Congress Abstracts 2004

91

A MULTIDISCIPLINARY TEAM APPROACH TO ADDRESS A CLINICAL NEED: CARE AND SYMPTOM MANAGEMENT OF PATIENTS WITH CANCER OF THE ESOPHAGUS. Pamela Ginex, RN, MPH, OCN^®, Jacqueline Hanson, RN, BSN, and Manjit Bains, MD, Memorial Sloan Kettering Cancer Center, New York, NY.

A multidisciplinary approach to developing a descriptive study of the clinical symptoms, quality-of-life issues, and educational needs of patients with esophageal cancer.

This year, over 13,000 people in the United States will be diagnosed with esophageal cancer, and the incidence rates are increasing 5%–10% per year, virtually more than any other cancer (Pera & Pera, 2001). Treatment for esophageal cancer has changed dramatically over the past several years and patients are confronted with potentially debilitating symptoms. A group of thoracic surgery oncology nurses at an NCI-designated comprehensive cancer center worked collaboratively with a thoracic surgeon to investigate evidence-based methods to improve symptom control and identify quality-of-life (QOL) issues before and after treatment. A review of the literature revealed that this disease has not been well researched and there is an absence of clear descriptions of the common symptoms, concerns, and clinical variables for patients undergoing treatment for esophageal cancer.

As a result, the group developed a descriptive study of the most significant patient needs based on experience from a patient support group as well as input from an esophageal cancer survivor. This unique project demonstrates true collaboration among clinicians and patients to address a clinical need and improve patient care. The study is designed to assess overall QOL, symptoms, physical activity, and social support for patients on treatment as well as long-term survivors. A measure of response shift was included to account for changing perspectives as patients undergo treatment.

The study objective is to develop specific educational and symptom management interventions in partnership with other clinicians and patients. The presentation will describe the methods and process of multidisciplinary teamwork that developed the study as well as include preliminary results.

The team approach to addressing this clinical need will provide evidence-based information to improve our management of patients with esophageal cancer. Other patient populations may benefit from a similar investigational framework. We anticipate that nurses working in a clinical setting could adapt this strategy in managing a broad spectrum of patient symptoms and educational needs.