Head and neck cancer (HNC) patients treated with chemoradiation have to rediscover their life after recovering from severe side-effects and build-up self-confidence. To assist patients in this, an aftercare intervention to support patients’ self-management was implemented. This study aimed to evaluate the feasibility and first effects

Braat, C. (Cora)

Offerman, M.P.J. (Marinella)

Oldenmenger, W.H. (Wendy)

Peeters, M.A.C. (Mariëlle A.C.)

Staa, A.L. (AnneLoes) van

Stege, H.A. (Heleen) van der

Verduijn, G.M. (Gerda)

Braat, C.

Verduijn, G.M.

Stege,van der, H.A.

Offerman, M.

Peeters, J.M.

Staa,van, A.L.

Oldenmenger, W.H.

NARCIS 

Evaluation of a nursing aftercare intervention for patients with head and neck cancer treated with chemoradiation

Peeters, M.A.C. (Mari\xc3\xablle A.C.)

Erasmus University Digital Repository

CN53 Rectal cancer survivorship: The struggle of the low anterior resectionsyndrome (LARS)E. Pape1, P. Pattyn1, A. van Hecke2, N. Somers3, D. Van De Putte1, W. Ceelen1, E. vanDaele1, W. Willaert1, Y. van Nieuwenhove11Gastrointestinal Surgery, Ghent University Hospital, Ghent, Belgium, 2University Centrefor Nursing and Midwifery, Ghent University, Ghent, Belgium, 3Faculty of Medicine,Ghent University, Ghent, BelgiumBackground: Due to better surgical techniques and radiotherapy there is an increase insphincter saving procedures for rectal cancer. The benefit of this approach is the lack ofa permanent stoma but it conducts a big change in the bowel habits namely LARS.When a permanent stoma could be avoided these patients are prepared to make exten-sive adjustments in order to accept the new lifestyle without a stoma. Patients experi-ence a number of functional, psychological and social problems. These symptomsworsen immediately after the surgery and improve in the following months. Howeversome patients experience permanent difficulties. Literature identifies that 60 to 90% ofall patients suffer from LARS with a negative impact on the quality of life (QOL).Methods: A cohort of surviving patients, who underwent a low anterior resection forrectal cancer, were identified. These patients were treated in the University Hospital inGhent between January 1, 2006 until September 15, 2016. QOL was assessed using theEORTC QLQ C30 questionnaire and the bowel function using the validated LARSscore. The relationship between LARS and QOL and the risk factors for developingLARS were analyzed. Patients with a major LARS score ( 30 points) were contacted toexplore their management of LARS.Results: A total of 121 patients were included in this study. 69% of these had majorLARS. QOL was closely associated with LARS. Significant differences were found in theglobal health status, functional (physical, role, cognitive and social) and symptom(fatigue, pain, insomnia and diarrhea) scales. The height of the anastomosis was a riskfactor for major LARS. Most patients used dietary regimens, medication and inconti-nence material in an attempt to manage their LARS.Conclusions: The removal of a temporary stoma signifies for many patients and theirsocial network the completion of treatment. However, after several years, 69% of thesepatients are still suffering from bowel difficulties. Patients with major LARS have a sig-nificant decreased QOL. For this reason it is imperative that the caregiver is aware ofthis problem. At this time there is no golden standard for the management of LARS.Patients and their informal caregivers are managing this condition through trial anderror.Legal entity responsible for the study: Gastrointestinal surgery University HospitalGhent.Funding: Has not received any funding.Disclosure: All authors have declared no conflicts of interest.CN54 Nurse-led approaches to self-management of symptoms in routineSwiss outpatient care: A qualitative explorationK. Ribi1, M. Bana2, S. Peters3, S. Kropf-Straub4, E. N€af5, S. Zürcher4, M. Eicher61Institut Universitaire de Formation et de Recherche en Soins – IUFRS, University ofLausanne, Lausanne, Switzerland, 2School of Health Sciences (HEdS-FR), HES-SOUniversity of Applied Sciences and Arts Western Switzerland, Fribourg, Switzerland,3Multidisciplinary Oncology Center, Centre Hospitalier Universitaire Vaudois - CHUV,Lausanne, Switzerland, 4Departement of Practice Development in Nursing, HospitalGroup Lindenhof, Bern, Switzerland, 5Departement of Practice Development in Nursing,Solothurner Spit€aler AG, Kantonsspital Olten, Olten, Switzerland, 6Departement ofOncology - Institut Universitaire de Formation et de Recherche en Soins – IUFRS, CentreHospitalier Universitaire Vaudois - CHUV, Lausanne, SwitzerlandBackground: The Symptom NaviVC Program is a new nurse-led intervention to facili-tate patients’ self-management of symptoms. Testing this intervention in a comparativestudy requires the assessment of nurses’ routines to support patients’ self-managementcompetencies in order to interpret the magnitude of the effect of the intervention. Aspart of a larger study, we aimed at gaining insight into these routines provided in theSwiss outpatient setting, specifically into those related to symptoms caused by anti-can-cer therapies.Methods: We conducted