ESTRO meets Asia 2024 - Abstract Book

S17

Invited Speaker

ESTRO meets Asia 2024

Introduction: Radiation therapy (RT) techniques are continuing to evolve, with innovations such as hypofractionation and SABR being treatment options for many patients. With the implementation of such techniques, dose per fraction and overall dose are increased, resulting in the potential to improve patient outcomes. Integral to the implementation of these treatment techniques is consideration of the risk of toxicity to critical structures. As such, accuracy and reproducibility are crucial. The need for both precision and efficiency during RT are reflected in the design of immobilisation devices and RT patient positioning techniques. However, exiting as these new techniques are, have we really considered the impact of these on patient experience, in particular patient comfort?

The aim of this presentation is to analyse the literature and reflections from clinical practice and explore the following questions;

1. What does comfort mean in the context of radiation therapy patients? 2. What are the dimensions of comfort for RT patients? 3. How is comfort defined in different groups of patients? 4. Why is comfort so important for patients receiving RT? 5. How is comfort evaluated? 6. How can comfort be enhanced for patients? 7. Where to next for patient comfort and the role of patient agency and preparation for treatment? Discussion: Comfort is a basic human need and should be a key tenet of patient centred practice. It can afford optimal patient experiences, improved precision in RT, more efficient service delivery and the best possible outcome for patients. So, why is comfort so important for RT patients? Is there more to positioning the patient than ensuring accurate treatment? What are the implications if the patient is not comfortable? Comfort can be characterised in a number of different ways (physical, environmental, emotional and psychological). Physical comfort relates to factors such as patient position (e.g. the impact of immobilisation devices/masks on patients receiving radiation therapy to the head and neck; bladder and rectal filling to ensure reproducibility of the position of critical structures within the pelvis; positioning for RT to the breast when arm mobility is an issue or challenges associated with the positioning of patients with lung cancer receiving radiation therapy in the supine position). Radiation induced toxicities and the side effects from concomitant treatments (e.g. chemotherapy and hormone therapy) and the impact of pain can also affect physical comfort during RT. Physical comfort can be improved by implementing alternative RT techniques and immobilisation equipment, relaxation techniques, educating patients on the importance of positioning and engaging patients in decision making about treatment and positioning, as well as effective management of side effects. Emotional and psychological comfort includes: patient mental health, and levels of anxiety, fear, distress and claustrophobia. It is important therefore to consider the individual patient context when defining comfort (diversity in age, gender diversity, neurodiversity, cultural diversity and co-morbidities or other health conditions/impairments). Environmental comfort is impacted by the surroundings, such as aesthetics and sensory stimuli. Strategies to improve emotional and psychological comfort include altering the environment with interventions (e.g. soothing artwork and music, aromatherapy, climate control). Family, social and spiritual support, education, mental health support strategies (e.g. mindfulness) compassion, effective communication and feedback, empathy and respect have all been suggested to impact on psychological and emotional comfort.

Conclusion: There are many factors which impact on patient comfort which are context specific for individual patients. In order to enhance RT patient comfort, practitioners need to engage patients in decision making about their physical,