Date of Award

2019

Document Type

Dissertation - MUSC Only

Degree Name

Doctor of Philosophy (PhD)

College

College of Nursing

First Advisor

Lynne S. Nemeth

Second Advisor

Julie Bradley

Third Advisor

Martina Mueller

Fourth Advisor

Michelle Mollica

Abstract

There are currently approximately 16.9 million cancer survivors in the U.S., and given advances in diagnostic and treatment capabilities, this number is estimated to increase to 26.1 million by year 2040. Survivorship care for individuals living with and beyond cancer has become a priority in the U.S. healthcare system. It is estimated nearly a third of patients diagnosed with solid tumor cancers will receive radiation therapy during treatment, often as the last phase of a multi-modality approach to cancer cure. Radiation therapy comes with its own associated side effects and is often a source of anxiety for cancer patients. Provider support may be one way to support patients; however, there is little known about the role radiation therapy healthcare providers play in supporting survivorship care. This dissertation research included four studies, all guided by the Quality of Life Model, which includes physical, psychological, social, and spiritual well-being. The first study determined the state of radiation therapy education provided by radiation oncologists and oncology nurse case managers through the administration of an investigator-developed survey at a radiation therapy practice affiliated with an academic medical center. Within this same practice, to expand upon the findings of the survey, a qualitative study explored patient reported outcomes of unmet needs and identified gaps, including radiation related symptom management and a need for improved patient education to prepare for radiation treatment. The third study investigated self-management instruments appropriate for assessing patient's ability to manage radiation dermatitis. Finally, the dissertation study evaluated the feasibility of a radiation oncology nurse-led animated video intervention and collected preliminary data on anxiety, distress, and radiation concerns. Results of the combined efforts reported in the included four manuscripts, suggest the importance of enhancing the role of the radiation oncology nurse in providing comprehensive continuity of care including physical, psychological, and social constructs for cancer survivors.

Rights

All rights reserved. Copyright is held by the author.

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