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Abstract
Introduction Telenursing is a component of telehealth that occurs when nurses use information and communication technologies to provide care and nursing services remotely. To understand how telenursing services in surgical oncology patients can be better implemented, it is important that the success models are collected and studied. Therefore, the general objective is to develop the scoping review protocol for the survey of existing evidence on the practice of oncological perioperative telenursing.
Methods and analysis The scoping review will be conducted following the scoping review directions of the Joanna Briggs Institute with the use of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for scoping reviews checklist for the review report. The databases that will be used for these searches will be: MEDLINE (PubMed), EMBASE, CINAHL, SCOPUS, Web of Science and Virtual Health Library. To search for grey literature, Google Scholar, WorldWideScience and Global ETD Search will be used. Primary studies, observational or experimental, published in any year or language will be considered. For the selection and extraction of data, two independent reviewers will read the title, summary and full text using the Rayyan software and a form prepared by the authors. The data to be extracted are related to the characterisation of the study (study design, country and year of publication) and details of the telenursing programme (surgery or surgical specialty, perioperative period, tools used, organisation and operation, outcome indicators and treatment methods and content in telenursing). Among others, the difficulties and potentialities for the development or implementation of telenursing will also be extracted, as the main result of the study.
Ethics and dissemination The study does not require ethical approval as it will use previously published research data. The results will be shared in journals and scientific events and may be used for the development and implementation of oncological perioperative telenursing programmes.
- Patient-Centered Care
- ONCOLOGY
- SURGERY
- Nursing Care
- Telemedicine
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STRENGTHS AND LIMITATIONS OF THIS STUDY
First review of existing literature that will consolidate oncological perioperative telenursing practice.
Research strategy developed by teachers and doctors in sickness.
Since this study identifies indicators of oncological perioperative telenursing, it will not have evaluated the quality of the study as well as the quality of two indicators.
Introduction
The development of nursing over the years has provided a change in the necessary care for patients. These changes imply, for example, in the increase in the level of skills related to communication with the patient, while they are in nursing care.1 2 Telenursing is a component of telehealth that occurs when nurses use information and communication technologies to provide remote nursing care and services.3 This communication model is a technological instrument capable of transmitting health data and providing care.2 Nursing, remotely, can monitor, educate, collect data, accompany and offer multidisciplinary care.2 4
Different telenursing programmes have been implemented to generate positive results regarding patient experience and institutional metrics. In the perioperative area, studies in various surgical specialties have been published.5–7 But among all, one that deserves highlighting is oncological surgery. The discipline of surgical oncological disease is indisputably one of the first forms of oncological care. Although the human suffering associated with oncological disease still exists, the work carried out for oncological disease and surgical oncology has helped to promote efforts to exactly achieve the minimisation of this problem.1
The unmet needs of patients with cancer are already the subject of studies, which suggest the need for improvements in communication between health professionals and patients to reduce the discrepancy between information about care, expectations and satisfaction with results.8 9 In this sense, studies on the practice of telenursing in these patients point to the possibilities of clarifying doubts and providing health guidance.10 Given this, to understand the implementation of telenursing in surgical oncology patients, it is important that the implemented models are gathered and studied. Likewise, an analysis of the characteristics of these services may provide information so that other health organisations can be assertive regarding their efforts to implement nursing interventions in this modality.4
There is a lack of unified knowledge about the implementation of perioperative telenursing services, which makes replication difficult in other institutions. Research with this purpose has not yet been identified even after a previous search in the last quarter of 2022 on the websites of PubMed, Cochrane, Joanna Briggs Institute (JBI) Evidence Synthesis, PROSPERO and Open Science Framework (OSF) Registries.
To fill this gap, a scoping review will be carried out with the objective of identifying the practice of oncological perioperative telenursing in the existing literature through: (1) characterisation of oncological perioperative telenursing services; (2) characterisation of outcome indicators used in oncological perioperative telenursing services, (3) identification of the content of care in oncological perioperative telenursing. In this article, the scoping review protocol to survey existing evidence on the practice of oncological perioperative telenursing will be detailed.
