CALM-N Builds Nurse Competence in Distress Interventions in Advanced Cancer

Oncology nurses are well-positioned to provide psychological interventions that can help reduce distress in patients with advanced cancer, according to a study recently published in Seminars in Oncology Nursing.

Research suggests that some cancer patients prefer seeing a nurse for help with psychological problems, rather than a psychologist. While nurses are positioned to offer such care, they often don’t receive any formal training to help them address concerns such as fear of dying with confidence and skill.

A team of researchers investigated the potential benefits of an intervention that would teach nurses the basics of using an evidence-based psychotherapy intervention called Managing Cancer and Living Meaningfully (CALM). 

For this CALM-Nurses (CALM-N) training, 55 nurses were recruited and divided into 3 training groups. Of 35 participants who completed a pretraining questionnaire and the first e-learning, 29 (83%) went on to attend the first group session. A total of 22 (63%) attended all the group sessions and submitted follow-up questionnaires.

The 20-item Jefferson Scale of Empathy (JSE) is used to measure empathy in the context of healthcare professionals. The response rate for the JSE in this study was 63% (22). The response rate for a self-efficacy scale was 66% (23). The response rates for the following subscales of the Professional Quality of Life (ProQOL) were as follows: 51% (18) for the burnout subscale, 49% (17) for secondary traumatic stress, and 57% (20) for compassion satisfaction.

The researchers found a statistically significant increase in self-efficacy, but changes in self-reported levels of professional empathy or professional quality of life were not significant.

However, focus group feedback indicated that the CALM-N training helped nurses increase their understanding of patients and nurse-patient communication, as well as increased their compassion for patients and increased their perspective taking.

The researchers noted that this study was limited by its small sample size, lack of a control group, and a “considerable” dropout rate among the original participants. Additionally, there may have been some bias in the studied group, as the nurses voluntarily signed up for the course and study.

The researchers concluded that teaching the basic principles of CALM to oncology nurses, who were motivated to learn about CALM, is feasible. The nurses reported increased self-efficacy, knowledge, skills, and changed attitudes after completing the training.

“More importantly, nurses reported an increase in their ability to reflect and use perspective taking,” the researchers stated. “Further research is needed to identify the generalizability of the findings to oncology nurses from different backgrounds and in different work settings and to assess the effect of CALM-N on nurse-patient interactions.”

Reference

van Klinken M, Hafkamp E, Gualtherie van Weezel A, et al. Teaching oncology nurses a psychosocial intervention for advanced cancer: a mixed-methods feasibility study. Semin Oncol Nurs. Published online September 25, 2023. doi:10.1016/j.soncn.2023.151507