The role of the specialist nurse in the review of patients with head and neck cancer--is it time for a rethink of the review process?

摘要

The follow up of patients after treatment of head and neck carcinoma is an essential part of management. The aims of the follow-up in head and neck cancer patients are multiple and should include the evaluation of treatment morbidity, psychosocial support and detection of recurrence as well as health related quality of life assessments (Kanatas et al., 2009). In February 2008 all units were contacted and 222 OMFS consultants in the UK with a head and neck interest were identified. A questionnaire was sent and written and telephone reminders were used to elicit responses. A total of 222 questionnaires were posted and we received 145, a response rate of 65% of those who replied, 115 were verified they were involved in the management of patients with head and neck cancer and 30 replied that they did not. Clinicians were asked if they would consider nurse-led clinics. 33% of consultants supported a nurse-led follow-up service. Some of the conditions for the support of nurse-led clinics were given as free text and included: "only for later than 2 years follow-up", "when additional training is given", "when there was no impact to junior clinician training", "when considering low-risk patients such as Tl tumours and more than 3 years post-treatment". 67% said no and the reasons given included, "feel it is important to review own work", "not confident nurses can spot new primaries", "positive feedback from surgeon to patient is important". In this study 67% of surgeons were against the set up of nurse led clinics with those who would consider it still expressing reservations.