Tom Hack

• PhD, CPsych
• Professor (Full) at University of Manitoba

Background Implementation strategies are crucial to facilitate implementation success. To prepare and support implementation of a clinical pathway for screening, assessment and management of anxiety and depression in cancer patients (the ADAPT CP), six broad categories of implementation strategies; (1) Awareness campaigns, (2) Champions, (3) Educat...

Background Given the distress associated with cancer experiences, there is a growing interest in mindfulness-based expressive arts interventions (MBAIs) for promoting patients' well-being. Our research objective was to develop a theoretical understanding of how patients with cancer experience, use, and draw meaning from an MBAI. Methods We used a...

Purpose There is a growing interest in mindfulness-based expressive arts interventions in oncology, to help patients process their experiences, learn how to live with cancer, and ameliorate psychological distress. Our research purpose was to explore how patients with cancer experience a mindfulness-based expressive arts group intervention, and to a...

Background Optimal strategies to facilitate implementation of evidence-based clinical pathways are unclear. We evaluated two implementation strategies (Core versus Enhanced) to facilitate implementation of a clinical pathway for the management of anxiety and depression in cancer patients (the ADAPT CP). Methods Twelve cancer services in NSW Austra...

Background : Optimal strategies to facilitate implementation of evidence-based clinical pathways are unclear. We evaluated two implementation strategies (core versus enhanced) to facilitate implementation of a clinical pathway for the management of anxiety and depression in cancer patients (the ADAPT CP). Methods : Twelve cancer services in NSW Aus...

Background Oncology patients who are migrants or refugees face worse outcomes due to language and communication barriers impacting care. Interventions such as consultation audio-recordings and question prompt lists may prove beneficial in mediating communication challenges. However, designing robust research inclusive of patients who do not speak E...

Our previous review of compassion measures in healthcare between 1985 and 2016 concluded that no available measure assessed compassion in healthcare in a comprehensive or methodologically rigorous fashion. The present study provided a comparative review of the design and psychometric properties of recently updated or newly published compassion meas...

Phenomenon: Training programs have been used to improve compassion in healthcare, but the factors necessary to make such programs successful and sustainable have not been identified. This thematic analysis aimed to bridge the gap between theory and practice by drawing on the experiences of international leaders and educators of compassion training...

Objective We aimed to determine the impact of a primary treatment consultation recording on perception of being informed, satisfaction with cancer care, satisfaction with the oncologist, and psychological distress in patients with brain tumors. Methods This was a prospective, double-blind, parallel, randomized controlled trial conducted in 3 Canad...

Background Patients and families want their healthcare to be delivered by healthcare providers that are both competent and compassionate. While compassion training has begun to emerge in healthcare education, there may be factors that facilitate or inhibit the uptake and implementation of training into practice. This review identified the attribute...

When research is conducted from a Western paradigm alone, the findings and resultant policies often ignore Indigenous peoples’ health practices and fail to align with their health care priorities. There is a need for decolonized approaches within qualitative health research to collaboratively identify intersecting reasons behind troubling health in...

Objectives Compassion is a key indicator of quality care that is reportedly eroding from patients’ care experience. While the need to assess compassion is recognised, valid and reliable measures are lacking. This study developed and validated a clinically informed, psychometrically rigorous, patient-reported compassion measure. Design Data were co...

Purpose: To investigate the current state and quality of compassion education interventions offered to health care providers during training or practice, determine how the components of each education intervention map onto the domains of an empirically based clinical model of compassion, and identify the most common approaches to compassion educat...

PurposePersonalised information and support can be provided to cancer survivors using a structured approach. Needs assessment tools such as the Holistic Needs Assessment (HNA) in the UK and the Comprehensive Problem and Symptom Screening (COMPASS) questionnaire in Canada are recommended for use in practice; however, they are not widely embedded int...

Purpose: Intimate care procedures, such as bathing and toileting, are often regarded as simple, humble tasks. However, the provision of such care transforms a very private, personal activity into a social process. Understanding this complex process and the psychological impact it has on those providing and receiving care is critical in order to mit...

