Endocrine Abstracts

Cushing’s syndrome is a rare disease and difficult to diagnose. Lots of patients have symptoms many years before diagnosis. A number of different physical and psychological signs and symptoms can be present. After successful surgery, psychological and 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. Endocrine nurses can play an important role and can make a difference for these patients during diagnosis, during medical or surgical treatment and in the recovery phase. During the diagnostic phase, nurses need to know why patients must undergo certain endocrine function tests, know how to perform new diagnostic 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. 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’. Endocrine nurses can make the difference for these patients. 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.