- Email: [email protected]
P-197 Development of core standards of practice for the lung cancer nurse specialist
Poster Session: The Interdisciplinary
Team and Cure of People with Lung Cancer/Supportive
Development of Core Standards of Practice for the Lung Cancer Nurse Specialist Patricia A. Hunt’, Sally Moores. I The Royal Marsden Hospital, Downs Road, Sutton, England; 2 The London and South East Lung Cancer Nurses Group, London, England Aim: To develop standards of practice for Lung Cancer Nurse Specialists in the United Kingdom, which can provide guidance for developing new posts for lung cancer nurse specialists, assist in improving lung cancer patient and carer experiences, and aid in service development. Method: The London and Southeast Lung Cancer Nurses Group, which is a regional group of the National Lung Cancer Nurses Forum in the United Kingdom, reviewed the evidence available. Sub-groups of the Forum developed specific standards relating to practice, and these were drawn together to develop a set of standards. Results: The members of the group felt that care for lung cancer patients in the region can be fragmented, as often the role of the lung cancer nurse specialist is unclear. The core standards of practice developed are as follows; communication and information, access to specialist help and advice, psychological and social support, expert symptom control and advice, co-ordination of care, and continuity of care. Each standard reviews the literature and provides guidance points for nurses. Discussion: Core standards of practice could make a significant contribution to improving the overall care of patients with lung cancer, as lung cancer nurse specialists will have a framework on which to pin their practice. The standards of practice can enable service and care evaluation through audit.
P 198 El
Interface of Professional Roles in the Management of Chronic Breathlessness in Lung Cancer Patients
Charlie Ewer-Smith’ , Nicki Thompson’, Jay Evans’, Jill Cooper’, Diane Laverty’ , Sara Travis’, Anna-Marie Stevens’, Patricia A. Hunt”. ’ The Royal Marsden Hospital London, England; ’ The Royal Marsden Hospital, Downs Road, Sutton, England
Aim: Breathlessness is the subjective experience of breathing discomfort. The experience is a result of a myriad of interactions between physiological, psy chological, social and environmental factors. It is present in approximately 70% of patients with cancer in the last few weeks of life and is severe in 25% of patients in their last week of life. The aim of this work is to demonstrate how a multiprofessional approach to the management of breathlessness can result in a holistic approach to patients with this distressing symptom. Method: During the last 12 months a clinical multi professional team have established a Specialist Breathlessness Service within the Royal Marsden NHS Trust, a London based cancer centre. The initiation of this service involved the setting up of a working party that comprised of an Occupational Therapist, Physiotherapist and Clinical Nurse Specialist in Palliative Care. The service is available to patients whose breathlessness is related to advanced disease either in the hospital setting or the outpatient department. All management of breathlessness in patients with advanced cancer is optimised by the combined approach between the Occupational Therapist, Physiotherapist and Clinical Nurse Specialist in Palliative Care. It is based on work previously done in patients with lung cancer patients (Bredin et al 1999), which uses a combination of non-pharmacological and pharmacological interventions to maximise the patient’s quality of life. Results: The multi professional approach to breathlessness is a combination of the biophysical and psychosocial approach. Each specialist plays a part in the management of the patients’ breathlessness, and each role dovetails with
Care
s141
the other, offering a seamless service to manage this distressing symptom. A patients journey from referral to the Breathlessness Team to discharge will demonstrate practice through a case study. An overview of an audit analysing the effectiveness of the marketing strategy for the service will also be included. Discussion: A multi professional approach to the management of breathlessness in lung cancer is a novel concept, as often this symptom is managed by each professional in a fragmented way. The service developed has enhanced the care of patients with breathlessness, allowing them to learn strategies to self manage this distressing symptom. Reference: Bredin M, Corner J, Kirshnasamy M, Plant H, Bailey, and A’Hern R (1999) Multicentre randomised controlled trial of nursing intervention for breathlessness in patients with lung cancer. British Medical Journal 318:901904.