Background There is a complicated and exploitative history of research with Indigenous peoples and accompanying calls to meaningfully and respectfully include Indigenous knowledge in healthcare. Storytelling approaches that privilege Indigenous voices can be a useful tool to break the hold that Western worldviews have within the research. Our colla...

Background: There is little concrete guidance on how to train current and future healthcare providers (HCPs) in the core competency of compassion. This study was undertaken using Straussian grounded theory to address the question: "What are healthcare providers' perspectives on training current and future HCPs in compassion?" Methods: Fifty-seve...

Background: Research has identified inadequacies in the quality and quantity of dementia-related information, particularly end-of-life information provided to those living with dementia and their family caregivers. The purpose of this study was to identify what types of information family caregivers of persons living with dementia in nursing homes...

Background and Purpose Although various measure development guidelines exist, practical guidance on how to systematically generate items is nascent. This article provides practical guidance on item generation in measure development and the use of a Table of Specifications (TOS) in this process. Methods In addition to a review of the literature, th...

Background Although compassionate care is considered a cornerstone of quality palliative care, there is a paucity of valid and reliable measures to study, assess, and evaluate how patients experience compassion/compassionate care in their care.Objective The aim was to develop a patient-reported compassion measure for use in research and clinical pr...

Background It is broadly acknowledged that the next global challenge for psycho-oncology is the implementation of robust evidence-based treatments into routine clinical practice. There is little guidance or texts specific to psycho-oncology to guide researchers and clinicians about implementation science and how to optimally accelerate the translat...

Objective and Study Setting: Research efforts to identify factors that influence successful implementation are growing. This paper describes methods of defining and measuring outcomes of implementation success, using a cluster randomized controlled trial with 12 cancer services in Australia comparing the effectiveness of implementation strategies t...

The present study is a follow‐up to an analysis of research citations of nursing academics in Canada that was conducted in 2009 (Hack et al., 2010). The goal of this earlier research was to describe the research publication productivity of these individuals using citation analysis, and in so doing, both honour these individuals and promote nursing...

Background Health service change is difficult to achieve. One strategy to facilitate such change is the clinical pathway, a guide for clinicians containing a defined set of evidence-based interventions for a specific condition. However, optimal strategies for implementing clinical pathways are not well understood. Building on a strong evidence-base...

Background: Cancer incidence and mortality continues to rise worldwide including in Kenya. Among the groups that are likely to get cancer in future are Kenyan youth that engage in behavior that can increase their lifetime cancer risk. Despite this awareness, little is known about Kenyan youth's understanding of cancer, cancer risk, and cancer preve...

Background: A lack of evidence and psychometrically sound measures of compassion necessitated the development of the first known, empirically derived, theoretical Patient Compassion Model (PCM) generated from qualitative interviews with advanced cancer inpatients. We aimed to assess the credibility and transferability of the PCM across diverse pal...

Context: It has become commonplace to use family caregivers as proxy responders where patients are unable to provide information about their symptoms and concerns to health care providers. Objective: To determine the degree of concordance between patients' and family members' reports of patient symptoms and concerns at end-of-life. Methods: Sa...

Objective Survivorship literature generally focuses on the cancer experience after diagnosis and treatment. However, acute survivorship, beginning with diagnosis and ending at the completion of treatment, has a lasting impact on the wellbeing of patients. The purpose of this study was to generate a theoretical understanding of how identity is affec...

Purpose Therapeutic Practices for Distress Management (TPDM) Project was carried out to support clinicians in integrating recommendations from four Clinical Practice Guidelines (CPGs) in routine care at five Pan Canadian cancer care sites. Methodology Using a concurrent, mixed‐method study design and knowledge translation (KT) activities, this pro...

Objective Ethnicity and migrant status results in disparities with cancer burden and survival; with communication difficulties cited as the main barrier to access. Our research team tested a communication intervention package comprising consultation audio‐recordings (ARs) and question prompt lists (QPLs) for Low English Speaking (LES) patients with...

