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A structured palliative care case management intervention (PalMaGiC) can help better support patients with incurable gastrointestinal cancer and reduce their symptom burden, according to a study recently published in the European Journal of Oncology Nursing.
A team of researchers conducted a qualitative exploratory study to learn more about the possible benefits, as well as the potential disadvantages, of using the PalMaGiC intervention to provide palliative care for patients with cancer.
Developed in Denmark, PalMaGiC is a nurse-led palliative care intervention intended to improve early identification of symptoms and related problems and reduce healthcare use, with the goal of ensuring health-related quality of life (HRQOL). It uses the European Organisation for Research and Treatment of Cancer-Quality of Life Questionnaire-Core 15- Palliative Care (EORTC QLQ-C15-PAL), as well as interviews, care planning, care and treatment, and needs-based follow-up to assess and manage palliative and home care needs.
Data analyzed were from patients older than 18 years with an incurable gastrointestinal cancer — esophageal, pancreatic, gastric, bile duct, colon, or rectal — and had at least 10 contacts with a nurse specialist, via telephone or in-person, through the PalMaGiC intervention. Between August 2019 and August 2022, the researchers conducted semistructured interviews with 14 patients with an incurable gastrointestinal cancer to assess the patients’ views on their participation in the intervention.
The interviews focused on 4 categories, with 15 subcategories: life changes and experienced needs, a death sentence and making the most out of the time left, my around-the-clock anchor, and areas of improvements.
Based on the patients’ responses, an overall theme of “filling in the gap and being a lifeline in the healthcare system to help increase quality of life” emerged.
An essential feature of the intervention for many patients was easy access to a designated nurse specialist with experience in surgical gastroenterology and palliative care skills. Other essential advantages included personalized follow-up care and access to professional help with navigating the healthcare system.
Participants reported that the intervention helped improve their outlook, which suffered when they received their diagnosis, and provided some hope. Patients and clinicians often have opposing views of hope; however, the patients expressed a preference for their support to allow for hope as well as provide honest information about their treatment and prognosis.
Participants experienced the palliative care case management intervention, which was established in a surgical department, as an asset in their lives while facing incurable cancer, the researchers concluded. “The intervention supported them in changing the balance from having a disease-oriented perspective to one that focused on QOL during their palliative illness trajectory.”
Reference
Gerhardt S, Leerhoy B, Jarlbaek L, Herling S. Qualitative evaluation of a palliative care case management intervention for patients with incurable gastrointestinal cancer (PalMaGiC) in a hospital department. Eur J Oncol Nurs. 2023;66:102409. doi:10.1016/j.ejon.2023.102409
