Bakitas M et al. 2009(2727 Bakitas M, Lyons K, Hegel M, Balan S, Brokaw F, Seville J, et al. Effects of a palliative care intervention on clinical outcomes in patients with advanced cancer: the project ENABLE II randomized controlled trial. JAMA. 2009;302(7):741-9. doi: 10.1001/jama.2009.1198
https://doi.org/10.1001/jama.2009.1198...
)
, USA,
Journal of the American Medical Association
Palliative care
|
Randomized Controlled Clinical Trial
(parallel) |
To determine the effect of a nursing intervention on quality of life, symptoms intensity, mood and resources used in patients with advanced cancer |
277 |
APN
|
Usual cancer care vs psychoeducational intervention conducted by APN (it consisted of 4 weekly educational sessions and monthly follow-up sessions until death or completion of the study)
IG: n=143
CG: n=134 |
Higher quality of life (p=0.02), less depressed mood (p=0.02) and tendency to lesser intensity of symptoms (p=0.06)
Increased survival: 5.5 months
The median survival was 14 months (95%CI= [10.6-18.4]) for the intervention group and 8.5 months (95%CI= [7.0-11.1]) for the usual treatment group (p=0.14) |
Cox CL et al. 2016(2828 Cox CL, Andersen MR, Santucci AK, Robison LL, Hudson MM. Increasing cardiomyopathy screening in childhood cancer survivors: a cost analysis of advanced practice nurse phone counseling. Oncol Nurs Forum. 2016;43(6):E242-E250. doi: 10.1188/16.ONF.E242-E250
https://doi.org/10.1188/16.ONF.E242-E250...
)
, USA,
Oncology Nursing Forum
Pediatric Oncology
|
Randomized Controlled Clinical Trial
(parallel) |
To document survivor tracking costs according to the care plan (with or without) APN counseling |
411 |
APN
|
Sending a "survival care plan" by mail, with APN telephone counseling or care plan without telephone counseling
IG: n=205
CG: n=206 |
The intervention motivated the participation of patients in the study of left ventricular function by 30% when compared to the control - Increased screening
Adding APN counseling to a survival care plan can help preserve heart health at little or no cost per survivor |
Dyar S et al. 2012(2929 Dyar S, Lesperance M, Shannon R, Sloan J, Colon-Otero G. A nurse practitioner directed intervention improves the quality of life of patients with metastatic cancer: results of a randomized pilot study. J Palliat Med. 2012;15(8):890-5. doi: 10.1089/jpm.2012.0014
https://doi.org/10.1089/jpm.2012.0014...
),
USA,
Journal of Palliative Medicine
Palliative care
|
Randomized Controlled Clinical Trial
(parallel) |
To evaluate the results of quality of life in advanced cancer patients who received palliative care interventions based on discussions with NP
|
26 |
NP
|
Standard treatment vs Intervention by NP (discussions about hospice benefits, discussions about wills in life and advance directives, along with an assessment of quality of life).
IG: n=12
CG: n=14 |
Statistically significant improvements were observed in the initial assessments in the emotional (p=0.0106) and mental (p=0.02) domains of quality of life in the intervention group
Patients found it helpful to have the living will and policy documents offered as part of the NP intervention |
Hudson MM et al. 2014(3030 Hudson MM, Leisenring W, Stratton KK, Tinner N, Steen BD, Ogg S, et al. Increasing cardiomyopathy screening in at-risk adult survivors of pediatric malignancies: a randomized controlled trial. J Clin Oncol. 2014;32(35):3974-U266. doi: 10.1200/JCO.2014.57.3493
https://doi.org/10.1200/JCO.2014.57.3493...
)
, USA and Canada,
Journal of Clinical Oncology
Cancer Survivors
|
Randomized Controlled Clinical Trial (parallel) |
To determine whether adding APN telephone counseling to a survival care plan significantly increases the proportion of survivors at risk who complete cardiomyopathy screening |
472 |
APN
|
Standard care consisted of a survival care plan summarizing cancer treatment and cardiac health screening recommendations.
The intervention consisted of standard treatment + 2 telephone counseling sessions with APN
IG: n=238
CG: n=234 |
1-year follow-up: 107 (52.2%) of 205 survivors in the APN group completed screening compared with 46 (22.3%) of 206 survivors in the non-APN group
Survivors in the APN group were 2 times more likely to complete the recommended cardiomyopathy screening at 2 or 5 years of follow-up than those in the control group (RR= 2.31; 95%CI: 1.74-3.07; (p<0.001)
Survivors in the control group were more likely to relate the lack of medical recommendation as a reason for not completing the cardiomyopathy screening when compared to those in the counseling group with APN (p=0.02) |
Kim MY 2011(3131 Kim MY. Effects of oncology clinical nurse specialists' interventions on nursing-sensitive outcomes in South Korea. Clin J Oncol Nurs. 2011;15(5):E66-74. doi: 10.1188/11.ONF.E66-E74.
https://doi.org/10.1188/11.ONF.E66-E74...
