Using integrative palliative care can enhance coping expertise, thus bettering high quality of life in sufferers with acute myeloid leukemia (AML) receiving intensive induction chemotherapy. That mentioned, it’s important that oncology nurses advocate for palliative take care of sufferers who may benefit from it.
“Usually what we’ve got present in our observe – and definitely in our research – is that nurses and nurse clinicians are begging for palliative care specialists to be invited to see these sufferers, and it’s typically the attending physicians who’re saying, ‘we don’t really want that’ or ‘the affected person isn’t prepared for that but,” mentioned Thomas W. LeBlanc, MD, affiliate professor of medication on the Duke College College of Medication, noting that some folks nonetheless consider the misperception that palliative care is synonymous with end-of-life care (hospice).
LeBlanc lately offered his analysis on palliative care in sufferers with AML on the 2021 ASCO Annual Assembly.
The examine analyzed high quality of life, despair, and anxiousness signs for sufferers with AML who’re of their second week of remedy with induction remedy. Researchers selected the second week of remedy as a result of that’s when sufferers are inclined to really feel the worst. Two teams had been in contrast: the built-in palliative and oncology care (IPC) cohort that noticed palliative care clinicians at the very least twice every week whereas hospitalized (n=86) versus regular care (n=74).
Findings confirmed that the sufferers randomized to IPC had extra approach-oriented coping expertise and fewer avoidant-oriented coping expertise. The interventions results on these given IPC who had approach-oriented coping had been sustained all the best way up till week 24.
An enchancment in coping expertise was correlated with improved high quality of life and decreased despair and anxiousness signs.
Nurses treating this affected person inhabitants can perceive how life-changing improved high quality of life may be for sufferers with AML.
“Nurses are sometimes those who’re seeing and witnessing the struggling of those sufferers and their households as a result of they’re within the room 11 out of the 12 hours of their shift,” LeBlanc mentioned. “The nurses have an unbelievable alternative and actually additionally (a) duty to be the voice of the affected person, who perhaps doesn’t know learn how to articulate that they’re actually struggling with one thing that we’re not doing job managing.”
Not solely do nurses need to advocate for palliative care to the clinicians and different members of the remedy staff, however they need to additionally be sure that sufferers and their households perceive the advantage of receiving palliative companies as properly.
“The error that usually is made is that we type of go in with our tail between our legs, as a result of we’re afraid that sufferers are going to get freaked out once they hear the P-word. Regardless that most [patients] have heard it, they don’t know what it means,” LeBlanc mentioned.
LeBlanc recommends clinicians strategy the dialog with a script just like this:
“We’re going to name one other group of specialists to return and see you. They’re referred to as palliative care specialists, they usually’re specialists in serving to sufferers and households take care of the stresses and signs that associate with having a critical sickness like AML. I’ve discovered that they typically can actually assist folks really feel higher with symptom administration and assist enhance or preserve high quality of life or make it easier to deal with anxieties that may come together with having this prognosis and getting remedy.”
Laying down the fundamentals for what palliative care truly is – and what it isn’t – can significantly sway sufferers’ opinions.
“We all know from different research that when sufferers and households hear an evidence of what palliative care is, and the way it could be useful to them, they only about universally need it,” LeBlanc mentioned.
LeBlanc TW, Kavanaugh A, Webb J, et al. Palliative care and coping in sufferers with acute myeloid leukemia receiving intensive induction remedy: A Mediation evaluation of information from a randomized path. Offered at: 2021 ASCO Annual Assembly. June 4-8, 2021. Digital