Abstract
Background
Palliative care has one of the largest numbers
of Clinical Nurse Specialists
[CNS] of any specialty. With the publication
of the NHS Cancer Plan, Department of
Health [2000] this is set to escalate,
particularly in the hospital setting. Despite
this there is limited evidence of the
effectiveness of the CNS. With the current
policy emphasis on demonstrable clinical
effectiveness, there is an urgent need to
establish the value of CNS in the area of
Palliative Care [Robbins 1998].
Method
This paper presents the quantitative findings
of an evaluation study on the impact of the
CNS within a palliative care team in a large
hospital in the northwest of England. A quasiexperimental design, using a quota sample,
investigated 50 patients receiving CNS input
and compared outcomes with 50 patients
receiving traditional care. Data was collected
using the PACA symptom assessment tool
[Ellershaw et al, 1995]. Patient and relatives
insight into the disease was examined, along
with key factors for patients with cancer such
as pain, anorexia, nausea, constipation and
insomnia.
Results and Discussion
The group receiving the input from a CNS
could be shown to have a greater
improvement in their insight in to their
disease and a greater reduction in the severity
of all the symptoms measured. All these
results were shown to be statistically
significant, with the single exception of
insomnia. In particular pain was found to
greatly improve [p<0.001] with CNS showing
an improvement of 40.6% more than the
patients who received traditional care. The
CNS had a positive impact on patients and
relatives, with the outcome of greater
improvement in both insight and symptoms.
This paper will discuss the results and explore
potential reasons for this improvement.
Intended learning outcomes
At the end of the session, participants will be able to:
• Be aware of the need to evaluate the
impact of the clinical nurse specialist
• Appreciate the potential benefits that the
CNS within a palliative care team can have
for patients and relatives
• Have an awareness of the methodological
problems that an inherent in researching
palliative care patients.
| Original language | English |
|---|---|
| Publication status | Published - 2003 |
| Event | Royal College of Nursing (RCN) International Nursing Research Conference - Exeter, United Kingdom Duration: 7 Apr 2002 → 10 Apr 2002 |
Conference
| Conference | Royal College of Nursing (RCN) International Nursing Research Conference |
|---|---|
| Country/Territory | United Kingdom |
| City | Exeter |
| Period | 7/04/02 → 10/04/02 |
