DEPARTMENTS: Guest Editorial
Responding to the individual needs of the person affected by cancer is a fundamental tenet of nursing care. The evidence base to enable highly personalized approaches to the way we provide care has grown enormously in recent years. Today, we have a much better understanding of the mechanisms underpinning health needs of people with cancer, as well as the wide range of environmental, sociocultural, psychological, and biological influences on these needs. This growing evidence base enables us to better target and tailor interventions in increasingly sophisticated ways.
At the same time, such developments present new challenges in practice as important advances in nursing science place real pressures on a healthcare system that may not have the capacity to deliver the benefits to all in our community. We live in times where the demand for health resources is increasing. What happens when we have evidence for a new intervention that can make a substantial difference to peoples’ lives, but the intervention won’t be available to all or is applicable only to a few?
There are many ethical issues that arise when faced with such dilemmas, and health reforms will be required at many levels to achieve best outcomes for our communities. A recent commentary published in the American Journal of Preventive Medicine entitled “Authentic Population Health”1 highlighted 2 key principles that resonated with me as I reflect on how nurse researchers can address these challenges.
First, the author commented that, to optimize health, we must “balance the equity equation” and “remember that everyone has a right to health.”1 To balance the equity equation, we need good epidemiological studies and good qualitative work to understand diversity and the reasons for this. Such studies can help build the evidence needed to enable risk stratification and needs-based care,2 so we are better able to provide the right care to the right person at the right time.
Second, the author argued that “the problems we face are systemic and deeply rooted, requiring creative approaches, hard work, and personal risk.”1 He argued we need to “be bold.” In research, this means we need to celebrate the diversity in our communities and build this into our study design and the way we conceptualize our interventions. The UK Medical Research Council3 provides useful guidance for researchers when designing studies to address problems where multiple interacting components and social and environmental influences can make a difference to the outcome.
As researchers in cancer nursing, we can do a lot to maximize the impact of our work for the population of people affected by cancer. The challenges of today’s healthcare system require us to take on board some of the principles of population-based approaches to health in the design and implementation of our research. As nurses, we are well placed to understand how these principles can be applied to enable personalized care.
My very best to you,
Patsy Yates, PhD, RN
Editorial Board Member, Cancer Nursing: An International Journal of Cancer Care
Institute of Health and Biomedical Innovation and School of Nursing
Queensland University of Technology
1. Frank SH. Principles for authentic population health. Am J Prev Med
. 2011; 41 (4): S152–S154.
2. Watson EK, Rose PW, Neal RD, et al.. Personalised cancer follow-up: risk stratification, needs assessment or both? Br J Cancer
. 2012; 106: 1–5.