Cancer practice
-
This paper offers a rationale for initiating bereavement support groups in sites providing cancer care and delineates models to implement them. Skills needed to lead a bereavement support group are identified, with emphasis on adding to staff members' competency that has already been developed by facilitating groups for oncology patients and their families. ⋯ Bereavement support is an essential element in the provision of comprehensive oncology care. Predictive models to identify individuals who are at higher risk for psychological distress could be used in oncology clinics to facilitate early referral or greater psychological support for family members. Staff members wishing to introduce this service can build on skills already developed leading traditional oncology support groups, and can utilize cofacilitation with a mental health professional to ease the anxiety of assuming a new role and obtain mentoring. Recruitment for a group might be achieved by inviting family members of patients who have died within a specific time frame or by issuing press releases to local papers and church bulletins. Offering bereavement support in the oncology setting is especially helpful to family members who might otherwise be unaware of such a service and who now have the opportunity to attend.
-
Clinical Trial Controlled Clinical Trial
An examination of nursing attitudes and pain management practices.
The purpose of this evaluation is to examine the relationship among nurses' pain management attitudes and pain management practices and to begin to explore the theoretical underpinnings that may influence this relationship. ⋯ Although nurses reported change in attitude, and high expectancy for change, feelings of increased credibility, and increased motivation as advocates for new approaches to practice, nurses sometimes found it difficult to implement new practices because of constraints in time and collaborative efforts. To implement new knowledge and achieve individualized goals for change, nurses must be allowed adequate time to analyze the relationships between their beliefs about pain and the ways that they solve patients' pain problems. In addition, more support for multidisciplinary collaboration is needed.
-
The goal of this project was to develop and test an educational program to extend the principles of palliative care into home-care agencies. The specific aims were: 1) to assess current practices within select home-care agencies regarding care of the dying; 2) to design the educational program, the HOPE (Home Care Outreach for Palliative Care Education) curriculum, to include relevant content for realistic implementation in home-care agencies; 3) to implement the HOPE project in two home-care agencies; and 4) to assess outcomes of the project and plan for future dissemination to home-care agencies and organizations. ⋯ Home care agencies provide extensive care to patients and families facing many physical and psychosocial demands at the end of life. Palliative care education is important to support home-care professionals across all disciplines in optimum end-of-life care. This education should focus on aspects of physical care, such as treatment of pain, dyspnea, confusion, and fatigue, and also to address decisions about physical care, such as hydration/nutrition at the end of life. Psychosocial dimensions of care at home can be improved by attention to issues such as communication with dying patients and families, cultural considerations, and the special care required at the time of the actual death at home.
-
Docetaxel is a taxane that disrupts the equilibrium in the polymerization and depolymerization of microtubules, thus inhibiting cell growth. This agent is indicated for the treatment of anthracycline-resistant metastatic breast cancer. ⋯ Although the mechanism of action, spectrum of activity, and side effect profile of this agent are similar to those of paclitaxel, docetaxel may be efficacious in patients with metastatic breast cancer who have become resistant or refractory to paclitaxel therapy. However, more studies are warranted before the role of docetaxel is defined in patients with paclitaxel-resistant breast cancer.