Use of health‐related quality‐of‐life assessments in daily clinical oncology nursing practice

Abstract

BACKGROUND.The current study evaluated the efficacy of incorporating standardized health‐related quality of life (HRQL) assessments as a routine part of the outpatient chemotherapy treatment of cancer patients in a community hospital in terms of: 1) facilitating nurse‐patient communication, 2) increasing nurses' awareness of patients' HRQL, 3) patient management, 4) patients' satisfaction, and 5) patients' HRQL.METHODS.The study employed a sequential cohort design with repeated measures. Ten nurses and 219 patients participated in this community hospital‐based study. The intervention involved patients completing standardized HRQL questionnaires via a touch‐screen computer, the results of which were provided to nurses and patients in a graphic summary. Questionnaire and medical record data were used to assess outcomes.RESULTS.HRQL‐related topics were discussed significantly more frequently in the intervention group than in the control group (mean = 4.8 topics vs 3.8 topics, respectively; P = .02). Nurses' awareness of patients' levels of daily activity, pain, and overall quality of life was significantly better in the intervention than the control group. The mean number of HRQL‐related notations in the medical records was significantly higher in the intervention group (24 vs 20; P< .05). Only modest effects were observed in patient management (counseling behavior), and no significant effects were found in patient satisfaction or changes in HRQL over time.CONCLUSIONS.Incorporating standardized HRQL assessments in daily clinical oncology nursing practice primarily facilitates the discussion of HRQL issues and increases nurses' awareness. Additional efforts are needed to enhance the effect of routine HRQL assessments on patient management and HRQL. Cancer 2008. © 2008 American Cancer Society.

Effects of screening for psychological distress on patient outcomes in cancer: A systematic review

“…It was not possible, however, to determine in this study how many patients screened positive for psychological distress versus other practical or logistical issues, such as difficulties with transportation, parking, drug coverage, or finances, none of which would be best managed through psychological intervention. Six studies [55][56][57][58][59][60] did not use a defined cutoff score to indicate a positive screen for heightened distress or to determine which patients would receive further assessment or treatment. In addition, 6 of the studies [58,[60][61][62][63][64] were not RCTs, but were, for example, sequential cohort designs.…”

“…Six studies [55][56][57][58][59][60] did not use a defined cutoff score to indicate a positive screen for heightened distress or to determine which patients would receive further assessment or treatment. In addition, 6 of the studies [58,[60][61][62][63][64] were not RCTs, but were, for example, sequential cohort designs. Finally, 3 of the studies [62][63][64] did not assess distress as an outcome, but investigated other outcomes, such as referral rates.…”

The Social Difficulties Inventory (SDI): development of subscales and scoring guidance for staff

“…Advantages of using questionnaires to enhance communication have been demonstrated in two randomised studies with nurses [19] and doctors [20]. Recklitis [5] champions the need for good psychometrics underpinning screening to avoid missing those patients whose condition is occult and not coming to clinical attention.…”

“…Each item of the SDI-21 self-report covers a different area of potential difficulty in daily life: (1) Independence, (2) Domestic Chores, (3) Personal Care, (4) Caring for dependents, (5) Support available for those close to you, (6) Welfare benefits, (7) Finances, (8) Financial services, (9) Work, (10) Planning the future, (11) Communicating with those close, (12) Communicating with others, (13) Sexual matters, (14) Plans to have a family, (15) Body Image, (16) Isolation, (17) Getting around, (18) Where you live, (19) Recreation, (20) Holidays and (21) Other (not specified). The scoring ranges from no difficulty to very much difficulty (0-3).…”

Using guided individualised feedback to review self-reported quality of life in health and its importance

“…Although person-centred studies have examined the effects of QoL assessment on individual patient satisfaction (De Wit et al, 2008;Gutteling et al, 2008;Hilarius, Kloeg, Gundy, & Aaronson, 2008;Mills, Murray, Johnston, Cardwell, & Donnelly, 2009;Rosenbloom, Victorson, Hahn, Peterman, & Cella, 2007), few have specifically examined whether patients' QoL can improve as an consequence of completing a QoL measure and receiving feedback about it. This represents an intervention in its own right, and evidence for its efficacy is contradictory.…”