Nurse-Led Consultation and Symptom Burden in Patients with Head and Neck Cancer: A Comparative Analysis of Routine Clinical Data.

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.

Le modèle de pratique des infirmières spécialistes cliniques aux Hôpitaux universitaires de Genève.

THE CLINICAL NURSE SPECIALIST PRACTICE MODEL AT GENEVA UNIVERSITY HOSPITALS.: A clinical nurse specialist practice model has been implemented at Geneva University Hospitals. It details the five dimensions of the function-clinical practice, coaching-consultation-guidance, research, leadership and collaboration, ethics-and its three spheres of influence-patients and their family, nursing teams, institutions. Arising from practice rather than the world of academia, it constitutes a tool to aid reflection among the nursing profession.

[Body image disturbance, nursing objectives and interventions]. / L'image corporelle perturbée, quels objectifs et interventions en soins infirmiers?

Faced with a changed body, several nursing care interventions are possible in order to restore self-esteem. Relational and personal care techniques or other forms of body mediation are all tools which can be used in order to reposition the patients at the centre of the care.

[Body image, clinical approach centered on the patient]. / L'image corporelle perturbée, pour la clinique centrée sur la personne soignée.

Any change to the body can have repercussions on the person affected, not only psychological but also social and professional. Their image of their own body and their self-esteem are often disturbed. Numerous deliberations have been carried out on this subject with a view to placing the patient's body experience at the heart of the clinical approach.