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PEOPLE@HES-SO – Annuaire et Répertoire des compétences
PEOPLE@HES-SO – Annuaire et Répertoire des compétences

PEOPLE@HES-SO
Annuaire et Répertoire des compétences

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Bana Marika

Bana Marika

Assoziierte Professorin FH

Compétences principales

Selbstmanagement Förderung

Pflegekonsultationen

Survivorship

Pflegeforschung

Klinisches Leadership

Qualitätsentwicklung

Onkologische Pflegepraxis

  • Contact

  • Enseignement

  • Recherche

  • Publications

  • Conférences

  • Portfolio

Contrat principal

Assoziierte Professorin FH

Bureau: 5.51

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

Terminés

Weiterentwicklung des Symptom Navi © Programms (SN©P)
AGP

Rôle: Requérant(e) principal(e)

Financement: HES-SO Rectorat

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

Equipe de recherche au sein de la 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: Terminé

Symptom Navi © Programm (SN©P)
AGP

Rôle: Requérant(e) principal(e)

Financement: HES-SO Rectorat

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

Equipe de recherche au sein de la 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: Terminé

2025

Krebs trifft die ganze Familie :
Article professionnel ArODES
Hilfe zur Selbsthilfe für unterstützende Nahestehende

Marika Bana, Monika Heger, Ursula Gehbauer Tichler

Onkologiepflege = Soins en oncologie = Cure oncologiche,  2025, 1, 17-20

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Résumé:

In der Schweiz erkrankten zwischen 2017 und 2021 jährlich durchschnittlich etwa 47 000 Menschen an Krebs. Laut Schätzungen leben ungefähr 450 000 Menschen mit einer Krebserkrankung. Krebsbetroffene werden von ihrem sozialen Umfeld in vielfältiger Weise unterstützt. Dieses aber erfährt selber kaum Unterstützung von Fach-personen. Wie kann das verbessert werden?

Comparison of student nurses' expectations and newly qualified nurses' experiences regarding clinical practice :
Article scientifique ArODES
a secondary analysis of a cross-sectional survey

Andrea Koppitz, Frank Spichiger, Anita Keller-Senn, Marika Bana, Claudia Huber, Derek Christie, Thomas Bucher, Thomas Volken

Journal of Advanced Nursing,  2025, 81, January, 1, 237-248

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Résumé:

Aim: To compare student nurses' expectations and newly qualified nurses' experiences regarding clinical practice in Switzerland 1 year after graduation. Design: A secondary explorative analysis of a cross-sectional survey. Methods: The data were sourced from the Swiss National Graduate Survey of Health Professionals covering six universities of applied sciences between 2016 and 2019, with information on three cohorts of bachelor student nurses, with a 1-year follow-up between each year. The participants were 533 bachelor-prepared nursing graduates. Results: The student nurses' overall expectations included the following top two prioritized aspects: ‘contributing to something important’ and ‘adequate time to spend with patients’. Newly graduated nurses' clinical practice experiences demonstrated that not all expectations were met 1 year after graduation. The largest gaps were found in ‘adequate time to spend with patients’, ‘work–life balance’ and experiencing ‘good management’. Conclusion: The most crucial expectation gaps are related to having sufficient time to spend with patients and a good work–life balance. The most important result is whether there is a shortage of places for nurses to work rather than the oft-cited shortage of nurses. Implications for the Profession and/or Patient Care: The expectations of Swiss newly qualified nurses can be better met by an assessment in the first year about which individual perceptions of workplace characteristics cause them to make choices to change something about their work, affect their job satisfaction or influence their intention to stay. Impact: Few of the student nurses' expectations were met 1 year after graduation, therefore Swiss healthcare institutions should improve needs assessments to strengthen the nurse workforce starting early in employment. The results underscore the importance of a constructive management culture, such as that in magnet hospitals in the United States which underpins the philosophy of changing in nursing.

2024

Infirmier-ères clinicien-nes spécialisé-es :
Article scientifique ArODES
leadership, entrepreneuriat et recherche pour les soins

Marika Bana, Susanne Kropf-Staub, Manuela Eicher

Revue médicale suisse,  2024, 20, 898-2, 2350-2353

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Résumé:

Les infirmier-ères clinicien-nes spécialisé-es (ICLS) sont des infirmier-ères titulaires d’un Master. Leurs compétences clés comprennent le leadership, l’entrepreneuriat et la recherche. En prenant l’exemple du programme Symptom Navi, l'étude montre l’importance des ICLS dans le développement d’un projet innovant et leur rôle de leadership pour l’implantation du programme dans la pratique. Les résultats de l’évaluation du programme Symptom Navi sont également présentés.

