Cancer nursing
-
The reluctance of patients with cancer to report pain and to use analgesics hinders the management of their pain. In the United States, this reluctance is related to the patient's misconceptions regarding addiction and tolerance to analgesics and the desire to be a "good patient" who does not complain. Reports in the literature suggest that patients in Taiwan may have these same concerns and misconceptions. ⋯ The responses indicated that patients who were less educated were more likely to have concerns and that patients in general were most worried about tolerance. Patients who were inadequately medicated, as determined by an index of "adequate pain management" constructed for the study, had significantly higher levels of concerns. Open communication between health professionals and patients and educational programs about pain and about the concerns measured in this study could help overcome these concerns and misconceptions and improve pain management.
-
Oncology nurses and patients identify nausea and vomiting as the two most distressing side effects of chemotherapy. The onset and duration of nausea and vomiting in patients receiving chemotherapy may vary. Inadequate control of emesis in the first 24 h following chemotherapy can lead to anticipatory nausea and vomiting and poor control in subsequent cycles of treatment. ⋯ Assessment should include nausea as a separate phenomenon that may occur in the absence of vomiting and can be equally, if not more, distressing. Objective measures are suitable for the assessment of vomiting, but are not available for assessment of nausea because it is a subjective phenomenon. The purpose of this article is to present evidence supporting the idea that patient reporting using a four-point scale may be a reliable indicator of the degree of nausea and antiemetic efficacy.
-
Bereavement, a well-established threat to health and work performance, is one of the most universal human responses that nurses experience. Because patient death is frequent, oncology nurses commonly experience bereavement; they may identify with the family, feel sad at the death, or feel awkward in responding to a death. After patients die, nurses manage bereavement tasks such as making sense of the death, managing mild to intense emotions, and realigning relationships. ⋯ Understanding theories, models, tasks, and factors influencing their bereavement may help nurses to facilitate their own grief and to reduce bereavement overload. The purpose of this article is to review knowledge and factors that influence nurses' bereavement and offer guidelines for managing grief. Information for this article was derived from several sources: (a) a review of existing literature; (b) clinical experience; and (c) analysis of personal inventories from over 300 nurses attending the authors' bereavement workshops.
-
Comparative Study
Concerns about reporting pain and using analgesics. A comparison of persons with and without cancer.
Cancer pain is not adequately managed, and patients' reluctance to report pain and to use analgesics contribute to this problem. The Barriers Questionnaire (BQ) assesses eight patient concerns about reporting pain and using analgesics. This study was designed to determine (a) whether such concerns differ for persons who have cancer versus those who do not, (b) whether the BQ has test-retest reliability, and (c) whether concerns are related to reticence in reporting pain and using analgesics. ⋯ At Time 1, 16% said they hesitated to report pain, and 12% hesitated to use analgesics; at Time 2, 15% hesitated to report pain, and 10% hesitated to use analgesics. At Time 2, those who hesitated to report pain had higher BQ total scores than those who did not hesitate to report it (p < 0.05). We discuss the results of this study with respect to patient and public education.
-
In this qualitative study, 26 white Dutch women were interviewed who had recently undergone breast cancer surgery. The interviews indicated that during their hospital stay many of them had hardly expressed their postoperative pain and had rarely asked for pain medication. Patients' conceptions of postoperative pain and analgesics, their insecurity and lack of assertiveness, and some suboptimal interactions with nurses seem to have been associated with their inhibition in reporting pain.