Feasibility of a Symptom Management Intervention for Honduran Adults Undergoing Chemotherapy

Abstract

Evidence-based interventions often need to be adapted to maximize their implementation potential in low-to middle-income countries. A single-arm feasibility study was conducted to determine the feasibility and acceptability of a telephone-delivered, nurse-led, symptom management intervention for adults undergoing chemotherapy in Honduras. Over the course of 6 months, nurses engaged 25 patients undergoing chemotherapy in the intervention. Each participant received an average of 16.2 attempts to contact them for telephone sessions ( SD = 8.0, range = 2-28). Collectively, the participants discussed 24 different types of symptoms. The most commonly discussed symptoms were pain (12%), nausea (7%), and constipation (5%). Qualitative and quantitative data were used to identify treatment manual modifications (i.e., adding content about different symptoms and addressing scheduling of treatment) and workplace modifications (i.e., dedicated nurse time and space) that are needed to optimize implementation of the intervention.

Protocolos para acompanhamento por telefone de pessoas com neoplasia gastrointestinal em quimioterapia

“…A QT oferece grande benefício para as pessoas com neoplasias malignas. Em geral, a doses terapêuticas e tóxicas estão muito próximas e, (4,7) está associada a uma miríade de sintomas e efeitos colaterais advindos do tratamento que podem variar de leves a potencialmente fatais, graves e incapacitantes. (6) Portanto, o reconhecimento precoce e o manejo eficaz desses sintomas por profissionais de saúde, pacientes e familiares são essenciais para reduzir as sequelas do tratamento físico e psicológico.…”

“…(1,2) A QT é um tipo de tratamento sistêmico, constitui-se no uso de medicamentos que, isolados ou associados, agem no processo de crescimento e divisão das células e, (1) as toxicidades sistêmicas são prevalentes e, frequentemente, pouco reconhecidas, resultando em altas taxas de sintomas desconfortáveis e, por consequência, visitas evitáveis ao pronto--socorro, além de hospitalizações. (1,(3)(4)(5)(6) O atendimento ambulatorial requer que os pacientes gerenciem os sintomas em sua residência, todavia, regularmente, essas pessoas estão inadequadamente preparadas ou esquecem as instruções sobre como lidar com os sintomas não aliviados. (7) Como resultado, o manejo dos sintomas da neoplasia maligna é muitas vezes insatisfatório.…”

Nurse‐led adult palliative care models in low‐ and middle‐income countries: A scoping review

“…Interdisciplinary healthcare team/ palliative care specialist team Palliative care specialist team Gwyther et al, 2018;Schaepe et al, 2011;Siva et al, 2021). The number of nurse leads was not indicated in some cases (Bejarano et al, 2019;Besley et al, 2014;Gwyther et al, 2018;Sankaran et al, 2015). Some studies described the nursing qualification and palliative care training of nurse lead(s) as 'specialist trained palliative care nurse' (Hongoro & Dinat, 2011;Kendall-Carpenter, 2011;De Villiers et al, 2018;Nkhoma et al, 2015;Schaepe et al, 2011).…”

“…Nurse leads were supported in their work either by a specialist palliative care team (Bejarano et al, 2019;de Souza et al, 2014;Downing et al, 2016;Sankaran et al, 2015;Schaepe et al, 2011), an oncologist (Bay et al, 2019;De Villiers et al, 2018), a palliative care specialist nurse (Boit et al, 2014;Downing et al, 2016), physicians (Arjunan & D'Souza, 2021;Besley et al, 2014;Oupra et al, 2010) or by cardiologists ( de Souza et al, 2014). These support services included:…”

Palliative and Supportive Care: …End of the Beginning

“…Rahemi, Dunphy, and Newman (2019) explored the relationship among cultural, social factors and other factors influencing EOL preferences of older Iranian Americans. Finally, Bejarano and colleagues (2019) translated an early palliative care intervention to match the cultural norms of adults receiving chemotherapy in Honduras. Their study demonstrates the importance of tailoring interventions to the culture of the seriously ill population.…”