Factors influencing physical activity in individuals with head and neck cancer :
Article scientifique ArODES
a scoping review

Martina Schmocker, Ramona Engst, Markus Wirz, Marika Bana

BMJ Open,  2024, 14, e083852, 1-12

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Résumé:

Objectives Higher physical activity (PA) levels are associated with better quality of life in people with head and neck cancer (HNC). Despite this positive association, most individuals with these cancer types have a sedentary or low-activity lifestyle. Limited knowledge exists regarding the factors that influence PA in this group. Therefore, we reviewed and mapped the available literature on factors that may influence PA in people with HNC. Design We conducted a scoping review based on the framework of Arksey and O'Malley and the Preferred. Reporting Items for Systematic Reviews and Meta-Analyses guideline extension for scoping reviews. Data sources CINHAL, the Cochrane Library, EMBASE, PsycINFO, MEDLINE and Scopus were searched from inception to July 2023. Eligibility criteria We included qualitative and quantitative studies that stated factors such as barriers, facilitators, beliefs, perceptions and views influencing. PA in individuals with HNC. Furthermore, views and recommendations of healthcare professionals involved in the care of people affected by HNC and researchers in this domain were eligible for data extraction. Data extraction and synthesis Data were extracted and synthesised by one reviewer according to the predefined items including characteristics, barriers, facilitators, beliefs, perceptions and views of people being affected and views and recommendations of experts. Quantitative data were charted descriptively, and qualitative data were analysed and summarised using a basic content analysis approach. Results Of the 1351 publications, we included 19 in our review. Publications mainly focused on barriers to PA, with some studies reporting facilitators and collecting data on patients’ and healthcare professionals’ views on PA. Most research teams made recommendations for promoting PA in people with HNC. Characteristics associated with activity levels included age, cancer type and stage, morbidity level and attitude towards being active. Prevalent barriers consisted of health-related factors, including fatigue, pain and nutritional issues, alongside personal and environmental impediments such as time constraints, lack of interest or motivation. Facilitating factors for PA included perceived or experienced mental and health-related benefits. Consensus among patients, healthcare professionals and researchers highlighted the necessity for enhanced information and education, emphasising individualized approaches to promote PA throughout the cancer continuum. Conclusions Numerous factors affect PA in individuals with HNC. Future research should concentrate on screening and addressing risk factors for sedentary behaviour and activity barriers and on optimal design and delivery of interventions to incorporate PA promotion into the care pathway.

Pflegerische Unterstützung und Begleitung bei Krebserkrankungen
Chapitre de livre ArODES

Marika Bana, Patrick Jahn

Dans Bana, Marika, Gaisser, Andrea, Jahn, Patrick, Renner, Christoph, Onkologische Krankenpflege  (pp. 277–287). 2024,  Berlin : Springer

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Résumé:

Die Unterstützung zum Management und Selbstmanagement von Symptomen gewinnt für die onkologische Pflege kontinuierlich an Bedeutung. In diesem Kapitel beschreiben wir die Grundlagen zum Management von Symptomen bei Krebserkrankungen und deren Therapien, stellen eine Auswahl von Screening und Assessment-Instrumenten vor und zeigen auf, wie die Unterstützung zum Selbstmanagement von Symptomen durch Pflegefachpersonen gestaltet werden sollte. Abschließend stellen wir ein Programm vor, welches die zentralen Elemente integriert und erfolgreich in die Praxis eingeführt wurde.

Survivorship
Chapitre de livre ArODES

Nicolas Sperisen, Sarah Stoll, Marika Bana

Dans Bana, Marika, Gaisser, Andrea, Jahn, Patrick, Renner, Christoph, Onkologische Krankenpflege  (pp. 761–774). 2024,  Berlin : Springer

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Résumé:

Frühzeitige Diagnostik und verbesserte Therapieoptionen bei Krebserkrankungen führen zu einem längeren Leben mit und Überleben von Krebs. Viele an Krebs erkrankte Menschen erfahren verschiedene Nebenwirkungen und Langzeitfolgen der Krankheit und/oder der Behandlung. Die Heterogenität dieser Auswirkungen erfordert eine individuelle, ganzheitliche und integrierte Betreuung. Pflegefachpersonen können dabei eine zentrale Rolle in der Betreuung und Begleitung übernehmen.

