Nurse-led Care Program for Cancer Patients in Chemotherapy Day Center

The Hong Kong Polytechnic University

Status: Completed

Conditions: Breast Neoplasms; Colorectal Neoplasms

Treatments: Behavioral: Nurse-led care; Behavioral: Routine care

Study type: Interventional

Funder types: Other

Identifiers

NCT02228200

POLYU-HSEARS20120117002

Details and patient eligibility

About

A nurse-led care program for cancer patients receiving chemotherapy in an outpatient setting was formulated. The aim of the study was to assess the effect of this nurse-led care program on cancer patients who received neo-adjuvant/adjuvant chemotherapy in a chemotherapy day center in terms of quality of life, symptom experiences, self-efficacy, health care utilization, and satisfaction with care. Specifically, the objectives are:

• To compare the differences of health care utilization between the two arms.
• To compare the differences of cancer patients' satisfaction with care between the two arms.
• To explore the experiences of cancer patients in the intervention arm.
• To understand the experiences of the intervention nurses of the program and their opinions on further development.

Full description

Chemotherapy affects cancer patients in many ways. It is common that patients suffer multiple side-effects simultaneously. Psychological distress is also a common problem during chemotherapy. Distressful experiences in chemotherapy may lead to deterioration in a patient's of quality of life (QOL). In addition, cancer patients have particularly high unmet needs during treatment, including informational needs, psychosocial needs, needs in the activities of daily living, supportive care needs, sexual needs, and communication needs. Among them, information is the most frequently reported need in the treatment phase. These unmet needs cause uncertainty, anxiety, and distress to cancer patients.

Outpatient-based chemotherapy is now widely established. Despite its benefits to health care institutions and cancer patients, there are attendant challenges. Cancer patients need to take care of themselves at home during each interval of chemotherapy. Without adequate support from health care providers, cancer patients may not be able to properly manage chemotherapy and its effects by themselves. The poor management of side-effects may lead to increased health care utilization. Cancer patients need to develop new self-care skills to cope with chemotherapy.

Facing increasing numbers of cancer patients and burgeoning health care needs, health care professionals must address the issue of how to improve the quality of care during chemotherapy. Nurse-led care is a highly recommended and innovative way of improving quality of care. It shows distinct advantages in terms of providing holistic care because it is based on the philosophy of the uniqueness of individuals and the multidimensionality of human beings. The feasibility and effects of nurse-led care are being explored in an increasing number of studies. However, studies of nurse-led care for cancer patients receiving outpatient-based chemotherapy are far away adequacy. There is a need to examine the feasibility and effects of nurse-led care for cancer patients receiving chemotherapy in outpatient settings.

Enrollment: 150 patients

Sex: All

Ages: 18+ years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• Diagnosed with primary breast /lung/stomach/colorectal cancer;
• Receive chemotherapy for the first time;
• Karnofsky performance scale equal or over 60;
• Communicate with Cantonese and read Chinese;
• Can be contacted with telephone.

Exclusion criteria

• Having a history of psychiatric or intellectual impairment such as: dementia, schizophrenia, mental retardation, depression, and anxiety disorder;
• Having received CT before either in the study hospital or other hospital;
• Receive concurrent chemoradiotherapy;
• At the end stage of life.

Trial design

Primary purpose: Supportive Care

Allocation: Randomized

Interventional model: Single Group Assignment

Masking: None (Open label)

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150 participants in 2 patient groups

Nurse-led care

Experimental group

Description:

Subjects in the nurse-led care arm received nurse-led care and routine care.

Treatment:

Behavioral: Routine care

Behavioral: Nurse-led care

Routine care

Active Comparator group

Description:

Subjects in the routine care arm received routine care provided by the study hospital.

Treatment:

Behavioral: Routine care