Comprehensive Geriatric Assessment (CGA) in the Elder Cancer Patient – Implications in Nursing Decision-making Process.

Pedrazzani, Carla Ambrogina and Valcarenghi, Dario and Bianchi, Monica (2008) Comprehensive Geriatric Assessment (CGA) in the Elder Cancer Patient – Implications in Nursing Decision-making Process. European Journal of Oncology Nursing, 16 (S1:S32).

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Abstract

Introduction: In the last decades there has been an important and progressive increase of elder cancer patients with consequent implications in oncology medical and nursing practice. As aging is a very diversified and individualized process, in the literature there is a general agreement about the importance and the essentiality of a comprehensive geriatric assessment (CGA) for the elder cancer patient in the oncology medical practice. Particularly CGA provides an evaluation of functional age and life expectancy,thus allowing tailoring of oncological treatments and preserving quality of life. The employment and utility of CGA for nursing practice in oncological settings is less explored in literature. For about two years, nurses of the Oncology Institute of Southern Switzerland outpatient department have applied an abbreviated comprehensive geriatric assessment (aCGA) for 140 elder cancer patients. No systematic data are available regarding how the use of this assessment modality has affected their care planning. Material and Method: The aim of this pilot qualitive study is to explore how nurses use the comprehensive geriatric assessment in their decision-making process for elder oncology patient care in an oncology outpatient department. In November–December 2011 two focus groups have been set up with twelve nurses who have utilized an abbreviated Comprehensive geriatric assessment (aCGA) for elder cancer patient in the last two years. The focus groups purpose is to explore whether and how the use of an aCGA has influenced nursing decision-making process and care planning in an oncology setting, by trying to identify which kind of decisions have been taken and interventions have been done in practice by using this method of multidimensional assessment. A framework analysis is being used for the data analysis. Result and Discussion: During the two years use of the aCGA, no systematic data were collected regarding the usefulness of such an assessment to improve nursing professional approach but the impression was that there is still a discrepancy between the data being collected by nurses and the actions which are implemented,as part of what can be managed by nursing staff independently. The study data, which will be available from February 2012, will be of help to verify this hypothesis. Conclusion: In order to improve nursing care quality, it is essential to understand the correlation between information which are collected and interventions which are realized in nursing practice. The data which are being collected in this study will help to clarify how this correlation is present particularly for the care of elder cancer patients in our oncology contest and the reasons for any difficulty.

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