Keith S J Mitchell1, Sarah Delfont2, Maria Lucinda Bracey3, Ruth Endacott4. 1. Royal Devon & Exeter NHS Foundation Trust, Barrack Rd, Exeter, Devon, EX2 5DW, United Kingdom. Electronic address: Keithmitchell1@nhs.net. 2. FORCE Cancer Charity, Barrack Rd, Exeter, Devon, EX2 5DW, United Kingdom. Electronic address: Sarah.delfont@nhs.net. 3. Royal Devon & Exeter NHS Foundation Trust, Barrack Rd, Exeter, Devon, EX2 5DW, United Kingdom. Electronic address: maria.bracey@nhs.net. 4. Plymouth University/Royal Devon and Exeter Hospital Clinical School, University of Plymouth, Faculty of Health and Human Sciences, Plymouth, PL4 8AA, United Kingdom. Electronic address: ruth.endacott@plymouth.ac.uk.
Abstract
PURPOSE: We examined the concerns that nurses perceive patients to have, whether these are congruent with patients' concerns and whether they vary according to cancer site. We also examined Distress Thermometer scores according to cancer site. METHOD: A cross-sectional survey design: (i) secondary analysis of an existing Holistic Needs Assessment (HNA) and Distress Thermometer (DT) dataset was used, (ii) a survey of specialist nurse teams to identify their perceptions of patient concerns. Data collected between January 2015 and June 2016 from the HNA database from one NHS Trust in England (n = 1233 patients). Specialist nurse teams for breast, colorectal, gynaecology, skin and urology cancers identified the concerns that they perceived their patients would report. RESULTS: The HNA showed high internal consistency (Cronbach's alpha 0.86). Across the five cancer sites, nurses identified between 3 and 6 of the top ten concerns (TTC) expressed by patients, with wide variation across cancer sites. Nine of the TTC were significantly associated (p < 0.05) with a specific cancer site. The breast and gynaecological cancer groups both recorded significantly higher median Distress Thermometer scores than the urology, skin and colorectal cancer groups (Kruskall-Wallis χ2 (4, n = 1228) 186.695, p=<.01). CONCLUSIONS: One of the aims of the eHNA is to enable service delivery appropriate to patient needs. Our findings suggest that this will only be achieved if eHNA is examined, and services developed, by individual cancer site. The misconception of patient needs by specialist nurses underscores the importance of review of information provided by patients during consultations.
PURPOSE: We examined the concerns that nurses perceive patients to have, whether these are congruent with patients' concerns and whether they vary according to cancer site. We also examined Distress Thermometer scores according to cancer site. METHOD: A cross-sectional survey design: (i) secondary analysis of an existing Holistic Needs Assessment (HNA) and Distress Thermometer (DT) dataset was used, (ii) a survey of specialist nurse teams to identify their perceptions of patient concerns. Data collected between January 2015 and June 2016 from the HNA database from one NHS Trust in England (n = 1233 patients). Specialist nurse teams for breast, colorectal, gynaecology, skin and urology cancers identified the concerns that they perceived their patients would report. RESULTS: The HNA showed high internal consistency (Cronbach's alpha 0.86). Across the five cancer sites, nurses identified between 3 and 6 of the top ten concerns (TTC) expressed by patients, with wide variation across cancer sites. Nine of the TTC were significantly associated (p < 0.05) with a specific cancer site. The breast and gynaecological cancer groups both recorded significantly higher median Distress Thermometer scores than the urology, skin and colorectal cancer groups (Kruskall-Wallis χ2 (4, n = 1228) 186.695, p=<.01). CONCLUSIONS: One of the aims of the eHNA is to enable service delivery appropriate to patient needs. Our findings suggest that this will only be achieved if eHNA is examined, and services developed, by individual cancer site. The misconception of patient needs by specialist nurses underscores the importance of review of information provided by patients during consultations.
Authors: Lisa M Wu; Nadia Kuprian; Krista Herbert; Ali Amidi; Jane Austin; Heiddis Valdimarsdottir; Christine Rini Journal: Palliat Support Care Date: 2019-08