Dr Hansen provided a comprehensive review of the challenges patients face when diagnosed with cancer. She illustrated that while improved survival is a welcome benefit to many of today’s cancer patients, psychological, social, and emotional struggles exist. Several considerations come to mind, such as where does one obtain information regarding care? Does the patient- provider relationship affect treatment, and what is the role of the oncology nurse (ON) in the care of cancer patients? Nurses are often the first in a series of healthcare professionals that the patient, family, and significant others will encounter, and their presence can make a great impact.
The role of each ON differs according to each practice setting. Despite this diversity in the nursing profession, providing information to patients and caregivers remains a key responsibility for ONs. The type of information varies from instructing patients when to call the office to discussing strategies for symptom management. A recent study explored the effectiveness of ONs as information providers and found their role is prominent and valued among cancer patients.1 In addition, patients prefer ONs as information providers throughout their course of treatment and especially in regard to symptom management.1,2 Thus, regardless of practice setting, ONs should embrace their role as educators as this often translates to better outcomes and improved patient satisfaction with their care.
Oncology nurses are valuable members of the multidisciplinary healthcare team and use strategies that can impact patient decision making.3,4 One method to increase patient comprehension of information includes the use of multimedia support. Multimedia support aids are designed to help patients make informed decisions about cancer treatment.5 Additional research is aimed at improving patient comprehension of information and provider responses. One group utilized an interactive patient assessment tool that evaluates patient cues and concerns and provider responsiveness to these cues.6 High-quality provider communication and trusting relationships are important to health-related quality of life of cancer survivors.7,8 Patients cite trust and confidence in their physician and ONs as being important. Establishing trust takes time and often occurs during the initial cancer consultation. Research suggests that sufficient consultation time improves quality care and must be allotted to meet an individual’s subjective needs.9 In addition, open discussion of symptoms and concerns with providers during and following treatment offers patients reassurance about cancer recurrence.10
Nurses function in a multifaceted role as patient navigators who focus on the physical, psychological, and social aspects of care.11 Despite our busy schedule, it is important that ONs screen patients for issues that can negatively affect their health. This includes finances, depression, cognitive impairment, and lack of social support. Working with a multidisciplinary treatment team that includes social workers and financial counselors can provide the framework necessary to complete treatment. By helping patients meet their information needs, employing techniques to improve communication, and identifying available resources, ONs can give patients confidence that their care is well coordinated. This can translate to improved outcomes.
- Koutsopoulou S, Papathanassoglou EDE, Katapodi MC, et al. A critical review of the evidence for nurses as information providers to cancer patients. J Clin Nurs. 2010;19:749-765.
- Markides M. The importance of good communication between patient and health professionals. J Pediatr Hematol/Oncol. 2011;33(suppl 2):S123-S125.
- Lamb B, Sevdalis N, Mostafid H, et al. Quality improvement in multidisciplinary cancer teams: an investigation of teamwork and clinical decision-making and cross-validation of assessments. Ann Surg Oncol. 2011;18:3535-3543.
- Wang LH, Tsai YF, Chen JS, et al. Intention, needs, and expectations of cancer patients participating in clinical trials. Cancer Nurs. 2011;34:117-123.
- Allen JD, Berry DL. Multi-media support for informed/shared decision-making before and after a cancer diagnosis. Semin Oncol Nurs. 2011;27:192-202.
- Heyn L, Ruland CM, Finset A. Effects of an interactive tailored patient assessment tool on eliciting and responding to cancer patients’ cues and concerns in clinical consultations with physicians and nurses. Patient Educ Couns. In press.
- Arora NK, Gustafson DH. Perceived helpfulness of physicians’ communication behavior and breast cancer patients’ level of trust over time. J Gen Intern Med. 2009;24:252-255.
- Waters EA, Arora NK, Klein WM, et al. Perceived risk, trust and health-related quality of life among cancer survivors. Ann Behav Med. 2010;39:91-97.
- Shin DW, Park JH, Shim EJ, et al. Predictors and outcomes of feeling of insufficient consultation time in cancer care in Korea: results of a nationwide multicenter survey [published online ahead of print November 9, 2011]. Support Care Cancer.
- Clayton MF, Dudley WN. Patient-centered communication during oncology follow-up visits for breast cancer survivors: content and temporal structure. Oncol Nurs Forum. 2009;36:E68-E79.
- Gilbert JE, Green E, Lankshear S, et al. Nurses as patient navigators in cancer diagnosis: review, consultation and model design. Eur J Cancer Care. 2011;20:228-236.