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T. Fynmore



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    P2.09 - Poster Session/ Nursing and Allied Professionals (ID 227)

    • Event: WCLC 2015
    • Type: Poster
    • Track: Nursing and Allied Professionals
    • Presentations: 1
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      P2.09-002 - Development of 'Living Well' - A Health and Wellbeing Programme for Thoracic Cancer Patients (ID 398)

      09:30 - 09:30  |  Author(s): T. Fynmore

      • Abstract
      • Slides

      Background:
      In 2013 the Holistic needs assessment (HNA) for newly diagnosed cancer patient, which highlights patient concerns and symptoms, was introduced in the UK. The use of the tool, in a leading cancer centre, identified a need for a multi-disciplinary education and support group to better address the management of patient symptoms and supportive care needs. The most common physical symptoms reported were; Fatigue/tiredness (74%), sleep (64%), walking/stairs (58%), breathing (56%), appetite/weight changes (46%), and pain (40%). The most common psychosocial concerns were; Fear/anxieties (48%), and sadness (48%). With increasing national focus on cancer survivorship and rehabilitation initiatives for cancer patients there is growing evidence that support programmes can increase quality of life and psychological functioning. A multi-disciplinary team (MDT) was established to develop a health and wellbeing programme for thoracic cancer patients treated at Guy's and St Thomas' NHS Foundation Trust (GSTT).

      Methods:
      Working as a MDT, consisting of Cancer Nurse Specialists, Physiotherapists, Occupational Therapists and Dietetics, a programme of physical, psychosocial and educational components was devised to address the key symptoms, including the following; 1. Managing your energy 2. Keeping active 3. Eating Well 4. Managing breathlessness 5. Keeping on top of things 6. Time to relax - Qigong Inclusion criteria; Medically stable thoracic cancer patients under GSTT, at any point along their pathway plus carer/family member Exclusion criteria; Anaemia, Hb <80g/L, untreated brain mets/cognitive issues restricting ability to participate in group sessions. Each session was paced to optimise patient care allowing interventions to be tailored to individual's situations, stage of disease, and their wishes. Patient experience questionnaires, which were standardised across all sessions, are handed out and following the end of the programme the CSQ-8 is completed by the patients, allowing for continuous quality control of our service from the patient's perspective.

      Results:
      Data to February 2015 showed the following; -94% of patients reported an improvement in their ability to self-manage their symptoms -100% of patients reported increased confidence in managing their symptoms -100% of patients reported that anxiety was reduced -Mean CSQ-8 evaluation score = 9.6/10 Patient attendance; -6 week programme format: 9 patients started the programme, 3 completed. -3 week programme format: 21 patients started the programme, 12 completed. -1 week programme format (only 1 programme completed at time of abstract submission): 9 attended and completed entire day

      Conclusion:
      A programme of this nature represents a valuable intervention output following HNA across the cancer pathway. It supports local and national cancer strategies around survivourship and rehabilitation. With progression free survival in thoracic cancer improving the self-management of physical and psychosocial symptoms, longer term, becomes increasingly relevant. The numbers have been limited, indicative of the symptom and treatment burden for this patient group, however overall results are impressive. This indicates the requirement of a flexible approach. In adapting the format over time patient reported experience remained very positive, moreover attendance improved. Thus making it more accessible for our patient group, as well as enabling, equiping and empowering them to self-manage symptoms and live well with cancer. This model can be adapted and translated into other health care settings and tumor types, both nationally and internationally.

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