Implementing the Fatigue Guidelines at one NCCN member institution: process and outcomes.

نویسندگان

  • Tami Borneman
  • Barbara F Piper
  • Virginia Chih-Yi Sun
  • Marianna Koczywas
  • Gwen Uman
  • Betty Ferrell
چکیده

Fatigue, despite being the most common and distressing symptom in cancer, is often unrelieved because of numerous patient, provider, and system barriers. The overall purpose of this 5-year prospective clinical trial is to translate the NCCN Cancer-Related Fatigue Clinical Practice Guidelines in Oncology and NCCN Adult Cancer Pain Clinical Practice Guidelines in Oncology into practice and develop a translational interventional model that can be replicated across settings. This article focuses on one NCCN member institution's experience related to the first phase of the NCCN Cancer-Related Fatigue Guidelines implementation, describing usual care compared with evidence-based guidelines. Phase 1 of this 3-phased clinical trial compared the usual care of fatigue with that administered according to the NCCN guidelines. Eligibility criteria included age 18 years or older; English-speaking; diagnosed with breast, lung, colon, or prostate cancer; and fatigue and/or pain ratings of 4 or more on a 0 to 10 screening scale. Research nurses screened all available subjects in a cancer center medical oncology clinic to identify those meeting these criteria. Instruments included the Piper Fatigue Scale, a Fatigue Barriers Scale, a Fatigue Knowledge Scale, and a Fatigue Chart Audit Tool. Descriptive and inferential statistics were used in data analysis. At baseline, 45 patients had fatigue only (> or = 4) and 24 had both fatigue and pain (> or = 4). This combined sample (N = 69) was predominantly Caucasian (65%), female (63%), an average of 60 years old, diagnosed with stage 3 or 4 breast cancer, and undergoing treatment (82%). The most common barriers noted were patients' belief that physicians would introduce the subject of fatigue if it was important (patient barrier); lack of fatigue documentation (professional barrier); and lack of supportive care referrals (system barrier). Findings showed several patient, professional, and system barriers that distinguish usual care from that recommended by the NCCN Cancer-Related Fatigue Guidelines. Phase 2, the intervention model, is designed to decrease these barriers and improve patient outcomes over time, and is in progress.

برای دانلود متن کامل این مقاله و بیش از 32 میلیون مقاله دیگر ابتدا ثبت نام کنید

ثبت نام

اگر عضو سایت هستید لطفا وارد حساب کاربری خود شوید

منابع مشابه

Oncology Patient Evidence-Based Notes (OPEN): cancer-related fatigue.

Fatigue is a common, significant problem in patients receiving cancer treatment. About 80%–100% of patients with cancer report some degree of fatigue (Nail, 2002; Ream & Richardson, 1999). Similar to pain, fatigue is a subjective, complex experience. Patients may report feelings of fatigue despite the use of erythropoietin therapy to increase or maintain their hemoglobin levels. In an effort to...

متن کامل

Implementation of NCCN distress management guidelines by member institutions.

Up to half of all adults with cancer experience clinically significant psychological distress and much of this distress goes unrecognized and untreated. As part of an effort to improve the care of cancer patients, the National Comprehensive Cancer Network (NCCN) has developed clinical practice guidelines for distress management that include recommendations about the evaluation and treatment of ...

متن کامل

NCCN's value pathways: the drive for quality cancer care.

The quality of patient care often varies based on numerous factors, including health care setting, geographic location, access to medications, insurance coverage, and treatment protocols. Variations in health care are well established, and often lead to different services having varied outcomes depending on location.1–3 Recently, the issue of whether the use of clinical pathways—evidence-based ...

متن کامل

Nurses' guide to understanding and implementing the National Comprehensive Cancer Network guidelines for myeloid growth factors.

PURPOSE/OBJECTIVES To review and determine the applicability of the 2006 National Comprehensive Cancer Network (NCCN) clinical practice guidelines for the use of myeloid growth factors in adult patients treated with chemotherapy for solid tumors and nonmyeloid malignancies. DATA SOURCES Published guidelines, original research, review articles, and conference presentations. DATA SYNTHESIS Ch...

متن کامل

NCCN: Touched by Cancer.

Joan S. McClure, MS, is Senior Vice President of Clinical Information and Publications for NCCN. Ms. McClure’s group develops the NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines), associated NCCN Guidelines for Patients, the NCCN Drugs & Biologics Compendium (NCCN Compendium), NCCN Chemotherapy Orders Templates (NCCN Templates), the NCCN Biomarkers Compendium, and JNCCN—Journal o...

متن کامل

ذخیره در منابع من


  با ذخیره ی این منبع در منابع من، دسترسی به آن را برای استفاده های بعدی آسان تر کنید

برای دانلود متن کامل این مقاله و بیش از 32 میلیون مقاله دیگر ابتدا ثبت نام کنید

ثبت نام

اگر عضو سایت هستید لطفا وارد حساب کاربری خود شوید

عنوان ژورنال:
  • Journal of the National Comprehensive Cancer Network : JNCCN

دوره 5 10  شماره 

صفحات  -

تاریخ انتشار 2007