The applicant proposes a career development award to strengthen skills in health services research methods, cost-effectiveness analysis, and instrument refinement. The principal learning activities include coursework, participation and presentation at seminars and scientific meetings, and research practica with recognized scholars in the related content. The ultimate goal is a career as an independent scientist focused on nursing and patient outcomes research. The objective of these research activities is to identify interventions to improve the health outcomes of the population of patients with cancer. The proposal aims are to 1) Utilize advanced health services research methods to evaluate whether ANCC Magnet Hospital status is associated with improved outcomes for older adults hospitalized for cancer surgery;2) Apply cost-effectiveness analysis to evaluate the economic outcomes for patients in Magnet- and non-Magnet hospitals, and 3) Revise the Practice Environment Scale of the Nursing Work Index instrument to measure the practice environment of nurses working in ambulatory oncology settings. Secondary analysis of Surveillance, Epidemiology, and End Results (SEER)-Medicare data will address Aims 1 and 2;
while Aim 3 will be accomplished through focus groups, cognitive interviews, and pilot testing of instrument items with oncology nurses working in ambulatory facilities. After completion of the training and research components, the applicant will be well positioned to conduct interdisciplinary, high-impact research that articulates the role of nursing on outcomes of care for patients with cancer. The proposed research responds directly to the Institute of Medicine and National Cancer Policy Board requests for additional research to elucidate the relationship between nursing practice environments and patient outcomes, and to identify factors associated with outcome variations in the cancer population. The career development plan combines coursework and mentored experiences to acquire additional skills for an independent career as a nurse and outcomes researcher. The research projects examine the relationship between the nursing practice environment and outcomes of care for patients with cancer.
