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Jenny Mitchell
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MA 08 - Supportive Care and Communication (ID 669)
- Event: WCLC 2017
- Type: Mini Oral
- Track: Nursing/Palliative Care/Ethics
- Presentations: 1
- Moderators:E. Esposito-Nguyen, John McPhelim
- Coordinates: 10/17/2017, 11:00 - 12:30, Room 511 + 512
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MA 08.05 - Surviving Lung Cancer, an Analysis of the Patient Concerns Identified in a Nurse-Led Follow-Up Clinic after Thoracic Surgery (ID 8079)
11:30 - 11:35 | Presenting Author(s): Jenny Mitchell
- Abstract
- Presentation
Background:
Using evidence based follow up guidelines, our nurse led follow-up clinic was established in December 2012. All post-operative thoracic surgery patients are seen, including patients with primary lung cancer. We evaluated problems and issues patients identified related to their post-operative recovery and follow-up period
Method:
Data was collected prospectively from December 2012 to March 2017. This included information for each patient on surgery, pathology, TNM stage, follow-up plan and smoking status. We recorded additional issues raised by patients. Data was analysed to generate descriptive statistics of post-operative problems. There were 546 patient episodes in 189 clinics for 285 patients with primary lung cancer
Result:
Of the 285 patients 70 (25%) were smokers in the 6 weeks prior to surgery. 171 (60%) were ex-smokers and 44 (15%) had never smoked. 32 (11%) patients smoked after surgery, all except one were pre-operative smokers. Smoking cessation was a concern after surgery with 44% of the pre-operative smokers restarting smoking post-operatively. The number of patients seen at each follow-up interval and the issues identified are shown in the table below. The most frequent issues reported by patients after thoracic surgery are pain, respiratory issues and anxiety. 80% of patients report problems at their first follow-up appointment after surgery, decreasing to 59% at five years. Respiratory issues are common in this group of patients who often have co-existing lung disease. Anxiety, most commonly associated with fears about recurrence of disease, remains a problem throughout the follow-up period. 31% of patients had abnormal imaging at one or more appointments.Issues identified in the nurse led thoracic surgery follow-up clinic
Number of patients % of the total patients seen in each survillance period Time since surgery Total Pain Respiratory issues Anxiety Imaging issues Other issues No issues 1st follow-up 120 33 27.5% 23 19% 24 20% 18 15% 16 13% 24 20% 6 months 118 21 18% 20 17% 11 9% 33 28% 14 12% 31 26% 12 months 79 10 13% 20 25% 8 10% 19 24% 8 10% 14 18% 18 months 66 9 14% 15 23% 8 12% 14 21% 7 11% 22 33% 2 years 65 9 14% 12 18% 7 11% 10 15% 10 15% 19 29% 3 years 48 7 15% 7 15% 7 15% 11 23% 8 17% 13 27% 4 years 28 0 7 25% 5 18% 5 18% 8 29% 7 25% 5 years 22 0 6 27% 2 9% 4 18% 2 9% 9 41% Totals 546 89 16% 110 20% 72 13% 114 21% 71 13% 139 25%
Conclusion:
The findings indicate the extent of physical, psychological and lifestyle (e.g. smoking) concerns in post-operative follow-up. A new telephone follow-up clinic has recently been introduced to address these needs. Further investigation with objective assessment and scoring of symptoms would improve the quality of the data collected.
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