Improved cancer screening and treatment has resulted in lung cancer (LC) survivors living longer than ever before with late and long-term treatment effects impacting their overall quality of life (QOL). The Survivorship clinic is a new and emerging service at our institution lacking a formal screening program to identify QOL issues in cancer survivors. Guided by Katherine Kolcaba’s comfort theory, the purpose of our DNP project was to implement a process improvement project to identify physical and psychosocial barriers affecting QOL in LC survivors at our institution.
Results
A 100% completion rate using the pen and paper PROMIS-29 profile was achieved. The nurse, medical assistants, and providers agreed the training was organized. No challenges were identified in assisting patients with profile completion. Analysis of PROMIS-29 standardized T-Scores indicated physical function (41.2) and pain interference (55.5) were the most impacted QOL domains while depression was the least impacted. Providers agreed the PROMIS-29 was instrumental in providing patient care and guiding LC survivors to appropriate resources.
Methodology
A guideline and education session was provided to nursing staff and healthcare providers prior to implementing a pen and paper version of the Patient-Reported Outcomes Measurement Information System® (PROMIS-29) profile in adult LC survivors. Medical assistants transferred patient responses into our institution’s electronic health record. Advanced practice providers used the information obtained for patient care, teaching, and referrals.
Implications
While technology encourages completion of patient reported outcome measures (PROMs) electronically, introducing and educating a predominately older population on the completion and usefulness of PROMs with a more familiar pen and paper method of data collection helped ensure reliable and accurate QOL data. Identifying physical function and pain as the most impactful QOL issues among our LC survivors is key in promoting meaningful clinical interventions and developing future resources beneficial to this emerging population of cancer survivors.
