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Bana Marika

Assoziierte Professorin FH

Main skills

Assoziierte Professorin FH

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Haute école de santé - Fribourg
Route des Arsenaux 16a, 1700 Fribourg, CH

BSc HES-SO en Soins infirmiers - Haute école de santé - Fribourg

Symptommanagement
Problem Based Learning
Qualitative Pflegeforschung
Implementierungsforschung
Klinische Pflegeexpertise

MSc HES-SO en Ostéopathie - Haute école de santé - Fribourg

Begleitung Abschlussarbeiten

Master of Advanced Studies in Onkologischer Pflege - Zürcher Hochschule für Angewandte Wissenschaften ZHAW

Symptom Management
Selbstmanagement von Symptomen

Höhere Fachprüfung Onkologische Pflege - HFP Onkologiepflege St. Gallen

Selbstmanagement Förderung
Genetik
Prävention

Completed

Weiterentwicklung des Symptom Navi © Programms (SN©P)

AGP

Role: Main Applicant

Financement: HES-SO Rectorat

Description du projet : Weiterentwicklung des Symptom Navi © Programms (SN©P)

Research team within HES-SO: Bana Marika

Partenaires académiques: FR-HEDS-recherche

Durée du projet: 01.01.2019 - 30.06.2021

Montant global du projet: 11'000 CHF

Statut: Completed

Symptom Navi © Programm (SN©P)

AGP

Role: Main Applicant

Financement: HES-SO Rectorat

Description du projet : Symptom Navi © Programm (SN©P)

Research team within HES-SO: Bana Marika

Partenaires académiques: FR-HEDS-recherche

Durée du projet: 01.01.2019 - 13.08.2019

Montant global du projet: 11'000 CHF

Statut: Completed

2023

Onkologische Krankenpflege

Book

In press!

Patrick Jahn, Andrea Gaisser, Bana Marika, Christoph Renner

2023, Deutschland : Springer Verlag, 793 p.

Link to the publication

Summary:

100% Onkologische Pflege!
Dieses Buch bietet allen Pflegenden und Teilnehmenden der Fachweiterbildung zur
onkologischen Pflegefachperson umfassendes, aktuelles Fachwissen für die spezielle
Betreuung ihrer Patienten. Lernen Sie solide Grundlagen, z.B. wie maligne Tumoren
entstehen und wachsen, wie man sie erkennt und welche Probleme bei der Behandlung
auftreten können, sowie spezielle Kompetenzen, um pflegerisch angemessen zu handeln.
Das Standardwerk ist der ideale Begleiter für die Weiterbildung und zum Nachschlagen
für die tägliche Praxis.
Empfohlen von der Konferenz Onkologischer Kranken- und Kinderkrankenpflege
(KOK), der Onkologie Pflege Schweiz (OPS) und der Arbeitsgemeinschaft hämatologischer
und onkologischer Pflegepersonen in Österreich (AHOP).
Der Inhalt
• Spezielle onkologische Pflege: Schmerzen, Atemnot, Fatigue, Ernährung,
Haarausfall, Hautveränderungen, Sexualität, onkologische Notfälle,
Kommunikation mit Krebskranken, u.a.
• Grundlagen der Onkologie, Prinzipien und Methoden der Tumordiagnostik
und -therapie
• Besondere Bereiche: Psychoonkologie, Sexualität, onkologische Pflege bei
älteren Menschen und Kindern, Komplementär- und Alternativmedizin bei
Krebs,
• Plus: Tumor-Checklisten, weiterführende Literatur
Neue Themen in dieser komplett überarbeiteten und aktualisierten 7. Auflage: Einführung
zum Symptommanagement durch pflegerische Unterstützung und Begleitung bei
Krebserkrankungen, Sport und Bewegung, Rehabilitation und Nachsorge, Survivorship,
Pflege in der Palliativsituation
Die Herausgebenden
Prof. Dr. rer. medic. Patrick Jahn, Krankenpfleger und Universitätsprofessor für Versorgungsforschung
mit Schwerpunkt Pflege im Krankenhaus, Department für Innere
Medizin, Universitätsklinikum Halle (Saale)
Andrea Gaisser, Ärztin, Deutsches Krebsforschungszentrum, Krebsinformationsdienst,
Heidelberg
Prof. Dr. Marika Bana, Onkologiepflegefachfrau und assoziierte Professorin FH an der
Hochschule für Gesundheit in Freiburg, Schweiz
Prof. Dr. med. Christoph Renner, Facharzt für Hämatologie, Allgemeine Innere Medizin,
Medizinische Onkologie, Klinik für Hämatologie & Onkologie Hirslanden, Zürich und
Department Biomedizin, Universität Base

