Oncology nursing forum · 2013
Outcomes evaluation of a weekly nurse practitioner-managed symptom management clinic for patients with head and neck cancer treated with chemoradiotherapy.
Оценочное исследованиеСтатьяПоддержка NIH: внешняя программаНазвание и аннотация: Перевод в очереди
Обработка статьи · этапы, ошибки и управление
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Состояние обновляется каждые 5 секунд, пока блок открыт. Процент показывается только там, где известен объём работы. Пауза останавливает продолжение этапа; текущий запрос к источнику может завершиться.
Mason Heidi, DeRubeis Mary Beth, Foster Jared C, Taylor Jeremy M G, Worden Francis P
Аннотация
PURPOSE/OBJECTIVES: To determine whether improved monitoring through close follow-up with a nurse practitioner (NP) could enhance treatment compliance and decrease frequency of hospitalizations.
DESIGN: Retrospective chart review.
SETTING: An academic National Cancer Institute-designated comprehensive cancer center.
SAMPLE: 151 patients aged 45-65 years diagnosed with stage III or IV oropharyngeal cancer.
METHODS: Patients were nonrandomized to one of two groups: a prechemotherapy clinic group and a weekly NP-led clinic group. After examination of descriptive statistics, multiple linear and logistic regressions were used to compare groups across patient outcomes.
MAIN RESEARCH VARIABLES: Hospitalization, chemotherapy dose deviations, and chemotherapy treatment completion.
FINDINGS: The average number of visits during traditional treatment was three and, after initiation of the NP-led clinic, the number was six. The hospitalization rate was 28% in the traditional clinic group compared to 12% in the NP-led group. The rate of chemotherapy dose deviations was 48% in the traditional clinic group compared to 6% in the NP-led clinic group. Forty-six percent of patients in the traditional clinic group received the full seven scheduled doses of chemotherapy compared to 90% of patients seen in the NP-led clinic group.
CONCLUSIONS: A weekly NP-led symptom management clinic reduces rates of hospitalization and chemotherapy dose deviations and increases chemotherapy completion in patients receiving intensive chemoradiotherapy for oropharyngeal cancer.
IMPLICATIONS FOR NURSING: Patients receiving chemoradiotherapy benefit from close monitoring for toxicities by NPs to successfully complete their treatment and avoid hospitalization.
KNOWLEDGE TRANSLATION: Early interventions to manage toxicities in patients with head and neck cancer can improve outcomes. NPs are in a key position to manage these toxicities and, when symptoms are controlled, costs are reduced.
DESIGN: Retrospective chart review.
SETTING: An academic National Cancer Institute-designated comprehensive cancer center.
SAMPLE: 151 patients aged 45-65 years diagnosed with stage III or IV oropharyngeal cancer.
METHODS: Patients were nonrandomized to one of two groups: a prechemotherapy clinic group and a weekly NP-led clinic group. After examination of descriptive statistics, multiple linear and logistic regressions were used to compare groups across patient outcomes.
MAIN RESEARCH VARIABLES: Hospitalization, chemotherapy dose deviations, and chemotherapy treatment completion.
FINDINGS: The average number of visits during traditional treatment was three and, after initiation of the NP-led clinic, the number was six. The hospitalization rate was 28% in the traditional clinic group compared to 12% in the NP-led group. The rate of chemotherapy dose deviations was 48% in the traditional clinic group compared to 6% in the NP-led clinic group. Forty-six percent of patients in the traditional clinic group received the full seven scheduled doses of chemotherapy compared to 90% of patients seen in the NP-led clinic group.
CONCLUSIONS: A weekly NP-led symptom management clinic reduces rates of hospitalization and chemotherapy dose deviations and increases chemotherapy completion in patients receiving intensive chemoradiotherapy for oropharyngeal cancer.
IMPLICATIONS FOR NURSING: Patients receiving chemoradiotherapy benefit from close monitoring for toxicities by NPs to successfully complete their treatment and avoid hospitalization.
KNOWLEDGE TRANSLATION: Early interventions to manage toxicities in patients with head and neck cancer can improve outcomes. NPs are in a key position to manage these toxicities and, when symptoms are controlled, costs are reduced.
Предметные рубрики MeSH
Academic Medical CentersAgedAntineoplastic Combined Chemotherapy ProtocolsCachexiaCancer Care FacilitiesCarboplatinChemoradiotherapyDehydrationGastrointestinal DiseasesHead and Neck NeoplasmsHospitalizationHumansMiddle AgedMucositisNurse PractitionersOutpatient Clinics, HospitalPaclitaxelPainPatient ComplianceProgram EvaluationRetrospective StudiesTreatment Outcome