Factors influencing physical activity in individuals with head and neck cancer: a scoping review
Article scientifique

Martina Schmocker, Ramona Engst, Markus Wirz, Bana Marika

BMJ Open, 2024 , vol.  14, no  7

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Résumé:

Objectives Higher physical activity (PA) levels are associated with better quality of life in people with head and neck cancer (HNC). Despite this positive association, most individuals with these cancer types have a sedentary or low-activity lifestyle. Limited knowledge exists regarding the factors that influence PA in this group. Therefore, we reviewed and mapped the available literature on factors that may influence PA in people with HNC.

Design We conducted a scoping review based on the framework of Arksey and O'Malley and the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guideline extension for scoping reviews.

Data sources CINHAL, the Cochrane Library, EMBASE, PsycINFO, MEDLINE and Scopus were searched from inception to July 2023.

Eligibility criteria We included qualitative and quantitative studies that stated factors such as barriers, facilitators, beliefs, perceptions and views influencing PA in individuals with HNC. Furthermore, views and recommendations of healthcare professionals involved in the care of people affected by HNC and researchers in this domain were eligible for data extraction.

Data extraction and synthesis Data were extracted and synthesised by one reviewer according to the predefined items including characteristics, barriers, facilitators, beliefs, perceptions and views of people being affected and views and recommendations of experts. Quantitative data were charted descriptively, and qualitative data were analysed and summarised using a basic content analysis approach.

Results Of the 1351 publications, we included 19 in our review. Publications mainly focused on barriers to PA, with some studies reporting facilitators and collecting data on patients’ and healthcare professionals’ views on PA. Most research teams made recommendations for promoting PA in people with HNC.

Characteristics associated with activity levels included age, cancer type and stage, morbidity level and attitude towards being active. Prevalent barriers consisted of health-related factors, including fatigue, pain and nutritional issues, alongside personal and environmental impediments such as time constraints, lack of interest or motivation. Facilitating factors for PA included perceived or experienced mental and health-related benefits. Consensus among patients, healthcare professionals and researchers highlighted the necessity for enhanced information and education, emphasising individualised approaches to promote PA throughout the cancer continuum.

Conclusions Numerous factors affect PA in individuals with HNC. Future research should concentrate on screening and addressing risk factors for sedentary behaviour and activity barriers and on optimal design and delivery of interventions to incorporate PA promotion into the care pathway.

Pflegerische Begleitung und Unterstützung bei Krebserkrankungen
Chapitre de livre

Bana Marika,

,  Onkologische Krankenpflege. 2024,  Heidelberg : Springer Verlag

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Résumé:

Die Unterstützung zum Management und Selbstmanagement von Symptomen gewinnt für die onkologische Pflege kontinuierlich an Bedeutung. In diesem Kapitel beschreiben wir die Grundlagen zum Management von Symptomen bei Krebserkrankungen und deren Therapien, stellen eine Auswahl von Screening und Assessment-Instrumenten vor und zeigen auf, wie die Unterstützung zum Selbstmanagement von Symptomen durch Pflegefachpersonen gestaltet werden sollte. Abschließend stellen wir ein Programm vor, welches die zentralen Elemente integriert und erfolgreich in die Praxis eingeführt wurde.

Onkologische Krankenpflege
Livre

Patrick Jahn, Andrea Gaisser, Bana Marika, Christoph Renner

2024,  Deutschland : Springer Verlag,  952  p.

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Résumé:

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

Survivorship
Chapitre de livre

Sperisen Nicolas, Sarah Stoll, Bana Marika

,  Onkologische Krankenpflege. 2024,  Heidelberg : Springer Verlag

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Résumé:

Frühzeitige Diagnostik und verbesserte Therapieoptionen bei Krebserkrankungen führen zu einem längeren Leben mit und Überleben von Krebs. Viele an Krebs erkrankte Menschen erfahren verschiedene Nebenwirkungen und Langzeitfolgen der Krankheit und/oder der Behandlung. Die Heterogenität dieser Auswirkungen erfordert eine individuelle, ganzheitliche und integrierte Betreuung. Pflegefachpersonen können dabei eine zentrale Rolle in der Betreuung und Begleitung übernehmen.