2022

Implémentation du programme Symptom Navi :

Professional paper ArODES

promotion de l’autogestion en cas de cancer

Marika Bana, Sabin Zürcher-Florin, Manuela Eicher

Krankenpflege = Soins infirmiers = Cure infermieristiche, 2022, vol.115, no. 6, pp. 64-67

Link to the publication

Selbstmanagement bei chronischen Krebserkrankungen fördern :

Professional paper ArODES

Implementierung des Symptom Navi Programms (SNP)

Marika Bana, Sabin Zürcher-Florin, Caroline Elsässer, Manuela Eicher

Krankenpflege = Soins infirmiers = Cure infermieristiche, 2022, Bd. 115 Heft 6, pp. 22-25

Link to the publication

Summary:

Onkologische Erkrankungen nehmen in der Schweiz zu und die Betroffenen sind vermehrt mit einem chronischen Verlauf konfrontiert. Bei chronischen Krebserkrankungen ist das Erlernen vom Selbstmanagement bei Symptomen zentral. Pflegefachpersonen können das Selbstmanagement unterstützen, wenn sie in Edukationsgesprächen die Selbstwirksamkeit der Betroffenen fördern. Das Symptom Navi Programm kann dabei als Basis dienen.

2021

Pilot Testing of a nurse-led basic symptom self-management support for patients receiving first-line systemic outpatient anticancer treatment :

Scientific paper ArODES

a cluster-randomized study (Symptom Navi Pilot Study)

Marika Bana, Karin Ribi, Solange Peters, Susanne Kropf-Staub, Ernst Näf, Sabin Zürcher-Florin, Barbara Stoffel, Cornelia Blaeuer, Markus Borner, Diana Malin, Rebecca Biber, Daniel Betticher, Trudy Kuhn-Bächler, Nathan Cantoni, Thomas Seeger, Lukas Bütikofer, Manuela Eicher

Cancer Nursing : an international journal for cancer care research, 2021, vol. 44, no 6, p. E687-E702

Link to the publication

Summary:

Background: The Symptom Navi Program (SNP) is a nurse-led intervention supporting basic symptom self-management for patients with any cancer diagnosis. The SNP has been accepted by patients and healthcare professionals alike. Objective: The aims of this study were to pilot the SNP and evaluate patient-reported symptomoutcomes, nursing support for symptom management, and patient safety. Methods: Using a cluster-randomized design, we randomized centers to the intervention (SNP) or control group (usual care). Adult patients starting first-line systemic cancer treatment were included. The primary outcome was the change in symptom interference with daily functions from treatment onset to 16 weeks. Secondary outcomes included changes in symptom severity, symptom burden, self-efficacy, and perceived symptom management support and patient safety. We used linear and logistic mixed-effects models to pilot-test differences in mean changes between groups. The trial was registered with ClinicalTrials. gov (NCT03649984). Results: Changes in symptom interference with daily functions did not differ (mean difference at 16 weeks: −0.50; 95% confidence interval, −1.38 to 0.38; P = 0.25) between SNP (3 centers, 49 patients) and control (5 centers, 85 patients) as for all other outcomes. No adverse events were reported. Conclusions: Our preliminary findings did not indicate an effect of the SNP on patient-reported symptom outcomes, self-efficacy, or symptom management support. Inadequate power and SNP components (eg, insufficient training, low number of follow-up consultations) may be attributed to the lack of an observed effect. Implications for Practice: The SNP training content and intervention procedures merit reconsideration.

