Knowledge, attitudes, and behavioral intentions of nurses toward providing artificial nutrition and hydration for terminal cancer patients in Taiwan.
p. 67-76,
Ke-Li-Shan, Chiu-Tai-Yuan, Lo-Su-Shun, Hu-Wen-Yu.
Abstract
The aim of this study was to understand present knowledge, attitudes, and behavioral intentions of clinical nurses providing artificial nutrition and hydration (ANH) for terminal cancer patients. Study subjects were composed of 197 nurses from the gastroenterology, general surgery, and intensive care units of Taipei Veterans General Hospital in Taiwan. Subjects were surveyed between April and June 2005 via self-developed structural questionnaires. Collected data were descriptively analyzed with SPSS 11.0 software. Nurses' knowledge about palliative care was high (accurate-answer rate, 96.75%); knowledge about providing ANH for terminal cancer patients was lower (accurate-answer rate, 53.67%). Although nurses' attitudes about providing ANH for terminal cancer patients viewed ANH as having more burdens (mean (SD), 14.12 (3.62)) than benefits (6.35 (2.19)), nurses' behavioral intentions still favored providing ANH (3.21 (0.95)). In subjective norms, attending physicians and/or superiors (45.3%) and, secondarily, patients (38.4%) were important influencing persons on nurses' support for ANH. Other influencing factors were communication difficulties with patients and/or family members (3.40 (0.83)), staff disagreements (3.01 (0.78)), and fear of medical dispute (3.42 (0.95)). Study results suggest that reinforcing in- service education to enhance nurses' knowledge of providing ANH for terminal cancer patients and building up positive attitudes and behavioral intentions may strengthen nurses' efforts to actively communicate and cooperate with physicians in assisting patients and families to make the most appropriate medical decisions.
Distress and quality of life concerns of family caregivers of patients undergoing palliative surgery.
p. 2-10
Author(s)
Juarez-Gloria, Ferrell-Betty, Uman-Gwen, Podnos-Yale, Wagman- Lawrence-D.
Abstract
There has been limited research in the field of palliative care and even far less focus on the area of palliative surgery. Although patient needs are paramount, family caregivers require information and support at the time surrounding surgery for advanced disease. The aim of this prospective cohort study of family caregivers of patients with advanced malignancies was to measure the impact of palliative surgery on dimensions of quality of life (QOL) for these family members. Family caregivers completed assessment tools preoperatively and at approximately 3 weeks and 2 and 3 months postoperatively. Parameters of physical, psychological, social, and spiritual QOL were measured on a scale of 0 (poor) to 10 (good) using the City of Hope QOL-Family instrument. Caregivers recorded their general distress on the Distress Thermometer using a scale of 0 (none) to 10 (severe). Analysis of the data revealed that family caregivers had disruptions similar to patients in physical, psychological, social, and spiritual dimensions of QOL. Findings suggest that caregivers should be assessed for distress and QOL concerns both before and after surgery for patients with advanced malignancies. Although caregiver concerns cannot always be eradicated, resources and interventions to support family caregivers are vital to improving QOL.
Showing posts with label Cancer Nursing [journal]. Show all posts
Showing posts with label Cancer Nursing [journal]. Show all posts
Wednesday, 25 June 2008
Cancer Nursing Mar-Apr 2008, vol. 31, no. 2
Intimacy and sexuality after cancer: a critical review of the literature.
p. E9-17, 83 refs
Hordern-Amanda.
Abstract
Experiencing a diagnosis of cancer may dramatically alter the way a person feels about themselves, their body, and their significant relationships with others at sexual and intimate levels. The purpose of this article is to provide a critical analysis of the way patient sexuality and intimacy has been constructed throughout cancer and palliative care literature. A critique of 3 well-cited communication frameworks for health professionals: the PLISSIT, ALARM, and BETTER models, will be offered. In summary, a dominant emphasis throughout the literature explores the narrow relationship between cancer treatments and the impact of those treatments on patient sexual function or dysfunction, so that patient sexuality and intimacy are inextricably limited to fertility, contraception, menopausal, erectile functional, or capacity for intercourse. Few studies explore sexual or intimate issues that have arisen in the face of life- threatening illness, particularly when patients are older than 65 years. Despite being well cited during the past 30 years, the PLISSIT and ALARM counseling models are outdated in terms of more reflective, patient-centered, and negotiated forms of communication promoted throughout clinical practice guidelines and patient feedback in qualitative research. The BETTER communication model provides a significant step in assessing and documenting the patient's experience of sexuality after cancer.