2022

Implémentation du programme Symptom Navi :
Article professionnel 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

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Selbstmanagement bei chronischen Krebserkrankungen fördern :
Article professionnel 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

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Résumé:

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 :
Article scientifique 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

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Résumé:

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 :
Thèse de doctorat ArODES
a cluster randomised pilot study (Symptom Navi Pilot Study)

Marika Bana

2020,  Lausanne : University of Lausanne.  138 p.

Manuela Eicher

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Résumé:

Introduction Le Programme Symptom Navi (« Symptom Navi Programme » ou SNP) est une intervention menée par le personnel infirmier en vue de soutenir les patient·e·s dans l’autogestion de leurs symptômes. Il comporte une information écrite (dépliants Symptom Navi ou dépliants SN, destinés aux patient·e·s), des consultations semi-structurées et un manuel de formation. Des études qualitatives antérieures auprès de patient×e×s et de professionnel·le·s ont montré une acceptabilité et une utilisabilité élevées des dépliants SN et la satisfaction des patient·e·s à l'égard des consultations dirigées par des infirmières et des infirmiers. La présente thèse s’insère dans l'étude pilote Symptom Navi. Elle avait pour objectif d’évaluer la faisabilité d’une mise en œuvre du SNP. Les résultats visés incluaient a) les taux de recrutement et de rétention des patient×e×s, b) le contenu de la formation et la fidélité du personnel infirmier à cette dernière ainsi que c) la sécurité préliminaire du programme et son impact sur les effets rapportés par les patient·e·s. Méthodes Une conception à deux bras parallèles randomisée par grappes a été employée pour attribuer les centres d’oncologie ambulatoire (= grappes) au groupe d'intervention (mise en œuvre du SNP) ou au groupe témoin (soins usuels). Ont été inclus·e·s dans l’étude des patient·e·s adultes germanophones commençant un traitement systémique de première ligne pour cancers de tout type. Les infirmières et les infirmiers du groupe d'intervention ont participé à deux cours de formation et évalué le contenu de celle-ci dans un questionnaire spécifique à l'étude. Après la formation relative au SNP, elles et ils se sont servi des dépliants SN pour fournir au moins deux consultations semistructurées par patient·e. Le sentiment de cohérence au travail du personnel infirmier a été utilisé pour examiner la relation entre sa confiance à appliquer le SNP et sa perception de la situation au travail sur le moment (échelle du sentiment de cohérence au travail [Work-related Sense of Coherence scale ou Work-SoC]. Pour investiguer la fidélité du personnel infirmier à la formation reçue, il a été recouru d’une part à des questionnaires spécifiques à l’étude évaluant son adhésion auto-déclarée à six éléments fondamentaux des consultations semi-structurées. Deux consultations semi-structurées ont d’autre part été observées dans chaque centre d’intervention. Afin de vérifier la sécurité du SNP, les infirmières, les infirmiers et les oncologues ont signalé tout événement indésirable potentiellement lié au programme. Des questionnaires validés ont été utilisés pour évaluer l'interférence des symptômes avec les fonctions de la vie quotidienne rapportée par les patient·e·s ainsi que la gravité/la pression des symptômes, l'auto-efficacité et la façon dont était perçu le soutien infirmier dans la gestion des symptômes. Les patient·e·s ont rempli les questionnaires au début de l’étude (stade baseline ou BL), après 1 à 3 semaines (t1), après 4 à 6 semaines (t2) et 16 semaines après le début (BL). Analyse Les observations des consultations semi-structurées ont été étudiées à l’aide d’une analyse thématique qualitative. Des analyses descriptives, le test Tau de Kendall et des modèles linéaires ou logistiques à effets mixtes ont servi à analyser les données. Afin d'explorer l'impact préliminaire sur les résultats déclarés par les patient·e·s, les changements de moyenne entre les deux groupes ont été comparés pour chaque point temporel (t1, t2, t3). Les scores de référence (scores BL), le groupe de traitement, le point temporel (t1, t2, ou t3 p. ex.) et l’interaction entre groupe et temps ont été inclus en tant que covariables fixes alors que la grappe et la/le patient×e étaient considérés en tant qu’effets aléatoires imbriqués. Résultats Quatre centres (49 patient×e×s) ont été attribués aléatoirement au groupe SNP et cinq autres (85 patient×e×s) servaient de contrôles. Un centre SNP s’est retiré de l’étude sans avoir recruté de patient×e×s. Le groupe SNP incluait davantage de femmes (p = .030), de patient×e×s plus jeunes (p = .001) et de personnes vivant avec des membres de leur famille nécessitant des soins. Le taux de recrutement s’est avéré notablement plus bas pour le groupe SNP que pour les contrôles (71% contre 90%, différence de risque -19%, 95% IC - 32% à - 7%, p = .003). Au total, 43 patient×e×s (88%) ont bénéficié de l’intervention telle que prévue (= taux de recrutement variant de 75% à 100%). Le personnel infirmier a accepté la forme et le contenu de la formation. La perception de sa confiance dans l’implémentation du SNP dans la pratique clinique a été corrélée positivement avec les scores globaux de l’échelle Work-SoC (rπ =.47, p = .04). Dans l’ensemble, le personnel a fait preuve d’une vi adhésion élevée à la formation. Selon ses déclarations, sa fidélité aux éléments centraux des consultations semi-structurées s’est élevée à 92% (95% IC : 87% à 97%). Toutefois, l’analyse des observations faites suggère qu’il a rarement fait usage des éléments de la formation à l’autogestion pour faciliter activement la gestion autonome des symptômes par les patient×e×s. Aucun événement indésirable n'a été signalé pour le groupe SNP. L’interférence des symptômes avec les fonctions de la vie quotidienne est restée inchangée sous application du SNP (différence moyenne à 16 semaines : -0.50; 95% IC : -1.38 à 0.38; p : 0.25) de même que tous les autres résultats relatés par les patient×e×s. Conclusions Dans l'ensemble, les taux de recrutement et de rétention, l'acceptation de la formation par les infirmières et les infirmiers et leur taux d'adhésion élevé à celle-ci indiquent que les centres participants ont bien accueilli la mise en œuvre du SNP. Aucun effet indésirable n'a été observé. Les résultats obtenus révèlent néanmoins que le programme n'a eu aucun impact sur les effets déclarés par les patients. Il convient d’améliorer le SNP en renforçant les éléments de formation à l'autogestion des symptômes et le rôle de coach du personnel infirmier avant de planifier de nouvelles investigations.