2020

Implementation of the Symptom Navi Program for cancer patients in ambulatory services :

Doctoral thesis ArODES

a cluster randomised pilot study (Symptom Navi Pilot Study)

Marika Bana

2020, Lausanne : University of Lausanne. 138 p.

Manuela Eicher

Link to the publication

Summary:

The Symptom Navi Program (SNP) is a nurse-led intervention supporting patient symptom self-management. It consists of written patient information leaflets (Symptom Navi Flyers, SN-Flyers), semi-structured consultations, and a training manual. Previous qualitative studies with patients and professionals showed good acceptability and usability of SN-Flyers and patient satisfaction with nurse-led consultations. This dissertation is embedded in the Symptom Navi Pilot Study. The objectives of the dissertation were to evaluate the feasibility of implementing the SNP. Outcomes of interest were a) patient accrual and retention rates, b) training content and nurses’ fidelity to the training, c) preliminary safety and impact on patient-reported outcomes. Methods A cluster-randomised two parallel arm design was employed by randomising the outpatient cancer centres (=clusters) to the intervention group (implementation of the SNP) or the control group (usual care). Adult German-speaking patients starting first-line systemic treatment (for any cancer type) were included. Nurses in the intervention group participated in two training courses and evaluated training content on a study specific questionnaire. Following SNP training, nurses used SN-Flyers to provide at least two semi-structured consultations per patient. Nurses Work-related Sense of Coherence (Work-SoC scale) was used to examine the relationship between nurses’ confidence in implementing the SNP and perceptions of their current work situation. To explore nurses’ fidelity to the training, study specific questionnaires assessing self-reported adherence to six core-elements of the semi-structured consultations were utilised. In addition to nurses’ self-reports, two semi-structured consultations were observed at each intervention centre. To investigate SNP safety, nurses and oncologists reported any adverse events potentially related to the program. Validated questionnaires were used to assess patient-reported symptom interference with daily functions, symptom severity/burden, self-efficacy, and perceived nursing support for symptom management. Patients completed questionnaires at baseline (BL), after 1 – 3 weeks (t1), after 4 – 6 weeks (t2), and 16 weeks post BL. Analysis Qualitative thematic analysis was used to explore the observations of semi-structured consultations. Statistics included descriptive analyses, the Kendall Tau test, and linear or logistic mixed-effect models. To explore the preliminary impact on patient-reported outcomes change in means between the two groups for each time point (t1, t2, t3) were compared. BL scores, treatment group, time point (i.e. t1, t2, or t3), and interaction of group and time were included as fixed covariates while cluster and patient were considered as nested random effects. Results Four centres (49 patients) were randomised to the SNP group and 5 centres (85 patients) to the control group. One SNP centre withdrew from the study without recruiting any patients. The SNP group included more women (p = .030), younger patients (p = .001), and more patients living with family members needing care (p = .019). The accrual rate was significantly lower for the SNP group compared to controls (71% versus 90%, risk difference -19%, 95% CI -32% to -7%, p = .003). Overall, 43 patients (88%) received the intervention as intended (= retention rate, range 75% to 100%). Nurses accepted the training format and content. Perceived confidence in implementing the SNP into clinical practice was positively correlated with overall Work-SoC scores (rπ =.47, p = .04). Overall, nurse self-reported compliance with the core-elements of the semi-structured consultations was 92% (95% CI: 87% to 97%). However, the analysis of the observations suggest that nurses rarely used self-management education elements to actively facilitate patients’ symptom self- management. No adverse events were reported for the SNP group. Symptom interference with daily functions was unchanged by the SNP (mean difference % CI: -1.38 to 0.38; p= 0.25) – as were all other patient-reported outcomes. Conclusions Overall, accrual/retention rates, nurses’ acceptance of the training and their high adherence rates to the training indicate that SNP implementation was well received by participating centres. No adverse events have been observed. Nevertheless, findings reveal that the program had no impact on patient-reported outcomes. Improving the SNP by strengthening symptom self- management education elements and nurses’ coaching role should be applied before planning further investigations.