focus groups (FG) with nurses at four cancer outpatient cen-ters. FG were held before introducing the program, and were audio-recorded and tran-scribed verbatim. Two researchers independently conducted a thematic analysis using adeductive approach to identify themes related to self-management support. Emergingthemes were discussed until consensus.Results: Four FG (one per center) with a total of 15 nurses revealed three main themes.The 1st theme covered information provision including both general information, andinformation tailored to the patient’s situation. The 2nd theme involved patient-centeredcare that was realized by a primary nursing approach and by focusing on each patient’sunique psycho-social needs. The 3rd theme addressed the documentation of the careprocess, which was considered important to monitor the course of care and to shareinformation between health care professionals. The level of standardization of consul-tations varied between centers ranging from experienced-based to highly structured,with peer-led quality assurance.Conclusions: Nurse routines to support patient’s self-management of symptoms showsimilar key themes across four centers in Switzerland. We identified information provi-sion to be the main focus of nurses’ support. Levels of standardization of the consulta-tions varied across centers. Our results also showed that other self-managementcompetencies considered relevant for patients (problem solving skills, decision making,or tailored action planning) are not yet explicitly addressed in nurse-led consultations.Legal entity responsible for the study: University of Lausanne and Centre HospitalierUniversitaire Vaudois (CHUV), Lausanne.Funding: Institut Universitaire ee Formation et de Recherche en Soins (IUFRS),University of Lausanne, School of Health Sciences Fribourg, Hospital GroupLindenhof Bern; Altschüler Foundation St. Gallen, Swiss Cancer League.Disclosure: All authors have declared no conflicts of interest.CN55 Evaluation of a nursing aftercare intervention for patients with headand neck cancer treated with chemoradiationC. Braat1, G. Verduijn1, H. van der Stege2, M. Offerman3, M. Peeters2, A. van Staa2,W. Oldenmenger41Radiotherapy, Erasmus MC Cancer Insitute, Rotterdam, Netherlands, 2KenniscentrumZorginnovatie, Hogeschool Rotterdam, Rotterdam, Netherlands, 3Head and NeckOncology, Erasmus MC, Rotterdam, Netherlands, 4Oncology, Erasmus MC CancerInsitute, Rotterdam, NetherlandsBackground: Head and neck cancer (HNC) patients treated with chemoradiation haveto rediscover their life after recovering from severe side-effects and build-up self-confi-dence. To assist patients in this, an aftercare intervention to support patients’ self-man-agement was implemented. This study aimed to evaluate the feasibility and first effects.Methods: HNC patients treated in the Erasmus MC between November 2015 andNovember 2016 were included in the intervention group (n¼ 39). They received anurse-led intervention using the Self-Management Web (SMW) while patients of thehistorical control group received standard care. The SMW contains 14 areas of life onphysical, psychological and social themes and was used to set priorities, define goalsand make action plans for the future. Patients completed questionnaires on quality oflife, self-management behaviour, self-efficacy and quality of care. Additionally, individ-ual interviews were performed to gain insight into patients’ experiences with the after-care intervention.Results: Patients in the intervention group showed a significant reduction in anxietyand an increase in self-efficacy. The differences between the extent to which the nursepaid attention to the topics compared to the importance patients attached to these weresmall. They need more attention to knowledge about their disease, emotional and spiri-tual well-being and self-care; patients in the control group indicated that they wantedmore attention on all topics. No significant differences were found in quality of life andself-management behaviour between both groups. In the interviews, patients highlyappreciated the opportunity to discuss a broad range of topics and recommended it forstandard practice.Conclusions: HNC patients experience a significant reduction in anxiety and increasedlevels of self-efficacy after our aftercare self-management intervention. The topics ofthe SMW represent a complete overview while the solution-focused approach encour-ages patients to set goals for their recovery progress.Legal entity responsible for the study: Erasmus MC.Funding: Has not received any funding.Disclosure: All authors have declared no conflicts of interest.VC European Society for Medical Oncology 2018. Published by Oxford University Press on behalf of the European Society for Medical Oncology.Annals of Oncology 29 (Supplement 8): viii698–viii701, 2018doi:10.1093/annonc/mdy278CANCER NURSING: SYMPTOM MANAGEMENTThis is an Open Access article under the  CC-BY-NC license.-ND

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Evaluation of a nursing aftercare intervention for patients with head and neck cancer treated with chemoradiation

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