A Comprehensive Cancer Care Project to Improve the Overall Situation of Patients Receiving Intensive Chemotherapy

The comprehensive cancer care project described was designed to improve the overall situation of patients treated with intensive chemotherapy with curative intent. The two-year project was a cooperative effort involving a resource group of professionals from various disciplines and the staff on three hospital wards; the management group consisted of one physician from each ward and a psychologist. A "contact nurse" on each ward had primary responsibility for the patients' care. Because all ward personnel participated in the project, an intensive educational program took place. The resource group consisted of people with expertise in analyzing and solving problems connected with the disease and its treatment (e.g., a dietician, a medical social worker, a physical therapist). Methods developed for prevention or early detection and treatment of complications associated with chemotherapy included a structured interview at admission, a genogram, problem-mapping lists, a nutrition sheet, and symptom diaries. Patients' relatives also were included in the care efforts. A Swedish version of the Cancer Inventory of Problem Situations (CIPS) was used to evaluate patients; their relatives were evaluated with a similar version of the CIPS. When the results of the project were compared with the results of an evaluation conducted before the initiation of the project, a number of improvements were observed. Because the inmovements formed a coherent pattern, the authors concluded that the cancer project improved the overall situation not only of patients but of their relatives as well.