{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,6]],"date-time":"2026-07-06T17:16:13Z","timestamp":1783358173884,"version":"3.54.6"},"reference-count":65,"publisher":"SAGE Publications","issue":"2","license":[{"start":{"date-parts":[[2026,1,13]],"date-time":"2026-01-13T00:00:00Z","timestamp":1768262400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2026,1,13]],"date-time":"2026-01-13T00:00:00Z","timestamp":1768262400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Can J Nurs Res"],"published-print":{"date-parts":[[2026,6]]},"abstract":"<jats:sec>\n                    <jats:title>Background and Purpose<\/jats:title>\n                    <jats:p>Nurse practitioners (NPs) make treatment decisions impacting older people with neurocognitive disorders (NCDs), like mild cognitive impairment and dementia. Research has shown that when this patient population has cancer, they face barriers accessing care, have higher mortality rates and limited involvement in decision-making. Despite their critical role, few NPs have been included in studies exploring treatment decision-making affecting this population. To improve experiences for older people and their families, this study explored NPs\u2019 decision-making experiences when individuals were living with an NCD and cancer.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This qualitative study was informed by interpretive description, a practice-oriented approach. Data collection methods included semi-structured interviews and reflective journaling. Data analysis was iterative with identification and revision of themes that have accompanying illustrations. The research team drew on relevant nursing and practice knowledge to identify meaningful implications for NP practice.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Five themes were identified which included the observation that participants\u2019 decision-making was shaped by NPs\u2019 knowledge and assumptions. NP participants experienced uncertainty and ethical challenges while needing to creatively navigate health systems. Drawing on nursing knowledge, NPs sought to actively involve older people and their family in decision making.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>NPs experience complex treatment decision-making when older people are living with an NCD and cancer, requiring navigation of multiple factors and challenges. The results showed shared decision-making processes are applied, suggesting that NPs take up relational treatment decision-making practices. However, there is a need for institutional change, further education, and research about NPs experiences in community settings.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/08445621251412229","type":"journal-article","created":{"date-parts":[[2026,1,13]],"date-time":"2026-01-13T18:34:44Z","timestamp":1768329284000},"page":"168-182","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Nurse Practitioners\u2019 Experiences Navigating Treatment Decision-Making Affecting Older People with Neurocognitive Disorders and Cancer"],"prefix":"10.1177","volume":"58","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9373-0576","authenticated-orcid":false,"given":"Kimberly","family":"Shapkin","sequence":"first","affiliation":[{"name":"University of Victoria"},{"name":"University of Calgary"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9662-9652","authenticated-orcid":false,"given":"Lorelei","family":"Newton","sequence":"additional","affiliation":[{"name":"University of Victoria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9686-3032","authenticated-orcid":false,"given":"Karen","family":"MacKinnon","sequence":"additional","affiliation":[{"name":"University of