Background Compassion is considered a component of quality healthcare that healthcare providers (HCPs) are increasingly expected to provide. While there have been some studies exploring facets of HCPs’ perspectives on the barriers and facilitators to providing compassion, a comprehensive understanding based on direct reports from HCPs is lacking....

Background Healthcare providers are considered the primary conduit of compassion in healthcare. Although most healthcare providers desire to provide compassion, and patients and families expect to receive it, an evidence-based understanding of the construct and its associated dimensions from the perspective of healthcare providers is needed. Objec...

Background Effective patient–family communication can reduce patients’ psychosocial distress and relieve family members’ current suffering and their subsequent grief. However, terminally ill patients and their family members often experience great difficulty in communicating their true feelings, concerns, and needs to each other. Aim To develop a...

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Objective: To conduct a systematic review of the effectiveness of consultation recordings, and identify factors contributing to their successful implementation in healthcare settings. Methods: A systematic review was conducted for quantitative studies examining the effectiveness of consultation recordings in healthcare. Two independent reviewers...

Background: Many patients who require an interpreter have difficulty remembering information from their medical consultations. Memory aids such as consultation audio-recordings may be of benefit to these patients. However, there is no established means of measuring patients' memory of medical information. Objectives: This study aimed to develop...

Background There is international concern about the lack of compassion in healthcare systems. A valid and reliable tool for measuring compassion in healthcare systems and educational institutions is required. This comprehensive and critical narrative synthesis identified and compared existing measures of compassionate care in clinical settings. Met...

Purpose Little is known about black African (BA) and black African-Caribbean (BAC) men's views towards cancer; yet culture and acculturation can contribute to the way in which people understand, explain and develop their attitudes towards cancer. Hence, cancer prevention and early detection strategies may not be sensitive to United Kingdom (UK)-bas...

Objective: Question prompt lists (QPLs) and consultation audio-recordings (CARs) are two communication strategies that can assist cancer patients in understanding and recalling information. We aimed to explore clinician and organisational barriers and facilitators to implementing QPLs and CARs into usual care. Methods: Semi-structured interviews...

Background Compassion is considered an essential element in quality patient care. One of the conceptual challenges in healthcare literature is that compassion is often confused with sympathy and empathy. Studies comparing and contrasting patients’ perspectives of sympathy, empathy, and compassion are largely absent. Aim The aim of this study was t...

Background The purpose of this qualitative study was to investigate advanced cancer patients’ perspectives on the importance, feasibility, teaching methods, and issues associated with training healthcare providers in compassionate care. Methods This study utilized grounded theory, a qualitative research method, to develop an empirical understandin...

Arm morbidity (AM) arising from breast cancer (BC) treatment can detrimentally impact quality of life; often limiting a survivor’s ability to participate in valued activities. The present study explored (a) the developmental time course of AM [restricted range of motion (ROM), pain, and arm volume changes], negative affect, and perceived disability...

Purpose/objectives: To gain insight into parental decision making regarding the disclosure or nondisclosure of a mutation-positive BRCA1/2 test result to minors. . Research approach: A qualitative study based on Heidegger hermeneutic phenomenology was undertaken to explore the lived experience of parental decision making regarding high-risk BRC...

Context: Compassion is frequently referenced as a hallmark of quality care by patients, health care providers, health care administrators and policy makers. Despite its putative centrality, including its institution in recent health care reform, an empirical understanding based on the perspectives of patients, the recipients of compassion, is lack...

Objective: The purpose of this study was to identify four non-cancer populations that might benefit from a palliative approach; and describe and compare the prevalence and patterns of dignity related distress across these diverse clinical populations. Design: A prospective, multi-site approach was used. Setting: Outpatient clinics, inpatient f...

Recent concerns about suboptimal patient care and a lack of compassion have prompted policymakers to question the preparedness of clinicians for the challenging environment in which they practice. Compassionate care is expected by patients and is a professional obligation of clinicians; however, little is known about the state of research on clinic...