Methods and analysis
The proposed scoping review protocol will be conducted according to the JBI scoping review guidelines11 and will be presented using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for scoping reviews (PRISMA-ScR) checklist,12 for reporting the review. The scoping review protocol will be registered in the OSF with the link: osf.io/hkznf. The scoping review will take place following all of the steps: definition of the research question and objectives, search for relevant studies, selection of eligible studies, synthesis of information and analysis of results.11
Patient and public involvement
There will be no involvement of patients or members of the public for the development of this research.
Review question
The research question was created based on the PCC mnemonic (Population, Concept and Context), being:
P (population)—surgical oncology patients.
C (concept)—telenursing.
C (context)—perioperative period.
The elements described above allowed the authors to define the scope and focus of this review, so that the following central research question could be developed: ‘How does perioperative telenursing occur in surgical oncology patients?’
Inclusion criteria
The PCC elements mentioned above will be used to describe the selection criteria. Furthermore, the scoping review will consider primary, observational and experimental studies, and grey literature published in any language or year, as long as they are related to the proposed objective.
Participants
This review will consider studies on adult or elderly patients undergoing surgical treatment for cancer.
Concept
The practice of telenursing between nurses and patients/guardians will be considered as a concept to assess their health status and propose care related to the surgical context.
Therefore, telenursing will be considered as any type of contact that may occur using the internet or telephone network to make video calls, voice calls, telephone calls, and use applications and send text messages or documents.
Context
The review will use elective surgeries in the preoperative (before hospital admission) and postoperative (within 1 year after hospital discharge) period as a context.
Types of evidence sources
This scoping review will use white and grey literature sources to carry out the research. The databases used to carry out the searches will be: MEDLINE (PubMed), EMBASE, CINAHL, SCOPUS, Web of Science and Virtual Health Library (VHL), which provides extensive scientific research content from reference databases in different health fields, such as: Latin American Health Sciences Literature of Latin America and the Caribbean, Spanish Bibliographic Index of Health Sciences and Nursing Database. The grey literature search sources will be: Google Scholar, WorldWideScience, Global ETD Search and the list of references of the included articles, to carry out the reverse search.
Search strategy
The search strategy will aim to locate primary studies, reviews and text and opinion articles published according to the theme. An initial search was carried out on MEDLINE (PubMed) to identify articles on the topic. The text words contained in the titles and abstracts of the relevant articles, and the index terms used to describe the articles were used to develop the search strategies for each indexing language. Different search strategies were developed by the team of reviewers to be used in five databases (MEDLINE (PubMed), EMBASE, CINAHL, SCOPUS, Web of Science), the VHL and grey literature (Google Scholar, WorldWideScience, Global ETD Search) according to the corresponding indexing languages (table 1).
Research strategy, Vitória, Brazil, 2023
Additionally, grey literature will be researched to include texts and opinion articles, as well as dissertations and theses. Likewise, study authors will be contacted via email for clarification, if necessary. Furthermore, based on the references of the selected articles, a manual search will be carried out for relevant articles that were not found in the initial search.
Study selection
The selection of studies will occur in three stages: exclusion of duplicate publications, selection by title and abstract, and selection by reading the full text. These steps will be carried out by two reviewers independently and after applying a pilot test to increase the consistency of the selection. First, the results obtained from all data sources will be exported and uploaded to the Rayyan online software13 where duplicates will be checked and excluded. After this step, the studies will automatically be classified as ‘undecided’ within Rayyan’s ‘inclusion decisions’ chart.
The pilot test will be applied before the official selection of studies. Reviewers must include studies according to previously agreed eligibility criteria for reading the title, abstract and full text. Therefore, studies that provide ‘yes’ as an answer to the following five questions will be included: Is the full text available?; Does the study address adult or elderly patients?; Does the study cover surgical oncology patients?; Is the study related to nursing?; Does the study use telenursing as an intervention to promote care?
