The advanced practice nurse: meeting the information needs of the rural cancer patient.

BACKGROUND: The goal of the Rural Cancer Care Project is to assist patients and families residing in rural areas to receive the highest-quality cancer care in their own communities. METHODS: An advanced practice nursing clinic, serving as an adjunct service to specialty cancer care, is the core of the intervention model demonstrated by the "Rural Partnership Linkage for Cancer Care", a National Cancer Institute grant awarded to Michigan State University in 1990. The nursing intervention is directed to meeting patient and family needs. RESULTS: One hundred seventy patients enrolled in the study beginning in January 1993 through September 1995. Knowledge deficit proved to be one of the most frequently identified problems (in 78% of the 170 patients evaluated), although the patient and family had often received care at a community oncology center with specialist health care professionals. Teaching was a major nursing intervention employed in patient care to address patient problems and needs as presented (e.g., chronic pain, fatigue). The data also demonstrated that the patients had more knowledge needs in the later stages of disease when they had cancers in all sites but the breast, where patients with Stage I and II disease had the greater learning needs. CONCLUSIONS: Nursing interventions were directed primarily at education regarding cancer as a disease or the understanding of chemotherapy. The advanced practice nurse, by providing direct patient and family education in a community setting, does improve patient knowledge and subsequent outcomes.