ABSTRACT
OBJECTIVES: To provide an overview of issues and challenges associated with integrating development of survivorship care plan processes with electronic medical records (EMRs). DATA SOURCES: Published peer-reviewed literature. CONCLUSION: Evidence seems to indicate that survivorship care plans have value to survivors, oncology specialist providers, and primary care providers. Yet, the existence of cost and time restraints are major barriers to creation and use of survivorship care plans, and the expectations that EMR can simplify and expedite survivorship care plan development have yet to be realized. IMPLICATIONS FOR NURSING PRACTICE: Nurses participating in the development of survivorship programs can contribute to successful implementation of EMR-facilitated survivorship care plans by involvement in strategic planning processes, and establishment of reasonable timelines to address the known and unknown barriers, and assuring the resulting EMR product includes essential data and information.
Subject(s)
Electronic Health Records/statistics & numerical data , Neoplasms/mortality , Neoplasms/nursing , Patient Care Planning/organization & administration , Quality Improvement , Survivors/statistics & numerical data , Delivery of Health Care, Integrated/organization & administration , Female , Humans , Male , Nurse's Role , Oncology Nursing/organization & administration , Patient Outcome Assessment , Peer Review , Prognosis , Survival Rate , Survivors/psychology , United StatesABSTRACT
Despite advances in the quality and availability of hospice and palliative care for people with end stage cancers, research addressing the psychosocial needs of family members and concerned others during the dying process has been limited primarily to caregivers. In addition, many of these studies focused on the recently bereaved. In this study, the authors sought to broaden that perspective by examining the psychosocial needs of secondary survivors, a term that applies to caregivers, family members, and others who felt a caring bond with a dying person. A qualitative exploration of needs expressed by secondary survivors following the conclusion of a structured 8-week psychoeducational grief group experience revealed that secondary cancer survivors experience a sense of isolation and powerlessness that is often unrecognized by physicians, nurses, oncology social workers, or other health care professionals. Furthermore, these secondary survivors needed support that extends well beyond activities that are traditionally associated with the physical and emotional care of the dying. Social work intervention strategies directed toward helping secondary survivors assert personal needs, develop greater proximity with the health care team, and prepare for the processes associated with end-of-life may be helpful later during bereavement.
Subject(s)
Bereavement , Death , Family/psychology , Neoplasms/mortality , Terminal Care/psychology , Caregivers/psychology , Female , Friends/psychology , Humans , Male , Self-Help GroupsABSTRACT
OBJECTIVE: Although several large distress studies have been conducted in outpatient oncology treatment settings, there are few, if any, studies that describe the incidence of psychological and physical distress in the inpatient oncology treatment setting. This pilot study hypothesized that inpatients experience levels of psychological distress that are equivalent to or greater than those reported in large outpatient studies. The study also sought to contribute to physical and psychological symptom distress incidence data. METHODS: Using two measures designed to screen for psychological and physical distress, the Brief Symptom Inventory-18 and the M.D. Anderson Symptom Inventory, 52 oncology patients were screened within 24 h of admission to a hospital oncology unit. RESULTS: Nearly two-thirds of the inpatient respondents reported levels of psychological distress that were not only within the clinically significant range but also at a rate that was nearly double that found in the outpatient distress screening studies that have been conducted to date. The physical symptoms most often rated at the severe level included fatigue (34.6%), pain (27.4%), and dry mouth (25.5%). CONCLUSIONS: Failure to screen for psychological and physical symptom distress has lead to under recognition of a population that may have higher levels of distress than their outpatient counterparts and could potentially lead to uneven access to biopsychosocial support. Results support the notion that routinely screening for psychological and physical distress should become a first step in the assessment of the biopsychosocial needs of people receiving inpatient treatment for cancer.