摘要:

The purpose of this secondary analysis was to determine (a) the nursing diagnoses in elderly patients with cancer and (b) whether elderly cancer patients with a current or past history of allergy were at risk for selected nursing problems. A retrospective clinical data base from 59 patients (32 male, 27 female) with a diagnosis of cancer and an age range of 55–85 years with a mean age of 65.6 years was examined. The most frequently occurring priority nursing diagnoses identified by Clinical Nurse Specialists (CNS) were Pain, Risk for Infection, and Impairment of Skin Integrity. When examining the comprehensive list of priority and nonpriority nursing diagnoses, identified for these patients with cancer, it was found that those with a history of allergy were significantly more likely to have a high risk for infection than those without a history of allergy. Two other diagnoses (knowledge deficit and potential fluid volume deficit) occurred in a significant number in the allergy group, but there was no occurrence of these two diagnoses in the nonallergy group. The limitations of assessing immunologic status as a part of regular nursing assessments were discussed. Recommendations were provided for future research in the area of immunology, aging, and nursing diagnoses.

ISSN:0162-220X    

出版商:OVID    

年代:1995

数据来源: OVID

ISSN:0162-220X    

出版商:OVID    

年代:1995

数据来源: OVID

摘要:

This article is written in response to anecdotal evidence from patients, reports from nurses, sociological studies, and documentation from oncologists, which all suggest that the process of refusing treatment for chemotherapy is not an easy one. There is substantial evidence to suggest that pressures that are counterproductive to informed consent are having an impact on the decision making of vulnerable individuals coping with the stress of terminal illness through cancer. Informed consent is a basic ethical principle underpinning any medical or nursing intervention (Johnstone M. Bioethics: a nursing perspective. Sydney: Harcourt Brace Jovanovich, 1989). The following focus on informed consent is an attempt to begin to address the present hiatus which exists in the health literature on ethical issues surrounding the modality, chemotherapy (Young D. An ethical approach to chemotherapy in private practice. J Natl Cancer Inst 1992;84:810). Recent research suggests that the holistic orientation of nurses, in comparison to the reductionist stance of physicians, allows them to be emotionally close to their patients and hence, more aware of the difficulties individuals experience in coping with stressful regimens (Uden G, Norberg A, Lindseth A, Marhaug V. Ethical reasoning in nurses' and physicians' stories about care episodes. J Adv Nurs 1992;17:1028–34). Consequently, it is anticipated that ethical issues in relation to chemotherapy, a modality that has been described as distressing and capable of seriously compromising quality of life (Burish T, Tope D. Psychological techniques for controlling the adverse side effects of cancer chemotherapy: findings from a decade of research. J Pain Sympt Man 1992;7:287–301), will have an impact on the working life of many oncology nurses.

ISSN:0162-220X    

出版商:OVID    

年代:1995

数据来源: OVID

摘要:

What common sense decision strategies do patients with cancer use when they are making health care choices that include alternate therapies? Existing research indicates that oncology patients are making alternate choices while associated with biomedicine. Often patients' decision strategies are exploited by the alternate system to promote and market alternate products. Although some of these practices are benign, others are dangerous or may interfere or delay successful treatment in biomedicine. Therefore, it seems important for biomedical professionals to understand patients' common sense decision patterns. A decision tree model, outlining patients' decision strategies, has recently been developed through intensive interviews with 300 patients who were diagnosed with cancer of the respiratory and digestive systems. The two-phase methodology included, first, a context sensitive approach to develop the model, followed by a predictive approach testing the model developed in the first phase on a separate yet similar random sample of patients. The discussion in this article focuses on the research, the patterns of the decision tree model, and the implications and adaptability of this model to nursing practice.

ISSN:0162-220X    

出版商:OVID    

年代:1995

数据来源: OVID

摘要:

Nurses play an integral role in the care of bone marrow transplant (BMT) patients from pre-transplant to posttransplant. The purpose of this study was to explore the nurses' perceptions of the impact of transplant on the quality of life (QOL) of survivors. The conceptual framework for the study was the model of QOL developed by Ferrell, Grant, Schmidt, Rhiner, Whitehead, and Forman (1992). It depicts the QOL domains of physical well-being, psychological well-being, social concerns, and spiritual well-being. One hundred fifty nurses responded to a mailed survey. The items were based on the Quality of Life-BMT Survey used previously with patients. Nurses' and patients' responses to the same item were compared. Results reflect that transplant nurses generally perceived patients as having a poorer QOL than they actually reported. Nurses described transplant as having both positive and negative consequences. Transplant was seen as providing patients with a second chance at life and an opportunity to increase their QOL. Nurses described negative consequences as resulting from physical losses, psychological distress, financial distress, and loss of relationships. The findings of the study have implications for training future transplant nurses and for improving nursing care for transplant patients.

ISSN:0162-220X    

出版商:OVID    

年代:1995

数据来源: OVID

摘要:

During the last 25 years, substantial progress has been made in the detection and treatment of bone tumors in adolescents and young adults. Due to more effective chemotherapy treatments, patients are now surviving these illnesses and living quality lives. In the past, the only surgical option for treatment of these tumors was amputation. Today, however, limb-sparing procedures such as allograft implantation, together with effective chemotherapy treatments, provide patients with another treatment option. The allograft procedure includes removing the tumor and affected bone and replacing it with bone procured from deceased donors. During the following 2 years, the body does the work of incorporating the allograft and replacing it, at least in part, with new host bone. After a long rehabilitation process, the patient will have a functioning limb. Nursing care of the adolescent undergoing allograft procedure encompasses meeting important physical and psychosocial needs. Adolescents are often still dealing with the emotional and physical stress of having cancer and chemotherapy or chemotherapy side effects at the time of surgery. They are concerned not only with their immediate recovery but also with their long-term prognosis. All treatment modalities, including allograft surgery, impinges on the normal developmental tasks of adolescents. The nursing challenge is to help the adolescent balance the limits of their illness and recovery with normal developmental needs.

ISSN:0162-220X    

出版商:OVID    

年代:1995

数据来源: OVID

摘要:

The impact of the diagnosis of cancer and its treatments on the body image of young adults (18–29 years) diagnosed with cancer is relatively unknown. This descriptive comparative study examined body image scores of young adults diagnosed with cancer and young adults without cancer. The conceptual framework for this study was taken from body image and developmental theory. Secord and Jourard's body cathexis/self-cathexis scales and a demographic sheet were mailed to 162 young adults diagnosed with cancer and to 150 young adults without cancer. A t test was used to compare the mean scores between the two groups. A statistically significant difference was found between the mean scores reported by the young adults diagnosed with cancer for the body cathexis and selfcathexis scales. The selfcathexis and body cathexis scores indicated that the young adults diagnosed with cancer had a more positive body image than the young adults without cancer. The mean scores were also compared in relation to the demographic data collected using t tests and analysis of variance. Within the group diagnosed with cancer, male subjects demonstrated a more secure body-cathexis (p value of 0.012) and married subjects demonstrated a more secure selfcathexis than the single subjects did (p value of 0.04). No statistically significant difference was found within the group without cancer related to demographic variables. Implications for the oncology clinical nurse specialist are explored.

ISSN:0162-220X    

出版商:OVID    

年代:1995

数据来源: OVID

ISSN:0162-220X    

出版商:OVID    

年代:1995

数据来源: OVID