Cancer nursing
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Comparative Study
Delirium resolution in hospitalized older patients with cancer.
Delirium is a troubling complication in hospitalized older patients with cancer. Although preventable and potentially reversible, delirium may be prolonged. Persistent delirium at the time of hospital discharge is common and associated with multiple adverse outcomes. ⋯ Care for hospitalized older patients with cancer should incorporate delirium prevention and intervention strategies. Caregiver education, communication between providers, and follow-up are critical when delirium persists. Additional research focusing on the management and impact of persistent delirium in hospitalized older patients with cancer is needed.
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Traditionally, the intensive care unit (ICU) has focused on reversal of life-threatening illness. Patients with incurable cancer admitted to the ICU present unique challenges for clinicians when these patients transition to end-of-life (EOL) care. A dimensional analysis of a single case study from a larger 30-case ethnographic study was used to explore the cancer patient's transition to EOL care in the ICU. ⋯ This process unified those involved and brought them to a place of acceptance. This case illustrates the turning point and rationale for the shift to EOL care in the ICU and the important role that communication plays in the transition. Understanding individual and family processes and family members' need for time to adjust to the transition to EOL is an essential element of practice within ICUs that increasingly manage terminally ill cancer patients.
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This study explored the experiences of families when a child with cancer relapses. The aim was to develop an understanding of the human actions and emotions that shape the experience of relapse, to question what influences the care provided at relapse, and to challenge current practices. Twelve families were involved in a critical ethnography exploring their child's relapse. ⋯ The families fluctuated between 2 states of reality-hoping for a cure and contemplating death-as they faced the uncertainty that surrounded their child's prognosis. A conceptual model of uncertainty at relapse is presented, demonstrating how uncertainty is significant to the child and family's experience, impacting the pursuit for cure, treatment-related decision making, and prognostic communications. Acknowledging the uncertainty of relapse and developing an awareness of the child and family's hopes and fears may lead to a greater understanding of the challenges faced and promote more open and honest communications at this critical period.
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Comparative Study
A hospital-based intervention using massage to reduce distress among oncology patients.
The objective of this study was to assess the impact of a Swedish massage intervention on oncology patients' perceived level of distress. Each patient's distress level was measured using 4 distinct dimensions: pain, physical discomfort, emotional discomfort, and fatigue. ⋯ This reduction in patient distress was observed regardless of gender, age, ethnicity, or cancer type. These results lend support for the inclusion of a complementary massage therapy program for hospitalized oncology patients as a means of enhancing their course of treatment.
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The purpose of this study was to evaluate the validity and reliability of the Taiwanese version of the M. D. Anderson Symptom Inventory (MDASI-T) in Taiwanese adolescent cancer patients. ⋯ The alpha coefficient of the symptoms severity and interference subscales demonstrated good internal consistency. There was acceptable test-retest stability of the MDASI-T in 35 adolescents during a 3-day interval. This study provides evidence that the MDASI-T is a reliable and valid instrument for measuring cancer-related symptoms in Taiwanese adolescents with cancer.