Abstract
The overall purpose of this pilot study is to finalize the interventions for a two arm randomized clinical trial. The larger study will extend our present program of research and evaluate nursing services designed to enhance the quality of life of newly diagnosed patients with ovarian cancer. Our recent studies have primarily focused on patients with early stage cancers and have demonstrated that few post surgical patients receive formalized home care services, leaving patients and their caregivers alone at home while attempting to cope with the short-term and long-term effects of surgery. The majority of the patients (68%) were diagnosed with early stage cancers at the time of their surgery. However, we were impressed with the fact that some of these patients were diagnosed with advanced cancers at the time of surgery and as a group did not seem to have the psychological resources to respond to the urgent demands of treatment protocols while confronting their existential concerns. Based on this important finding, we believe that there is a great need to evaluate nursing care to facilitate the transition from hospital to home among people who undergo diagnostic surgery for a curative attempt of their malignant disease but in fact may have non-resectable cancer.
The proposed intervention in this pilot study builds on our previous work. We propose to extend our current intervention to include a psychiatric consultation- liaison component to enhance outcomes for women newly diagnosed with ovarian cancer over time. The psychiatric consultation-liaison nurse (PCLN) will work in conjunction with an oncology advanced practice nurse (APN). This collaboration is designed to address assessment and management needs associated with the high rate of anxiety and depression documented in this patient population. The need to address common psychiatric symptoms is an important yet complex and unmet need in many oncology settings. Ovarian cancer, usually at an advanced stage at diagnosis is characterized by profound physical symptoms that are pathognomic to the cancer and its treatment and also to depression. Thus psychiatric symptoms, despite their receptivity to treatment are often ignored. Expertise is needed to identify the patients who require psychiatric intervention and to provide or obtain it. The PCLN will serve this specialized function and thus to enhance overall quality of life.
The specific aims of this pilot study are to: 1) finalize and test a standardized nursing intervention protocol (SNIP) in women newly diagnosed with ovarian cancer, and 2) develop and test an attention control intervention protocol in women newly diagnosed with ovarian cancer.
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