Article Text
Abstract
Introduction/Background Current models of care are failing to adequately address the impact that a cancer diagnosis and treatment can have on the physical, psychological and health information needs of the cancer survivor. From an Irish perspective, patients have identified this component of their care as fragmented, where challenging side effects from treatment are not being addressed in a holistic fashion or not even addressed at all.
Methodology In September 2021, a nurse-led surveillance and survivorship clinic was established at the Mater Misericordiae University Hospital, Dublin, to provide care to women following diagnosis and treatment for cervical and vulval cancer. Through this clinic a multidisciplinary team (MDT) was established to address the complex post treatment needs in this population. The service is provided by a clinical nurse specialist in gynaecological oncology, a dietitian and a physiotherapist with additional support from an extended gynaecological oncology MDT.
Results This collaborative approach by the MDT, provides a unified service which adequately addresses post-treatment issues including but not limited to: treatment induced menopause and its sequelae, gastrointestinal toxicity, genitourinary toxicity, lymphedema, pelvic floor dysfunction, pelvic pain, pelvic insufficiency fractures. Since the establishment of this clinic, the attendance rate was assessed at two time-points in the first 6 months of the clinic (September 2021 – March 2022, 59%) and the most recent 6 months of the clinic (August 2023 – November 2023, 82%). A total of 360 patient interactions was provided by the Specialist Nurse, 34 by the Physiotherapist and 38 by the Dietician.
Conclusion Through the development of this clinic, we are providing evidence based information and tangible support to the patient as they enter the follow up and survivorship component of their cancer pathway. As the service matures, it will allow the nurse specialist to provide nursing care that is continuous and non-fragmented in its approach.