ISSN:0961-5423    

DOI:10.1111/j.1365-2354.1995.tb00084.x

出版商:Blackwell Publishing Ltd    

年代:1995

数据来源: WILEY

ISSN:0961-5423    

DOI:10.1111/j.1365-2354.1995.tb00085.x

出版商:Blackwell Publishing Ltd    

年代:1995

数据来源: WILEY

摘要:

In this paper the accepted holistic approach to pain management in cancer care is scrutinized. A series of oppositions are considered to result from the essential indeterminate nature of pain, and that pain is fundamentally lived and experienced in the body. These oppositions are discussed in terms of mind‐body dualism and embodiment, and in particular the body as subject and object. The discussion is illustrated with examples from research examining individual expressions of pain. Patients’powerful attempts to manipulate subject‐object distinctions in recounting their experience of pain is offered as a means by which patients make sense of their pain, and connect it to their bodies and to their identity. The implications of acknowledging personal and cultural meanings attributed to pain are highlighted, with recommendations for future research and clinical practice initia

ISSN:0961-5423    

DOI:10.1111/j.1365-2354.1995.tb00086.x

出版商:Blackwell Publishing Ltd    

年代:1995

数据来源: WILEY

摘要:

Fifty per cent of patients with cancer are treated with radiotherapy during the course of their disease. Although side‐effects have been described in studies, these are often not representative of the impact that these symptoms have on the individual. This article explores one area of radiotherapy management, that of pelvic radiotherapy in men, and describes how symptoms that patients experience during and following treatment can be a debilitating outcome of cancer therapy. At present, there is limited knowledge on how best to prevent symptoms from occurring, who is most at risk and how to manage these symptoms. Technology has advanced with accelerated regimes, conformal planning and new radiotherapy treatments. Yet still we are no further forward in dealing with toxicity from treatment. The focus of research has been on developing new cures and only now are questions being raised about the quality of life of patients having radiotherapy treatmen

ISSN:0961-5423    

DOI:10.1111/j.1365-2354.1995.tb00087.x

出版商:Blackwell Publishing Ltd    

年代:1995

数据来源: WILEY

摘要:

Many women who are treated for breast cancer will subsequently undergo the menopause, either as a result of cancer treatment or as a natural process. For this group of women hormone replacement therapy is currently not recommended and so women lose a major option to help control menopausal symptoms. The extent of this problem has not been widely researched and alternative methods of coping with menopause in this group have not been explored. This paper reviews the menopause in relation to these women and suggests avenues for future research.

ISSN:0961-5423    

DOI:10.1111/j.1365-2354.1995.tb00088.x

出版商:Blackwell Publishing Ltd    

年代:1995

数据来源: WILEY

摘要:

Despite the unquestionable relevance of ensuring effective oral care for patients with advanced cancer, inadequate research activity has been directed towards developing and evaluating specific mouth care regimes for this group of seriously ill patients. The prevalence of the problems experienced by these individuals is well known and ensures that we have a clear picture of the areas where practice development is urgently needed. This paper presents a critique of research‐based oral care interventions through a consideration of the management of the following problems:• coated mouth and tongue;• dry mouth;• infection (fungal, viral, bacterial);• pain;• altered taste.Where possible, research findings are presented, but for many of the areas of care it is possible only to offer guidelines based upon an understanding of the normal structure and function of the oral cavity, the agents and tools currently in use, and practice‐based evidence. There is an urgent need for a coordinated body of research activity with

ISSN:0961-5423    

DOI:10.1111/j.1365-2354.1995.tb00089.x

出版商:Blackwell Publishing Ltd    

年代:1995

数据来源: WILEY

摘要:

Intractable malignant ascites accounts for 6% of all hospice admissions. The onset of malignant ascites indicates a poor prognosis, hence minimal supportive therapy is indicated. This paper examines the method of control for malignant ascites presently available to patients, examines their limitations and proposes new strategies for managing intractable malignant ascites. Ascites is discussed in terms of its pathology—that is, as a form of lymphoedema. With this in mind treatment is proposed based upon principles incorporated into lymphoedema management. Nurses have taken a dominant role in the care of patients with lymphoedema and there appears no reason why ascites management cannot become the remit of nurses offering appropriate, but predominantly palliative therap

ISSN:0961-5423    

DOI:10.1111/j.1365-2354.1995.tb00090.x

出版商:Blackwell Publishing Ltd    

年代:1995

数据来源: WILEY

摘要:

Breathlessness has been described as an unpleasant sensation, but if it encompasses suffering, as some argue, it is much more than this. Breathlessness is also a major issue for people with cancer. Much of the effort to manage breathlessness has thus far focused on the treatment of underlying causes or on pharmacological strategies. In this paper, broader rehabilitative goals of care and treatment for breathlessness in lung cancer are addressed. Breathing control techniques have been developed to help patients with non‐malignant disease to avoid breathlessness at rest or on exertion. A study is described (Corneret al., 1995) which evaluated the effectiveness of breathing retraining and psychosocial support for breathlessness in lung cancer. Breathlessness can be a frightening and powerful experience. It can symbolize a threat to life itself. In these circumstances, the goal of therapy is to alleviate loss of function and to ease the psychological burden that so restricts the individual. An‘integrative’model of breathlessness is discussed, in which the emotional experience of breathlessness is considered inseparable from the sensory experience and the biological mechanisms. Evidence is presented from a small study of the experiences of nurses working in the experimental clinic for breathlessness which suggests that the emotional consequences of breathlessness have a profound influence on how it is managed in practice. Finally, it is argued that symptoms are sometimes generalized too much. Experience is particular, not universal, and an open, accepting and therapeutic approach to managing illness has to be involved with messy and sometimes frightening emo

ISSN:0961-5423    

DOI:10.1111/j.1365-2354.1995.tb00091.x

出版商:Blackwell Publishing Ltd    

年代:1995

数据来源: WILEY