Implications for Practice
The use of existing data documented on telephone calls can provide patient-centered insight into the prevalence and pattern of symptom reporting specific to an oncology setting. These results on the symptom experience can be of assistance in any ambulatory oncology setting for quality improvement initiatives. Awareness of the specific symptoms that are spontaneously reported in a practice can be used to analyze what information is provided during visits and what instructions individuals with cancer are given for contacting the cancer center in between visits. Identification of practice implications from this study are most appropriate for the specific setting in which it was conducted. In this study's cancer center, the emergence of pain as the primary symptom reported by telephone prompted educational efforts for both in-person clinic visit management of pain and prioritizing nursing education and protocol management of pain reported by telephone.
Future Research
Although extensive research has been conducted on the oncology symptom experience, many aspects require additional study. One specific gap is the knowledge of patient-identified priority in the symptom experience. Telephone reporting of symptoms provides a unique opportunity to consider patient-identified priority in the symptom experience. Continued examination of factors that influence symptom reporting is warranted because the reasons individuals with cancer choose to call or not call to report a symptom are not known. Individuals may choose to report a symptom because they were specifically instructed to report the symptom, because they find the symptom distressing or unmanageable, because they believe an intervention could help relieve the symptom, or because recommendations were not made for symptom relief when they were at their scheduled visit. Patient-centered care begins with an understanding of the symptom experience from the patient's perspective. The preponderance of pain as the primary symptom reported in telephone calls provides evidence of the priority of pain from a patient perspective. The intriguing finding of telephoning to report a solitary symptom versus a cluster of symptom complaints warrants additional investigation as researchers seek to understand the symptom experience from patient experiences and priorities.