patient. Their perception of medical responsibility, whether they work proactively and expectations of the specialist define care. As follow-up is less systematic, proactively working GPs feel like they are left out of care. They would like to receive more and timely information (on psychosocial aspects). There is no true transmural teamwork and GPs are rarely well informed about the role of APNs.
Conclusions: Because of the variety of roles GPs describe, differentiation in communi-cation is recommended, where an APN could be involved. To improve this collabora-tion, across the borders of primary and secondary/tertiary care, further efforts are needed.
Legal entity responsible for the study: Ghent University. Funding: Has not received any funding.
Disclosure: All authors have declared no conflicts of interest.
CN29 The use of patient reported outcome (PRO) instruments in immune checkpoint inhibitor (ICI) therapy for cancer: A systematic review S. Colomer-Lahiguera1 , D. Bryant-Lukosius2 , S. Rietkoetter2 , L. Martelli2 , K. Ribi3 , A. Orcurto4 , R. Juergens5 , M. Eicher1 1
Department of Oncology - Institute of Higher Education and Research in Healthcare (IUFRS), Centre Hospitalier Universitaire Vaudois (CHUV), Lausanne, Switzerland, 2
School of Nursing/Department of Oncology, McMaster University, Hamilton, ON, Canada,3
Institute of Higher Education and Research in Healthcare (IUFRS), University of Lausanne, Lausanne, Switzerland,4
Department of Oncology, Centre Hospitalier Universitaire Vaudois (CHUV), Lausanne, Switzerland,5
Division of Medical Oncology, Juravinski Cancer Centre, Hamilton Health Sciences, Hamilton, ON, Canada Background: ICI have shown significant clinical benefit for patients diagnosed with varied types of cancer. With an increasing use of these therapies, it is of urgent interest to achieve a comprehensive understanding of the overall patient experience – thus PROs should be systematically included in clinical ICI trials. We conducted a system-atic review of published literature to identify and categorize PRO instruments and examine related utility and measurement issues in studies reporting on ICI. Methods: Literature was searched using PubMed, Embase, PsycINFO, Medline and CINAHL databases (June 2017). Search terms included controlled vocabulary and spe-cific keywords related to: (1) Food and Drug Administration (FDA) approved ICI, (2) PRO, and (3) Oncology. Eight reviewers independently screened titles/abstracts fol-lowed by a full text selection based on predefined criteria. We included clinical trials, intervention studies, systematic reviews, study protocols, observational studies, and case reports. Information regarding the clinical trial protocol and PRO tools was col-lected. (PROSPERO CRD42018090912).
Results: Of the 24 articles included in the review, 13 reported PRO data from primary clinical studies, nine were quality-adjusted life year analyses, and two were study protocols. These articles referred to a total of 14 clinical trials reporting PRO results. Of these, 12 used cancer-specific (11 EORTC-QLQ-C30 and 1 FACT-G) and 11 a generic quality of life (QoL) questionnaire (10 EQ-5D and 1 SF-36). Whereas in seven cases, only cancer-specific and generic questionnaires were used, five studies combined them with disease-specific modules, and two included a symptom-disease-specific questionnaire. Furthermore, six studies used PROs to conduct analyses of health economics and work productivity. Conclusions: Cancer-specific or generic QoL questionnaires are the most widely used PRO measures in clinical ICI trials. As ICI therapies exhibit unique characteristics dif-ferent from conventional cancer therapies, such broad instruments may not capture the specific ICI-related symptoms, toxicities, and impact on the patient’s QoL. Hence, the adaptation or development of ICI specific PRO tools should be further investigated. Legal entity responsible for the study: Centre Hospitalier Universitaire Vaudois (CHUV) - University of Lausanne (UNIL) and McMaster University. Funding: Has not received any funding.
Disclosure: All authors have declared no conflicts of interest.
CN30 Laryngectomized patients caregivers’ life experience: A phenomenological study V. Bressan1 , E. Dri1 , S. Stevanin2 , L. Cadorin3 , A. Rizzuto4 , G. Bulfone1 , L. Ghirotto5 1
Department of Medical Sciences, University of Udine, Udine, Italy,2
Agency for Health and Social Care, Veneto Region, Venice, Italy,3
Continuing Education Center, National Cancer Institute CRO Aviano, Aviano, Italy,4
Department of Otolaryngology/Head & Neck Surgery, Udine University Hospital, Udine, Italy,5
Research, Azienda Santa Maria Nuova-IRCCS, Reggio Emilia, Italy
Background: Laryngectomized patients often depend on their caregivers who have a cen-tral and difficult role in supporting them dealing with financial, social, and relational issues. In fact, they feel very responsible and committed, especially considering the time devoted to take care of their beloved. Besides, providing care induces caregivers high stress levels, emotional distress, anxiety and the fear of cancer recurrence or progress. Few stud-ies investigated laryngectomized patients caregivers’ life experience during both the whole course of illness and at the end of the treatment. Therefore, the purpose of our study was to explore, through a phenomenological approach, the lived-experience of primary family caregivers of laryngectomized patients undergoing radical surgery.
