ISSN:0961-5423    

DOI:10.1111/j.1365-2354.1993.tb00148.x

出版商:Blackwell Publishing Ltd    

年代:1993

数据来源: WILEY

ISSN:0961-5423    

DOI:10.1111/j.1365-2354.1993.tb00149.x

出版商:Blackwell Publishing Ltd    

年代:1993

数据来源: WILEY

摘要:

The recognition that the elderly with cancer are frequently neglected has led to an upsurge in calls to address their needs. This paper argues that there needs to be caution before launching wholesale into a new sub‐speciality, that of ‘geriatric oncology’, when we have yet to delineate the characteristics of cancer in the elderly. The most important factor in determining the best treatment approach for any individual with cancer is to be able to distinguish accurately chronological age from physical vulnerability or frailty. Current methods for determining vulnerability in patients with cancer are criticized; what is needed is the development of indices of frailty so that treatment and care packages for the elderly can be tailored to those who are ‘frail’, whilst treating the ‘non‐frail’ as any other ad

ISSN:0961-5423    

DOI:10.1111/j.1365-2354.1993.tb00150.x

出版商:Blackwell Publishing Ltd    

年代:1993

数据来源: WILEY

摘要:

Cisplatin is among the most active chemotherapeutic agents available today for the treatment of a variety of cancers. Toxic side‐effects have up until now prevented dose escalation and schedule intensification which might be interesting in view of the dose‐response relationship and the schedule‐response relationship.Recent developments in supportive care and pharmacology limited these side‐effects and thereby rendered dose‐intensification feasible.Currently, we have treated 71 patients with high‐dose cisplatin administered in hypertonic saline weekly for 6 weeks. Most cycles were supported by 5HT3antagonists to achieve maximal anti‐emetic control. The patients participated in a phase I study (MTD 85 mg/m2) or phase II studies (80 mg/m2) in head and neck cancer/mesothelioma/non‐small cell lung carcinoma or a pilot study of cisplatin weekly in combination with etoposide orally(MTD 70mg CDDP/m2dl + 8 + 15 etoposide50mg/dd p.o. dl‐15 qd282 cycles). The phase II studies are ongoing.The major problem associated with this treatment schedule was myelosuppression. Less frequently observed side‐effects were: nausea/vomiting, nephrotoxicity, anorexia, neuro‐ and ototoxicity. Besides, the weekly treatment schedule has an impact on the patient's quality of life due to frequent hospitalizations. In order to optimize the care of these patients, continuity of care was provided by a process plan. Optimal patient information and education improved patient motivation and compliance with this regime.This paper will present information on this process plan and the nursing implic

ISSN:0961-5423    

DOI:10.1111/j.1365-2354.1993.tb00151.x

出版商:Blackwell Publishing Ltd    

年代:1993

数据来源: WILEY

摘要:

This article highligts some of the issues associated with the administration of cytotoxic chemotherapy agents. As can be seen, the practical aspects of drug preparation and administration, and the toxicities associated with these two drugs vary greatly (Table2), despite their structural similarities. The potential harm which can be caused by the administration of these drugs without a prior knowledge of these factors cannot be over emphasized. It is hoped that this and subsequent articles can provide some insight into the administration of such agents, but their safe administration is only really possible under the guidance of experienced personnel. Hopefully, this fact will be recognized and all hospitals where cytotoxic chemotherapy is administered will employ suitably trained health professional and pharmacists.

ISSN:0961-5423    

DOI:10.1111/j.1365-2354.1993.tb00152.x

出版商:Blackwell Publishing Ltd    

年代:1993

数据来源: WILEY

摘要:

This paper examines the concept of the sick role and its effect on the cancer patient. The hypothesis is put forward that lack of control and the creation of a feeling of helplessness can adversely affect the illness career of the cancer sufferer. Some of the various strategies used by cancer patients as ways of regaining a degree of control and overriding the paternalistic approach of the health care professions are examined and the importance of patient empowerment is emphasized.

ISSN:0961-5423    

DOI:10.1111/j.1365-2354.1993.tb00153.x

出版商:Blackwell Publishing Ltd    

年代:1993

数据来源: WILEY

摘要:

Nurses who care for patients suffering from terminal illnesses cannot afford to rest on their laurels. It is, I believe, important for nurses, however effective they believe they are, to question their practice frequently and to reconsider their own personal beliefs surrounding death. This article sets out to offer some insight into some of the negative psychological effects that terminal illness can bring, both to the sufferer and to their friends and family. This paper finally offers some ideas for consideration to aid the nurse to take another look at the way he or she cares for the patient.

ISSN:0961-5423    

DOI:10.1111/j.1365-2354.1993.tb00154.x

出版商:Blackwell Publishing Ltd    

年代:1993

数据来源: WILEY

摘要:

Nurses' contribution to overall health care differs greatly across European Community (EC) Member States. There is great diversity of labour, delineation of responsibilities, tasks and competencies of nurses in general and cancer nurses in particular. One of the objectives of the EC Action Program against cancer was to improve competence of health professionals, including nurses, by training. For that reason a core curriculum for cancer nursing has been developed. Both developmental and dissemination issues are addressed in this article. It is concluded that the reality of European diversity has been successfully addressed in this core curriculum. Furthermore, it has been the first attempt to improve the quality of nursing education in Europe not by standardization of procedures and formal requirements, but on nursing content and consensus of experts. The risks of isolated efforts of nurses in curriculum development have been avoided. The purpose and content of the curriculum clearly reflect societal needs which were identified and acknowledged in public through the Europe Against Cancer Program.

ISSN:0961-5423    

DOI:10.1111/j.1365-2354.1993.tb00155.x

出版商:Blackwell Publishing Ltd    

年代:1993

数据来源: WILEY

摘要:

This paper details our experiences in Post‐Basic Cancer Nursing Education at the Lisbon centre of the ‘Instituto Português de Oncologia Francisco Gentil’, the Portuguese Cancer Institute, hereafter designated as IPOFG. The purpose, aims, methods and organization of the course will be described, and the role of the nurse in cancer prevention and early detection, stomatherapy, treatment, social reintegration and palliative care will be eva

ISSN:0961-5423    

DOI:10.1111/j.1365-2354.1993.tb00156.x

出版商:Blackwell Publishing Ltd    

年代:1993

数据来源: WILEY

摘要:

A 1‐year distance learning course, divided into six modules, has been developed at the University of Wales College of Medicine. The course leads to a Diploma in Palliative Medicine. Study is based in the participant's own clinical practice, with reading and audio‐taped materials supplied weekly. Written work, which is returned to the University Department for marking and comment, is designed to enhance team building within the student's own clinical practice by addressing factual, attitudinal, protocol and administrative approaches to care. The whole course is based on the principles of problem‐based learning and learner‐centred teaching.Course work contributes to the final examination mark. In addition, the students maintain a personal learning portfolio during the course. The portfolio must demonstrate the student's ability to incorporate the course work into clinical practice and an ability to appraise their own medical decision‐making. This portfolio contributes to final examination marks.Each participant must undertake and write a report on an audit of palliative care in his or her own clinical practice, which is marked towards the final exam.There are two residential weekends during which communication skills are taugh; and these are formally examined in the final examination.We describe the course design and report the results of the first year. Twenty‐six course participants entered the 1990–91 course, of whom 24 obtained the Diploma in Palliative Medicine, one wit

ISSN:0961-5423    

DOI:10.1111/j.1365-2354.1993.tb00157.x

出版商:Blackwell Publishing Ltd    

年代:1993

数据来源: WILEY