COVID-19 und Onkologiepflege :

Professional paper ArODES

Pflegeexpertinnen/-experten diskutieren Herausforderungen

Marika Bana, Manuela Eicher

Onkologiepflege = Soins en oncologie = Cure oncologiche, 2020, no. 2, p. 11-14

Link to the publication

Symptom Navi Programm :

Professional paper ArODES

Symptom-Selbstmanagement bei ambulanten Krebstherapien

Marika Bana, Karin Ribi, Manuela Eicher

Onkologiepflege = Soins en oncologie = Cure oncologiche, 2020, no. 2, p. 30-32

Link to the publication

Patients atteints de cancer - une offre de soutien ambulatoire :

Professional paper ArODES

la consultation infirmière CINA-CANCER à Fribourg

Natacha Szüts, Marika Bana

Soins infirmiers = Krankenpflege = Cure infermieristiche, 2020, no. 5, p. 62-63

Link to the publication

Development and implementation strategies of a nurse-led symptom self-management program in outpatient cancer centres :

Scientific paper ArODES

the symptom Navi© Programme

Marika Bana, Karin Ribi, Susanne Kropf-Staub, Ernst Näf, Monique Sailer Schramm, Sabin Zürcher-Florin, Solange Peters, Manuela Eicher

European Journal of Oncology Nursing, 2020, vol. 44, 101714

Link to the publication

Summary:

Purpose The Symptom Navi© Programme (SN©P) is a structured nurse-led intervention supporting symptom self-management in cancer patients. We describe the development and evaluation of the intervention, implementation strategy, and the evaluation of nurse training for the Symptom Navi© Pilot Study. Methods The intervention was developed using multiple methods (e.g. literature synthesis, focus groups) to produce SN©P information leaflets (SN©Flyers in French and German) and standardised training for nurses to deliver semi-structured consultations. We evaluated the SN©P using online surveys, focus groups, interviews, and the Item-Content Validity Index (I-CVI). Nurse training was evaluated in relation to content, acceptability, and confidence in implementing the SN©P. We examined the association between scored on the Work-related Sense of Coherence (Work-SoC) scale and nurses’ confidence in implementing the SN©P. Thematic analysis was used to analyse qualitative data. Quantitative data was descriptively analysed and the Kendall Tau test was employed for correlations. Results Patients and health care professionals confirmed that SN©Flyers and semi-structured consultations facilitated symptom self-management. Nurses considered training content/format acceptable and appropriate and felt confident in implementing the SN©P. Overall Work-SoC scores were correlated with nurses’ confidence in implementing the SN©P (rπ = .47, p = .04). Conclusions Health care professionals and cancer patients perceived the SN©P as a useful support. Successful implementation of the SN©P depends on centre-specific factors including time, resources and workflow.

Development and implementation strategies of a nurse-led symptom selfmanagement program in outpatient cancer centres: The Symptom Navi© Programme

Scientific paper

Bana Marika, Karin Ribi, Susanne Kropf-Staub, Ernst Näf, Monique Sailer Schramm, Sabin Zürcher-Florin, Solange Peters, Manuela Eicher

European Journal of Oncology Nursing, 2020 , vol. 44

Link to the publication

Summary:

Purpose: The Symptom Navi© Programme (SN©P) is a structured nurse-led intervention supporting symptom self-management in cancer patients. We describe the development and evaluation of the intervention, implementation strategy, and the evaluation of nurse training for the Symptom Navi© Pilot Study.
Methods: The intervention was developed using multiple methods (e.g. literature synthesis, focus groups) to produce SN©P information leaflets (SN©Flyers in French and German) and standardised training for nurses to deliver semi-structured consultations. We evaluated the SN©P using online surveys, focus groups, interviews, and the Item-Content Validity Index (I-CVI). Nurse training was evaluated in relation to content, acceptability, and confidence in implementing the SN©P. We examined the association between scored on the Work-related Sense of Coherence (Work-SoC) scale and nurses’ confidence in implementing the SN©P. Thematic analysis was used to analyse qualitative data. Quantitative data was descriptively analysed and the Kendall Tau test was employed for correlations.
Results: Patients and health care professionals confirmed that SN©Flyers and semi-structured consultations facilitated symptom self-management. Nurses considered training content/format acceptable and appropriate and felt confident in implementing the SN©P. Overall Work-SoC scores were correlated with nurses’ confidence in implementing the SN©P (rπ = .47, p = .04).