COVID-19 und Onkologiepflege :
Article professionnel ArODES
Pflegeexpertinnen/-experten diskutieren Herausforderungen

Marika Bana, Manuela Eicher

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

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Symptom Navi Programm :
Article professionnel ArODES
Symptom-Selbstmanagement bei ambulanten Krebstherapien

Marika Bana, Karin Ribi, Manuela Eicher

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

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Patients atteints de cancer - une offre de soutien ambulatoire :
Article professionnel ArODES
la consultation infirmière CINA-CANCER à Fribourg

Natacha Szüts, Marika Bana

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

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

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Résumé:

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
Article scientifique

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

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Résumé:

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 :
Article scientifique 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

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Résumé:

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 :
Article professionnel ArODES
Selbstwirksamkeit beeinflusst das Symptom-Selbstmanagement

Marika Bana

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

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Résumé:

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)
Article scientifique

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

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Résumé:

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

Onkologische Pflegekonsultationen :
Article professionnel 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

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La consultation infirmière en oncologie :
Article professionnel 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

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2024

Social quality of life experience after allogeneic stem cell transplantation for Swiss Non-Hodgkin Lymphoma long-term survivors
Conférence
SQoL ALLOHNS study

Bana Marika

SOHC 24, 20.11.2024 - 22.11.2024, Basel

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Résumé:

Background: Non-Hodgkin Lymphoma (NHL) standardized relative survival 5-years after diagnosis is 74.9% (95% CI 73.7-76.1%). Allogeneic stem cell transplantation (alloHSCT) is the only potentially curative treatment for relapse/refractory NHL (rrNHL), a subgroup facing health and social problems. We explored rrNHL post alloHSCT psychosocial quality of life (SQoL) as part of the ALLOHNS study (Swiss Cancer Research grant HSR-5223-11-2020).

Methods: We invited 97 rrNHL survivors at least 2 years post alloHSCT treated in a Swiss University Hospital (Zurich, Basel, or Geneva) to an online survey. Participants completed the WHOQoL-BREF questionnaire in German or French. Survey data were descriptively analysed. Hypotheses testing was not possible due to the small cohort size. In-depths interviews on subjective health and psychosocial needs were added to complement survey results.