I
P 199
Nursmg Support Through Educating Lung Cancer Patients :. Posmvely Impacts Their Quality of Life
Marni M. Besser, Paramjit Taheem. British Columbia Cancer Agency Vancouver Cancer Centre, Vancouver, Canada Patients receiving radiation and chemotherapy for treatment of lung cancer experience common challenges. The physical, emotional, cultural and spiritual experience of a person with lung disease, superimposed with the side effects of treatment, is seen to negatively impact their quality of life, (Symptom Distress and Coping Strategies in Patients With Non-small cell Lung Cancer, Cancer Nursing, Vol. 25, No.4, 2002). Nursing interventions through supportive education, with the application of timely communication opportunities, can positively affect change. Radiation Oncology Nurses and Systemic (Chemotherapy) Oncology Nurses provide ongoing education to support self-care with symptom management. This fosters self determination in this patient population. This presentation will highlight the utilization of interdisciplinary collaboration involved in enhancing the quality of life of lung patients through education and communication Patients are challenged by their physiological symptoms along with distressed mood. Oncology Nurses are in a pivotal position to assess patients’ total situations and their timely access to appropriate resources. Enhanced communication between patients and nurses has the potential to positively impact their quality of life. When patients engage and utilize resources that are offered, the Oncology Nurse is assured of successful interventions. The patient, the family unit and care team can observe improve capacity to self-manage stressors and symptoms.
P 200
I
Enhancing Quality of Life by Addressing Cancer-related Fatigue
Carole A. Robinson. SC Cancer Agenq Kelowna, Canada
Centre for the Southern Inferior,
Fatigue is the most commonly reported symptom among cancer patients. Further, it is the symptom that lasts the longest, has the most significant impact on quality of life, and is the symptom patients report getting the least assistance with managing. This session will explore the multidimensional nature of cancerrelated fatigue as well as assessment and evidence-based approaches to management. Discussion will include the place of fatigue in the symptom complex profile of patients diagnosed with lung cancer. As well, recent research that has identified behavioral responses to cancer and cancer treatment associated with both the presence and absence of fatigue will be highlighted. Therefore, we will be challenged to consider whether fatigue may be preventable or simply manageable.
Team and Cure of People with Lung Cancer/Supportive
Development of Core Standards of Practice for the Lung Cancer Nurse Specialist Patricia A. Hunt’, Sally Moores. I The Royal Marsden Hospital, Downs Road, Sutton, England; 2 The London and South East Lung Cancer Nurses Group, London, England Aim: To develop standards of practice for Lung Cancer Nurse Specialists in the United Kingdom, which can provide guidance for developing new posts for lung cancer nurse specialists, assist in improving lung cancer patient and carer experiences, and aid in service development. Method: The London and Southeast Lung Cancer Nurses Group, which is a regional group of the National Lung Cancer Nurses Forum in the United Kingdom, reviewed the evidence available. Sub-groups of the Forum developed specific standards relating to practice, and these were drawn together to develop a set of standards. Results: The members of the group felt that care for lung cancer patients in the region can be fragmented, as often the role of the lung cancer nurse specialist is unclear. The core standards of practice developed are as follows; communication and information, access to specialist help and advice, psychological and social support, expert symptom control and advice, co-ordination of care, and continuity of care. Each standard reviews the literature and provides guidance points for nurses. Discussion: Core standards of practice could make a significant contribution to improving the overall care of patients with lung cancer, as lung cancer nurse specialists will have a framework on which to pin their practice. The standards of practice can enable service and care evaluation through audit.
