title: Evaluating the care of patients with malignant spinal cord compression at a regional cancer centre.
abstract: The consequences of malignant spinal cord compression (MSCC) can be devastating. If not detected early, MSCC can result in paralysis and significant bowel and bladder dysfunction that is not improved by treatment. Patients have to cope with sudden and unexpected disability alongside a diagnosis of advanced cancer. A multidisciplinary group was established within a cancer centre to review the care of patients with MSCC. Two linked studies were carried out: a staff questionnaire sent to senior medical staff and all nurses and an audit of documentation. The documentation audit reviewed the notes of 50 patients who had received radiotherapy for MSCC. The symptoms patients presented with on admission and before discharge demonstrated that many experienced significant physical problems as a consequence of developing MSCC. Usually, these symptoms were either unaffected by treatment, or had deteriorated further by the time of their discharge from hospital. The average number of days between admission with MSCC and death was 58.6 days (range 2 to 319 days). The project identified variations in practice in a range of aspects of care and provided clear evidence for the need to develop interventions in relation to specific concerns.
authors.affiliation: SCC Group, Sheffield Teaching Hospitals, NHS Foundation Trust, Sheffield, UK. clare.warnock@sth.nhs.uk
authors.forename: Clare
authors.initials: C
authors.lastname: Warnock
authors.forename: Christine
authors.initials: C
authors.lastname: Cafferty
authors.forename: Suzanne
authors.initials: S
authors.lastname: Hodson
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Kirkham
authors.forename: Charles
authors.initials: C
authors.lastname: Osguthorpe
authors.forename: Jan
authors.initials: J
authors.lastname: Siddall
authors.forename: Rebecca
authors.initials: R
authors.lastname: Walsh
authors.forename: Bernadette
authors.initials: B
authors.lastname: Foran
mesh_terms: D000223:Adaptation, Psychological; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001510:Bed Rest; D004739:England; D005260:Female; D006801:Humans; D008297:Male; D008485:Medical Audit; D008875:Middle Aged; D009369:Neoplasms / Q000150:complications* / Q000451:nursing; D055496:Neurogenic Bowel / Q000209:etiology / Q000451:nursing; D009731:Nursing Audit; D013117:Spinal Cord Compression / Q000209:etiology / Q000451:nursing / Q000523:psychology / Q000628:therapy*; D001750:Urinary Bladder, Neurogenic / Q000209:etiology / Q000451:nursing