Exploring nursing outcomes for patients with advanced cancer following intervention by Macmillan specialist palliative care nurses.
BACKGROUND
Little information exists about the outcomes from nursing interventions, and few studies report new approaches to evaluating the complex web of effects that may result from specialist nursing care.


OBJECTIVE
The aim of this study was to explore nursing outcomes for patients with advanced cancer that may be identified as resulting from the care of a Macmillan specialist palliative care nurse. METHODS/INSTRUMENTS: Seventy-six patients referred to 12 United Kingdom Macmillan specialist palliative care nursing services participated in a longitudinal study of their care over 28 days. Patients were interviewed and completed the European Organization for Research on Treatment of Cancer Quality of Life Scale and the Palliative Care Outcomes Scale at referral, and 3, 7 and 28 days following referral to a Macmillan specialist palliative care nursing service. A nominated carer was interviewed at baseline and 28 days. Notes recorded by Macmillan specialist palliative care nurses in relation to each patient case were analysed.


RESULTS
Significant improvements in emotional (P = 0.03) and cognitive functioning (P = 0.03) were identified in changes in patients' European Organization for Research on Treatment of Cancer Quality of Life Scale scores, and in Palliative Care Outcomes Scale patient anxiety scores (P = 0.003), from baseline to day 7. Analysis of case study data indicated that overall positive outcomes of care from Macmillan specialist palliative care nursing intervention were achieved in 42 (55%) cases.


CONCLUSIONS
Sample attrition due to patients' deteriorating condition limited the value of data from the quality of life measures. The method developed for evaluating nursing outcomes using data from patient and carer interviews and nursing records was limited by a lack of focus on outcomes of care in these data sources.


CONCLUSIONS
A method was developed for evaluating outcomes of nursing care in complex situations such as care of people who are dying. Positive outcomes of care for patients that were directly attributable to the care provided by Macmillan specialist palliative care nurses were found for the majority of patients. For a small number of patients, negative outcomes of care were identified.
Corner
Jessica
J
School of Nursing and Midwifery, University of Southampton, Highfield, UK. j.l.corner@soton.ac.uk
Halliday
Debbie
D
Haviland
Jo
J
Douglas
Hannah-Rose
HR
Bath
Peter
P
Clark
David
D
Normand
Charles
C
Beech
Nicola
N
Hughes
Philippa
P
Marples
Rachael
R
Seymour
Jane
J
Skilbeck
Julie
J
Webb
Tom
T
D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D007407:Interviews as Topic; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000451:nursing* / Q000523:psychology; D015403:Nursing Evaluation Research; D009859:Oncology Nursing; D010166:Palliative Care; D011788:Quality of Life; D016896:Treatment Outcome