Results: 41 rrNHL, (42%) completed the survey between December 2023 and August 2024, with a median of 8 years (4-23) post alloHSCT. The median age was 64 (53,69) years and most participants were men (76%). The level of education in 22% was university, and 29% tertiary education level, 59% were married and 17% lived with a partner. Overall QoL satisfaction was mostly “very good” (46%) or “good” (39%). Most participants were very satisfied or satisfied with their work capacity (74%), social relationships (83%) and social support (90%). 39% of participants were retired and 12% self-employed. Sexuality concerns were frequently reported (67.5%). 11 patients participated in-depth interviews where they confirmed overall good SQoL but altered sexuality life, and reported furthermore fatigue affecting daily routines and work activities demanding modifications. Important support resources were the HSCT care team and a sustainable social network. Main issues reported were financial and insurance matters, reduced work capacity, dismissals, unemployment and the lack of support to solve them. Supportive peer meetings to facilitate after alloHSCT reintegration arised as a relevant unmet need.

Conclusions: Well-educated Swiss post alloHSCT rrNHL survivors report overall good SQoL and seem to be satisfied with their general situation, work capacity, and social network. In-depth interviews revealed support needs related to finances and professional integration post alloHSCT. The results should be interpreted with caution due to the small cohort size.

Cancer Survivorship
Conférence
Massnahmen zur Überwindung von 'Lost in Transition'

Bana Marika

SOHC 24, 20.11.2024 - 22.11.2024, Basel

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Résumé:

Vorstellung des Masterplans von Oncosuisse zum Thema Survivorship und die vorgeschlagenen Ziele, welche in einen nationalen Krebsplan einfliessen sollen.

Massnahmen zur Unterstützung des Selbstmanagements
Conférence

Bana Marika

Jahrestagung 24 DGHO, 12.10.2024 - 12.10.2024, Basel

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Résumé:

Introduction
Cancer and its treatments can lead to physical and psychological symptoms, financial challenges and worries about recurrence. To support selfmanagement of such challenges early in the disease course can make an important difference for persons living with cancer and beyond. Coaching people affected by cancer to improve their symptom self-management requires a behaviour change in health care professionals (HCP).
Methods
We developed the Symptom Navi Programme (SNP) a standardised programme in cooperation with cancer patients and HCPs. The SNP comprises 3
components: 1) semi-structured consultations to facilitate self-efficacy, 2) evidence-based recommendations on leaflets in written and digital format to
support self-management, and 3) a standardised training for HCPs applying the SNP. Semi-structured consultations are based on self-management and self-efficacy theories. The SNP implementation at different cancer centres has been evaluated with mixed methods using questionnaires with responses based on Likert scales, written narrative feedback, and telephone interviews. Data were analysed descriptively.
Results
We implemented the SNP in 13 Swiss cancer teams: at 7 cancer centres, at 3 medical cancer practices, at 2 cancer leagues, and at 1 outpatient palliative
care team. Overall, we trained 100 HCPs to support self-management with the SNP (duration: M 3.48 h, SD = 0.31), and 47 HCPs attended a follow-up
training to enlarge self-management skills (duration: M 1.8 h, SD = 0.25). HCPs reported that self-management recommendations on leaflets were of high
quality and very useful. They further confirmed that the trained semi-structured consultation approach was very important (m = 5.7 on a 6-point Likert
scale). Narrative feedback revealed that HCPs are motivated to apply semi-structured consultations and they found supporting self-management as
important and feasible. However, HCPs emphasized that contextual factors as time and staff shortage are relevant barriers to implement the SNP in their
daily praxis.
Conclusions
Trained HCPs confirmed the significance for supporting self-management in the cancer setting. To implement self-management interventions, it is key to
support HCPs motivation to coach patients and families even in a challenging practice context facing staff shortage.

2023

Selbstmanagement bei Krebserkrankungen unterstützen
Conférence

Bana Marika

Summer School in Palliative Nursing, 07.09.2023 - 07.09.2023, Zürich

2022

Evaluation of the implementation of the Symptom Navi Programme
Conférence
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

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Résumé:

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
Conférence

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

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Résumé:

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
Conférence
Eine qualitative Evaluation der Anwendung des Symptom Navi Programms

Bana Marika

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

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Résumé:

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
Conférence
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

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Résumé:

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.

Réalisations

2020

PhD in Nursing Science

 2020 ; Faculty of Biology and Medicine, University of Lausanne

Collaborateurs: Bana Marika

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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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