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Advanced practice nurses improve survival in elderly cancer patients

Yale University : 13 December, 2000  (New Product)
A study in the December Journal of the American Geriatrics Society showed that elderly cancer patients who received home care from advanced practice nurses lived 7 months longer on average than patients who received standard care.
The four-year study followed 375 elderly patients newly discharged from the hospital after cancer surgery. Some patients received standard care, while an experimental group received three home visits and five telephone contacts with an advanced practice nurse, who also educated family members about caregiving. Advanced practice nurses are specially trained registered nurses, usually holding master's degrees, who can provide such highly skilled care as medication prescription and physical examinations.

The findings were especially significant because the patients in the group who received the special nursing care tended to be in later stages of their cancer than the group that received standard care. I was assumed that these later stage patients would die sooner, but the reverse happened.

'These findings tell us a great deal about the role of nurses,' said Ruth McCorkle, a professor at the Yale University School of Nursing and lead author of the study. McCorkle was at the University of Pennsylvania, as was the rest of the team, while the research was being done. 'Traditionally we have thought of nurses as making patients more comfortable, thus improving quality of life. This study shows that good nursing not only improves but also extends life. Imagine what a breakthrough it would be to find a drug that bought cancer patients seven months of high quality time. Well, we've found something that can extend life that dramatically, and it's not a drug that requires a long and expensive approval process before patients can benefit from it.'

But current health care delivery does have to change before patients can receive such care, McCorkle cautioned. Few home care agencies employ advanced practice nurses as direct care providers.

The study focused on elderly patients, who are more likely to experience post-operative complications. This problem is exacerbated by a trend to discharge patients rapidly after surgery. The interventions of the advanced practice nurse served to avert or address complications rapidly. In contrast, some patients in the standard care group died prematurely from surgical complications, such as infections. The authors speculate that survival may also have been enhanced in the experimental group by the psychosocial support that nurses gave patients and families.
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