Endocrine Abstracts

Cushing’s syndrome is a rare disease and difficult to diagnose. A number of different physical and psychological signs and symptoms can be present. Lots of patients have symptoms many years before diagnosis. Endocrine nurses can play an important role for these patients during diagnosis, medical or surgical treatment and in the postoperative phase.

During the diagnostic phase, nurses need to know why patients must undergo certain endocrine function tests, which diagnostic medication needs to be administrated and how to inform the patient. During the operative phase, the endocrine nurse will inform the patient about the pre-operative work up, the surgery and post-operative observations. But it is also important to pay attention to the psychological disturbances patient may suffer from like depression, anxiety and even psychoses.

After surgery, psychological en physical recovery may take a long time. Even after long-term remission of Cushing’s syndrome, patients report more negative illness perceptions compared with patients with other acute or chronic conditions. There are some patients who will need a rehabilitation program to work on a better physical condition and to get psychological support during reducing the glucocorticoid replacement therapy to a ‘normal level’. In this phase, the endocrine nurse gives education about the recovery process, helps the patient with coping strategies, adherence to medication and self-management. The self-management aspects that come with glucocorticoid replacement therapy, like dose adaptation during medical emergencies, recognising and preventing life threatening situations, like an acute adrenal crisis needs to be highlighted repeatedly.

Not only information and instructions given by nurses to the patient and his family are important, but also education for nurses in the ward or outpatient clinic is recommended. Endocrine nurses can make the difference for these patients.