Effects of a nursing intervention on quality of life outcomes in post-surgical women with gynecological cancers.
OBJECTIVE
Women with gynecological cancers have reported poor health-related quality of life (QOL), with complex physical and psychological needs post-surgery and during chemotherapy treatment. There are no studies reporting interventions addressing these needs post-hospital discharge in this population.


METHODS
Patients were randomized into two groups. The intervention group received 6 months of specialized care by an Advanced Practice Nurse (APN); in addition, women with high distress were evaluated and monitored by a psychiatric consultation-liaison nurse (PCLN). The attention control group was assisted with symptom management by a research assistant. The effects of the 6-month intervention were evaluated using self-report questionnaires at baseline (24-48 h after surgery), 1, 3, and 6 months post- surgery. QOL assessments included the Center for Epidemiological Studies-Depression Scale , the ambiguity subscale of the Mishel Uncertainty in Illness Scale , the Symptom Distress Scale, and the Short-Form Health Survey (SF-12). The sample for the longitudinal analysis included 123 who completed QOL outcome measures across three occasions post-surgery.


RESULTS
The APN intervention resulted in significantly less uncertainty than the attention control intervention 6 months after surgery. When the sub-group who received the APN plus PCLN intervention was compared with the total attention control group, the sub-group had significantly less uncertainty, less symptom distress, and better SF-12 mental and physical QOL over time.


CONCLUSIONS
Nurse tailored interventions that target both physical and psychological aspects of QOL in women recovering from cancer surgery and undergoing chemotherapy produce stronger outcomes than interventions that target solely one QOL aspect.
McCorkle
Ruth
R
Yale School of Nursing, Center for Excellence in Chronic Illness Care, New Haven, Connecticut 06536-0740, USA. ruth.mccorkle@yale.edu
Dowd
Michael
M
Ercolano
Elizabeth
E
Schulman-Green
Dena
D
Williams
Anna-leila
AL
Siefert
Mary Lou
ML
Steiner
Jeanne
J
Schwartz
Peter
P
D000359:Aftercare / Q000379:methods*; D017024:Chemotherapy, Adjuvant / Q000009:adverse effects / Q000451:nursing; D003237:Connecticut; D005260:Female; D006304:Health Status; D006801:Humans; D001523:Mental Disorders / Q000517:prevention & control; D008875:Middle Aged; D009722:Nurse Practitioners; D010051:Ovarian Neoplasms / Q000188:drug therapy / Q000451:nursing* / Q000523:psychology / Q000601:surgery; D011182:Postoperative Care / Q000379:methods / Q000451:nursing*; D011568:Psychiatric Nursing; D011788:Quality of Life; D012044:Regression Analysis; D016037:Single-Blind Method