Employing patient-reported outcome (PRO) measures to support newly diagnosed patients with melanoma: Feasibility and acceptability of a holistic needs assessment intervention. (December 2017)

• Record Type: Journal Article
• Authors: Kotronoulas, Grigorios; Connaghan, John; Grenfell, Jean; Gupta, Girish; Smith, Leigh; Simpson, Mhairi; Maguire, Roma
• Is Part Of: European journal of oncology nursing. Volume 31(2017)
• Page Start: 59
• Page End: 68
• Publication Date: 2017-12
• Subjects: Melanoma -- Supportive care needs -- Patient-reported outcome measures -- Cancer nurse specialist -- Feasibility -- Acceptability; Cancer -- Nursing -- Periodicals; Cancer -- Research -- Periodicals; Oncology -- Periodicals; Oncology Nursing -- Periodicals; Neoplasms -- nursing -- Periodicals; Cancer -- Soins infirmiers -- Périodiques; Cancer -- Recherche -- Périodiques; Cancérologie -- Périodiques; Verpleegkunde; Kanker; Cancer -- Nursing; Cancer -- Research; Oncology; Electronic journals; Periodicals; Electronic journals; 616.9940231
• DOI: 10.1016/j.ejon.2017.10.002
• Languages: English
• ISSNs: 1462-3889

Abstract

Abstract: Purpose: Living with a melanoma diagnosis can be challenging. We aimed to assess the feasibility, acceptability, and perceived value of a nurse-led intervention that utilised patient-reported outcome (PRO) measures to identify and address the supportive care needs of newly diagnosed patients with Stage I/II melanoma over the first 4 months post-diagnosis. Methods: We conducted an exploratory, repeated-measures, single-arm, feasibility trial. One baseline (4 weeks post-diagnosis; T1) and one follow-up intervention session (4 weeks after wide local excision; T3) took place, two months apart. Patient survey data were collected monthly, at four assessment points (T1-T4), followed by exit interviews. Results: A recruitment rate of 55% (10/18) was achieved. The skin cancer nurse specialist (CNS) performed 19 in-clinic patient assessments within 6 months. One patient missed their follow-up intervention session (90% retention rate). Three participants (30%) were lost to follow-up at T4. Patients endorsed the standardised use of easy-to-use PRO measures as a means to help them shortlist, report and prioritise their needs. The CNS viewed the intervention as a highly structured activity that allowed tailoring support priority needs. A sizeable reduction in information needs was found from T1 to T4 (Standardised Response Mean [SRM] change = −0.99; p < 0.05). From T1 to T2, significant reductions in psychological (SRM change = −1.18; p < 0.001), practical (SRM change = −0.67; p < 0.05) and sexuality needs (SRM change = −0.78; p < 0.05) were observed. Conclusions: The intervention appears to be feasible in clinical practice and acceptable to both patients with newly diagnosed melanoma and clinicians. Future research is warranted to test its effectiveness against standard care. Highlights: Nurse-led, PRO measure-driven consultations to identify and address the supportive care needs of newly diagnosed patients with melanoma are feasible and acceptable in clinical practice. Patients endorsed the standardised use of easy-to-use PRO measures as a means to help them shortlist, report and prioritise their needs. The skin CNS viewed the intervention as a highly structured activity that allowed tailoring support priority needs. The intervention could be associated with (a) reduction in information needs from the point of diagnosis throughout the first four months post-diagnosis, and (b) reduction in psychological, patient care and support and sexuality needs in the month following the baseline intervention session.