Clinical journal of oncology nursing
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For the current study, clinical observations of communication between patients, families, and clinicians during chronic, serious, or terminal illness in a cancer care trajectory were examined for patterns and trends. Five communication characteristics were concluded, which informed a typology of illness journeys experienced by patients with cancer and their families. The isolated journey characterizes an illness path in which communication about terminal prognosis and end-of-life care options are not present; communication is restricted by a curative-only approach to diagnosis as well as the structure of medical care. ⋯ Finally, palliative care prior to hospice provides patients and families with an illness journey more readily characterized by open awareness and community, which facilitates a comforted journey. Nurses play a pivotal role in communicating about disease progression and plans of care. The typology presented can inform a structured communication curriculum for nurses and assist in the implementation of early palliative care.
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Recognizing delirium and its impact on older patients and their caregivers is an important aspect of oncology nursing. Delirium is the most common complication of hospital admissions for older adults and is associated with a significant amount of morbidity and mortality, prolonged hospital stays, functional decline, and decreased quality of life. Oncology nurses caring for older patients with cancer have the opportunity to recognize the onset of delirium, provide ongoing patient assessment and monitoring, and implement pharmacologic and nonpharmacologic interventions.
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Survival rates for people treated for breast or prostate cancer have increased steadily since 2000, which has been attributed to advances in early detection and improvements in treatments. However, breast and prostate cancer therapies that target estrogen and testosterone production are associated with hormone-deprivation symptoms--most commonly hot flashes--that may have a significant negative impact on quality of life. ⋯ Most of the interventions were rated effectiveness not established or lower; however, two drugs, venlafaxine and gabapentin, were rated likely to be effective. In addition, the placebo effect was noted to produce a high percentage of positive results in mitigating hot flashes.
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The number of hematopoietic stem cell transplantations (HSCTs) performed annually is increasing. Although general survival rates have risen since 1990, mortality and morbidity from preventable complications can be improved. As a result, this article will review developments in preventing and managing infections in neutropenic HSCT recipients.
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Cancer-related fatigue (CRF) is a distressing symptom that affects the quality of life (QOL) of patients with breast cancer and their families. The effectiveness of pharmacologic therapies alone has not been sufficient in the management of CRF; therefore, a combination of pharmacologic and nonpharmacologic approaches is justified. ⋯ Therefore, nurses may consider these nonpharmacologic supportive strategies as adjunctive interventions to pharmacologic interventions in enhancing QOL for patients with breast cancer experiencing CRF. However, because previous studies had some methodologic limitations, such as small sample size, lack of objective measures, or predominantly Caucasian sample, future research to further explore nonpharmacologic interventions in this area is warranted.