3491 - EONS session: Nurse-led approaches to self-management of symptoms in routine Swiss outpatient care: a qualitative exploration

Background

The Symptom Navi© Program is a new nurse-led intervention to facilitate patients’ self-management of symptoms. Testing this intervention in a comparative study requires the assessment of nurses’ routines to support patients’ self-management competencies in order to interpret the magnitude of the effect of the intervention. As part of a larger study, we aimed at gaining insight into these routines provided in the Swiss outpatient setting, specifically into those related to symptoms caused by anti-cancer therapies.

Methods

We conducted focus groups (FG) with nurses at four cancer outpatient centers. FG were held before introducing the program, and were audio-recorded and transcribed verbatim. Two researchers independently conducted a thematic analysis using a deductive approach to identify themes related to self-management support. Emerging themes were discussed until consensus.

Results

Four FG (one per center) with a total of 15 nurses revealed three main themes. The 1^st theme covered information provision including both general information, and information tailored to the patient’s situation. The 2^nd theme involved patient-centered care that was realized by a primary nursing approach and by focusing on each patient’s unique psycho-social needs. The 3^rd theme addressed the documentation of the care process, which was considered important to monitor the course of care and to share information between health care professionals. The level of standardization of consultations varied between centers ranging from experienced-based to highly structured, with peer-led quality assurance.

Conclusions

Nurse routines to support patient’s self-management of symptoms show similar key themes across four centers in Switzerland. We identified information provision to be the main focus of nurses’ support. Levels of standardization of the consultations varied across centers. Our results also showed that other self-management competencies considered relevant for patients (problem solving skills, decision making, or tailored action planning) are not yet explicitly addressed in nurse-led consultations.

Clinical trial identification

Legal entity responsible for the study

University of Lausanne and Centre Hospitalier Universitaire Vaudois (CHUV), Lausanne.

Funding

Institut Universitaire ee Formation et de Recherche en Soins (IUFRS), University of Lausanne, School of Health Sciences Fribourg, Hospital Group Lindenhof Bern; Altschüler Foundation St. Gallen, Swiss Cancer League.

Editorial Acknowledgement

Disclosure

All authors have declared no conflicts of interest.