Cohen Abigail G, Kramer Dana, Mazzarella Kathryn, Scott Megan H, Szkolnicki Mia, Tucker Alli, Qualters Kelley, Perales Miguel-Angel, Brooklyn Chelsea, Epstein Andrew S, Nelson Judith E, Lestrange Nicole
Abigail G. Cohen, MSc, ANP-BC, AOCNP, BMTCN, is a Nurse Practitioner, BMT/CAR-T Survivorship Program, Memorial Sloan Kettering Cancer Center, New York, NY.
Dana Kramer, MSc, ANP-BC, is a Nurse Practitioner, Supportive Care Service, Memorial Sloan Kettering Cancer Center, New York, NY.
J Hosp Palliat Nurs. 2025 Aug 22. doi: 10.1097/NJH.0000000000001148.
Patients undergoing hematopoietic stem cell transplant and chimeric antigen receptor-T cell therapy face significant uncertainty, distress, risk of serious treatment-related complications, and disease relapse. Although palliative care and advance care planning offer clear benefits, both remain underutilized or delayed in this patient population. To address this gap, a nurse practitioner (NP)-led primary palliative care intervention was implemented in the outpatient Bone Marrow Transplant and Cellular Therapy Services at a comprehensive cancer center. This paper provides an overview of the program model, involving NP-led health-related values and care preferences discussions with patients and their families. This highlights the pivotal role of NPs in delivering primary palliative care by integrating values-based discussions into routine oncology practice. Future goals include evaluating the intervention's impact on patient and caregiver outcomes, clinician understanding, care alignment with patient's goals, advance directive completion, and high-intensity care at the end of life.
接受造血干细胞移植和嵌合抗原受体T细胞疗法的患者面临着巨大的不确定性、痛苦、严重治疗相关并发症的风险以及疾病复发。尽管姑息治疗和预先护理计划有明显益处，但在这一患者群体中，两者的使用仍然不足或延迟。为了弥补这一差距，在一家综合癌症中心的门诊骨髓移植和细胞治疗服务部门实施了一项由执业护士主导的初级姑息治疗干预措施。本文概述了该项目模式，包括由执业护士主导的与患者及其家属进行的与健康相关的价值观和护理偏好讨论。这突出了执业护士在将基于价值观的讨论融入常规肿瘤学实践以提供初级姑息治疗方面的关键作用。未来的目标包括评估该干预措施对患者和护理人员结局、临床医生理解、护理与患者目标的一致性、预先医疗指示的完成情况以及临终时的高强度护理的影响。
