Patient Experience
4 February, 2022
Close the Care Gap is the theme for World Cancer Day. Often people who seek cancer care hit barriers at every turn and experience inequalities in care. It is important to create care that is centred around people living with cancer and their communities. Health and Social Care Professionals in St James’s Hospital run a number of services to support patients through their cancer journey.
Dietitians in St James’s run a tube feeding service for patients diagnosed with cancers that can cause difficulty swallowing foods and fluids. Sometimes these patients need a feeding tube to help maintain their weight and muscle mass during cancer treatment. There is a dietitian in St James’s dedicated to managing any patients requiring home tube feeding. This helps to manage feeding tube complications, reduce patients’ length of stay in hospital and prevent avoidable admissions with feeding tube complications. Almost 200 hospital bed days have been saved so far by this new service. Patient advice was used to develop this service, and feedback from patients who have been discharged with a new feeding tube under the care of the dietitian has been collected. Patient’s feedback is positive, some examples include ‘the tuition provided prior to discharge was excellent and congratulations to all concerned. I am managing the tube very well’, ‘your service was very valuable to me and I thank you for keeping in touch’, ‘I found the service concise and informative’.
OPTIMAL is an education programme delivered and led by occupational therapists in St. James’s Hospital, that gives information and strategies for improving health and well-being after cancer treatment. OPTIMAL runs once/per week for 6-weeks. The topics covered each week vary but mainly focuses on managing fatigue, how to eat healthily, different ways to exercise and looking after your emotional health. It is also a chance to meet others who have completed cancer treatment. Dr. Deirdre Connolly, School of Medicine, Trinity College, Dublin, developed OPTIMAL. Her research shows that people who attended OPTIMAL had better quality of life, less anxiety and that it helped them to get back doing the things they want to do and that they enjoy. Participants of OPTIMAL the optimal programme have given feedback on the programme:
“It was brilliant. I would do it again and I would recommend it to anyone who has cancer”
“I really enjoyed it. It gave me the confidence to get back to work. I took something out of each week that I found helpful”
Speech and Language therapists in St James’s Hospital have established a pilot prehabilitation (prehab) service for patients preparing for head and neck surgery. This surgery impacts speech, voice, or swallow. All patients undergoing this life-changing surgery are offered a preoperative assessment and sessions focussing on optimising communication and swallow, counselling, information provision, and to ensured inclusion of family members and loved ones in the pre-surgery journey. As part of preparing patients undergoing Total Laryngectomy surgery (removal of the entire larynx / voicebox), the Speech and Language team lead a well-established pathway in arranging and facilitating pre-operative laryngectomee visits. These visits involve a patient meeting a volunteer (who previously underwent laryngectomy surgery), in which the lived experience and expertise of the laryngectomee visitor is shared. In context of COVID-19, a tele-health model of delivering the programme has been developed to deliver this service. Quote from patient” Meeting another laryngectomy patient before my surgery gave me so much hope and reassurance seeing someone doing so well living their life to the full”
The Physiotherapy department in St James’s Hospital runs a cancer rehabilitation service for older patients experiencing physical limitations during and after cancer treatments. These limitations can include cancer-related fatigue, pain, deconditioning and lymphoedema. There is strong evidence to support conservative management of these side-effects through physiotherapy interventions such as exercise. Patients are assessed by a physiotherapist and given an exercise programme with the goal of maximising strength and function. There is an 8-week exercise programme available to any patients that need exercise guidance and supervision from a physiotherapist. Patients report “I found the exercise very helpful. It was explained very well, it is really benefiting my recovery from major lung surgery.”
Medical Social Work works with families with children and are here to support patients to support them. CLIMB (Children’s Lives Include Moments of Bravery) is a six week programme designed especially for children of primary school-going age (5-12yrs) who have a parent or significant adult with a diagnosis of cancer. The programme is run over six weeks and the groups run in the evenings so as not to disrupt school attendance.
It’s an enjoyable, sharing, interactive experience and a time for the children to come together to deal with their feelings. Throughout the programme the children will develop an understanding of cancer and from this understanding the myths and fears that children can hold about cancer will be dispelled. The programme is creative, using drama, arts and play. They are also based on having fun together and meeting new friends.