The Nurse's Role in Curative-to-Palliative Transitions in Advanced Cancer: A Theory Synthesis Using Turner's Method

Area of Science:

• Oncology Nursing
• Palliative Care
• Theory Development

Background:

• The transition from curative to palliative care in advanced cancer presents complex challenges for patients and nurses.
• Understanding the full scope of nursing roles during this transition is crucial for effective patient support.
• Existing theories may not fully capture the multifaceted nature of nursing practice in this context.

Purpose of the Study:

• To formulate a robust theory explaining the nurse's role during the transition from curative to palliative care in advanced cancer.
• To develop a comprehensive and testable theoretical framework for oncology nursing practice.

Main Methods:

• A qualitative theory synthesis approach using Turner's 9-step method.
• Integration of five grounded theories and 10 qualitative studies.
• Application of the Walker and Avant method for concept development and analysis.

Main Results:

• A novel theory was formulated, describing nursing roles within a "visible spectrum" (known/recognized) and an "invisible spectrum" (unknown/unrecognized).
• Key invisible roles include brokering referrals, emotional reframing, and cultural advocacy.
• The theory was refined through expert review for real-world applicability.

Conclusions:

• Theory synthesis is a valuable method for accumulating evidence and building theory-driven, evidence-based practice.
• The developed theoretical framework explicates the visible and invisible roles of nurses in cancer care transitions.
• This framework can inform curriculum development, professional recognition, and practice standards, enhancing patient care and interdisciplinary collaboration.