摘要:

PurposeThe purposes of this study were to describe the concerns of patients and their spouses after a diagnosis of colon cancer and to identify ways in which health care professionals could assist both patients and their spouses to cope more effectively with this illness and its treatment.DesignDescriptive, cross-sectional study.Setting and SubjectsThirty patients with colon cancer and their spouses completed interviews in their homes. Most patients (83%) had undergone partial colon resection, and 77% had no evidence of cancer in adjacent lymph nodes. Twelve of the patients (40%) had a colostomy at the time the data were collected.MethodsPatients and spouses participated in semistructured interviews that elicited information concerning their reactions to a diagnosis of colon cancer, to a colostomy (if present), to changes in lifestyle, to their satisfaction with information they received, and to ways that health care professionals could assist them with the illness and treatments. Content analysis was used to analyze the interview data and to group data into inductively derived categories. Interrater reliability was obtained by having 2 researchers independently code the data.ResultsSpouses tended to regard a colon cancer diagnosis more negatively than did patients. Both patients and spouses reported that fear of cancer's recurrence was their greatest concern. Most also reported lifestyle changes (80%) as a result of the illness; but the patients reported more changes in their functional ability, whereas spouses reported more changes in their roles and relationships. Half of the patients and most of the spouses (75%) reported a favorable reaction to the colostomy. Approximately half of the couples expressed satisfaction with the information they received; they reported a need for more information about treatments and management of side effects. When asked how professionals could help them, most couples stated that they wanted more information about the expected course of recovery.ConclusionSpouses should be included in health assessment and teaching because they regard the illness more negatively than do patients. Both patients and spouses desire information that will help them to understand the typical course of recovery, assist them to plan for lifestyle changes, and enable them to manage the side effects of treatment.

ISSN:1071-5754    

出版商:OVID    

年代:1999

数据来源: OVID

摘要:

The patient with a spinal cord injury presents significant challenges to the nurse seeking to promote an optimal state of physical wellness and maximum independence with self-care. This article describes the nature of spinal cord injuries and their long-term effects on the gastrointestinal system. The preoperative and postoperative needs that the WOC nurse must consider when designing a care plan for the patient with a spinal cord injury and a colostomy are discussed, as well as the indications and efficacy of elective colostomy surgery as a management alternative for the neuropathic bowel.

ISSN:1071-5754    

出版商:OVID    

年代:1999

数据来源: OVID

摘要:

Blockage of the mesenteric artery typically causes necrosis to the colon, requiring extensive surgical resection. In severe cases, the necrosis requires removal of the entire colon, creating numerous problems for the WOC nurse when pouching the opening created for effluent. This article describes the management of a draining duodenal fistula in a middle-aged woman, who survived surgery for a blocked mesenteric artery that necessitated the removal of the majority of the small and large intestine. Nutrition, skin management, and pouch options are described over a number of months as the fistula evolved and a stoma was created.

ISSN:1071-5754    

出版商:OVID    

年代:1999

数据来源: OVID

摘要:

ObjectiveTo examine the occurrence, attitudes, and knowledge of urinary incontinence (UI) among older women in a rural setting.DesignClient questionnaire.Settings and SubjectsA randomly selected sample of community-dwelling women aged 55 years and older living in a rural midwestern state.InstrumentParticipants completed several instruments, including an Incontinence Survey that queried primarily demographic data, an Incontinence Quiz that queried knowledge and attitudes toward UI, and specific questions related to its clinical and psychosocial consequences.MethodsThe questionnaire was mailed to 300 women whose names had been randomly selected from a seniors' group mailing list.Main Outcome MeasureThe prevalence of UI among a group of community-dwelling older women as well as attitudes and knowledge concerning incontinence.ResultsOne hundred twenty women returned the questionnaire, providing a response rate of 40%. Three of the 120 respondents were excluded because they did not answer the question pertaining to UI status. Of the 117 who did respond, 79 (67.5%) reported UI. Most of the respondents with incontinence categorized their UI as minor (81.9%), and 88% denied that incontinence had a significant impact on their lifestyle. Thirty-seven percent of the incontinent women sought treatment. When questioned about UI, over half of the 117 respondents incorrectly indicated that incontinence is a normal result of advanced age. Almost one third of the respondents incorrectly believed that most people become incontinent by the time they reach the age of 85.ConclusionsMisconceptions concerning the causes of and the availability of treatment for incontinence among community-dwelling women may have an impact on their decision to seek care for this typically remediable condition.

ISSN:1071-5754    

出版商:OVID    

年代:1999

数据来源: OVID

摘要:

A significant number of patients with chronic venous insufficiency, venous hypertension, and venous ulceration are cared for by WOC nurses and other health care practitioners in the hospital, at home, or in an office setting. Although chronic and complicated in nature, all 3 of these disease processes may be successfully treated with gradient compression therapy. Many practitioners, however, are unaware that compression is the treatment of choice for venous ulceration, venous insufficiency, and venous hypertension. Instead, they rely primarily or exclusively on topical treatments to promote ulcer healing, and frequently become frustrated when such treatments fail or when ulceration recurs. The purpose of this article is to present an evidence-based rationale for the use of gradient compression therapy as the mainstay of venous ulcer treatment.

ISSN:1071-5754    

出版商:OVID    

年代:1999

数据来源: OVID

ISSN:1071-5754    

出版商:OVID    

年代:1999

数据来源: OVID