Victoria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4120-0792","authenticated-orcid":false,"given":"Jayna","family":"Holroyd-Leduc","sequence":"additional","affiliation":[{"name":"University of Calgary"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2026,1,13]]},"reference":[{"key":"e_1_3_4_2_1","unstructured":"Alzheimer\u2019s Association. (2022). More than normal aging understanding mild cognitive impairment [Special report]. https:\/\/www.alz.org\/getmedia\/257803ff-0335-4882-a37b-c4acb77b1a66\/alzheimers-facts-and-figures-special-report-2022.pdf."},{"key":"e_1_3_4_3_1","unstructured":"Alzheimer's Association. (2024). Alzheimer's disease facts and figures [Special report]. https:\/\/www.alz.org\/getmedia\/76e51bb6-c003-4d84-8019-e0779d8c4e8d\/alzheimers-facts-and-figures.pdf."},{"key":"e_1_3_4_4_1","doi-asserted-by":"publisher","DOI":"10.1093\/ageing\/afaa210"},{"issue":"3","key":"e_1_3_4_5_1","first-page":"320","article-title":"Cancer care for people with dementia: Literature overview and recommendations for practice and research","volume":"73","author":"Ashley L.","year":"2023","unstructured":"Ashley L., Surr C., Kelley R., Price M., Griffiths A. W., Fowler N. R., Giza D. E., Neal R. D., Martin C., Hopkinson J. B., O\u2019Donovan A., Dale W., Koczwara B., Spencer K., Wyld L. (2023). Cancer care for people with dementia: Literature overview and recommendations for practice and research. CA, 73(3), 320\u2013338. https:\/\/doi.org\/10.3322\/caac.21767","journal-title":"CA"},{"key":"e_1_3_4_6_1","doi-asserted-by":"publisher","DOI":"10.1111\/jgs.15856"},{"key":"e_1_3_4_7_1","doi-asserted-by":"publisher","DOI":"10.1111\/jocn.16110"},{"key":"e_1_3_4_8_1","doi-asserted-by":"publisher","DOI":"10.3233\/JAD-200700"},{"key":"e_1_3_4_9_1","doi-asserted-by":"publisher","DOI":"10.1002\/capr.12360"},{"key":"e_1_3_4_10_1","doi-asserted-by":"publisher","DOI":"10.1093\/jncics\/pkab002"},{"key":"e_1_3_4_11_1","unstructured":"Canadian Cancer Society. (2023 October). Advancing health equity through cancer information and support services: Report on communities that are underserved. https:\/\/cdn.cancer.ca\/-\/media\/files\/about-us\/our-health-equity-work\/underserved-communities-report_2023_en.pdf."},{"key":"e_1_3_4_12_1","unstructured":"Canadian Institute of Health Information. (2024 July 25). Nurse practitioners.https:\/\/www.cihi.ca\/en\/nurse-practitioners."},{"key":"e_1_3_4_13_1","doi-asserted-by":"publisher","DOI":"10.1111\/jocn.13136"},{"key":"e_1_3_4_14_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12875-022-01882-w"},{"key":"e_1_3_4_15_1","doi-asserted-by":"publisher","DOI":"10.3390\/curroncol31070279"},{"key":"e_1_3_4_16_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jgo.2022.09.013"},{"key":"e_1_3_4_17_1","doi-asserted-by":"publisher","DOI":"10.1002\/pon.4212"},{"key":"e_1_3_4_18_1","doi-asserted-by":"publisher","DOI":"10.1111\/ecc.12684"},{"key":"e_1_3_4_19_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen-2017-018977"},{"key":"e_1_3_4_20_1","doi-asserted-by":"publisher","DOI":"10.1097\/HRP.0000000000000163"},{"key":"e_1_3_4_21_1","doi-asserted-by":"publisher","DOI":"10.3928\/19404921-20170831-05"},{"key":"e_1_3_4_22_1","doi-asserted-by":"publisher","DOI":"10.1155\/2023\/6678458"},{"key":"e_1_3_4_23_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12904-019-0453-2"},{"key":"e_1_3_4_24_1","volume-title":"How to nurse: relational inquiry with individuals and families in changing health and health care contexts","author":"Doane G. H.","year":"2015","unstructured":"Doane G. H., Varcoe C. (2015). How to nurse: relational inquiry with individuals and families in changing health and health care contexts. Wolters Kluwer Health."