2021 Volume 35 Article ID: 35_1_asaumi
Purpose: This study aimed to investigate the performance and difficulties of outpatient nurses engaging in prognosis of patients with metastatic/recurrent breast cancer who have multiple symptoms and are undergoing outpatient pharmacotherapy.
Methods: Semi-structured interviews were conducted with six nurses working in the department of outpatient breast surgical oncology or outpatient chemotherapy in two facilities in Tokyo. Data from the interviews were analyzed qualitatively and inductively.
Results: The practice of outpatient nurses engaging in prognosis of patients with metastatic/recurrent breast cancer who have multiple symptoms and are undergoing outpatient pharmacotherapy consisted of “clarification of core symptoms based on the cluster of physical pain,” “organization of priority care with the aim of continuation of home care,” and “accompanying patients/family members from time of notice of recurrence to period of consciousness of death.” The difficulty of outpatient nurses engaging in prognosis of patients with metastatic/recurrent breast cancer who have multiple symptoms and are undergoing outpatient pharmacotherapy consisted of “confusion regarding facing a patient who has received bad news,” “difficulty in predicting sudden changes in patients who are physically and mentally vulnerable,” and “dealing with a patient facing death and family members who are upset.”
Discussion and Conclusion: We inferred that outpatient nurses sorted patients’ multiple symptoms and determination of care strategies in a circular manner within the limited waiting time for medical examination. Some of the practical difficulties faced by outpatient nurses were problems regarding the effective implementation of outpatient end-of-life discussions for patients during the transitional phase to palliative care-oriented medical care and the cooperation between outpatient and home nursing for the continuation of home care for patients. Based on these findings, we recommend the creation of a specific set of guidelines for outpatient nursing support to better perform prognosis of patients with metastatic/recurrent breast cancer during pharmacotherapy.