Qualitative research has been conducted extensively to advance the field of psychosocial oncology. It may be argued, however, that qualitative research has received insufficient credit for its contributions in the psychosocial oncology arena, relative to its quantitative research counterpart. Psychosocial interventions are often validated in quanti...

To gain an understanding of how patient satisfaction (PS) with the doctor (PSD) is conceptualized through an empirical review of how it is currently being measured. The content of PS questionnaire items was examined to (a) determine the primary domains underlying PSD, and (b) summarize the specific doctor-related characteristics and behaviors, and...

The impact of arm morbidity on leisure and quality of life is an understudied area in cancer survivorship. The purpose of this study was to qualitatively describe the impact of breast cancer-related arm morbidity on leisure participation in Canadian women. A grounded theory approach was used to generate thematic categories and a model. Drawing on p...

L’incidence de l’atteinte du bras sur les loisirs et la qualite de vie est un domaine sous-etudie de la survie au cancer. Cette etude visait a decrire qualitativement l’incidence de l’atteinte du bras liee au cancer sur la participation a des loisirs parmi des femmes canadiennes. Nous avons utilise une approche basee sur la theorie ancree afin de p...

Failure to acknowledged personhood is often the cause of patient and family dissatisfaction. We developed the Patient Dignity Question (PDQ) as a simple means of inquiring about personhood: "What do I need to know about you as a person to give you the best care possible?" This study aimed 1) to evaluate the impact of the PDQ on patients and familie...

Purpose/Objectives: To delineate the role of the oncology patient navigator, drawing from the experiences and descriptions of younger women with breast cancer. Research Approach: Interpretive, descriptive, qualitative research design. Setting: Participants' homes, researcher's home, and via telephone, all in Winnipeg, Manitoba, Canada. Participants...

Background: Breast cancer surgery is the most common cause of secondary lymphoedema, yet there is little understanding about the changes in lymphoedema over time in breast cancer survivors. Further, the role of arm dominance in the development and persistence of lymphoedema has not been adequately explored. Aim: This study aimed to determine the ra...

The purpose of this study was to conduct a historical review of psycho-oncology and supportive care research in Canada using citation analysis and to review the clinical impact of the research conducted by the most highly cited researchers. The lifetime journal publication records of 109 psycho-oncology and supportive care researchers in Canada wer...

Objectives: The purpose of this paper is to summarize the use of the knowledge to action framework for adapting guidelines for practice and the evidence for effective implementation interventions to promote a quality response to cancer distress screening data. Methods: We summarize progress in screening implementation in Ontario, Canada and the...

Objective: The objectives of this implementation study were to (i) address the evidentiary, contextual, and facilitative mechanisms that serve to retard or promote the transfer and uptake of consultation recording use in oncology practice and (ii) follow patients during the first few days following receipt of the consultation recording to document...

The purpose of the present systematic review was to develop a practice guideline to inform health care providers about screening, assessment, and effective management of cancer-related fatigue (crf) in adults. The internationally endorsed adapte methodology was used to develop a practice guideline for pan-Canadian use. A systematic search of the li...

Background: Patients who are facing life-threatening and life-limiting cancer almost invariably experience psychological distress. Responding effectively requires therapeutic sensitivity and skill. In this study, we examined therapeutic effectiveness within the setting of cancer-related distress with the objective of understanding its constituent...

Background: The Patient Dignity Inventory (PDI) is a novel 25-item psychometric instrument, designed to identify multiple sources of distress (physical, functional, psychosocial, existential, and spiritual) commonly seen in patients who are terminally ill. It was also designed to help guide psychosocial clinicians in their work with patients. Whil...

The purpose of this investigation was to explicate the content of primary treatment consultations in prostate oncology and examine the predictive relationships between patient, significant other, and oncologist consultation factors and patient satisfaction with communication. The recorded consultations of 156 newly diagnosed prostate cancer patient...

Purpose: The impact of cancer and cancer treatment on the long-term health and quality of life of survivors is substantial, leading to questions about the most appropriate configuration of services and models of care for follow-up of post-primary treatment survivors. Methods: A systematic review and quality appraisal of the health literature for...

