Systematic, Adaptable Symptom Management Is Long Overdue In Oncology Practice


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.

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 Oncology Nursing News® in an interview to discuss the impact of the newly designed WRITE tool—an online symptom management tool 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.

While speaking with Oncology Nursing News®, 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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