients and caregivers in managing symptoms from cancer diseases and side effects from cancer treatment. In connection with telephone consultations, it may be a challenge that healthcare professionals have to rely on their auditory sense alone when they assess whether the problem can be solved over the telephone, or whether patients need an examination face to face.OBJECTIVETo explore how healthcare professionals identify patients' essential concerns and assess serious conditions in calls to an oncological emergency telephone without face-to-face contact.METHODSFrom a phenomenological-hermeneutical frame of reference, the analysis of three focus groups with a total of 16 healthcare professionals was guided by content analysis.ETHICSThe study follows the ethical guidelines for research.RESULTSTwo themes emerged. To identify patients in serious conditions, healthcare professionals kept focus on: (1) 'Reaching a mutual understanding without the clinical eye'. Before making a decision regarding a face-to-face examination, the healthcare providers were as follows: (2) 'Listening to an inner voice - attention on clues and signs'.LIMITATIONSThe transferability of the findings is limited to healthcare professionals who perform telephone-mediated care in a team of nurses and physicians.CONCLUSIONStaying open for diverse perspectives and integrating nonanalytical as well as analytical illness scripts, healthcare professionals were able to identify patients that needed further examination face to face.

Aims and objectives To explore from a nurse and patient perspective what questionnaire-"Functional assessment of cancer treatment gynecological group neurotoxicity" or "Oxaliplatin-Associated Neuropathy Questionnaire"-best describes chemotherapy-induced peripheral neuropathy and its influence on everyday life in a comprehensive and meaningful way, prior to implementation in daily practice. Background Patients experience chemotherapy-induced peripheral neuropathy during and after chemotherapy for colorectal cancer with oxaliplatin. This neuropathy is difficult to describe for patients and to identify for nurses. To address the specific needs of patients and improve identification of neuropathy and its influence on everyday life, we wanted to implement a questionnaire in clinical practice. Design A phenomenological hermeneutic frame of reference was used. Method Semi-structured interviews with 15 patients and two focus groups with eight cancer nurses were used for data collection. Data were organised and interpreted by content analytical steps in a hermeneutical process. COREQ checklist was used in reporting of the study. Results The analysis resulted in two main themes (a) "To dig deeper" with sub-themes "to identify the line between acceptable and nonacceptable chemotherapy-induced peripheral neuropathy," and "searching for a precise description." (b). "When everything is interrelated" with sub-themes "to be aware of different perspectives and understandings" and "recognise potential pitfalls." Conclusion Involving patients and nurses in choosing between the two questionnaires revealed that neither alone was sufficient to describe the patients' experiences. Instead, it seems essential to implement both questionnaires, using the answers as a basis for a dialogue to address the patients' specific needs. Relevance for clinical practice Using patients and nurses perspectives in a complementary way may provide a solid foundation before starting an implementation process in clinical practice. However, attention must be paid to potential barriers and facilitators as well as the fact that a successful implementing process requires leadership and information sharing.

Background: Patients and their caregivers are expected to take joint responsibility for reporting symptoms and seeking medical assistance, for example, by calling oncology emergency telephones or other helplines during a cancer trajectory. Research objective: The aim was to explore the meaning of responsibility as it appeared in patients' or caregivers' experiences of calling an oncological emergency telephone. Design, participants and context: Inspired by qualitative description and qualitative content analysis, a secondary analysis of data from interviews with 12 participants calling the oncological emergency telephone at a Danish university hospital was performed. Ethical considerations: The project observes demands for safekeeping data and all regulations concerning research ethics in agreement with the Nordic Nurses Federation and the Danish Health Act. Findings: Two main themes emerged: (1) to act responsibly as a patient or caregiver was to 'be watchful and alert', 'report symptoms the right way' and 'do crosschecking' and (2) to deal with the burden of responsibility was to 'feel safe when dealing with the burden of responsibility' and 'be relieved from the burden of responsibility'. Discussion: Too much responsibility and a potential imbalance between healthcare professionals' expectations and callers' knowledge and capacity to act may place additional burdens on the callers, which may be eased by person-centred care. Conclusion: The meaning of responsibility appeared in the participants' capacity to act, where they observed, assessed and reported symptoms and controlled prescribed treatments as well as shared or handed over the responsibility to the healthcare providers. Thus, the analysis provided essential knowledge for healthcare professionals on how patients and caregivers handle this responsibility when faced with a cancer disease that is treated on an outpatient basis.

