A study to evaluate nurse-led on-treatment review for patients undergoing radiotherapy for head and neck cancer.
A study to evaluate nurse-led on-treatment review for patients undergoing radiotherapy for head and neck cancer.
复制标题
一项评估护士主导的对接受头颈癌放射治疗的患者进行治疗审查的研究。
作者：
M. Wells;P. Donnan;L. Sharp;C. Ackland;J. Fletcher;J. Dewar
宗旨和目标
评估一个护士主导的诊所，为病人接受放射治疗的头部和颈部。
背景
头部和颈部放射治疗的副作用叠加在已经显着的身体和心理疾病上。医疗审查诊所往往侧重于治疗并发症，有证据表明，专科护士可以为病人提供更全面的护理。然而，在这个高度症状和复杂的群体中，护士主导的审查是否合适，已经引起了怀疑。
设计
本评价使用历史对照组，比较了头颈部放疗患者的医疗治疗审查（第1阶段）与护士主导的诊所（第2阶段）。
方法
20名患者由他们的顾问和23名护士专家进行审查，使用临床协议。对数据收集采取了混合方法。患者每周完成生活质量问卷，并被问及他们的支持和护理经验。全科医生完成了一份关于从诊所收到的沟通的问卷。检查表评估了诊所咨询的内容。
结果
患者重视与护士专家的关系，有更长的时间，更频繁的咨询，更经常地被称为多学科团队。83%的咨询是由专科护士处理的，而不需要转介给顾问。两组之间的生活质量几乎没有显著差异。有迹象表明，口腔和营养问题更有效地管理在护士领导的诊所，虽然情绪功能较高的医疗组。全科医生对收到信息的时间和内容持积极态度。
结论
头颈部癌症患者的治疗回顾可由专科护士有效管理。实践的相关性。放射治疗护理专家对头颈部癌症患者的支持性护理做出了重要贡献。需要更多的投资来最大限度地发挥它们的作用。
AIMS AND OBJECTIVES
To evaluate a nurse-led clinic for patients undergoing radiotherapy to the head and neck.
BACKGROUND
The side effects of radiotherapy to the head and neck are superimposed on already significant physical and psychological morbidity. Medical review clinics tend to focus on treatment complications and there is evidence that specialist nurses can provide more holistic care for patients. However, doubts have been raised about the appropriateness of nurse-led review in this highly symptomatic and complex group.
DESIGN
This evaluation compared medical on-treatment review (Phase 1) with a nurse-led clinic (Phase 2) for patients having radiotherapy to the head and neck, using an historical control group.
METHODS
Twenty patients were reviewed by their consultant and 23 by a nurse specialist, using a clinic protocol. A mixed-method approach to data collection was taken. Patients completed weekly quality of life questionnaires and were asked about their experiences of support and care. General practitioners completed a questionnaire about the communication received from the clinic. Checklists assessed the content of clinic consultations.
RESULTS
Patients valued the relationship developed with the nurse specialist, had longer, more frequent consultations and were more often referred to the multidisciplinary team. The nurse specialist managed 83% of consultations without referral to the consultant. Few significant differences in quality of life were found between the groups. There were indications that oral and nutritional problems were managed more effectively in the nurse-led clinic, although emotional functioning was higher in the medical group. GPs were positive about the timing and content of information received.
CONCLUSIONS
On-treatment review for patients with head and neck cancer can be effectively managed by a nurse specialist. Relevance to Practice. Radiotherapy nurse specialists make an important contribution to the supportive care of patients with head and neck cancer. More investment is required to maximize their contribution.