We present a prospective study comparing nursing care workload for cancer patients receiving curative or palliative care in a medical oncology unit. Methods: All patients admitted between 01-20-03 and 03-31-03 were prospectively included. Nursing care workload was evaluated daily by nurses using the SIIPS method. For each patient, a mean SIIPS score (0 to 20) and a correspondence with duration of care were established for: basic nursing tasks, technical care, relation care and global workload. Patients were then affected to the ‘‘palliative group’’ (P) when i) prognosis estimated by physician wasB<3 months, ii) no curative treatment was yet available and iii) performance status was<=2. Other patients were affected to the ‘‘curative group’’ (C).
Results: 198 hospitalization periods were analyzed, 166 in group C (84%) and 32 in group P (16%). At time of analysis (05-15-03), 22 patients had died in group C (13.3%) and 26 in group P (81.6%). Age, sex, disease and number of hospitalization days were similar in both groups. SIIPS scores were: basic nursing task 6.0 vs 12.2 (50 min vs 1h41 min) p<0.001; technical care 13.3 vs 13.6 (1h50 vs 1h53) p=0.750; relation care 11.4 vs 13.4 (1h35 vs 1h52) p=0.032 and global woarkload 10.2 vs 13.1 (4h15 vs 5h34) p=0.004.
Discussion: Defining palliative cancer patients is not easy and criteria are partly subjective. Our definition may be too restrictive and select only endof- life patients. Even though, nursing care workload was higher in group P regarding basic nursing task, relation care and global care. There was no difference for technical care. We conclude that offering palliative care is a necessity for cancer centers; it involves high levels of care, either technical or basic. However, our study considers actual care, which does not necessarily correspond to required care.