Patients receiving oncology palliative care experience substantial psychological distress, emotional suffering, and complex symptom burden. This study aimed to evaluate the effects of a nursing-led predictive symptom management program incorporating selected laboratory indicators on psychosocial outcomes, symptom burden, quality of life, functional status, and clinical parameters among patients receiving oncology palliative care.

A quasi-experimental study was conducted on 150 adult cancer patients receiving palliative care in a governmental hospital in Al-Kharj, Saudi Arabia. Participants were assigned to an intervention group (n = 75) or a control group (n = 75). Effects were assessed at baseline and after a 6-week intervention by the European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire-Core 30, Edmonton Symptom Assessment System (ESAS), Hospital Anxiety and Depression Scale, Eastern Cooperative Oncology Group Performance Status, and selected routine laboratory parameters.

The intervention resulted in a significant decrease in total symptom burden compared with the control group (ESAS total score: 34.04 ± 8.86 vs. 41.51 ± 8.48; p < 0.001; Cohen’s d = 0.86) and significant improvement in pain scores (p = 0.003). No statistically significant between-group differences in anxiety, depression, quality of life, or functional status were observed post the 6-week intervention. Some laboratory parameters, including hemoglobin, sodium, potassium, and calcium, differed significantly between groups at specific follow-up time points. C-reactive protein correlated weakly and positively with symptom burden (r = 0.180; p = 0.028).

A nursing-led predictive symptom management program incorporating clinical assessment and laboratory monitoring may effectively reduce symptom burden and improve comfort among patients receiving oncology palliative care. However, longer interventions including structured psychosocial support as well as emotional evaluation and supportive care strategies may be required for psychological distress and quality-of-life outcomes.

To determine whether a nursing intervention delivered at emergency department (ED) discharge would reduce ED revisits.

A randomized study was conducted in the ED of a tertiary cardiac hospital in Montreal, Quebec. Between November 2006 and March 2010, 3,795 patients were assessed for eligibility based on two risk factors for ED revisits (≥1 ED visit in the past year and ≥6 medications); 132 were randomized to the experimental group (EG) and 133 to the control group (CG). The intervention included one nurse-patient meeting before leaving the ED, with two additional telephone contacts over the next 2 weeks. The primary outcome was time to ED revisits within 30 days after discharge. Secondary outcomes included time to ED revisits over 90, 180, and 365 days and hospitalizations over 30, 90, 180, and 365 days.

A planned interim analysis that stopped the study with half of the planned sample showed that the time to ED revisits was similar in both groups at 30 days (p=0.81; revisits: 18.2% in EG, 19.6% in CG), 90 days (p=0.44), 180 days (p=0.98), and 365 days (p=0.75). The only difference identified was a lower hospitalization proportion at 180 days in the EG group (13.6% v. 24.1%; p=0.038).

These findings are consistent with previous research showing that few ED-based interventions are successful in reducing ED returns. Factors other than those targeted by the intervention, including an improvement in usual care, may explain the findings.