Artikel
A nurse-led complex complementary and alternative medicine intervention for gynaecologic patients to improve health related quality of life
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Autoren
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Cornelia Mahler
- UniversitätsKlinikum Heidelberg
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Nadja Klafke
- UniversitätsKlinikum Heidelberg
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Lorenz Uhlmann
- Institut für Medizinische Biometrie und Informatik, Heidelberg
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Martina Bentner
- UniversitätsKlinikum Heidelberg
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Andreas Schneeweiss
- UniversitätsKlinikum Heidelberg
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Andreas Müller
- Städtisches Klinikum Karlsruhe
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Stefanie Joos
- Universitätsklinikum Tübingen
| Veröffentlicht: | 30. April 2018 |
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Gliederung
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Background and Purpose: Patients with gynaecological cancer complement chemotherapy with various methods from Complementary and Alternative Medicine (CAM) for supportive care. A complex nursing intervention was developed for patients undergoing chemotherapy to improve health related quality of life. Aim was to assess the intervention.
Model/Framework: The intervention addressed all four areas of Myra Levine’s model. Various complementary methods were used to support conservation of energy and structural integrity. Conservation of personal and societal integrity was achieved through counseling.
Methods: Within the CONGO (Complementary Nursing in Gynecologic Oncology) trial a complex nursing intervention was developed.
Research Focus: Randomized controlled trial. From July 2014 until April 2016 data of 251 patients were collected in two day clinics. Patients in the intervention group received CAM interventions by CAM trained oncology nurses; patients in the control group routine supportive care. Primary outcome was HRQoL (EORCT-QLQ-C30) measured at four timepoints and in the patient diary. Secondary outcomes (Self-efficacy, fatigue, nausea, mucositis, …) were chosen according to Levine’s principles of conservation. Data were analysed using mixed models.
Methodological and Theoretical Focus: The intervention consisted of three components: a) indication-based CAM nursing package, b) resource-oriented counseling, c) evidence-based CAM information material which were applied in every day routine care.
Results 243 data sets were analysed. At end of chemotherapy no significant difference could be detected in HRQoL between both groups (p = 0.5964). However at follow-up the intervention group showed a significant difference in HRQol (p = 0.0095) and other secondary outcomes.
Conclusions: Levine’s model provided a grounded approach to design key areas of the nurse-led intervention. HRQoL can be improved when nurses regularly provide CAM care for patients in all four conservation areas.
Funding Information: The study was funded by the BMBF. Förderkennzeichen: 01GY1334