End-of-life care for terminal head and neck cancer patients.
p. E40-6
Sesterhenn-Andreas-M, Folz-Benedikt-J, Bieker-Michael, Teymoortash- Afshin, Werner-Jochen-A.
Abstract
The objective of this study was to describe end-stage disease in patients suffering from advanced head and neck cancer (hnc). It is one of the most unpleasant and agonizing way a person may die and is a challenging problem for all involved with its treatment. Until today, only few detailed information about the final phase of life of hnc patients in a hospice setting are available. The design of this study was a cohort sample. The course of disease until death was thoroughly analyzed. In addition, hospice staff was interviewed. The study was conducted in a hospice setting (University Hospital). The charts of 16 patients suffering from end-stage hnc were evaluated. The median survival time in the hospice was 19.5 days. There, a more or less rapid deterioration of disease was evident. Several nurses sometimes felt extremely distressed after confrontation with the advanced disease stages. Partially, the situations for the nursing staff were unbearable because of visible, odorous, and fungating tumors or metastasis. The final days were characterized by restlessness followed by somnolence and resulting in an irreversible coma. The goal of palliative treatment of terminal hnc patients is offering the most convenient way to live the final days of their lives in dignity. The short survival time in hospice indicates that incurable patients may be referred to terminal care institutions too late in their dying trajectory. Physicians should be encouraged to talk to their terminally ill patients about the status and incurability of the disease as early as possible to facilitate patient and family decision making on how to prepare for the impending end of life.
p. E9-17, 83 refs
Hordern-Amanda.
Abstract
Experiencing a diagnosis of cancer may dramatically alter the way a person feels about themselves, their body, and their significant relationships with others at sexual and intimate levels. The purpose of this article is to provide a critical analysis of the way patient sexuality and intimacy has been constructed throughout cancer and palliative care literature. A critique of 3 well-cited communication frameworks for health professionals: the PLISSIT, ALARM, and BETTER models, will be offered. In summary, a dominant emphasis throughout the literature explores the narrow relationship between cancer treatments and the impact of those treatments on patient sexual function or dysfunction, so that patient sexuality and intimacy are inextricably limited to fertility, contraception, menopausal, erectile functional, or capacity for intercourse. Few studies explore sexual or intimate issues that have arisen in the face of life- threatening illness, particularly when patients are older than 65 years. Despite being well cited during the past 30 years, the PLISSIT and ALARM counseling models are outdated in terms of more reflective, patient-centered, and negotiated forms of communication promoted throughout clinical practice guidelines and patient feedback in qualitative research. The BETTER communication model provides a significant step in assessing and documenting the patient's experience of sexuality after cancer.
End-of-life care for terminal head and neck cancer patients.
p. E40-6
Sesterhenn-Andreas-M, Folz-Benedikt-J, Bieker-Michael, Teymoortash- Afshin, Werner-Jochen-A.
Abstract
The objective of this study was to describe end-stage disease in patients suffering from advanced head and neck cancer (hnc). It is one of the most unpleasant and agonizing way a person may die and is a challenging problem for all involved with its treatment. Until today, only few detailed information about the final phase of life of hnc patients in a hospice setting are available. The design of this study was a cohort sample. The course of disease until death was thoroughly analyzed. In addition, hospice staff was interviewed. The study was conducted in a hospice setting (University Hospital). The charts of 16 patients suffering from end-stage hnc were evaluated. The median survival time in the hospice was 19.5 days. There, a more or less rapid deterioration of disease was evident. Several nurses sometimes felt extremely distressed after confrontation with the advanced disease stages. Partially, the situations for the nursing staff were unbearable because of visible, odorous, and fungating tumors or metastasis. The final days were characterized by restlessness followed by somnolence and resulting in an irreversible coma. The goal of palliative treatment of terminal hnc patients is offering the most convenient way to live the final days of their lives in dignity. The short survival time in hospice indicates that incurable patients may be referred to terminal care institutions too late in their dying trajectory. Physicians should be encouraged to talk to their terminally ill patients about the status and incurability of the disease as early as possible to facilitate patient and family decision making on how to prepare for the impending end of life.
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