Methods: Qualitative semi-structured and audiotaped interviews were held with 12 lar-yngectomized patients’ primary family caregivers. Data were analysed using the descriptive phenomenological approach outlined by Colaizzi.
Results: Three key themes emerged: the caregivers lived experience of illness; the change of caregivers’ daily life and how they support their sick beloved. The experience of caregivers’ lived relations changes from being a family member to a supportive carer, and the illness of their beloved negatively affects their psychological lived experience. Their perception of time and Quality of Life change as their perception of the future becomes uncertain. Finally, they feel guilty mainly because of the limited amount of time they can devote to their beloved.
Conclusions: The study findings allowed to understand in depth how the presence of a laryngectomized person in the family may affect the life of the caregiver, even after the treatment phase. This suggests the need for healthcare professionals to support care-givers throughout the whole care journey and especially in dealing with the perception of time during the diagnosis and care phases. Further research should be conducted on factors contributing to time perception alteration and possible interventions to support caregivers to cope with it.
Legal entity responsible for the study: Valentina Bressan. Funding: Has not received any funding.
Disclosure: All authors have declared no conflicts of interest.
CN31 Comparing nurses’ and patients’ research priorities in cancer care: A mixed methods systematic review
L. Cadorin1
, I. Truccolo2
, V. Bressan3
, N. Suter1 1
Continuing Education Centre, CRO Aviano National Cancer Institute, Pordenone, Italy,
2
Scientific and Patient Library, CRO Aviano National Cancer Institute, Aviano, Italy,
3
ENT Department, University of Udine, Udine, Italy
Background:Cancer nurses struggle to meet the challenges in providing quality nurs-ing care in changnurs-ing environments characterized by advances in drugs and technolo-gies, aging populations, increasing rates of cancer and survival, rising costs, long-term survival patients and increasing economic constraints. Research priorities need to be established within this context because they can encourage the new generation of nurses to respond competently to patients’ advanced care needs.
Methods:A systematic review was performed to compare and discuss nurses’ and can-cer patients’ main cancan-cer research priorities according to the PRISMA guidelines (PROSPERO registration: CRD42017059721). Studies retrieved were evaluated with a Mixed Methods Appraisal (MMAT). All medical databases were searched from January 2000 to July 2017. Study inclusion, data extraction, and assessment were performed by two researchers independently (inter-rater agreement, kappa¼0.70; SE ¼ 0.87; p < 0.01).
Results:Among 16 studies identified, 13 included nurses’ research priorities, 2 patients’, and 1 both. They included descriptive cross-sectional (50%), Delphi (44%), and exploratory qualitative studies (6%). Qualitative studies varied from 75% to 100% of the total MMAT score. Nurses’ priorities were as follows: cancer behavioral psycho-logical/social issues and professional dimensions. Patients’ priorities were patient life dimensions and health promotion. Cancer care dimensions and continuum of care emerged as research priorities of both.
Conclusions:The results underline nurses’ and patients’ research priorities to investi-gate the patients’ advanced care needs and provide a useful template to guide cancer-nursing research. Identifying priorities helps focus on particular issues rather than pro-moting isolated and unrelated studies of patients’ needs. Most of the nurses who par-ticipated were affiliated with professional associations and do not reflect the entire nursing population. Moreover, very similar survey questionnaires have been used (the items did not cover all areas) with the possible priorities not considered by participants. More studies are needed for the creation of a cancer research priority agenda. Legal entity responsible for the study:CRO Aviano National Cancer Institute. Funding:Has not received any funding.
Disclosure:All authors have declared no conflicts of interest.
CN32 Most prevalent unmet supportive care needs in Greek ambulatory advanced breast cancer female patients receiving chemotherapy A. Psychogyiou, S. Katsaragakis, C. Lemonidou, D. Protogiros, E. Patiraki Nursing, National and Kapodistrian University of Athens, Athens, Greece
Background: This cross-sectional study, supported by the National and Kapodistrian University of Athens, aimed to describe the unmet supportive care needs of ambulatory advanced breast cancer female patients receiving chemotherapy and the association between patients’ characteristics and their unmet needs.
Methods: A convenient sample of 117 ambulatory (response rate 96%) advanced breast cancer (stage III or IV) female patients receiving chemotherapy, from two outpatient units of cancer hospitals in Attica consented to participate between July 2017 to February 2018. Patients were assessed by the translated in Hellenic language Short-Form Supportive Care Needs Survey Questionnaire: a 34 items 5-point (1-5) Likert type scale that covers five domains of need: health system and information (HIS),