),
South Korea,
Clinical Journal of Oncology Nursing
Chemotherapy Treatment
|
Quasi-experimental study |
To demonstrate the effect of CNS oncological interventions in cancer patients undergoing chemotherapy |
112 |
APN
CNS
|
Intervention: consisted of patients who were treated by an oncological CNS
Control: composed of patients who were not treated by CNS
CNS performance: education, direct care, counseling, research and leadership
IG: n=65
CG: n=47 |
CNS interventions decreased pain by 69% and fatigue by 77%
There was an increase in health-related quality of life, being 4.43 times higher in the intervention group (95%CI= [1.34-14.66]; p=0.02)
Overall satisfaction with the intervention group was 0.2 times greater than the control group (95%CI= [0.07-0.57]; p<0.01) and satisfaction with the CNS technical skills was 0.24 times higher (95%CI= [0.08-0.69]; p<0.01)
Ease of access to counseling with a CNS was 7.93 times greater than counseling with other professionals (95%CI= [1.05- 59.82]; p=0.05) |
McCorkle R et al. 2000(3232 McCorkle R, Strumpf N, Nuamah I, Adler D, Cooley M, Jepson C, et al. A specialized home care intervention improves survival among older post-surgical cancer patients. J Am Geriatr Soc. 2000;48(12):1707-13. doi: 10.1111/j.1532-5415.2000.tb03886.x
https://doi.org/10.1111/j.1532-5415.2000...
)
, USA,
Journal o the American Geriatrics Society
Home Care
|
Randomized Controlled Clinical Trial
(parallel) |
To compare the survival time of older adults post-surgical patients who received a specialized intervention in home care performed by APN with patients who received regular follow-up in an outpatient setting |
375 |
APN
|
Intervention: a standardized protocol that consisted of standard assessment and management of post-surgical guidelines, doses of instructional content and contact hours, for 4 weeks, which consisted of 3 home visits and 5 telephone contacts provided by APN. Both patients and their families received comprehensive clinical assessments, monitoring and teaching, including skills training |
Among patients in advanced stage, the survival time was considerably better in the intervention group
2-year survival in cases of intervention groups in advanced stage was 67% compared to 40% among control cases
The relative risk of death in the usual care group was 2.04 (95%CI= [1.33-3.12]; p=0.001) |
McCorkle R et al. 2009(3333 McCorkle R, Dowd M, Ercolano E, Schulman-Green D, Williams A, Siefert M, et al. Effects of a nursing intervention on quality of life outcomes in post-surgical women with gynecological cancers. Psycho-Oncology. 2009;18(1):62-70. doi: 10.1002/pon.1365
https://doi.org/10.1002/pon.1365...
),
USA,
Psychooncology
Gynecological Cancer
|
Randomized Controlled Clinical Trial
(parallel) |
To assess health-related quality of life, complex physical and psychological needs after surgery and during chemotherapy |
123 |
APN
|
Intervention: 6 months of care by APN; the main objective of the intervention was to help patients develop and maintain self-management skills in the postoperative period and facilitate their active participation in decisions that affect treatment. In addition, women in high distress were assessed and monitored by psychiatric APN
Control: they were assigned to a research assistant who used a written manual with information on commonly experienced symptoms and calls to their oncologist when needed
IG: n=63
CG: n=60 |
The effect of the intervention improves the patients' quality of life
The rate of improvement on the 'uncertainty scale' was significantly higher for the intervention group (p=0.0006)
The psychiatric APN component was found to significantly increase the rate of improvement over time for uncertainties (p=0.0181), distress symptoms (p<0.0001), mental (p=0.0001) and physical (p<0.0001) health |
McCorkle R et al. 2011(3434 McCorkle R, Jeon S, Ercolano E, Schwartz P. Healthcare utilization in women after abdominal surgery for ovarian cancer. Nurs Res. 2011;60(1):47-57. doi: 10.1097/NNR.0b013e3181ff77e4
https://doi.org/10.1097/NNR.0b013e3181ff...
)
, USA,
Nursing Research
Gynecological Cancer
|
Randomized Controlled Clinical Trial
(parallel) |
To evaluate the effectiveness of interventions provided by APN (oncological and psychiatric) in patients undergoing gynecological surgery |
121 |
APN
|
Intervention: 16 contacts made by APN: symptom management, counseling, education, direct nursing care, resource coordination and referrals. Control: 9 contacts that included instructions on using a symptom management toolkit and strategies on how to manage symptoms
IG: n=59
CG: n=62 |
Patients who received the APN intervention reported fewer visits to their primary care providers (p=0.0003)
Women who reported more visits (control group) to their primary care providers also reported more depressive symptoms
The intervention group visited the emergency more often because the APN instructed patients to go when they recognized symptoms that needed urgent care (0.38 vs 0.28 in the control group) |
Moore S et al. 2002(3535 Moore S, Corner J, Haviland J, Wells M, Salmon E, Normand C, et al. Nurse led follow up and conventional medical follow up in management of patients with lung cancer: randomised trial. BMJ. 2002;325(7373):1145. doi: 10.1136/bmj.325.7373.1145.
https://doi.org/10.1136/bmj.325.7373.114...
