Abstract
BackgroundGiven the great symptom burden associated with chemotherapy on the one hand and generally poor self-management of symptoms by cancer patients on the other hand, our aim was to develop a nursing intervention to reduce symptom burden in adult cancer patients treated with chemotherapy and to support them in dealing with their various symptoms at home.MethodsDevelopment of the intervention was guided by the Intervention Mapping Approach and included following steps: needs assessment, formulation of proximal programme objectives, selection of methods and strategies, production of programme components, and planning for implementation and evaluation of the intervention. A panel of multidisciplinary healthcare professionals (n = 12) and a panel of patients and family caregivers (n = 7) were actively involved developing the intervention at each stage.ResultsFor the intervention, four patient performance objectives relating to self-management were advanced. Self-efficacy and outcome expectations were selected as key determinants of dealing with chemotherapy-related symptoms. As methods for supporting patients, motivational interviewing and tailoring were found to fit best with the change objectives and determinants. Existing patient information materials were re-designed after panel input to reinforce the new intervention approach.ConclusionThe intervention mapping approach, including active involvement of the intervention providers and receivers, informed the design of this nursing intervention with two or more contacts. Further evaluation is needed to gain insight into the potential effects, feasibility and mechanisms of this complex intervention.
Highlights
Given the great symptom burden associated with chemotherapy on the one hand and generally poor self-management of symptoms by cancer patients on the other hand, our aim was to develop a nursing intervention to reduce symptom burden in adult cancer patients treated with chemotherapy and to support them in dealing with their various symptoms at home
Many have focused on managing a single symptom, such as oral mucositis or fatigue, but it is likely that meaningful improvement in quality of life can only be achieved by interventions that focus on multiple symptoms that cancer patients face [17]
We systematically developed a nursing intervention—called CHEMO-SUPPORT—aimed at reducing chemotherapy-related symptom burden that patients experience at home
Summary
Given the great symptom burden associated with chemotherapy on the one hand and generally poor self-management of symptoms by cancer patients on the other hand, our aim was to develop a nursing intervention to reduce symptom burden in adult cancer patients treated with chemotherapy and to support them in dealing with their various symptoms at home. The negative impact of these on quality of life is widely recognized [1, 2] These side effects are experienced at home, in the absence of professional assistance [3]. The burden of chemotherapy-related symptoms and (often unmet) patient needs related to their self-management has catalysed the development of several new nursing interventions to address these issues [12, 14,15,16]. Many have focused on managing a single symptom, such as oral mucositis or fatigue, but it is likely that meaningful improvement in quality of life can only be achieved by interventions that focus on multiple symptoms that cancer patients face [17]. Many questions remain unanswered: How were outcomes reached? Which intervention components produced measurable effects and by what mechanism(s)? what factors promoted or hindered their results? [28, 29]
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