Breast cancer is the most prevalent form of cancer that affects women worldwide, posing a significant burden on public health. While advancements in early detection and improved treatments have led to a remarkable 90% five-year survival rate and an 83% ten-year survival rate, this has also resulted in more prophylactic mastectomies being performed. Despite advancements in breast-conserving techniques, immunotherapy, and hormone therapy, many women still undergo mastectomies as part of their cancer treatment. In all cases, this results in scarring, and additional side effects from treatment modalities may arise. The loss of a breast can profoundly impact health-related quality of life (HRQoL). Although HRQoL has improved greatly during the recent years, systematic and local therapy having side effects is not uncommon, and this needs more attention.
There is a wide range of literature suggesting that implicit learning is more effective than explicit learning when acquiring motor skills. However, the acquisition of nursing skills in educational settings continues to rely heavily on detailed protocols and explicit instructions. This study aimed to examine the necessity for comprehensive protocols in the acquisition of nursing skills. In the context of bandaging techniques, three studies were conducted to investigate whether students who practiced with an instruction card containing minimal instructions (implicit group) performed comparably to the students who practiced with a protocol containing step-by-step instructions (explicit group). Study 1 was designed to determine whether both groups performed equally well in applying a bandage during training. Study 2 and 3 were designed to determine if both groups performed equally well during a retention and transfer (multitasking) test, administered after a series of three training sessions. In comparison with the explicit group, the implicit group demonstrated comparable performance with their practice attempts in Study 1 and performed equally well during the retention and transfer test in Study 2. Furthermore, several results from Study 3 indicated better performance of the implicit group. In conclusion, the use of protocols with explicit step-by-step instructions may not be essential for the acquisition of nursing skills. Instead, instructional methods that facilitate implicit learning may be preferable, as students in the implicit group demonstrated at least comparable performance in all studies and tended towards greater consistency when multitasking.
Background: Despite the large availability of caregivers, there are no standardized care pathways for patients with acne. This increases the risk of ineffective care and unnecessary medicalizing. To better understand how to provide effective, efficient, and patient-satisfying care, it is necessary to gain insights into the patient journey through acne healthcare services. Objective: To explore the patient journeys, assessed by a series of consecutive steps through acne healthcare. Methods: A cross-sectional survey was conducted among Dutch individuals with acne. Results: A total of 371 respondents completed the questionnaire. Data revealed 58 different pathways through acne healthcare services. Patient with severe acne had a stronger tendency to seek professional care than those with mild acne (p<.05). The highest proportion of clinically relevant improvement was found in patients treated by dermatologists, compared to respondents treated by beauticians, p¼.023 and dermal therapists, p¼.018. Conclusions: Mapping the patient journeys contributed to a better understanding of the gap between professional guidelines and the experiences of patients. Identifying these areas of care implies that there is potential to bring acne care services more in line with the patients’ needs. Further research is recommended; for example by comparing the clinical treatment outcomes of multiple sequences of caregivers.
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