Effects of a nursing intervention on quality of life outcomes in post‐surgical women with gynecological cancers

Abstract

Objective Women with gynecological cancers have reported poor health-related quality of life (QOL), with complex physical and psychological needs post-surgery and during chemotherapy treatment. There are no studies reporting interventions addressing these needs post-hospital discharge in this population. Methods Patients were randomized into two groups. The intervention group received 6 months of specialized care by an Advanced Practice Nurse (APN); in addition, women with high distress were evaluated and monitored by a psychiatric consultation–liaison nurse (PCLN). The attention control group was assisted with symptom management by a research assistant. The effects of the 6-month intervention were evaluated using self-report questionnaires at baseline (24–48 h after surgery), 1, 3, and 6 months post-surgery. QOL assessments included the Center for Epidemiological Studies–Depression Scale, the ambiguity subscale of the Mishel Uncertainty in Illness Scale, the Symptom Distress Scale, and the Short-Form Health Survey (SF-12). The sample for the longitudinal analysis included 123 who completed QOL outcome measures across three occasions post-surgery. Results The APN intervention resulted in significantly less uncertainty than the attention control intervention 6 months after surgery. When the sub-group who received the APN plus PCLN intervention was compared with the total attention control group, the sub-group had significantly less uncertainty, less symptom distress, and better SF-12 mental and physical QOL over time. Conclusion Nurse tailored interventions that target both physical and psychological aspects of QOL in women recovering from cancer surgery and undergoing chemotherapy produce stronger outcomes than interventions that target solely one QOL aspect.

An Advanced Practice Nurse Coordinated Multidisciplinary Intervention for Patients with Late-Stage Cancer: A Cluster Randomized Trial

“…In light of this need, the investigators took their previously tested advanced practice nursing intervention [5][6][7][8][9] and translated it into disease-specific clinics by members of the multidisciplinary team at a Northeastern cancer comprehensive center. The translation of the nursing intervention by different members of the team provided an opportunity to focus on care of the whole patient and not on which member of the team would deliver each component of the care the patient needed.…”

Knowledge, Attitudes, and Practice Behaviors of Oncology Advanced Practice Nurses Regarding Advanced Care Planning for Patients With Cancer

“…Oncology advanced practice nurses (APNs) are important members of the cancer care team, and they have demonstrated positive patient care outcomes regarding symptom management, functional status, and psychosocial adjustment (Cunningham, 2004;McCorkle et al, 2009;Volker, Kahn, & Penticuff, 2004). Therefore, how effectively oncology APNs practice advanced care planning in a timely manner can significantly affect the psychosocial experiences of patients and their families during the difficult journey from cancer diagnosis to death.…”

Care requirements of patients with advanced cancer within a specialist centre – moving to person-centered approaches

“…Such roles are increasingly promoted as appropriate and necessary for the provision of specialised cancer care [26,27]. Advanced roles have been successful for women with gynaecological cancers recovering from surgery and undergoing chemotherapy as measured by symptom and support outcomes, dissemination of information, and coordination of referrals and resources [28]. They have also been successful in radiation oncology multidisciplinary teams as evidenced by the provision of direct patient care, involvement in specialized procedures, and conducting initial and/or follow-up visits [29].…”