Randomized Clinical Trial to Evaluate Advance Nursing Care for Women with Newly Diagnosed Breast Cancer

摘要

The purpose of this randomized clinical trial is to evaluate the impact of an advanced practice nurse on the cost of care and quality of life for women newly diagnosed with breast cancer. The control group receives standard medical care while the experimental group receives standard medical care plus advanced practice nursing care. Interventions of the advanced practice nurses (APN) include coordination of care, education, direct care, and support. The two year study has been completed by 135/210 (64%) women. Univariate analyses indicate uncertainty decreased on the Mishel Uncertainty in Illness Scale (MUIS) from baseline significantly more in the intervention group than the control group at 1 month (p = .001), 3 months (p = .026), and 6 months (p = .011) after diagnosis. At 12 months the two groups showed similar decreases in uncertainty (p = .589). The intervention group showed greater reduction of the MUIS sub- scales of complexity, inconsistency, and unpredictability (p = .002, .004, .008 respectively). Changes in mood states and well being did not differ significantly in the four follow-up periods which have received preliminary analysis. Cost of care data has been collected for 118/210 (56%) participants. After data is collected for the entire sample, analysis of the cost data will begin. Translation of study results into clinical practice is occurring concurrent with interpretation of results. A second study with a modified APN intervention, all analyses, and reporting of all results will be completed 9/30/ 99 as per statement of work.