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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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.
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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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Neuropathic side effects are commonly reported in patients receiving oxaliplatin, but little is known about the characteristics of peripheral neuropathy in this patient population. The purpose of this descriptive study was to explore the prevalence of neuropathic symptoms in patients with colorectal cancer receiving oxaliplatin as well as to explore symptom severity, distress, frequency, and neuropathic interference with activities. Thirty-three patients receiving oxaliplatin at two outpatient facilities completed the Chemotherapy-Induced Peripheral Neuropathy Assessment Tool. ⋯ Trouble with balance, muscle or joint aches, and neuropathic pain were the most distressing symptoms, and numbness in the fingers and hands and in the toes and feet were the most frequent symptoms. Patients reported that neuropathic symptoms interfered with numerous activities. Oncology nurses can use this information to help educate patients and families about potential side effects of oxaliplatin and to coordinate the care of patients with peripheral neuropathy using a symptom-focused, multidisciplinary approach.