Conclusions: Health care professionals and cancer patients perceived the SN©P as a useful support. Successful implementation of the SN©P depends on centre-specific factors including time, resources and workflow.
Clinical trial registry: NCT03649984 and SNCTP000002381.

2019

Implementation of the Symptom Navi © Programme for cancer patients in the Swiss outpatient setting :

Scientific paper ArODES

a study protocol for a cluster randomised pilot study (Symptom Navi© Pilot Study)

Marika Bana, Karin Ribi, Susanne Kropf-Staub, Sabin Zürcher-Florin, Ernst Näf, Tanja Manser, Lukas Bütikofer, Felix Rintelen, Solange Peters, Manuela Eicher

BMJ Open, 2019, no. 9, e027942, pp. 1-11

Link to the publication

Summary:

Introduction Self-management interventions show promising results on symptom outcomes and selfmanagement behaviours. The Symptom Navi© Programme (SN©P) is a nurse-led intervention supporting patients’ symptom self-management during anticancer treatment. It consists of written patient information (Symptom Navi© Flyers (SN©Flyers)), semistructured consultations and a training manual for nurses. Methods and analysis This pilot study will evaluate the implementation of the SN©P based on the Reach Effectiveness—Adoption Implementation Maintenance framework at Swiss outpatient cancer centres. We will use a cluster-randomised design and randomise the nine participating centres to the intervention or usual care group. We expect to include 140 adult cancer patients receiving first-line systemic anticancer treatment. Trained nurses at the intervention clusters will provide at least two semistructured consultations with the involvement of SN©Flyers. Outcomes include patients’ accrual and retention rates, patient-reported interference of symptoms with daily functions, symptom burden, perceived self-efficacy, quality of nursing care, nurse-reported facilitators and barriers of adopting the programme, nurses’ fidelity of providing the intervention as intended, and patients’ safety (patients timely reporting of severe symptoms). We will use validated questionnaires for patient-reported outcomes, focus group interviews with nurses and individual interviews with oncologists. Linear mixed models will be used to analyse patient-reported outcomes. Focus group and individual interviews will be analysed by thematic analysis. Ethics and dissemination The Symptom Navi© Pilot Study has been reviewed and approved by Swiss Ethic Committee Bern (KEK-BE: 2017–00020). Results of the study will be disseminated in peer-reviewed journal and at scientific conferences. Trial registration number NCT03649984; Pre-results.

Patientenedukation :

Professional paper ArODES

Selbstwirksamkeit beeinflusst das Symptom-Selbstmanagement

Marika Bana

Onkologiepflege = Soins en oncologie = Cure oncologiche, 2019, no. 1, pp. 5-8 / 14-16

Link to the publication

Summary:

L’éducation du patient est une intervention complexe qui doit être structurée et planifiée. Cet article décrit trois éléments de base de l’éducation du patient : l’autogestion des symptômes par des patients, l’auto-efficacité et la communication fondée sur le partenariat

Implementation of the Symptom Navi © Programme for cancer patients in the Swiss outpatient setting: a study protocol for a cluster randomised pilot study (Symptom Navi© Pilot Study)

Scientific paper

Bana Marika, Karin Ribi, Susanne Kropf-Staub, Sabin Zürcher-Florin, Ernst Näf, Tanja Manser, Lukas Bütikofer, Felix Rintelen, Solange Peters, Manuela Eicher

BMJ Open, 2019

Link to the publication

Summary:

