Describing an episode of home nursing care for elderly postsurgical cancer patients.
BACKGROUND
While studies have documented the beneficial effect of home care for cancer patients, the actual interventions implemented during these studies have not been well described.


OBJECTIVE
Purposes of this study were to analyze interventions documented in narrative form by advanced practice nurses during a four-week episode of home care and describe intervention type, frequency, range, and variation over time in intervention emphasis and dose intensity.


METHODS
Chart audits were performed on records kept for 148 postsurgical cancer patients who were assigned to the experimental group in a randomized clinical trial to evaluate the effect of home care on quality of life outcomes (McCorkle et al., 2000). Interventions statements (N = 7,275) were analyzed using Grobe's (1996) Nursing Intervention Lexicon and Taxonomy.


RESULTS
Teaching accounted for the highest percentage of interventions documented, followed by provision of psychological support and reassurance, determination of patient needs and nursing care requirements, assessment of current status, and indirect care. Physical care and actions to promote self-care independence were documented least frequently. Differences in nursing care were found by cancer site with the greatest diversity of interventions documented for breast cancer patients. Intervention emphasis and dose intensity varied over time, suggesting that these nurses altered their care in response to the changing needs of their patients.


CONCLUSIONS
These nurses responded to complex problems and used a variety of interventions to assist patients and families in management of the illness experience. They also tailored their care to each patient's location along the illness trajectory. These findings provide beginning support for the clinical utility of Nursing Intervention Lexicon and Taxonomy as a way to quantify an episode of nursing care.
Hughes
Linda C
LC
School of Nursing, University of Texas Medical Branch, Galveston, 77555-1029, USA. lchughes@utmb.edu
Robinson
Linda A
LA
Cooley
Mary E
ME
Nuamah
Isaac
I
Grobe
Susan J
SJ
McCorkle
Ruth
R
D000368:Aged; D000369:Aged, 80 and over; D003152:Community Health Nursing / Q000379:methods* / Q000592:standards; D017050:Episode of Care; D005260:Female; D006699:Home Care Services / Q000592:standards; D006801:Humans; D007587:Job Description; D008297:Male; D008875:Middle Aged; D020380:Needs Assessment; D009369:Neoplasms / Q000451:nursing* / Q000523:psychology / Q000601:surgery; D024802:Nurse's Role; D009723:Nurse-Patient Relations; D009731:Nursing Audit; D009732:Nursing Care / Q000145:classification / Q000379:methods* / Q000592:standards; D015403:Nursing Evaluation Research; D017063:Outcome Assessment, Health Care; D010353:Patient Education as Topic; D011182:Postoperative Care / Q000379:methods* / Q000451:nursing* / Q000592:standards; D011788:Quality of Life; D012944:Social Support; D013997:Time Factors; D013996:Time and Motion Studies