},{"key":"e_1_3_4_25_1","doi-asserted-by":"publisher","DOI":"10.1177\/1477750917704156"},{"issue":"2","key":"e_1_3_4_26_1","first-page":"203","article-title":"Arti hurria and the progress in integrating the geriatric assessment into oncology","volume":"11","author":"Du Montier C.","year":"2020","unstructured":"Du Montier C., Sedrak M. S., Soo W. K., Kenis C., Williams G. R., Haase K., Harneshaug M., Mian H., Loh K. P., Rostoft S., Dale W., Cohen H. J. (2020). Arti hurria and the progress in integrating the geriatric assessment into oncology. Young International Society of Geriatric Oncology Review Paper. Journal of Geriatric Oncology, 11(2), 203\u2013211. https:\/\/doi.org\/10.1016\/j.jgo.2019.08.005","journal-title":"Young International Society of Geriatric Oncology Review Paper. Journal of Geriatric Oncology"},{"key":"e_1_3_4_27_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12904-021-00845-9"},{"key":"e_1_3_4_28_1","doi-asserted-by":"publisher","DOI":"10.1177\/08404704231212781"},{"key":"e_1_3_4_29_1","doi-asserted-by":"publisher","DOI":"10.3928\/19404921-20130110-02"},{"issue":"6","key":"e_1_3_4_30_1","first-page":"19","article-title":"Nursing education: Review of assessment, clinical care, and implications for practice regarding older adult patients with cancer","volume":"22","author":"Goldberg J. I.","year":"2018","unstructured":"Goldberg J. I., Burhenn P. S., Ginex P. K. (2018). Nursing education: Review of assessment, clinical care, and implications for practice regarding older adult patients with cancer. Clinical Journal of Oncology Nursing, 22(6), 19\u201325. https:\/\/doi.org\/10.1188\/18.CJON.S2.19-25","journal-title":"Clinical Journal of Oncology Nursing"},{"key":"e_1_3_4_31_1","doi-asserted-by":"publisher","DOI":"10.3122\/jabfm.2019.03.180335"},{"key":"e_1_3_4_32_1","doi-asserted-by":"publisher","DOI":"10.1002\/pon.5448"},{"key":"e_1_3_4_33_1","first-page":"191","volume-title":"The SAGE handbook of qualitative research","author":"Guba E. G.","year":"2005","unstructured":"Guba E. G., Lincoln Y. S. (2005). Paradigmatic controversies, contradictions, and emerging confluences. In Denzin N. K., Lincoln Y. S. (Eds.), The SAGE handbook of qualitative research (3rd ed, Vol. 3, pp. 191\u2013215). Sage.","edition":"3"},{"key":"e_1_3_4_34_1","doi-asserted-by":"publisher","DOI":"10.1007\/978-3-030-89162-6_1"},{"key":"e_1_3_4_35_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jgo.2022.04.008"},{"key":"e_1_3_4_36_1","doi-asserted-by":"publisher","DOI":"10.1370\/afm.536"},{"key":"e_1_3_4_37_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpainsymman.2013.02.021"},{"key":"e_1_3_4_38_1","first-page":"1993\u20131999","article-title":"Challenges for the cataract surgeon treating people with dementia: A qualitative study exploring anesthetic choices","volume":"8","author":"Jefferis J. M.","year":"2014","unstructured":"Jefferis J. M., Clarke M. P., Taylor J. P., Brittain K. R. (2014). Challenges for the cataract surgeon treating people with dementia: A qualitative study exploring anesthetic choices. Clinical Ophthalmology, 8, 1993\u20131999. https:\/\/doi.org\/10.2147\/OPTH.S69388","journal-title":"Clinical Ophthalmology"},{"key":"e_1_3_4_39_1","doi-asserted-by":"publisher","DOI":"10.1177\/0193945906295522"},{"key":"e_1_3_4_40_1","first-page":"191","volume-title":"Evaluation of chemotherapeutic agents","author":"Karnofsky D. A.","year":"1949","unstructured":"Karnofsky D. A., Burchenal J. H. (1949). The clinical evaluation of chemotherapeutic agents in cancer. In MacLeod C. M. (Ed.), Evaluation of chemotherapeutic agents (pp. 191\u2013205). Columbia University Press."