Orientation Eases Stress and Helps Breast Cancer Patients Manage Neoadjuvant Regimens

Nurses at the Rutgers Cancer Institute of New Jersey have developed a program to help patients with early-stage breast cancer to better understand and retain information about their presurgical treatments.

The clinical management of patients with early-stage breast cancer has grown to include more patients receiving neoadjuvant chemotherapy, followed by surgery and/or radiation. However, nurses at the Institute found that patients often felt anxious and overwhelmed by the complexity of information and lacked the ability to retain information essential for self-management.

To address this need, Hemanshu Patel, MSN, RN, APN-C, OCN, and Jacquelyn Lauria, MSN, RN, APN-C, AOCPN, designed an educational intervention with information about presurgical treatment to be included in the facility’s orientation program for new patients. Through this program, patients learn about self-care strategies and support resources and also take a tour of the treatment area.

The nurses shared details of the intervention and early results in a poster presentation at the recent 2014 ONS Congress.

Patel and Lauria used information from literature reviews and interdisciplinary experts to develop a 20-minute class for patients on what to expect with neoadjuvant therapy, as well as a patient education sheet and treatment calendar, incorporating periodic reevaluation by a multidisciplinary team.

The class is aimed at improving patients’ understanding of treatment goals while explaining why treatment plans may require adjustments based on tumor response. It also provides support to patients who may have a poor clinical response to treatment and explains why surgery is needed, even if there is no evidence of a tumor following treatment.

“Feedback from patients and our healthcare team indicates this enhanced education is reducing patient stress and leading to better comprehension of what is involved in this form of therapy,” noted Patel and Lauria. “By helping patients appropriately navigate such complexities, we can help improve their treatment outcomes.”

The education program is designed to be adapted for use by nurses nationally.

Patel H, Lauria J. Neoadjuvant chemotherapy in breast cancer—evolving nursing implications for patient navigation and education. Oncol Nurs Forum. 2014;41(2):E159.