Luta Xhyljeta, Colomer-Lahiguera Sara, Martins Cardoso Rodrigo Jose, Hof Frank, Savoie Manon, Schuler Cosette, Wicht Justine, Fucina Nadia, Debarge Patricia, Ninane Françoise, Bourhis Jean, Eicher Manuela
Institute of Higher Education and Research in Healthcare, Faculty of Biology and Medicine, Lausanne University Hospital, University of Lausanne, CH-1010 Lausanne, Switzerland.
Department of Radiation Oncology, Lausanne University Hospital, CH-1205 Lausanne, Switzerland.
Cancers (Basel). 2022 Feb 26;14(5):1227. doi: 10.3390/cancers14051227.
Background: Head and neck cancer (HNC) patients experience distressing symptoms that can significantly impact their health-related quality of life (HRQoL). We analyzed the implementation of a nurse-led consultation (NLC) and explored potential associations with symptom burden in HNC patients. Methods: We retrospectively analyzed routinely collected data to describe the implementation of the nurse-led interventions and the evolution of the M.D. Anderson Symptom Inventory scores as patient-reported outcome measures (PROMs). Patients who received routine care (n = 72) were compared with patients in the NLC group (n = 62) at a radiation oncology unit between 2017 and 2019. PROMs were measured at T0 (between simulation and the first week of radiotherapy), T1 (week 3−4), and T2 (week 5−6). Results: Screening for nutrition, smoking, oral cavity status, and capacity for swallowing/chewing, but not for pain, was applied in >80% of patients in the NLC group from T0 to T1. Education (16%) and care coordination (7%) were implemented to a lesser extent. Symptom burden increased over time with no significant differences between groups. Conclusions: The nurse-led consultation was not associated with symptom burden over time. A larger implementation study including a detailed process evaluation, larger sample size, and a focus on long-term effects is needed.
头颈癌（HNC）患者会经历令人痛苦的症状，这些症状会对其健康相关生活质量（HRQoL）产生重大影响。我们分析了由护士主导的咨询（NLC）的实施情况，并探讨了其与HNC患者症状负担的潜在关联。方法：我们回顾性分析了常规收集的数据，以描述护士主导干预措施的实施情况以及作为患者报告结局指标（PROMs）的MD安德森症状量表评分的变化。将2017年至2019年期间在一家放射肿瘤学单位接受常规护理的患者（n = 72）与NLC组的患者（n = 62）进行比较。在T0（模拟放疗和放疗第一周之间）、T1（第3 - 4周）和T2（第5 - 6周）测量PROMs。结果：从T0到T1，NLC组中超过80%的患者接受了营养、吸烟、口腔状况以及吞咽/咀嚼能力的筛查，但未对疼痛进行筛查。教育（16%）和护理协调（7%）的实施程度较低。症状负担随时间增加，两组之间无显著差异。结论：随着时间推移，由护士主导的咨询与症状负担无关。需要开展一项更大规模的实施研究，包括详细的过程评估、更大的样本量以及关注长期效果。
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