The test will be carried out by two reviewers, using the same random sample containing 25 publications. Any discrepancies that arose were handled by the third reviewer in order to resolve conflicts of understanding. The team of reviewers was only able to start screening when there was agreement superiority above 75%.11 In screening, within Rayyan software, reviewers will classify ‘undefined’ studies as ‘maybe’ or ‘excluded’. For articles classified as ‘excluded’, the reason for exclusion must be added: ‘not related to the topic’ or ‘text not available’. Studies classified as ‘maybe’ after reading the title and abstract will move on to the third selection stage: reading the full text. At this stage, the same eligibility criteria previously described must be used. Articles that are accepted to compose this scoping review must be classified as ‘included’. Articles that are rejected at this stage must be classified as ‘excluded’, adding the reason for this.
Articles approved to be included in this review will have their list of bibliographical references evaluated. This reverse search will occur by evaluating the title, summary and full reading of the text, taking into account the inclusion and exclusion criteria. For each stage, if there are disagreements between the reviewers, a third reviewer must be allocated to mediate the discussion of inclusion or exclusion of the study. The results of each stage were fully reported in the scoping review and were presented in the PRISMA-ScR flow chart.12
Data extraction
Data will be extracted from the articles included in the scoping review independently by two reviewers. At the end of the extraction, the information collected will be evaluated and if there is a discrepancy between the reviewers, a third reviewer will be contacted. A data extraction tool developed by the team of reviewers in Microsoft Excel 365 and previously tested on five publications will be used, ensuring that the following desired characteristics are extracted in detail:
Title.
Authors.
Type of publication (scientific article, editorial, others).
Main goal.
Search method (database, grey literature, reverse search).
Year of publication.
Geographical location (country and continent).
Research design and total number of participants evaluated (if any).
Result indicators and measurement methods (instrument or scales used).
Surgery or surgical specialty.
Tools used to practise telenursing.
Perioperative period of telenursing application (preoperative or postoperative).
Time of the first telenursing.
Frequency of telenursing practice.
Duration of patient follow-up via telenursing.
Average duration of the telenursing session.
Content of telenursing care.
Difficulties/limitations and facilities/potential for the development or implementation of telenursing.
Main result of the study.
The data extraction tool may be modified as necessary during the data extraction process, as long as it is mutually agreed upon by the review team members. Any changes that occur will be detailed in the scoping review. When necessary, the authors of the studies will be contacted to request additional data.
Synthesis of results
Data analysis will occur using the content analysis method, whose information will be synthesised through its characteristics and theoretical approach. Furthermore, to characterise some data, the quantitative method of occurrence of concepts and characteristics will be used. Assessment of the quality of studies will not be evaluated, as the objective of the scoping review is to provide a descriptive overview of oncology perioperative telenursing programmes and evidence will also come from the grey literature. In this way, the data will be organised to better elucidate the information that will form the existing body of evidence on the practice of oncological perioperative telenursing.
Ethics and dissemination
As the scoping review methodology consists of reviewing and collecting data from publicly available studies, this study does not require ethical approval. The results of this scoping review will be shared in journals and scientific events to demonstrate the use of communication technologies in nursing. Furthermore, the results could be used to guide the development and implementation of oncological perioperative telenursing programmes.
Ethics statements
Patient consent for publication
Footnotes
Twitter @carlaanmozer
Contributors CAdNM—acquisition, analysis and interpretation of data for the work; drafting the work; final approval of the version to be published; accountability for all aspects of the work. JdCG—acquisition, analysis and interpretation of data for the work; drafting the work; final approval of the version to be published; accountability for all aspects of the work. LSdS—interpretation of data for the work; drafting the work; final approval of the version to be published; accountability for all aspects of the work. LBF—contributions to the conception and design of the work; critical revision for intellectual content; supervision; final approval of the version to be published; accountability for all aspects of the work. MF—contributions to the conception and design of the work; critical revision for intellectual content; supervision; final approval of the version to be published; accountability for all aspects of the work.
Funding This work was carried out through the following support:Espírito Santo Research and Innovation Support Foundation (FAPES) – 379/2022 - P:2022-WDFC7;Agreement Foundation Coordination for the Improvement of Higher Education Personnel (CAPES)/Federal Nursing Council (COFEN). Notice No. 28/2019.
Competing interests None declared.
Patient and public involvement Patients and/or the public were not involved in the design, or conduct, or reporting, or dissemination plans of this research.
Provenance and peer review Not commissioned; externally peer reviewed.