P 198 El
Interface of Professional Roles in the Management of Chronic Breathlessness in Lung Cancer Patients
Charlie Ewer-Smith’ , Nicki Thompson’, Jay Evans’, Jill Cooper’, Diane Laverty’ , Sara Travis’, Anna-Marie Stevens’, Patricia A. Hunt”. ’ The Royal Marsden Hospital London, England; ’ The Royal Marsden Hospital, Downs Road, Sutton, England
Aim: Breathlessness is the subjective experience of breathing discomfort. The experience is a result of a myriad of interactions between physiological, psy chological, social and environmental factors. It is present in approximately 70% of patients with cancer in the last few weeks of life and is severe in 25% of patients in their last week of life. The aim of this work is to demonstrate how a multiprofessional approach to the management of breathlessness can result in a holistic approach to patients with this distressing symptom. Method: During the last 12 months a clinical multi professional team have established a Specialist Breathlessness Service within the Royal Marsden NHS Trust, a London based cancer centre. The initiation of this service involved the setting up of a working party that comprised of an Occupational Therapist, Physiotherapist and Clinical Nurse Specialist in Palliative Care. The service is available to patients whose breathlessness is related to advanced disease either in the hospital setting or the outpatient department. All management of breathlessness in patients with advanced cancer is optimised by the combined approach between the Occupational Therapist, Physiotherapist and Clinical Nurse Specialist in Palliative Care. It is based on work previously done in patients with lung cancer patients (Bredin et al 1999), which uses a combination of non-pharmacological and pharmacological interventions to maximise the patient’s quality of life. Results: The multi professional approach to breathlessness is a combination of the biophysical and psychosocial approach. Each specialist plays a part in the management of the patients’ breathlessness, and each role dovetails with
Care
s141
the other, offering a seamless service to manage this distressing symptom. A patients journey from referral to the Breathlessness Team to discharge will demonstrate practice through a case study. An overview of an audit analysing the effectiveness of the marketing strategy for the service will also be included. Discussion: A multi professional approach to the management of breathlessness in lung cancer is a novel concept, as often this symptom is managed by each professional in a fragmented way. The service developed has enhanced the care of patients with breathlessness, allowing them to learn strategies to self manage this distressing symptom. Reference: Bredin M, Corner J, Kirshnasamy M, Plant H, Bailey, and A’Hern R (1999) Multicentre randomised controlled trial of nursing intervention for breathlessness in patients with lung cancer. British Medical Journal 318:901904.
I
P 199
Nursmg Support Through Educating Lung Cancer Patients :. Posmvely Impacts Their Quality of Life
Marni M. Besser, Paramjit Taheem. British Columbia Cancer Agency Vancouver Cancer Centre, Vancouver, Canada Patients receiving radiation and chemotherapy for treatment of lung cancer experience common challenges. The physical, emotional, cultural and spiritual experience of a person with lung disease, superimposed with the side effects of treatment, is seen to negatively impact their quality of life, (Symptom Distress and Coping Strategies in Patients With Non-small cell Lung Cancer, Cancer Nursing, Vol. 25, No.4, 2002). Nursing interventions through supportive education, with the application of timely communication opportunities, can positively affect change. Radiation Oncology Nurses and Systemic (Chemotherapy) Oncology Nurses provide ongoing education to support self-care with symptom management. This fosters self determination in this patient population. This presentation will highlight the utilization of interdisciplinary collaboration involved in enhancing the quality of life of lung patients through education and communication Patients are challenged by their physiological symptoms along with distressed mood. Oncology Nurses are in a pivotal position to assess patients’ total situations and their timely access to appropriate resources. Enhanced communication between patients and nurses has the potential to positively impact their quality of life. When patients engage and utilize resources that are offered, the Oncology Nurse is assured of successful interventions. The patient, the family unit and care team can observe improve capacity to self-manage stressors and symptoms.
P 200
I
Enhancing Quality of Life by Addressing Cancer-related Fatigue
Carole A. Robinson. SC Cancer Agenq Kelowna, Canada
Centre for the Southern Inferior,
Fatigue is the most commonly reported symptom among cancer patients. Further, it is the symptom that lasts the longest, has the most significant impact on quality of life, and is the symptom patients report getting the least assistance with managing. This session will explore the multidimensional nature of cancerrelated fatigue as well as assessment and evidence-based approaches to management. Discussion will include the place of fatigue in the symptom complex profile of patients diagnosed with lung cancer. As well, recent research that has identified behavioral responses to cancer and cancer treatment associated with both the presence and absence of fatigue will be highlighted. Therefore, we will be challenged to consider whether fatigue may be preventable or simply manageable.