Educational program focuses on therapy-induced menopause

Implementing an educational program for nurses designed specifically to address therapy-induced menopause in premenopausal women undergoing a blood or marrow transplant (BMT) would help improve patient outcomes, especially since few opportunities exist for in-depth conversations about this topic.

That is the goal of a project proposed at the Ottawa Hospital, Ottawa, Ontario, Canada, noted Erin Mutterback, RN, BScN, MScN/PHC-NP(c). The number of women undergoing BMT to treat nonmalignant and malignant diseases is increasing and they are surviving longer, Mutterback noted, with long-term complications that include irreversible ovarian damage due to the intensive doses of chemotherapy administered, resulting in therapy-induced menopause (TIM).

Currently, there is a lack of standardization in providing premenopausal patients with information related to TIM before and after BMT, and the literature suggests this topic should be addressed in patients undergoing high-dose chemotherapy, added Mutterback and her colleague, Linda Hamelin, RN, BN, MSN, in a presentation at the Oncology Nursing Society 36th Annual Congress.

The education program is designed to increase nursing knowledge, confidence, and assessment skills in the care and management of premenopausal patients undergoing BMT; improve nurse-patient discussions related to therapy-induced menopause; and provide an opportunity to identify signs and symptoms before they become problematic.

A needs assessment will be conducted among nurses working in BMT units to determine current knowledge of therapy-induced menopause. Focus groups will then discuss four questions, which will provide the basis for the content of the educational program. The questions included: 1) What do you know about the causes, symptoms, treatments, and side effects related to TIM?, 2) When do you think is the right time to talk to patients about TIM?, 3) Are you comfortable talking to clients about TIM?, and 4) What are the current resources available? After the program is created, the nurses from the focus groups will conduct a pilot project on the BMT units, with follow-up planned 3 months later to determine its usability.

Despite a large oncology population, the Ottawa Hospital does not have formal nursing or patient education programs, the researchers noted. In the future, the program could also potentially be implemented hospital-wide, including at The Ottawa Hospital Cancer Clinic (TOH).

The researchers concluded by recommending that different approaches be utilized to educate nurses, such as lunch and learns, oncology orientation at TOH, and unit posters. The creation of an algorithm to guide nurse interventions with patients undergoing treatments that may cause TIM would also be useful, they added.
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