Background Despite several investigations, findings on weight changes during and after adjuvant treatment for breast cancer are diverse and point in several directions. Objective The aims of this study were to investigate changes in weight and body composition associated with contemporary anticancer medication and to examine factors that might influence the assessment and diversity of the findings. Methods This article used the method of a scoping review to map the body of literature. From searching the databases PubMed, CINAHL, and EMBASE using MeSH terms, CINAHL terms, and Emtree, as well as free text, 19 articles were selected for further investigation. Results The scoping review illustrates how findings in weight and body composition changes fluctuate over time as illustrated in 4 measure points: short term, 1 year, 18 months/2 years, and long term. The studies displayed differences regarding study designs, sample sizes, treatment regimens, measure points and techniques, and cutoff values for assessing weight changes, which make it difficult to synthesize findings and provide strong evidence for use in clinical practice. Conclusion Synthesizing findings over time illustrates the need for attention on younger premenopausal women given chemotherapy. Weight need to be monitored for at least 2 years as short-term changes may be caused by increased body water, whereas long-term changes seem to be related with increased fat mass essential for risking recurrence and early death. Implications for Practice The diversity in methods discloses the need for the research community to reach consensus regarding study designs for future research in this area.

Background Cancer patients and their caregivers are expected to take joint responsibility with regard to reporting symptoms and seeking medical assistance e.g. by calling oncology emergency telephones or other helplines during their cancer trajectory. This responsibility may pose additional burdens on patients and caregivers when they are at home with symptoms that can be potential life threatening. Furthermore, in this vulnerable situation, the ability to handle the responsibility is compromised, which may influence safeguarding fundamentals of care needs. Therefore, the objective of this study is to explore the meaning of responsibility as it appeared in patients or caregivers calls to an oncology emergency telephone. Methods Qualitative description and qualitative content analysis guided a secondary analysis and interpretation of data from interviews with 12 participants calling an oncology emergency telephone. Results The analysis revealed two main themes. 1). To act responsibly as patient or caregivers was elaborated by: ‘Being watchful and alert’, ‘Reporting the symptoms’, and ‘Cross checking’. 2). To deal with the burden of responsibility was elaborated by the sub-themes: ‘Feeling safe in dealing with the burden of responsibility’, and ‘Being relieved from the burden of responsibility’. Conclusions Conclusion: The study provided essential knowledge on how patients and caregivers handle responsibility in their everyday living with a cancer disease, treated on an outpatient basis. The meaning of responsibility appeared in the informants’ capacity to act where they displayed responsibility to observe, assess and report symptoms and control prescribed treatment as well as to share or hand over the responsibility to the healthcare providers. Easing the burden of responsibility requires a person-centered approach that integrates physical, psychosocial and relational needs and bridge a potential imbalance between healthcare providers’ expectations and the patients’ or caregivers knowledge and capacity to act. For this to succeed, establishing a caring relationship between HCPs, patients and caregivers is essential. Legal entity responsible for the study Birgith Pedersen. Funding Has not received any funding. Disclosure All authors have declared no conflicts of interest.

Background Cancer treatment is increasingly provided on an outpatient basis, which may challenge patients and caregivers coping with illness and adverse effects at home. A telephone consultation is an accepted type of healthcare provision to support patients and prevent adverse outcomes when their capacity to self-manage is inadequate. Whether this option for help sufficiently supports patients needs further investigation. Objectives The aim of this study was to explore patients’ and caregivers’ experience of calling an oncological emergency telephone. Methods The study applies a phenomenological hermeneutic approach with 12 semistructured interviews. Patients and caregivers who had called the oncological emergency telephone within the last 2 months were included. The interview texts were analyzed by content analysis. Results Patients and caregivers perceive the emergency telephone as a lifeline that they consider calling when the patient’s condition changes from what they understand as normal to what they perceive as abnormal. They would rather call “one time too many than one time too few” if their resources are inadequate to ensure their safety. The tone, attitude, and professional competency of healthcare providers affect patients’ experience of the call. Conclusions The value of calling the oncological emergency telephone depends on the healthcare providers’ professional competences and skills to establish a relationship that makes patients feeling accommodated and taken care of. Implications for Practice Patients’ and caregivers’ perceptions of what constitutes a good telephone consultation represent significant knowledge that contributes to a more comprehensive and practice-based understanding of what is required to advise patients and caregivers in an oncological emergency telephone.