Introduction Self-management interventions show promising results on symptom outcomes and selfmanagement behaviours. The Symptom Navi© Programme (SN©P) is a nurse-led intervention supporting patients’ symptom self-management during anticancer treatment. It consists of written patient information (Symptom Navi© Flyers (SN©Flyers)), semistructured consultations and a training manual for nurses.
Methods and analysis This pilot study will evaluate the implementation of the SN©P based on the Reach Effectiveness—Adoption Implementation Maintenance framework at Swiss outpatient cancer centres. We will use a cluster-randomised design and randomise the nine participating centres to the intervention or usual care group. We expect to include 140 adult cancer patients receiving first-line systemic anticancer treatment. Trained nurses at the
intervention clusters will provide at least two semistructured consultations with the involvement of SN©Flyers. Outcomes include patients’ accrual and retention rates, patient-reported interference of symptoms with daily functions, symptom burden, perceived self-efficacy, quality of nursing care, nurse-reported facilitators and barriers of adopting the programme, nurses’ fidelity of providing the intervention as intended, and patients’ safety (patients timely reporting of severe symptoms). We will use validated questionnaires for patient-reported outcomes, focus group interviews with nurses and individual interviews with oncologists. Linear mixed models will be used to analyse patient-reported outcomes. Focus group and individual interviews will be
analysed by thematic analysis.
Ethics and dissemination The Symptom Navi© Pilot Study has been reviewed and approved by Swiss Ethic Committee Bern (KEK-BE: 2017–00020). Results of the study will be disseminated in peer-reviewed journal and at scientific conferences.
Trial registration number NCT03649984; Pre-results.

2018

La consultation infirmière en oncologie :

Professional paper ArODES

soutenir de manière ciblée les patients adultes atteints de cancer traités en oncologie ambulatoire

Marika Bana, Natacha Szüts, Christine Sager Tinguely, Catherine Senn-Dubey, Sonja Rappo, Frédérique Hériché-Ferreira, Daniel Betticher, Manuela Eicher

Onkologiepflege = Soins en oncologie = Cure oncologiche, 2018, no. 2, pp.26-30

Link to the publication

Onkologische Pflegekonsultationen :

Professional paper ArODES

ambulant behandelte Krebspatienten gezielt unterstützen

Marika Bana, Natacha Szüts, Christine Sager Tinguely, Catherine Senn-Dubey, Sonja Rappo, Frédérique Hériché-Ferreira, Daniel Betticher, Manuela Eicher

Onkologiepflege = Soins en oncologie = Cure oncologiche, 2018, no. 2, S. 31-35

Link to the publication

2023

Selbstmanagement bei Krebserkrankungen unterstützen

Conference

Bana Marika

Summer School in Palliative Nursing, 07.09.2023 - 07.09.2023, Zürich

2022

Evaluation of the implementation of the Symptom Navi Programme

Conference

A nurse-led intervention supporting cancer outpatient self-management

Bana Marika, Karin Ribi, Sabin Zürcher, Manuela Eicher

Swiss Oncology and Hematology Congress, 16.11.2022 - 18.11.2022, Basel

Link to the conference

Summary:

Background & objectives

The Symptom Navi Programme (SNP) is a standardised self-management support (SMS) intervention employing patient coaching and facilitating self-efficacy aiming at reducing patients’ burden of symptoms. As part of an implementation study, we included the analysis of the nurses’ behaviour before and after SNP implementation.

Methods

We conducted semi-structured focus group interviews with nurses at Swiss (German-speaking) outpatient cancer centres. Participants completed study-specific fidelity questionnaires after each SNP intervention and study team members conducted structured observations of the interventions. Thematic analysis and descriptive statistics were performed. The Howell et al. (2017) self-management education framework informed data interpretation.

Results

We conducted 4 focus group interviews with 14 oncology nurses before SNP training and 3 interviews with 9 nurses at study end. Before the training, nurses emphasised that they had established a solid partnership with their patients, and had informed them carefully about cancer therapy and its expected side-effects. Their SMS intervention was mainly based on Cancer League brochures and pharmaceutical information material complemented with inhouse leaflets. At study end, nurses referred mainly to SNP leaflets to guide patients, structure SMS interventions, and tailor information to patient needs. The nurses estimated that patients’ communication regarding symptoms had improved and that patients showed more self-management behaviour than before the intervention. Employing SNP within daily nursing routine was considered feasible and nurses reported high fidelity rates to the SNP training with on average 92% of all items applied (95% CI: 87-95%). However, proactive coaching and facilitating patient self-efficacy did not appear in the focus groups nor in the observations. Nurses stated that they would require regularly updated SNP leaflets for long-term SNP implementation.

