A Guide to Oncology Symptom Management

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Foreword

Oncology nurses around the world care for people who experience multiple and varied symptoms and conditions that are cancer-related, treatment-related, or related to non-cancer issues. These nurses require information that is based on highest-level evidence and focused on responses to these symptoms. They will benefit from the thorough coverage of symptoms and conditions in A Guide to Oncology Symptom Management. From the book's first chapter with its evaluation of the unique experiences of older adults with cancer through the final chapter that covers spiritual needs of patients with cancer, this book offers an excellent overview of common symptoms and problems that affect individuals with cancer.

Major symptoms and conditions are addressed thoroughly. Each chapter offers incidence and prevalence information along with an explanation of pathophysiology related to the topic. This background information informs the reader about elements of the unique case study that begins and ends each chapter. Appropriate evidence-based assessment and treatment strategies-both medical and nursing-are discussed from a nursing perspective. All chapters focus on human responses to the symptom or condition. For each topic, clinical practice recommendations and major patient teaching points stemming from the evidence are included. Outcomes to be expected from optimal management are delineated clearly.

This book evolved naturally from the Oncology Nursing Society's (ONS's) forward-thinking initiatives related to evidence-based practice. From the Fatigue Initiative Through Research and Education (FIRE^®) and the subsequent Priority Symptom Management (PRISM) project (Ropka & Spencer-Cisek, 2001), ONS spearheaded development of the online Evidence-Based Practice Resource Area in 2002 (http://onsopcontent.ons.org/toolkits/evidence). In 2003, a Steering Council Project Team developed a definition of oncology nursing-sensitive patient outcomes based on a review of models and literature and proposed definitions and an organizing framework. Following this, researchers developed evidence-based summaries of select patient outcomes (e.g., lymphedema, nausea and vomiting, pain) that were used in published studies. These are found in the Outcomes Resource Area of the ONS Web site (www.ons.org/outcomes/measures/summaries.shtml). A natural spin-off, the Putting Evidence Into Practice (PEP) project aims to improve oncology nursing-sensitive patient outcomes through resources that provide evidence-based interventions. Between 2006 and 2008, groups of clinicians and researchers developed literature syntheses that led to 16 PEP resources. Each resource provides evidence-based interventions for patient care and teaching that are color-coded based on strength of evidence (Doorenbos et al., 2008). Literature syntheses and a toolkit developed for use by ONS chapters are available on the ONS Web site. A compilation of updated PEP resources (Eaton & Tipton, 2009) contains assessment and measurement tools as well as ideas for patient care and organizational use, along with case studies to illustrate application of the tools. Each sponsored effort has involved delineation of the current state of the knowledge on particular oncology-related topics and subsequently has supported education programs for oncology nurses and the public.

A Guide to Oncology Symptom Management contains useful and evidence-based nursing information focused on important oncology-specific symptoms and conditions. Nurses will recognize signs and symptoms experienced by real patients and can be confident that the assessment and treatment strategies recommended are based on best evidence and are feasible in real-world settings. They will discover that each chapter considers psychological, physiologic, sociologic, and spiritual needs of patients experiencing symptoms and that implementation of recommended management will assist in enhancing their patients' quality of life. This book is an important acknowledgment of the important part that nurses play in helping people with cancer to manage the often devastating symptoms and problems related to their disease. It is an important and timely contribution to the oncology nursing literature.

Dana N. Rutledge, RN, PhD
Professor, Department of Nursing, California State University, Fullerton
Nursing Research Facilitator, St. Joseph Hospital
Orange, California

References

Doorenbos, A.Z., Berger, A.M., Brohard-Holbert, C., Eaton, L., Kozachik, S., LoBiondo-Wood, G., et al. (2008). Oncology Nursing Society Putting Evidence Into Practice Resources: Where are we now and what is next? Clinical Journal of Oncology Nursing, 12(6), 965-970.

Eaton, L.H., & Tipton, J.M. (Eds.). (2009). Putting evidence into practice: Improving oncology patient outcomes. Pittsburgh, PA: Oncology Nursing Society.

Ropka, M.E., & Spencer-Cisek, P. (2001). PRISM: Priority Symptom Management Project phase I: Assessment. Oncology Nursing Forum, 28(10), 1585-1594.