The approach to symptom management in oncology clinical practice may deserve a revamp, according to Heidi Donovan, PhD, RN.

Donovan, a professor of nursing and medicine, co-director of the National Center on family support, at the University of Pittsburgh, recently met with 

in an interview to discuss the impact of the newly designed WRITE tool—an 

 designed by oncology nurses to help women with ovarian cancer feel more in control of their disease.

The tool, which guides patients to reflect and describe a symptom—elaborating on what causes it, what worsens it, how it feels, what impact it makes on their daily lives, and how they have approached managing it, was observed to help women achieve a higher level of satisfaction with their care management plan.

®, Donovan highlighted some of the lessons learned from the tool’s implementation, including the need for systematic assessment as well ensuring women feel confident in confiding with their health care providers about the symptoms they may be facing.

“[By systematic] I mean [asking] the same questions repeatedly, over time, in order to pick up on changes that that are affecting patients and on symptoms that are affecting their quality of life, and their ability to function on a day-to-day basis,” she said. “The second principle was really enhancing women's confidence… A lot of what we did in this intervention was try to motivate women to recognize how much [of an] effect their symptoms were [causing] and build their confidence in their ability or their knowledge of things that they could try to get better management.”

The third principle that this intervention encompassed was an iterative approach to symptom management, according to Donovan. Symptom management requires a lot of “adjustment and communication” she said.

The intervention, therefore, focused on consistent communication between patients and providers, following through on provider recommendations for symptom management, and providing patients with symptom-management strategies that they could complete at home. “Those are things we should be doing in clinical practice—all the time,” she concluded.

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Heidi Donovan, PhD, RN, comments on principles of symptom management that she believes need to be better implemented in clinical practice—particularly for patients with ovarian cancer. 

Systematic, Adaptable Symptom Management Is Long Overdue In Oncology Practice

Heidi Donovan, PhD, RN, Associate Professor, University of Pittsburgh School of Nursing, discusses prioritizing symptoms based on their severity in order to aid symptom management and assessment for women with ovarian cancer.

Donovan notes that some symptoms of ovarian cancer are always going to be the most prevalent and severe, no matter which method you use to prioritize. The top three almost always include fatigue, sleep disturbances, and pain. However, some symptoms appear in different locations depending on the method used for prioritizing. For instance, nausea may not always be highly prevalent or a symptom that women say needs to be controlled but it has an effect on functional well being.

The best method of prioritizing the symptoms of ovarian cancer is to combine all of the possible methods. If anything reaches the top ten for the combination then it is definitely a symptom that needs recognition and treatment.

Articles

Heidi Donovan from the University of Pittsburgh School of Nursing Discusses Prioritizing Symptoms

Heidi Donovan, PhD, RN

Articles

Systematic, Adaptable Symptom Management Is Long Overdue In Oncology Practice

Heidi Donovan Discusses Prioritizing Symptoms