TOPLINE
Higher nurse-led supportive care intensity (SCI) was associated with greater improvements in quality of life (QOL), symptom burden, coping, and self-management capability among patients with advanced solid tumors who received palliative chemotherapy.
METHODOLOGY
- Researchers conducted a prospective observational cohort study of 180 adults with advanced solid tumors who received palliative chemotherapy at the Hebei Engineering University Affiliated Hospital in China between 2021 and 2023.
- SCI was quantified using a composite score based on the frequency and depth of nurse-delivered supportive care encounters.
- The outcomes included health-related QOL (measured using the European Organisation for Research and Treatment of Cancer Quality of Life Group Core Questionnaire 30), symptom burden (measured using the Edmonton Symptom Assessment System), coping ability, self-management capability, existential well-being, and overall survival. A clinically meaningful improvement in QOL was defined as a ≥ 10-point increase from baseline.
- Patients were followed up for 24 weeks for assessing patient-reported outcomes, with survival monitored until data lock.
TAKEAWAY
- Higher SCI was independently associated with greater improvements in global QOL over 24 weeks (P < .001), with greater improvements noted in physical and role functioning. It was also associated with a greater likelihood of achieving a clinically meaningful ≥ 10-point improvement in the global QOL (adjusted odds ratio [OR], 1.46; 95% CI, 1.12-1.90).
- Higher SCI was associated with a lower symptom burden (beta = -2.21; P < .001), and fatigue, appetite loss, sleep disturbance, and overall well-being showed greater reductions. It was also associated with lower odds of persistent high symptom burden (adjusted OR, 0.71; P = .007).
- Higher SCI was associated with better self-management capability at 24 weeks (adjusted OR, 1.82; P < .001), better existential well-being (beta = 1.28; P = .004) for 24 weeks, and increased use of adaptive coping strategies, including active coping, positive reframing, and acceptance for 18 weeks.
- Higher SCI was independently associated with lower all-cause mortality (adjusted hazard ratio [HR], 0.68; P = .030). Patients receiving eight or more nurse-led supportive care contacts also had a lower mortality risk than those receiving fewer contacts (adjusted HR, 0.61; P = .018).
IN PRACTICE
"These findings underscore the central role of nurses in palliative and supportive oncology care," the authors wrote. "From a pragmatic perspective, achieving higher supportive care intensity may be feasible through structured prioritization of supportive care encounters within existing nursing workflows and the use of scalable approaches such as proactive follow-up and remote symptom monitoring, rather than expansion of specialized services alone."
SOURCE
The study was led by Bao-Mei Wang, MD, Affiliated Hospital of Hebei University of Engineering, Handan, China. It was published online on July 24 in Medicine.
LIMITATIONS
The observational design precluded causal inference, and residual confounding could not be excluded despite adjustment for baseline symptom severity, functional status, and disease characteristics. The single-center setting might limit the generalizability of the findings. The number of survival events was modest, warranting a cautious interpretation of the exploratory survival analyses. The approximately 20% attrition rate in the longitudinal patient-reported outcome assessments might also have influenced the results.
DISCLOSURES
The authors have no funding and conflicts of interests to disclose.
This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.