)
, England,
British Medical Journal
Lung cancer
|
Randomized Controlled Clinical Trial
(parallel) |
To evaluate the effectiveness of nurse monitoring in the management of lung cancer patients |
203 |
CNS
|
Conventional medical follow-up vs Intervention: CNS led the follow-up of outpatients
IG: n=100
CG: n=103 |
Patient acceptance of follow-up conducted by CNS was high: 75% (203/271 patients)
Intervention patients: had less severe dyspnoea at 3 months (p=0.03) and had better scores on emotional functioning (p=0.03), in addition to less peripheral neuropathy (p=0.05) at 12 months. They scored significantly better in most satisfaction subscales with 3, 6 and 12 months (p<0.01 for all subscales at 3 months)
CNS reported progression of symptoms earlier than physicians (p=0.01)
Patients who received follow-up from CNS died more at home rather than at the hospital (p=0.04), attended fewer consultations with a physician during the first 3 months (p=0.004), underwent fewer radiographs during the first 6 months (p=0.04) |
Spoelstra SL et al. 2017
(
3636 Spoelstra SL, Sikorskii A, Majumder A, Burhenn PS, Schueller M, Given B. Oral anticancer agents: an intervention to promote medication adherence and symptom management. Clin J Oncol Nurs. 2017;21(2):157-60. doi: 10.1188/17.CJON.157-160
https://doi.org/10.1188/17.CJON.157-160...
)
,USA,
Clinical Journal of Oncology Nursing
Chemotherapy Treatment
|
Quasi-experimental study |
To refine an NP-led intervention to promote medication adherence and symptom management in newly prescribed adults with cancer (phase 1)
To explore viability, preliminary efficacy with adherence and severity of symptoms and patient satisfaction (phase 2) |
54 |
APN
NP
|
Usual care: instructions on the oral antineoplastic regimen, common side effects, symptom management, ways to remember to take it, medication safety and when to contact the provider vs
Intervention: a 30 min face to face session (week 1) with NP at the clinic, followed by 3 weekly calls with NP (weeks 2, 3 and 4); the NP discussed medication adherence, symptom management and safety tips, as well as providing a toolkit consisting of strategies to support self-management
IG: n=24
CG: n=30 |
Weekly comparisons of number and severity of symptoms favored the intervention group, with significance reached at weeks 2 and 5 (p=0.03-0.05)
Most patients reported that they were satisfied with the content of the intervention, as well as its usefulness |
Traeger L et al. 2015(3737 Traeger L, McDonnell TM, McCarty CE, Greer JA, El-Jawahri A, Temel JS. Nursing intervention to enhance outpatient chemotherapy symptom management: patient-reported outcomes of a randomized controlled trial. Cancer. 2015;121(21):3905-13. doi: 10.1002/cncr.29585
https://doi.org/10.1002/cncr.29585...
)
, USA,CancerChemotherapy Treatment
|
Randomized Controlled Clinical Trial
(parallel) |
To reduce the burden of patient-reported symptoms, facilitating collaboration between patients and NP in early symptom management |
120 |
NP
|
Standard treatment: patients receive a clinical visit on the first day of each chemotherapy administration cycle and call the clinic as needed vs Standard treatment + intervention (NP proactive guidance and support by phone during the first 2 chemotherapy administration cycles, using clinical judgment and patient-centered intervention)
IG: n=60
CG: n=60 |
Satisfaction with the service was relatively high
Regardless of the randomized group, both the number of symptoms (p<0.001) and the symptom of distress (p<0.001) increased
Satisfaction with care increased (p=0.004), while the probability of anxiety symptoms decreased (p=0.02)
Approximately 93.3% of patients in the intervention group reported that the intervention was useful (56/60 patients) |
Visser A et al. 2015(3838 Visser A, Bos WC, Prins JB, Hoogerbrugge N, van Laarhoven HW. Breast self-examination education for BRCA mutation carriers by clinical nurse specialists. Clin Nurse Spec. 2015;29(3):E1-7. doi: 10.1097/NUR.0000000000000118
https://doi.org/10.1097/NUR.000000000000...
)
, Netherlands,
Clinical Nurse Specialist Journal
Breast cancer
|
Randomized Controlled Clinical Trial
(parallel) |
To assess the feasibility of breast self-examination education led by CNS as part of the BRCA surveillance
To assess the effects and feasibility of written information leaflets on breast self-examination |
37 |
CNS
|
Women in both groups were educated about breast self-examination by a CNS specially trained during the annual visit to the clinic
Intervention: they received additional written instructions, in addition to self-examination education
IG: n=15
CG: n=14 |
62% increased frequency of breast self-examination after receiving education
Significant overall increase in frequency of breast self-examination after education, compared to frequency before education - regardless of receiving educational material (p<0.001)
Overall patient satisfaction with breast self-examination education at the outpatient clinic was 4.3 on a 5-point scale
Patient satisfaction with written educational materials scored 4.2 on a 5-point scale
Trend towards a positive association between patient satisfaction with education on breast self-examination led by CNS and the frequency of its performance (p=0.055) |
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