Nursing Implication of People Treated by Radical Cystectomy Postsurgery and Rehabilitation

Objective: The purpose of this paper is to summarize existing evidence about nursing interventions to selected symptoms experienced by patients undergoing radical cystectomy (RC) to maintain or return to their daily life activities. Data Sources: A non-systematic narrative review was conducted. A search in PubMed and CINAHL was conducted eliciting evidence about frequent symptoms experienced after RC. The following search terms were used: radical cystectomy and/or nursing interventions, pain, distress, fatigue, urinary dysfunction, sexual dysfunction, loss of appetite, sleep disturbance, and enhanced recovery after surgery (ERAS). Conclusion: Evidence in the ERAS pathway is still lacking regarding the effect of preoperative education and counseling of the patient and the most difficult part to implement is related to preoperative optimization of the patient such as lifestyle changes. Most nursing interventions to alleviate symptoms in the rehabilitation period after RC are still practice based. Implications for Nursing Practice: Priority should be given to implementation of the ERAS protocol. To improve the management of symptoms experienced by patients in the RC rehabilitation period it is essential that validated screening tools to identify the symptoms be used. Accepted and effective strategies for treating the individual symptoms should be initiated and clear treatment outcomes should be defined. Urology nurse researchers should investigate the concept of symptom clusters to clarify whether there are more efficient methods to identify symptoms or symptom clusters and if so would the use of symptom clusters knowledge improve patient care. (c) 2020 Elsevier Inc. All rights reserved.

Automated summary

This paper aims to summarize evidence on nursing interventions for symptoms in RC patients, finding gaps in evidence within the ERAS pathway and most interventions being practice-based. Implementation of the ERAS protocol is recommended, along with the use of validated screening tools, initiation of effective treatment strategies, and definition of treatment outcomes to improve patient care.