Date of Award

Fall 10-18-2023

Degree Type

Thesis

Degree Name

DNP Doctor of Nursing Practice

Department

Nursing

Advisor

Mary Ellen Roberts, DNP

Committee Member

Mary Ellen Roberts, DNP

Committee Member

Teresa Conklin, DNP

Committee Member

Courtney Gabriel, MD

Keywords

survivorship, cancer survivors, ovarian cancer, quality of life, distress

Abstract

Background: The cancer survivorship population has been growing significantly in the last few years due to advancements in treatments such as immunotherapy, targeted medications and other types of chemotherapy. However, these survivors can have lifelong symptom burdens due to their diagnoses and adverse effects of their curative therapies. Symptoms are not always physical and can include emotional distress. Ovarian cancer patients in particular tend to have symptom complications because of their disease process. Symptoms include pain, constipation, neuropathy and fatigue. Ovarian cancer patients also experience a high level of cancer relapses. Early detection is key in cancer recurrences for patients to have better outcomes. Strong symptom management and close follow up can lead to improved quality of life for ovarian cancer survivors. There is no standard for healthcare providers to address survivorship needs in the ovarian cancer population and sometimes key aspects of a patient’s care plan are missed.

Project Aim: The primary objective for this quality improvement project was to implement a survivorship checklist for oncologists and oncology nurse practitioners to use during visits with ovarian cancer survivors. The checklist incorporated and addressed physical, emotional, and psychosocial aspects of survivorship care for this gynecologic oncologic population. If there were any cancer recurrences, the checklist guided providers to hopefully detect these right away. The checklist should improve provider workflow to best address patients’ concerns and help improve patients’ qualities of life through effective symptom management. Methods: This was a quality improvement project with an intervention, the survivorship checklist, to be used during ovarian cancer survivorship clinic visits. The checklist was populated in the electronic medical record for providers to review with patients and then document so responses could be tracked. Results: Through the results of a post implementation survey, providers including both physicians and nurse practitioners found the checklist helped encompass multiple symptom topics during follow up visits. The checklist was comprehensive and helped providers organize care plans in the electronic medical record. Providers found the use of the checklist in the electronic medical record to be convenient and helpful when comparing patients’ responses to previous encounters.

Conclusion: Ovarian cancer survivors tend to have complex symptoms related to their disease and prior treatment. It is important for providers to have an organized checklist to address patients’ needs and identify emotional distress and physical ailments. Symptoms are able to be better managed when patients are given the time to share concerns and have a rapport with their healthcare providers.

Keywords: survivorship, cancer survivors, ovarian cancer, quality of life, distress

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