Introduction
Methods
Phase One: Systematic Review of Advanced Breast Cancer Education Programs for Nurses
Phase Two: a Modified Four-Round Delphi Study
Phase Three: Module Development and Implementation
Modules | Learning outcomes |
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Module 1: understanding metastatic breast cancer | • Understand terminology relevant to advanced breast cancer • Describe signs and symptoms of advanced breast cancer • Explain staging and grading in breast cancer • Explain the incidence and risk factors for metastatic breast cancer • Describe the molecular heterogeneity of metastatic breast cancer • Explain the metastatic cascade in breast cancer |
Module 2: supportive care skills in metastatic breast cancer | • Explain what is meant by person-centred supportive care in advanced breast cancer • Explain the nurse’s role in supportive care in advanced breast cancer • Outline how nurses can provide culturally sensitive care in advanced breast cancer • Identify support services for family members and informal caregivers of people living with advanced breast cancer • Describe the communication challenges that arise throughout the metastatic breast cancer trajectory (information provision, living with uncertainty, disease progression, transition to palliative care, end-of-life care) • Outline barriers to therapeutic communication in advanced breast cancer • Outline the six-step protocol used in SPIKES, when giving bad news • Outline communication challenges with family members and informal caregivers of people with cancer • Describe how to de-escalate conflict situations and strategies to establish a working relationship with a dominant family member • Understand coping with emotional demands of caring for people with advanced breast cancer (family, informal carers and members of the MDT) |
Module 3: treatment options and decision-making in metastatic breast cancer | • Explain what is meant by inter-disciplinary/multi-disciplinary/collaborative care • Explain the nurse’s role within the advanced breast cancer multidisciplinary team • Explain international consensus guidelines for advanced breast cancer and the role of specialised breast cancer units • Describe the objectives of treatment in advanced breast cancer • Describe the factors that influence cancer treatment choices in advanced breast cancer • Outline the factors underpinning informed decision-making in advanced breast cancer • Explain the role of chemotherapy in the management of advanced breast cancer. • Explain the role of targeted therapy in the management of advanced breast cancer • Explain the role of hormone therapy in the management of advanced breast cancer • Explain the role of immunotherapy in the management of advanced breast cancer • Explain the role of radiotherapy in the management of advanced breast cancer symptoms and acute care needs • Describe the role of clinical trials in advanced breast cancer |
Module 4: acute care needs of metastatic breast cancer | • Explain the common terminology criteria for adverse events (CTCAE) • Outline the most common and most dangerous side effects of treatment in advanced breast cancer • Describe pathophysiology and management of hypercalcemia in malignancy • Describe the pathophysiology and management of malignant spinal cord compression • Describe the pathophysiology and management of neutropenic sepsis • Describe the pathophysiology of disease and treatment-related thromboembolism • Describe the pathophysiology and management of pleural effusion • Describe the pathophysiology and management of superior vena cava obstruction • Describe pathophysiology and management of brain metastases |
Module 5: assessing and managing common symptoms in metastatic breast cancer | • Explain person-centred assessment in advanced breast cancer • Explain what is meant by a symptom cluster • Describe the symptoms of the ‘fatigue, depression, sleep-wake disturbance’ symptom cluster and evidence-based interventions • Describe the role of bone modifiers (bisphosphonates and denosumab) in the management of metastatic bone pain and reducing skeletal-related events • Describe symptom management for fungating breast wounds to reduce pain, bleeding, discharge and offensive odour • Describe symptom management for disease-related breathlessness • Describe symptom management for disease and treatment-related gastrointestinal symptoms |
Module 6: living well with metastatic breast cancer | • Outline the physical, psychological, social and spiritual implications of living with metastatic breast cancer • Outline the impact of a metastatic breast cancer diagnosis on family, children and informal caregivers • Explain the meaning of living well for individuals with advanced breast cancer • Identify support services for people living with advanced breast cancer • Describe interventions that support the self-management skills of people living with advanced breast cancer • Outline the role of complementary therapies in symptom management and wellbeing in advanced breast cancer • Explain the factors necessary for integrating early palliative care to support wellbeing throughout the treatment journey in metastatic breast cancer • Describe the role of advance care planning in end-of-life communication in metastatic breast cancer |