},{"key":"e_1_3_4_41_1","doi-asserted-by":"publisher","DOI":"10.1111\/jonm.13462"},{"key":"e_1_3_4_42_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0230446"},{"key":"e_1_3_4_43_1","doi-asserted-by":"publisher","DOI":"10.1111\/inr.12951"},{"key":"e_1_3_4_44_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12913-016-1690-1"},{"key":"e_1_3_4_45_1","doi-asserted-by":"publisher","DOI":"10.1177\/14713012231156976"},{"key":"e_1_3_4_46_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen-2017-020250"},{"key":"e_1_3_4_47_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jgo.2020.10.018"},{"key":"e_1_3_4_48_1","volume-title":"Caring a relational approach to ethics & moral education","author":"Noddings N.","year":"2013","unstructured":"Noddings N. (2013). Caring a relational approach to ethics & moral education (2nd ed.). University of California Press. https:\/\/doi.org\/10.1525\/9780520957343","edition":"2"},{"key":"e_1_3_4_49_1","doi-asserted-by":"publisher","DOI":"10.1097\/00000421-198212000-00014"},{"key":"e_1_3_4_50_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jgo.2022.07.007"},{"key":"e_1_3_4_51_1","doi-asserted-by":"publisher","DOI":"10.1111\/jan.16107"},{"key":"e_1_3_4_52_1","unstructured":"Public Health Agency of Canada. (2018). Cancer in Canada.https:\/\/www.canada.ca\/content\/dam\/phac-aspc\/documents\/services\/publications\/diseases-conditions\/fact-sheet-cancer-canada\/fact-sheet-cancer-canada.pdf."},{"key":"e_1_3_4_53_1","unstructured":"QSR International. (2020). NVivo [Version 12.0]. https:\/\/help-nv.qsrinternational.com\/12\/win\/v12.1.115-d3ea61\/Content\/welcome.htm."},{"key":"e_1_3_4_54_1","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.1984.2.3.187"},{"key":"e_1_3_4_55_1","doi-asserted-by":"publisher","DOI":"10.5694\/mja2.51925"},{"key":"e_1_3_4_56_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen-2018-022385"},{"key":"e_1_3_4_57_1","doi-asserted-by":"publisher","DOI":"10.11124\/JBIES-23-00486"},{"key":"e_1_3_4_58_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.socscimed.2021.113900"},{"key":"e_1_3_4_59_1","doi-asserted-by":"publisher","DOI":"10.1111\/nin.12062"},{"key":"e_1_3_4_60_1","doi-asserted-by":"publisher","DOI":"10.4324\/9781315426259"},{"key":"e_1_3_4_61_1","doi-asserted-by":"publisher","DOI":"10.4324\/9781003503538"},{"key":"e_1_3_4_62_1","doi-asserted-by":"publisher","DOI":"10.9778\/cmajo.20170052"},{"key":"e_1_3_4_63_1","doi-asserted-by":"publisher","DOI":"10.1093\/intqhc\/mzm042"},{"key":"e_1_3_4_64_1","doi-asserted-by":"publisher","DOI":"10.3389\/fonc.2020.01052"},{"key":"e_1_3_4_65_1","doi-asserted-by":"publisher","DOI":"10.55729\/2000-9666.1344"},{"key":"e_1_3_4_66_1","volume-title":"Decision theory","author":"Weirich P.","year":"2020","unstructured":"Weirich P., Atkinson P., Delamont S., Cernat A., Sakshaug J. W., Williams R. A. (eds) (2020). Decision theory. Sage. http:\/\/doi.org\/10.4135\/9781526421036867919."}],"container-title":["Canadian Journal of Nursing Research"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/08445621251412229","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/08445621251412229","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/08445621251412229","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,7,6]],"date-time":"2026-07-06T16:34:34Z","timestamp":1783355674000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/08445621251412229"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,1,13]]},"references-count":65,"journal-issue":{"issue":"2","published-print":{"date-parts":[[2026,6]]}},"alternative-id":["10.1177\/08445621251412229"],"URL":"https:\/\/doi.org\/10.1177\/08445621251412229","relation":{},"ISSN":["0844-5621","1705-7051"],"issn-type":[{"value":"0844-5621","type":"print"},{"value":"1705-7051","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,1,13]]}}}