Natalie Williams

Benchmarking vulvar cancer wound care practice in Australia and New Zealand: A cross-sectional study

This study aimed to investigate current vulvar cancer wound care practices in Australia and New Zealand, identify knowledge of evidence supporting practice, explore enablers and barriers and determine areas for future improvement and research. An online cross-sectional survey collected quantitative and qualitative data from 64 nurses and doctors between May and July 2023. Descriptive statistics and content analysis were conducted. A consumer advisory group contextualised findings within lived experiences. Common vulvar wound care practices included wound irrigation (n = 48, 83 %) and perineal drying (n = 40, 69 %), along with urinary catheters (n = 50, 86 %) and drains (n = 33, 57 %). Not using a wound dressing was common (n = 41, 71 %). Using silver (n = 25, 39 %), topical (n = 11, 17 %) or prophylactic (n = 2, 3 %) antibacterial agents were less common. Only 23 % (n = 15) of respondents reported knowledge of organisational guidance and care was commonly determined by practitioner preference, clinical assessment, and specialist wound nurse review. Reported enablers included guidance documents, clear instructions, clinician expertise, effective communication, and a well-informed patient. Reported barriers included infection, comorbidities, clinician variability, lack of evidence, systematic barriers, poor communication, and wound access challenges. The most common suggestion for improvement was the development of evidence based guidance. Four priority areas for future research were identified as; building an evidence base, evaluating the patient experience, investigating the impact of reducing risk factors and evaluating education interventions. By benchmarking current wound care practices following surgery for vulvar cancer in Australia and New Zealand, priorities to direct future research and practice change efforts are supported.

Support for an innovative approach to delivering gynaecological cancer nursing guidance: A qualitative exploration – Part 2

Gynaecological cancer nurses in Australia are seeking formal guidance to support them and improve equitable nursing care delivery. No comprehensive guide for specialised nursing care of gynaecological cancers is available; however, it is recognised that challenges exist to guidance implementation and active involvement of stakeholders during development is critical to enhance implementation success. This study aimed to explore expectations of nurses and people with lived experience during development of a guidance resource for specialised gynaecological cancer nursing. This paper presents expectations on content and design. Utilising an exploratory qualitative descriptive design, gynaecological cancer nurses and people with lived experience of a gynaecological cancer participated in focus groups or interviews following a semi-structured interview guide. Transcripts underwent inductive content analysis. Participants included 20 nurses and seven people with lived experience of gynaecological cancers. Two major themes emerged: "Support care and educate nurses with content across the care continuum" and "Design the guidance with functionality and practicality for nurses in everyday practice". Participants wanted provision of "practical and instructive" guidance that "incorporates interactive elements", "ensures easy accessibility" and "integrates visual appeal". "Comprehensive patient support content linked to clinical tools and external resources" and "Including education on disease, nursing roles and well-being" were considered important. Expectations for gynaecological cancer nursing guidance to include content across the care continuum and functionality supports the need to plan for an innovative resource format. Further exploration of implementation determinants, along with adopting an implementation science framework and integrating adult learning principles is recommended.

Exploring clinical trials awareness, information access and participation amongst Australians with ovarian cancer: a qualitative study

Abstract Purpose Ovarian cancer is associated with advanced stage diagnosis and poor survival rates. Clinical trials are critical for improving both clinical and quality of life outcomes. Challenges exist to clinical trials awareness, information access and participation, but perspectives of Australians with ovarian cancer have not been previously investigated. We aimed to explore clinical trials awareness, information access and participation amongst Australians with ovarian cancer. Methods Utilising an exploratory qualitative approach, women with ovarian cancer participated in online focus groups and interviews between December 2023 and February 2024. Transcripts underwent inductive content analysis. Results Five themes and five subthemes emerged. In theme 1, participants identified “Barriers exist that affect clinical trial awareness and participation” and were explored through their experience of ovarian cancer. In theme 2, participants shared that “Instigating the conversation and doing my own research” was necessary to access clinical trials. Theme 3 describes ideas on “Finding solutions to improve clinical trial awareness and information access” through subthemes: “we need a centralised, credible source”; “communicate clinical trials in various ways from trusted contacts”; and “I want tailored, relevant information”. Theme 4 explained that “Altruism is a motivator” in willingness to participate in trials. Finally, in theme 5, participants explained that “Emotions regarding clinical trials are varied” illustrated in subthemes: “feeling left behind” and “feeling fortunate”. Conclusions These qualitative insights will inform development of a cross-sectional survey for national distribution amongst Australians with ovarian cancer. Results will assist in developing solutions to improve clinical trials awareness and information access.

Listening to Australians with ovarian cancer: a cross-sectional survey investigating clinical trials awareness, information access and participation

Abstract Purpose To inform development of centralised, evidence-based clinical trials resources for Australians with ovarian cancer, a structured understanding of knowledge gaps and resource needs was essential. The study aimed to assist resource development by assessing awareness, information access, and participation in clinical trials of ovarian cancer patients. Methods A national, cross-sectional online survey among Australians with ovarian cancer was conducted between October and November 2024. Descriptive and inferential statistics along with qualitative content analyses were conducted. Associations were examined using Chi-Square and Fisher Exact tests. Results Surveys from 272 respondents indicated moderate knowledge ( $$\overline{x }$$ x ¯ = 4.46/10, SD = 2.34) and a high perception of importance of clinical trials ( $$\overline{x }$$ x ¯ = 9.27/10, SD = 1.17). 56% of respondents reported not receiving clinical trials information and 44% had sought information themselves. Respondents preferred information by email newsletter (34%), through health professional discussions (20%) and accessing an online information hub (17%). Information access enablers included clinicians being knowledgeable about clinical trials, personalised discussions, and access to a centralised information source. Barriers included fragmented information across websites, use of complex medical language and competing responsibilities as caregivers. A qualitative analysis of open-ended responses ( n  = 96) revealed three core themes: ‘we need better solutions to help find information and participate in clinical trials’, ‘weighing up options’ in their decision to participate, and ‘we want to help improve outcomes for women in the future’. Conclusions Results from this study of Australians with ovarian cancer inform actionable change through development of evidence-based, tailored resources. Further solutions and evaluation of intervention effectiveness will continue through sector collaboration.