The Improvement of Cancer Patients Symptoms Following the Impact of the Hospital Palliative Care Team

Background: Palliative care has one of the largest numbers of Clinical Nurse Specialists (CNS) particularly in the hospital setting, where they play a major role in the palliative care team. With the emphasis on clinical effectiveness, there is an urgent need to establish the value of CNS within the hospital setting (Robbins 1998). Method: This paper presents the quantitative findings of an evaluation study on the impact of CNS within a palliative care team in a large acute university hospital in the UK. A non-equivalent control group design, using a quota sample, investigated 50 patients receiving palliative care CNS input and compared outcomes with 50 patients receiving traditional care. Data was collected using the PACA symptom assessment tool (Ellershaw et al, 1995), evaluating the symptoms of pain, anorexia, nausea, insomnia and constipation on 3 occasions (within 24 hours of admission/diagnosis or referral to the palliative care team, day 4 and day 7) Results and Discussion: Both groups demonstrated a statistically significant improvement in their symptoms. The group receiving palliative care CNS input had a greater reduction in the severity of all the symptoms. These results were statistically significant (pain p<0.001; anorexia p<0.001; nausea p=.040; constipation p=.002) except for insomnia (p=.527). In particular pain was found to greatly improve showing a 40.6% improvement compared to patients receiving traditional care. The results indicate that palliative care CNS had a positive impact on patient symptom control. This paper will discuss the results and explore potential reasons for this improvement.