Although recommended as an essential part of cancer care, there is limited evidence regarding the optimum approach to psychosocial health care needs assessment in this setting. To address this gap, the Cancer Journey Action Group of the Canadian Partnership Against Cancer (CPAC) and the Canadian Association of Psychosocial Oncology (CAPO) partnered...

The purpose of this study was to assess the feasibility of dignity therapy for the frail elderly. Participants were recruited from personal care units contained within a large rehabilitation and long-term care facility in Winnipeg, Manitoba. Two groups of participants were identified; residents who were cognitively able to directly take part in dig...

155 Background: The objectives of this implementation study were to 1) identify and address the evidentiary, contextual, and facilitative mechanisms that serve to retard or promote the transfer and uptake of consultation recording use in oncology practice, and 2) follow patients during the first few days following receipt of the consultation record...

BACKGROUND: Patients who are facing life-threatening and life-limiting cancer almost invariably experience psychological distress. Responding effectively requires therapeutic sensitivity and skill. In this study, we examined therapeutic effectiveness within the set- ting of cancer-related distress with the objective of understanding its constituent...

Our goal was to develop evidence-based recommendations for the organization and structure of cancer survivorship services, and best-care practices to optimize the health and well-being of post-primary treatment survivors. This review sought to determine the optimal organization and care delivery structure for cancer survivorship services, and the s...

Dignity therapy is a unique, individualised, short-term psychotherapy that was developed for patients (and their families) living with life-threatening or life-limiting illness. We investigated whether dignity therapy could mitigate distress or bolster the experience in patients nearing the end of their lives. Patients (aged ≥18 years) with a termi...

Most longitudinal breast cancer studies have found that treatment-related sequelae such as arm morbidity [lymphedema, pain, and range of motion (ROM) restrictions] can have a significant impact on quality of life. In a previous study, we found that at 6-12 months after breast cancer surgery, 49% of participants had difficulties engaging in recreati...

Breast cancer survivors can anticipate a number of years of paid labor market participation. Therefore, the link between breast cancer survivorship and productivity deserves serious consideration. The hypothesis guiding this study is that arm disability, particularly pain and range of motion limitations, are important explanatory variables in survi...

Over the past two decades, the fields of psychosocial oncology and supportive care have seen clinically effective tools as underutilized despite proven benefits to cancer patients and their families. The purpose of this paper is to discuss the reasons for the failure of psychosocial and supportive care interventions in oncology to realize broad cli...

To provide a critical analysis of a patient navigation model using the Synthesized Method of Theory Evaluation and the Criterion-Based Critique as frameworks for the analysis. English-language research and clinical articles and Internet sources (CINAHL®, PubMed, and Google™ Scholar) on patient navigation up to April 2009. The British Columbia Patie...

The time period from diagnosis to the end of treatment is challenging for newly diagnosed cancer patients. Patients have a substantial need for information, decision aids, and psychosocial support. Recordings of initial oncology consultations improve information recall, reduce anxiety, enhance patient satisfaction with communication, and increase p...

The experience of cancer is one of the most challenging and potentially devastating events that can befall a person. Family members can be a source of emotional support and provide assistance with decision-making but they, like patients, have poor memories for what is said during consultations. If the information that is imparted during any given c...

Arm morbidity post-breast cancer surgery is increasingly being recognized as a chronic problem for some women following breast cancer surgery. The purpose of this study was to examine demographic, disease, and treatment-related predictors of a comprehensive array of chronic arm morbidity (pain, lymphedema, functional disability, and range of motion...

This article is a report of a citation analysis of research publications by Canadian nursing academics. Citation analysis can yield objective criteria for assessing the value of published research and is becoming increasingly popular as an academic evaluation tool in universities around the world. Citation analysis is useful for examining the resea...

Dignity therapy is a novel therapeutic approach designed to decrease suffering, enhance quality of life and bolster a sense of dignity for patients approaching death. The benefits of dignity therapy were previously documented in a sample of 100 terminally ill patients. One of the products of dignity therapy is a transcript of the edited therapy ses...