Clinical Nurse Specialists impact on cancer patients pain Africa

Background: There has been an expansion in the number of palliative care teams based in the acute hospital setting. Although organization of these teams varies both in structure and approach, clinical nurse specialists (CNS) are one of the key members. Pain is reported to occur in the majority of patients with advanced cancer varying with tumour type, spread of disease and disease treatments (Bruera and Portenoy 200�). Pain control is one of the main reasons for referral to a hospital specialist palliative care team. Yet there is a paucity of research studies to demonstrate their effectiveness, and no studies that specifically focus on hospital based palliative care. The aim of this study was to assess the effect of the CNS on cancer patients reported level of pain Method: A non equivalent control group design using a quota sample investigated �00 cancer patients who had been admitted to a UK University Hospital for symptom control. 50 patients received specialist hospital palliative care CNS intervention, compared with 50 patients receiving traditional care. Outcome was assessed using the Palliative Care Assessment (PACA) tool (Ellershaw et al �995) on three occasions (within 24 hours of admission/diagnosis or referral to the palliative care team, day � and day 7) that measured patients reported level of pain. Results and Discussion: The results indicated that cancer patients admitted to hospital had a significant improvement in their pain control. There was no difference between the groups on the initial assessment of pain, which allows comparisons to be made between the groups. The patients who had the additional input of the palliative care CNS demonstrated a statistically significant greater improvement than the control group (P<0.00�). Potential explanations are made for the results including the enhanced knowledge and skills of the hospital palliative care CNS.