Oncology out-patients nursing: a challenge within the changing face of cancer care

A qualitative study exploring perceptions and experiences of patients and clinicians of palliative medicine outpatient clinics in different settings

Palliative care exists in a variety of settings and palliative care teams form many guises within this. A Palliative Medicine Outpatient Clinic (PMOC) exists to meet the flexible provision of the needs and preferences of individuals within whatever care setting they reside. This explorative study used a qualitative methodology, capturing patients' actual experience of care in preference to their satisfaction, as this is a more accurate measure of how and what patients judge as important in their healthcare. The overall themes in this paper point to the 'value' that patients perceived from attending the PMOC and how important the clinics were to clinicians that provided the care. The clinic facilitates much more than symptom control and here lies the challenge in how we convert the very positive experience of individuals into a language of outcome measures that captures the 'essence' of our work in this fiscally driven health economy.

Proactive nurse management guidelines for managing intensive chemotherapy regimens in patients with advanced gastric cancer

Patients with advanced gastric cancer have a poor prognosis. Intensive chemotherapy regimens may be effective for the treatment of this disease but may be associated with a significant number of severe adverse events. Optimal management of these adverse events can improve outcome for the patient. Currently, there is little information in the literature about the nursing management of this particular group of patients. This American study involved the nursing management of all patients with gastric or gastroesophageal cancer enrolled in clinical trials at a single center. Patients had close contact with research nurses and received education about adverse events and how to deal with them. Patients completed a detailed treatment diary for each cycle of treatment. Protocols were established for the management of emergent adverse events. The guidelines developed during this study could help to underpin the role of the specialist oncology nurse and improve the management of patients undergoing intensive chemotherapy for gastric and gastroesophageal cancer, with the potential of improving outcome, or at least quality of life, for the patients. The nurses' role should be pivotal in the management of intensive chemotherapy for gastric and gastroesophageal cancer.