Conclusion

Although nurses self-reported high fidelity to the SNP training, their actual SMS behaviour was only partly in keeping with the intended intervention. In particular, coaching and the facilitation of patient self-efficacy was poorly reported and rarely observed. Nurse training would need to be enhanced to facilitate effective behaviour change to help improve SMS within daily routines.

Insights from Swiss Symptom Navi Programme: evaluation of a nurse-led self-management support intervention

Conference

Bana Marika, Carl Rudolf Blankart, Karin Ribi, Susanne Kropf-Staub, Manuela Eicher

COMPAR-EU final Conference, 26.10.2022 - 27.10.2022, Palma de Mallorca

Link to the conference

Summary:

Background

Cancer can cause early and long-term consequences that ask for tailored self-management support (SMS) during and beyond cancer treatments. The Symptom Navi Programme (SNP) is a SMS intervention based on coaching and facilitating patients’ self-efficacy. It consists of leaflets providing evidence-based self-management recommendations, semi-structured SMS interventions, and a standardised implementation training.

Methods

The SNP was developed in collaboration with patients, family members and health care professionals (HCP). Patients and family members’ SNP experience have been explored by semi-structured interviews. Subsequently, a cluster-randomised pilot study using multiple methods was conducted to evaluate the SNP implementation process in nine outpatient cancer centres. We used validated patient-reported outcome measurements (PROMs), focus group interviews, fidelity assessments and observations. Statistical analysis included descriptive analyses, correlations, and linear logistic mixed effect models. Qualitative data were analysed thematically. [1]

Findings

Patients and their families confirmed leaflets content as helpful and SMS interventions as supportive. In the SNP pilot study, nurses reported high satisfaction rates with 92% of all items applied as trained (95% CI: 87-95%) and 88% of patients received SMS interventions as planned (range 75-100%). Nurses confidence to use the SNP in daily routines was positively correlated with working conditions (r π =.47, p = .04). Focus group interviews and observations revealed rather poor implementation regarding coaching behaviour and facilitating self-efficacy. The SNP showed no impact on any PROMs compared to the control group and over sixteen weeks. We observed no adverse events.

Discussion

The SNP is a safe SMS intervention that will be further evaluated. Fourteen institutions use the SNP in Switzerland, among them cancer centres, home care nurses, and Swiss Cancer Leagues. We improved HCP training regarding coaching, self-efficacy support, improved SNP adaptation support to centre context, added online training modules, and created a website.

Selbstmanagement fördern bei Krebserkrankungen

Conference

Eine qualitative Evaluation der Anwendung des Symptom Navi Programms

Bana Marika

Swiss Congress for Health Professions 2022, 01.09.2022 - 02.09.2022, Neuchâtel

Link to the conference

Summary:

