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Senior Citizen Health & Medicine
Contribution of Specialist Breast Cancer Care Nurses
Is Hard to Gauge
Research shows they do help navigate life and
social adjustments
By Taunya English, Associate Editor
Health Behavior News Service
 Feb. 25, 2008 - In the United States and in other
high-income countries, women diagnosed with breast cancer are commonly
matched with a specialist cancer nurse who provides care, support and
information. However, a new review of randomized controlled trials
reveals that research on the subject is slim and the ability to assess
the contribution of specialist nurses is, so far, elusive.
Lead review author Susanne Cruickshank and her team
set out to determine if specialist cancer care nurses improve the
well-being and quality of life of women with breast cancer.
We couldnt come to any firm conclusions just by
looking at randomized controlled trials, she said. There is limited
evidence from RCTs. I think, in this type of field, we need a
combination of methods really to answer this question. The next stage is
to look at the qualitative studies, said Cruickshank, a lecturer in the
School of Acute and Continuing Care Nursing at Napier University in
Edinburgh, Scotland.
Cruickshank said the wide use and acceptance of
specialist cancer care nurses and evidence from qualitative research
suggest that specialist nurses do help women navigate the many life and
social adjustments that come with a breast cancer diagnosis.
The review appears in the latest issue of The
Cochrane Library, a publication of The Cochrane Collaboration, an
international organization that evaluates medical research. Systematic
reviews draw evidence-based conclusions about medical practice after
considering both the content and quality of existing medical trials on a
topic.
The reviewers analyzed five randomized controlled
studies involving more than 1,050 breast cancer patients. The
interventions provided by the specialist cancer care nurses varied from
simple bedside conversations to managing after-treatment care for women.
The researchers analyzed quality of life measures
including anxiety and depression; sexual, physical and functional
well-being; and coping and fatigue.
Specialist cancer care nurses are often members of
multidisciplinary health care teams that provide care for women with
breast cancer in high-resource countries. Cruickshank said specialist
cancer care nurses complement the team, but existing research cannot
single out the nurse contributions that improve patient well-being and
quality of life.
Its hard to see a benefit and say that one person
did that alone, Cruickshank said.
The reviewers could not combine the study results
because the five trials were too different. Nevertheless, one study
found that breast cancer patients were equally satisfied to have a nurse
take care of them following treatment versus medical staff.
Another study showed that specific breast care
nurse interventions can alleviate perceived distress for women
undergoing radiotherapy treatment; however, this did not have any impact
on coping skills, mood or overall quality of life, the review found.
It is not clear from the review what proportion of
the studied interventions were delivered by breast care nurses with
masters level training or if that distinction matters in health
outcomes.
Esther Green, board member for the International
Society of Nurses in Cancer Care, said that is information she would
like to have in order to analyze future research on breast cancer care
nurses.
Nurses prepared at the graduate level have
specialized cancer care knowledge, clinical skills and clinical
decision-making skills, Green said.
I think that we need to take from this [review]
that there is a need for advance practice nurses to work with some of
these complex-need populations, Green said.
She said breast cancer patients often have
long-term side effects that require monitoring. These nurses were
introduced to the health care team because, in the past, the oncologist
or family doctor was overloaded not as oriented, to support or care
for those needs, Green said.
Cruickshank, who worked as a breast care nurse
specialist for seven years, said breast cancer patients face a string of
treatment choices and decisions after diagnosis.
In my role as a breast care nurse, [patients]
literally met me at diagnosis. It enabled you to build up a relationship
with that individual, Cruickshank said. It meant that some of them saw
me every week for a year. The women often have the focus of this nurse
as a person to touch base with.
More Links to
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December 15, 2006
Decline in
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Since based on
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Reduced Risk of Breast Cancer Noted in Older Women
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