Quality of Life and Chemo induced neutropenia

[Jinx500]

Hi..

I'm a second year nursing student working on a paper and I could really use some advice.

The paper I am writing is a reaction-paper... based on an article that has to do with developing a quality of life questionnaire - to be given to patients with chemotherapy induced neutropenia... The goal of the questionnaire is to help nurses determine which interventions would be beneficial to the patient. However, the questionnaires would be compiled (results tallied) and put to use in the clinical setting.

My initial reaction was that - lol - I didn't understand a word the article said... however, after reading it several times - and defining the various terms and acronyms - I think I have a pretty good hold on it.

So - my second reaction was this: Quality of Life is very subjective - and I don't think that tallying the results would be beneficial. I would think that if the questionnaire was used to come up with an individual care plan - it would work better. In addition, the questions are subject to interpretation by the individual. And finally, I would think that the answers would vary if it questions were asked verbally versus a patient just filling out the form. So - here is where I need the advice...

Is this something that can be done? Is there actually time for a nurse to verbally ask the questions and ensure that the patient understands them - and answers them accurately? Do you think that this type of questionnaire would help a nurse come up with beneficial interventions to give the patient a better quality of life? Can you think of any alternatives?

I know it is a lot... but, I thought i could pick a few brains and perhaps see through the eyes of the more experienced.

Thank you.

[iluvivt, BSN, RN]

In many Oncology settings there is time to talk with the patients and review any symptoms they are having in relation to their chemotherapy. As a matter of fact it is necessary and part of your assessment.As you are aware almost every chemotherapy agent causes bone marrow depression to some degree and some specifically effect the neutrophils. Most patients will tell you that the nausea,fatique,stomatitis,loss of appetite and alteration in taste sensations affects their daily life in profound ways. Not until they experience an infection orr virus or catheter infection do they feel the full impact of the BMD.They are instucted on the nadir of their specific agent or agents as well as steps to prevent infection. I think I like the general questionare so then you can make recommendations or a teaching tool to use on all patients. Yes you are correct about the quality of life and illness being subjective but I bet you will get very similar responses. Then you can take all of them and give them to all your patients and they can take or leave what works for them. For example,oncology patients are instructed to avoid crowds during times when their WBCs are low.Maybe some advice you may give is to have them plan ahead to have some of their favorite home activities planned and ready to go. (ie knitting project movies books etc.) You will get ideas from the patients and you can share them with other patients. Does this fit in with your project and am I answering the question?. Individual care plans are nice,but teaching tools to capture a broad range of patients are very useful and time-saving in our cost-saving health care system.

[Jinx500]

ILUVIVT,

Thank you... this is exactly what I was looking for - a perspective of someone who has seen many patients. My initial reaction was based soley on what I have personally seen (when my mother had chemo). However, you have opened my eyes and I can now see how the questionnaire can be helpful for many patients and how it does not have to be specific to one patient. I never even thought of using the results to possible help others prepare ahead... (great thought!).

Thank you so much! I didn't think anyone was going to reply - lol.

[iluvivt, BSN, RN]

jinx500 you are welcome. I really enjoy making teaching tools for patients. I often found I was saying the same things over and over again and charting these as well. So I have made several teaching tools that are mostly CVC instructions. Patients are so stressed they often only hear a small percentage of the advice and help you are giving them and if they can take home a teaching instruction sheet it help. Just make sure you keep it at a 6-7th grade reading level so all can use it. Seems low...I know but all medical teaching material should stay at that level.