Transitional nursing or transitional care is a model that was developed to address the set of practices that are needed when patients have to transit from one place (e.g. hospital) to another (home). This model of nursing care is especially relevant to patients with chronic illnesses that have to change locations frequently during their treatment. Transitional nursing focuses on different patients, including those with cancer, mental illnesses, diabetes, heart failure, rheumatologic diseases, etc.
Identification of the Problem
Transitional care in oncology is often implemented, as these patients have to go through different stages of their treatment. While some of them prepare to transition from a healthcare facility to home, others have to transit from hospital care to end-of-life care. Although various transitional strategies focus on patient’s transition, little research was done to understand how transitional care affects patients with cancer and their quality of life.
During a transition, patients have to manage pain that cancer often causes. Nevertheless, pain management can worsen depending on patient’s education on the problem and their cognitive barriers (Jahn et al., 2014). Poor managing skills can hurt the patient’s quality of life and psychological state. This happens because it is easier for patients to manage cancer pain at the hospital facility, while during the transition they have to face different cognitive barriers (e.g. fear of addiction) that prevent them from pain management (Wang & Wu, 2016). Thus, it is essential to understand what transitional nursing strategies can be used to improve patients’ quality of life.
Significance of the Problem to Nursing
With the development of patient-centered care and evidence-based medicine, transitional nursing in oncology also needs to be researched; however, it is rarely addressed. Although it may seem that transitional care in oncology is not different from other units, it should be noted that patients with cancer or cancer survivors have other demands and require different approaches. It is essential to promote these strategies not only among nurses but also among healthcare providers, family, and medical staff as well. Some of the patients, e.g. elderly or orphan, might not have a family that will help them during the transition period.
Therefore, a set of rules and strategies needs to be developed to ensure that nurses are capable of providing an accurate and efficient plan of care during the transition. After discharge, many patients experience the inability to continue the successful management of their illnesses, which leads to readmissions (Wang, Zhao, & Zang, 2014). During the transition from a hospital to their community, patients noticed “a lack of continuity and coordination between hospital and community services” (Wang et al., 2014, p. 6). This problem led to readmissions or difficulties in disorder management, as well as distress.
As can be seen, the care process after discharge is often unplanned, neither by nurses nor by patients, which results in severe anxiety and fear; this, in return, negatively influences patients’ quality of life. Therefore, it is important to develop a planning program that will help patients after discharge or during a transition to another hospital/hospice. Patients’ needs often remain unmet during their transition, while continuing care could help them avoid difficulties and improve outcomes of self-management (Wang et al., 2014).
To improve patients’ quality of life and ability to cope, transitional nursing needs to develop a framework that will involve multiple teams (community, resource, primary teams). This framework will allow nurses to create effective strategies to address cancer patients’ needs. Moreover, nurses will have the chance to set up their assessment tools when developing a plan of care during the transition.
Purpose of the Research
The purpose of the research is to understand what strategies can be implemented in the transitional care of patients with cancer or cancer survivors. A few specific strategies addressing the transition of cancer patients were developed, and transitional care models were rarely tested in the context of cancer (Christ, Behar, & Messner, 2015). It seems reasonable to assume that additional research about transitional nursing in oncology is needed.
The research questions are the following:
- What transitional nursing strategies need to be developed to address patients with cancer?
- How can transitional nursing improve the life of patients with cancer and cancer survivors?
- Would it be helpful for patients to develop a plan of care after discharge?
Multiple master’s essentials align with my topic. First, master’s prepared nurses are expected to implement evidence-based plans that were developed concerning gathering data and performed analyses. Discharge plans should be evidence-based and rely on the data that patients and hospital facilities can provide. Second, nurses need to “contribute to the integration of healthcare services” (AACN, 2011); if transition plans for patients with cancer are seen as a healthcare service, this research will help to integrate them. At last, nurses need to understand how they can translate research and theory into practice. This research has the potential to provide new information to transitional nursing and improve clinical practice.
AACN. (2011). The essentials of master’s education in nursing. Web.
Christ, G. H., Behar, L. C., & Messner, C. (2015). Handbook of oncology social work: Psychosocial care for people with cancer. Oxford, UK: Oxford University Press.
Jahn, P., Kuss, O., Schmidt, H., Bauer, A., Kitzmantel, M., Jordan, K., & Landenberger, M. (2014). Improvement of pain-related self-management for cancer patients through a modular transitional nursing intervention: A cluster-randomized multicenter trial. PAIN®, 155(4), 746-754.
Wang, S. Y., Zhao, Y., & Zang, X. Y. (2014). Continuing care for older patients during the transitional period. Chinese Nursing Research, 1(3), 5-13.
Wang, X., & Wu, X. C. (2016). Application of transitional care model in cancer pain management after discharge: A randomized controlled trial. Chinese Nursing Research, 3(2), 86-89.