Einleitung: Das Symptom Navi Programm (SNP) zielt auf die Förderung des Selbstmanagements von Symptomen bei Krebserkrankungen ab. Es umfasst evidenzbasierte SM-Informationen (SN-Flyer), halbstrukturierte Edukationsgespräche und eine standardisierte Schulung für Pflegende. Im Rahmen der Symptom Navi Pilotstudie wurde die Implementierung und Anwendung des SNP mittels Fokusgruppen-Interviews mit Pflegefachpersonen vor Einführung und am Studienende evaluiert. Methode: Die Einführung des SNP umfasste 6 Stunden Schulung und integrierte Wissensvermittlung zur SM-Unterstützung, Motivation der Pflegenden für eine Coaching-Rolle und SNP Kontextanpassungen. Notizen, Zusammenfassungen und Transkripte der Interviews wurden thematisch analysiert basierend auf 8 Kernelementen von SM-Edukationen. Zur Analyse wurde atlas.ti verwendet. Resultate: 3 von 4 onkologischen Ambulatorien implementierten das SNP. Wir führten 4 Gruppeninterviews vor Einführung des SNP und 3 am Studienende mit jeweils 3 bis 4 Pflegenden durch (Dauer 30 - 50 Minuten). Vor Einführung des SNP nutzten die Pflegenden hausinterne Flyer und Broschüren zur Patient:innen Information und Wissensvermittlung bei Therapiestart, wünschten sich standardisierte interprofessionelle Abläufe und eine verbesserte Dokumentation. Am Ende der Symptom Navi Pilotstudie betonten die Pflegenden den Nutzen der SN-Flyer für a) die Unterstützung von Handlungs- und Kommunikationskompetenzen der Patient:innen, b) die Symptomeinschätzung und Wahl von SM-Interventionen sowie c) die Strukturierung der Beratungsgespräche mit Patient:innen. Als hindernde Faktoren zur Anwendung des SNP beschrieben die Pflegenden insbesondere organisatorische Barrieren für Verlaufsgespräche und bei der interprofessionellen Zusammenarbeit, sowie Herausforderungen in Verbindung mit Lese- und Sprachkompetenzen der Patient:innen. Auch am Studienende und nach mehrmonatiger Anwendung des SNP wendeten Pflegefachpersonen kaum Coaching-Strategien zur SM-Förderung an, und priorisierten weiterhin die Informationsgabe zu Therapien und Nebenwirkungen. Diskussion: Trotz einem erkennbaren Nutzen des SNP beschreiben Pflegende kaum eine Veränderung ihres Verhaltens im Hinblick auf die Förderung des SM von Patient:innen mit Krebs. Die Schulung scheint nicht auszureichen, um Coaching Strategien zur gezielten SM-Unterstützung nachhaltig zu implementieren. Die Integration des SNP in den lokalen Kontext muss daher in der Implementierung berücksichtig werden.

Soutenir l'autogestion

Conference

Prendre du temps pour aider les patient·e·s à s’aider eux-mêmes

Bana Marika

Schweizer Onkologiepflegekongress 2022, 31.03.2022 - 31.03.2022, Bern

Link to the conference

Summary:

L’autogestion des symptômes est synonyme d'autonomie et d'indépendance pour les personnes touchées par le cancer. Le personnel infirmier peut jouer un rôle central dans le soutien à l'autogestion s’il arrive à y consacrer le temps nécessaire. Au cours de l'atelier, nous discutons des éléments importants liés au soutien à l'autogestion des symptômes, ainsi que de la manière dont nous pouvons les intégrer dans nos vies professionnelles chargées. L'atelier comporte des présentations, des discussions de groupe et des discussions plénières.

Achievements

2020

PhD in Nursing Science

2020 ; Faculty of Biology and Medicine, University of Lausanne

Collaborateurs: Bana Marika

Link to the achievement

Supervisor: Prof Dre rer. medic. Manuela Eicher, IUFRS, University of Lausanne

Co-Supervisor: Prof Dre med Solange Peters, PhD, CHUV, Lausanne

2014

Master of Science ZFH in Nursing

2014 ; University of Applied Science Zurich ZHAW

Collaborateurs: Bana Marika

Supervisor: Prof Dr Lorenz Imhof

Publication of the Master Thesis:

Bana, M. & Imhof, L. Alltag nach allogener Stammzelltransplantation, Die Sicht der Patientinnen und Patienten im Familienumfeld. Pflegewissenschaft 2015 (1/2), 51-60. doi: 10.3936/1329

2012

CAS Hochschuldidaktik

2012 ; Pädagogische Hochschule Zürich PHZH

Collaborateurs: Bana Marika

post-graduate education for teaching at university level

Master of Advanced Studies in Oncological Nursing

2012 ; Kaleidos Hochschule Zürich

Collaborateurs: Bana Marika

post-graduate education, specialisation for oncology nursing

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Bana Marika

Assoziierte Professorin FH

Main skills

Selbstmanagement Förderung

Pflegekonsultationen

Survivorship

Pflegeforschung

Klinisches Leadership

Qualitätsentwicklung

Onkologische Pflegepraxis

Assoziierte Professorin FH