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Biomedical subjects

C Borrill

Publications and source records attributed to C Borrill.

8 recordsLinked to original sources

The professional role of breast cancer nurses in multi-disciplinary breast cancer care teams.

Since the 1970s breast cancer services have witnessed considerable changes in the management of patients. One significant change was the introduction of specialist core personnel, including the breast care nurse (BCN). The role of the BCN has been gaining credence rapidly in the British NHS and this service is perhaps the paradigm of care for other services. With the lack of specific evidence of the role of specialist nurses in the breast care team, the current study aims to explore this area by in-depth interviews with core team members, and observations of 16 multi-disciplinary teams in England. The study explores the following themes: Nurses' unique informal management leadership role in ensuring the co-ordination, communication and planning of the team work; nurses' innovatory role in making the bureaucracy respond to patients and their relatives needs; nurses supportive role in the provision of expert advice and guidance to other members of the team; nurses confidence and humour in well-performing teams; and the limitations of the professional role of the breast cancer nurse. This study indicates that there is evidence that the BCN is practicing at an advanced level of practice. However, there is a severe lack of evidence-based description of that advanced practice. Cancer nurses including the BCNs should develop and participate in programmes of research in line with cancer legislation in order to build an evidence base that ultimately supports their unique role.

Attitude of Health Personnel↗

Breast cancer teams: the impact of constitution, new cancer workload, and methods of operation on their effectiveness.

National guidance and clinical guidelines recommended multidisciplinary teams (MDTs) for cancer services in order to bring specialists in relevant disciplines together, ensure clinical decisions are fully informed, and to coordinate care effectively. However, the effectiveness of cancer teams was not previously evaluated systematically. A random sample of 72 breast cancer teams in England was studied (548 members in six core disciplines), stratified by region and caseload. Information about team constitution, processes, effectiveness, clinical performance, and members' mental well-being was gathered using appropriate instruments. Two input variables, team workload (P=0.009) and the proportion of breast care nurses (P=0.003), positively predicted overall clinical performance in multivariate analysis using a two-stage regression model. There were significant correlations between individual team inputs, team composition variables, and clinical performance. Some disciplines consistently perceived their team's effectiveness differently from the mean. Teams with shared leadership of their clinical decision-making were most effective. The mental well-being of team members appeared significantly better than in previous studies of cancer clinicians, the NHS, and the general population. This study established that team composition, working methods, and workloads are related to measures of effectiveness, including the quality of clinical care.

Adult↗

Managers' lives. Stressed to kill.

Stress is more prevalent among NHS managers than those in other sectors. Managers suffer more stress than other groups in the NHS. Perceived failure to influence decision-making was particularly stressful for managers. Managers should be targeted first in any organisation's stress-reduction programme.

Administrative Personnel↗

Strain as a moderator of the relationship between work characteristics and work attitudes.

Research on the psychological effects of work characteristics has investigated their relationships with both work attitudes and psychological strain, with the latter 2 variables being treated as alternative or joint dependent variables. The focus of this article is to propose that strain moderates the relationship between perceptions of work characteristics and work attitudes. The proposition is tested on a maximum sample of 9,327 health care employees by using moderated multiple regression followed by subgroup comparisons. The results strongly support the moderating effect, showing that as strain increases, the strength of the relationship between perceptions of work characteristics and work attitudes decreases.

Attitude↗

Nursing an ambition.

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Adolescent↗

The chosen ones.

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Educational Measurement↗