Faculty of Health and Well-Being

Advanced nurse practitioner (ANP) roles are continuing to emerge and evolve worldwide, including in the Republic of Ireland. Progress has been influenced by a number of factors which include; affording opportunities for nurses to advance their careers while remaining in clinical practice; health care cost containment; improving access to care; continuity of patient care and due to limits on junior doctors working hours. Confusion related to the definition of the ANP role, a multitude of role titles, what the role entails and what differentiates it from other specialist roles has impeded its overall development. This has led to difficulties in measuring clinical impact, and leads to conflicting conceptualizations of the role. This article focuses on the application of two domains of advanced practice as identified by Hutchinson et al. and applies the components of those domains of practice to an emerging advanced practice role in urology. The purpose of the article is to provide a tentative professional development framework for the advanced practice urology nursing role involved in managing a caseload of patients diagnosed with non-muscle invasive bladder cancer (NMIBC) focusing on autonomous practice and improving systems of care. These domains of practice are discussed in cognisance of the needs of the population, the demands on the health care organization, and within the defined framework of advanced nursing practice in Ireland.

Prostate cancer is one of the most prevalent forms of cancer in men worldwide. Cancer-related fatigue (CRF) is the most frequently reported side effect of all cancer treatments and occurs in up to 74% of men treated for prostate cancer, particularly those receiving combined hormone and radiation therapies. Patients report the devastating impact of CRF on their quality of life and psychosocial functioning, affecting work, social, emotional and cognitive performance. It can manifest during treatment and persist long after its completion. A diagnosis of CRF is achieved once all other treatable factors such as anaemia or anxiety and depression have been managed, but does not alleviate the fatigue. The Functional Assessment of Cancer Therapy-Fatigue (FACT-F) is a brief and easily administered valid and reliable tool recommended for the assessment of CRF. Non-pharmacological interventions such as activity-based programs and psychosocial interventions including prostate cancer specific education and cognitive behavioural therapy have shown benefits in reducing levels of CRF. A multidisciplinary approach to the management of CRF in prostate cancer patients is advocated. The NICE four-tier model of psychological support can be used as a framework to assist nurses and other health care professionals to alleviate the psychosocial burden of CRF. More research studies using a solid methodological foundation are required in men with prostate cancer to provide robust evidence which can be applied in practice. Key words: Fatigue • Men's health • Oncology nursing • Prostate cancer • Psychological and social scoping • Quality of life Prostate cancer is one of the most prevalent male cancers worldwide with more than one million men diagnosed with the disease in 2012 (Cancer Research UK, 2014), and is the most frequently diagnosed cancer in men in Ireland (National Cancer Registry Ireland, 2013). Active treatment options for prostate cancer include radical prostatectomy surgery, various forms of radiotherapy, hormone therapy and chemotherapy. Side effects of treatment include erectile dysfunction, urinary and/or bowel complications, weight gain, gynecomastia and fatigue (Albaugh and Hacker, 2008). Fatigue is experienced almost universally by cancer patients (Reilly et al., 2013; National Comprehensive Cancer Network (NCCN), 2015), and by up to 74% of men with prostate cancer (Langston et al., 2013b). Fatigue can be a debilitating side effect of prostate cancer treatments to varying degrees with an inconsistent duration, and is sometimes overlooked,