WASHINGTON, DC—A nurse-directed intervention to help chemotherapy patients manage pain and fatigue not only relieved those symptoms but also reduced the number of other symptoms patients suffered, according to Barbara Given, PhD, RN, professor of nursing at Michigan State University in East Lansing. She reported results on behalf of researchers at that institution, as well as at the University of Michigan in Ann Arbor and Yale University in New Haven, Connecticut.
Results of this randomized, controlled clinical trial "support the need for targeted interventions to assist patients undergoing chemotherapy to manage pain and fatigue," Dr. Given concluded.
Varied Tumor Sites
The National Cancer Institute-funded study, which is now in its fifth year, included patients undergoing chemotherapy for breast, colon, lung, or other solid tumors who reported pain and fatigue at baseline. Patients entered the study within 56 days of their first chemotherapy cycle. Patients were randomized either to conventional care (n = 60) or to conventional care plus the nursing intervention (n = 53). The study endpoints were severity of pain and fatigue, limitations caused by pain and fatigue, and number of other symptoms reported at 20 weeks.
The nursing intervention was a 20-week, 10-contact program for patients and family caregivers. The program included problem solving approaches to symptom management, techniques for improving physical functioning, and strategies for maintaining emotional health. All of these areas were dealt with at each of the 10 contacts, and patients were interviewed about symptoms at baseline and again at 10, 20, and 32 weeks.
Key to applying nursing intervention was building it into the computerized documentation system. If pain and fatigue were present at "threshold levels," that fact was posted to the plan of care and had to be dealt with before the computerized record would advance to the next screen.
Symptom Clusters
