2.50
Hdl Handle:
http://hdl.handle.net/10755/243137
Category:
Abstract
Type:
Presentation
Title:
Nurse-Led Model of Assessment and Care for Older People with Cancer
Author(s):
McCarthy, Alexandra L.; Hausmann, Susan; Yates, Patsy; Salkield, Gayle; Walpole, Euan; Thomson, Damien; Skerman, Helen
Author Details:
McCarthy, Alexandra L., RN, MN, PhD, al.mccarthy@qut.edu.au; Hausmann, Susan, RN, BN; Yates, Patsy, PhD, MSocSci, BA, DipAppSc, RN, FRCNA; Salkield, Gayle, RN, BBus; Walpole, Euan, MBBS, FRACP; Thomson, Damien, MBBS, FRACP; Skerman, Helen, PhD;
Abstract:
Purpose: To present the results of a mixed-method study comparing the level of agreement of a two-phased, nurse-administered Comprehensive Geriatric Assessment (CGA) with current methods that assess the fitness for chemotherapy of older cancer patients.  A nurse-led model of multidisciplinary cancer care based on the results is also described.

Methods: The two phases comprised initial screening by a nurse with the Vulnerable Elders Survey-13 [VES-13], followed by nurse administration of a detailed CGA. Both phases were linked to a computerised algorithm categorising the patient as ‘fit’, ‘vulnerable’ or ‘frail’. The study determined the level of agreement between VES-13- and CGA-determined categories; and between the CGA and the physicians’ assessments. It also compared the CGA’s predictive abilities in terms of subsequent treatment toxicity; while interviews determined the acceptability of the nurse-led procedure from key stakeholders' perspectives.

Results: Data collection was completed in December 2011. The results will be presented at the conference. A consecutive-series n=170 will be enrolled, 33% of whom are ‘fit’; 33% ‘vulnerable’; and 33% ‘too frail’ for treatment. This sample can detect, with 90% power, kappa coefficients of agreement of ≥ 0.70 or higher (“substantial agreement”). Fitness sub-group comparisons of agreement between the medical oncologist and the nurse assessments can detect kappa estimates of Κ ≥ 0.80 with the same power.

Conclusion: The results have informed a nurse-led model of cancer care. It meets a clear need to develop, implement and test a nurse-led, robust, evidence-based, clinically-justifiable and economically-feasible CGA process that has relevance in national and international contexts.

 

Keywords:
Comprehensive geriatric assessment; cancer care
Repository Posting Date:
12-Sep-2012
Date of Publication:
12-Sep-2012
Conference Date:
2012
Conference Name:
23rd International Nursing Research Congress
Conference Host:
Sigma Theta Tau International, the Honor Society of Nursing
Conference Location:
Brisbane, Australia

Full metadata record

DC FieldValue Language
dc.type.categoryAbstracten_GB
dc.typePresentationen_GB
dc.titleNurse-Led Model of Assessment and Care for Older People with Canceren_GB
dc.contributor.authorMcCarthy, Alexandra L.en_GB
dc.contributor.authorHausmann, Susanen_GB
dc.contributor.authorYates, Patsyen_GB
dc.contributor.authorSalkield, Gayleen_GB
dc.contributor.authorWalpole, Euanen_GB
dc.contributor.authorThomson, Damienen_GB
dc.contributor.authorSkerman, Helenen_GB
dc.author.detailsMcCarthy, Alexandra L., RN, MN, PhD, al.mccarthy@qut.edu.au; Hausmann, Susan, RN, BN; Yates, Patsy, PhD, MSocSci, BA, DipAppSc, RN, FRCNA; Salkield, Gayle, RN, BBus; Walpole, Euan, MBBS, FRACP; Thomson, Damien, MBBS, FRACP; Skerman, Helen, PhD;en_GB
dc.identifier.urihttp://hdl.handle.net/10755/243137-
dc.description.abstract<strong><b>Purpose</strong>: </b>To present the results of&nbsp;a mixed-method study comparing the level of agreement of a two-phased, nurse-administered Comprehensive Geriatric Assessment (CGA) with current methods that assess the fitness for chemotherapy of older cancer patients.&nbsp;&nbsp;A nurse-led model of multidisciplinary cancer care based on the results is also described. <p><strong><b>Methods</strong>: </b>The two phases comprised initial screening by a nurse with the Vulnerable Elders Survey-13 [VES-13], followed by nurse administration of a detailed CGA. Both phases were linked to a computerised algorithm categorising the patient as &lsquo;fit&rsquo;, &lsquo;vulnerable&rsquo; or &lsquo;frail&rsquo;. The study determined the level of agreement between VES-13- and CGA-determined categories; and between the CGA and the physicians&rsquo; assessments. It also compared the CGA&rsquo;s predictive abilities in terms of subsequent treatment toxicity; while interviews determined the acceptability of the nurse-led procedure from key stakeholders' perspectives. <p><strong><b>Results</strong>: </b>Data collection was&nbsp;completed in December 2011. The&nbsp;results will be presented at the conference. A consecutive-series n=170 will be&nbsp;enrolled, 33% of whom are &lsquo;fit&rsquo;; 33% &lsquo;vulnerable&rsquo;; and 33% &lsquo;too frail&rsquo; for treatment.&nbsp;This&nbsp;sample can detect, with 90% power, kappa coefficients of agreement of &ge; 0.70 or higher (&ldquo;substantial agreement&rdquo;). Fitness sub-group comparisons of agreement between the medical oncologist and the nurse assessments can detect kappa estimates of &Kappa; &ge; 0.80 with the same power. <p><strong><b>Conclusion</strong>: </b> The results have informed a nurse-led model of cancer care. It meets a clear need to develop, implement and test a nurse-led, robust, evidence-based, clinically-justifiable and economically-feasible CGA process that has relevance in national and international contexts. <p>&nbsp;en_GB
dc.subjectComprehensive geriatric assessmenten_GB
dc.subjectcancer careen_GB
dc.date.available2012-09-12T09:18:12Z-
dc.date.issued2012-09-12-
dc.date.accessioned2012-09-12T09:18:12Z-
dc.conference.date2012en_GB
dc.conference.name23rd International Nursing Research Congressen_GB
dc.conference.hostSigma Theta Tau International, the Honor Society of Nursingen_GB
dc.conference.locationBrisbane, Australiaen_GB
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