Authors (including presenting author) :
Lam CH(1), Wu PY(1), Chan K(1), Chan WY(2), Ling WM(1), Chan MF(1), Au WY(1), Soong S(1)
Affiliation :
(1)Department of Clinical Oncology, Pamela Youde Nethersole Eastern Hospital,(2)Department of Surgery, Pamela Youde Nethersole Eastern Hospital
Introduction :
Breast cancer is the commonest female cancer, accounting ~13% of cancer burden in Hong Kong. With advancement in diagnostic and treatment strategies, ~80% of patients are diagnosed at curable stage, and 5-year survival rates reach 90%. We therefore face a growing demand for quality survivorship care, including long-term surveillance and management of physical and psychosocial complications that may arise from treatment.
In recognition of the importance of survivorship care, nurse-led survivorship models have been explored by various institutions internationally, with reported success. The current practice in Hong Kong incorporates cancer case manager in patient care during active treatment, yet no extended care is available thereafter. Hence, we propose to establish a nurse-led clinic to optimise holistic survivorship care.
Objectives :
To introduce a nurse-led clinic to enhance quality of extended breast cancer survivorship care in Clinical Oncology. This includes early detection of recurrence, management of treatment related toxicity, attention to psychosocial well-being, and empowerment.
Methodology :
Departmental protocol on breast cancer survivorship was developed based on international recommendations.
A pilot nurse-led clinic was introduced from 9/2019 to 12/2020. The programme consists of:
A) Initial consultation upon completion of active anti-cancer treatment to provide tailored survivorship plan, including counseling on lifestyle, treatment toxicity, breast self-awareness and resources navigation.
B) Follow-up consultation for patients > 10 years into survivorship, for surveillance and management of long-term treatment effects.
Specialist nurses were trained to ensure competency in clinical assessment.
Questionnaires were used to assess patient receptiveness and overall satisfaction.
Result & Outcome :
Thirty patients were recruited. 15 patients attended the initial consultation on tailored survivorship plan and yielded positive feedback regarding patient experience compliance, enablement, and overall satisfaction.. Another 15 patients attended the nurse-led follow-up clinic and were content with subsequent follow-up arrangements.
Conclusion:
Optimising care for breast cancer survivors is critical to the overall healthcare landscape in Hong Kong. The departmental pilot nurse-led clinic was positively received by patients and staff, and successfully fills current service gaps in extended survivorship care. Future efforts shall address the cost effectiveness of such model in the shared care of survivors, and the integration of a multidisciplinary team to provide structured rehabilitation.
