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Table 3 Breast cancer: clinical tasks undertaken by percentage of physicians and nurses, by countries’ SoP, 2015/2016

From: Task shifting between physicians and nurses in acute care hospitals: cross-sectional study in nine countries

  % Physicians performing tasks % Nurses performing tasks (all nurses and APN/SN)
  Countries with SoP expansion [1] Countries with no/limited SoP expansion [2] Countries with SoP expansion [1] Countries with no/limited SoP expansion [2] Countries with SoP expansion [1] Countries with no/limited SoP expansion [2]
Breast cancer % Physicians, N = 91 % Physicians, N = 132 % All nurses, N = 79 % All nurses, N = 242 % APN/SN, N = 46 % APN/SN N = 43
Tasks related to diagnosis/physical examination
 Assessing extent of disease/staging: physical examination[i,ii] 53.8 54.5 16.4*** 1.6*** 21.7** 0.0**
 Detecting and treating local recurrence: perform physical examination[i,ii] 59.3 63.6 26.5*** 2.8*** 32.6*** 0.0***
 Detecting and treating metastatic diseases: perform physical examination[i,ii] 51.6 61.3 15.1*** 3.3*** 17.3** 0.0**
 Endocrine/hormonal therapy: perform physical examination[i] 40.6 36.3 13.9*** 1.6*** 15.2 4.6
 Biological therapy: perform physical examination[i] 10.9*** 31.0*** 8.8* 3.3* 8.7 9.3
 Interpret ultrasound scan[i] 23.0*** 46.2*** 3.8 0.8 6.5 0.0
 Clinical interpretation of mammogram[i] 42.8 31.0 5.0* 0.8* 8.7 0.0
 Clinical interpretation of MRI[i] 34.0* 21.9* 2.5 0.8 4.3 0.0
 Clinical interpretation of biopsy[i] 41.7 30.3 3.8* 0.0* 4.3 0.0
 Interpret X-ray[i] 27.4 21.9 2.5 0.0 4.3 0.0
 Interpret CT scan[i] 29.6 21.2 1.2 0.0 2.1 0.0
 Interpret bone scan[i] 21.9 17.4 1.2 0.0 2.1 0.0
Tasks related to treatment/therapy
 Surgical treatment: perform surgical procedures[i,ii] 40.6 43.1 2.5 3.3 2.1 2.3
 Local recurrence: initiate diagnosing treatment[i,ii] 52.7 57.4 21.0*** 0.8*** 30.4*** 0.0***
 Metastatic diseases: initiate diagnosing treatment[i,ii] 47.2 58.3 15.1*** 1.2*** 19.5** 0.0**
 Chemotherapy: decide on therapy based on lab results and protocols[i] 16.4*** 44.7*** 24.0*** 1.6*** 30.4*** 0.0***
 Chemotherapy: revise therapy[i] 12.0*** 38.6*** 22.7** 8.2** 30.4*** 2.3***
 Endocrine/hormonal therapy: prescribe therapy[i] 45.0 37.8 12.6** 4.1** 19.5** 0.0**
 Endocrine/hormonal therapy: revise therapy[i] 43.9 34.8 13.9*** 1.2*** 19.5** 0.0**
 Biological therapy: prescribe therapy[i] 12.0** 31.0** 8.8 5.7 13.0 4.6
 Biological therapy: revise therapy[i] 12.0** 27.2** 11.3** 1.6** 15.2* 0.0*
 Lymphedema: initiate treatment[i] 23.0 33.3 24.0* 12.4* 30.4 20.9
 Cancer-related fatigue: prescribe therapy[i] 7.6*** 31.0*** 30.3*** 7.8*** 41.3** 9.3**
Tasks related to prescribing medications
 Prescribe medication related to treatment[i] 37.3 46.9 10.1** 2.0** 13.0* 0.0*
 Adapt medication treatment in the course of therapy[i] 30.7 42.4 16.4** 4.9** 21.7** 0.0**
 Side effects: prescribe medications[i] 27.4** 49.2** 10.1** 2.0** 15.2 2.3
 Administer medications[i] 5.4*** 26.5*** 17.7** 35.5** 17.3 32.5
 Palliative care: prescribe medications[i] 17.5** 37.8** 6.3 4.1 10.8 0.0
 Palliative care: administer medications[i] 0.0*** 13.6*** 21.5*** 50.4*** 21.7 37.3
Tasks related to providing information to patients
 Providing information to patient about test results[ii] 61.5 50.0 35.2*** 2.0*** 44.6*** 6.0***
 Detecting and treating local recurrence: inform patients about results[ii] 53.8 54.2 23.5*** 3.1*** 34.0*** 4.0***
 Detecting and treating metastatic diseases: inform patient about results[ii] 50.5 52.1 16.4*** 0.6*** 21.2*** 0.0***
 Providing information to patient about clinical aspects and perspective of treatment[ii] 58.2 46.4 38.8*** 4.8*** 48.9*** 10.0***
 Surgical treatment: inform patient about surgical treatment[ii] 46.1 52.8 30.5*** 11.3*** 36.1* 14.0*
 Endocrine/hormonal therapy: inform patient about therapy[ii] 50.5 42.8 32.9*** 7.9*** 42.5** 18.0**
 Information to patient about non-clinical consequences of treatment[ii] 42.8 40.7 40.0*** 5.5*** 53.1*** 14.0***
  1. Source: MUNROS 2015/2016. Rationale for inclusion of tasks: [i] = suggested clinical activities as Advanced Nursing Practice: diagnosis/advanced health assessment, treatment/therapy, prescribing medications, by International Council of Nurses (ICN), [ii] = common medical tasks, reported by the majority of physicians as being part of normal duties (≥ 50% of physicians in ≥ 50% of countries). [1] England, Scotland, Netherlands, [2] Czech Republic, Germany, Italy, Norway, Poland, Turkey
  2. SoP Scope-of-Practice, APN Advanced Practice Nurses, SN Specialist Nurses
  3. ***p value < .001; ** = p value < .01, * = p value < .05