Running Head: APPROACH TO CARE Approach to Care of Cancer NRS 410V David Ludwig 1/16/2011 Grand Canyon University Introduction According to the American Cancer Society, half of all men and one third of all women will develop cancer within their lifetime (Cancer.org). These figures are staggering. Cancer is a leading cause of morbidity and mortality worldwide and is a terrifying and unpredictable disease for many cancer sufferers. As such, it is imperative that healthcare workers have a thorough understanding of the various cancer diagnoses, treatments, and preventative strategies necessary to combat this devastating plague. Skills at managing not only the illness itself, but also the psychological and social side effects …show more content…
Pain is one of the most common and feared complications of cancer. It is exacerbated by stress, anxiety, fatigue, and malaise which accompany advanced cancer. Pain is generally absent in the early stages of cancer, but it is a significant factor as the illness progresses to advanced stages. Cancer-associated pain can arise from a variety of direct and indirect mechanisms including direct pressure, obstruction, and invasion of a sensitive structure, stretching of visceral surfaces, tissue destruction, infection, and inflammation (McCance 2010). Pain is generally accepted as whatever the patient says it is, wherever the patient says it is. Treatment of pain and its associated symptoms is a primary responsibility of the healthcare team. Treatment modalities for pain include the use of opioid analgesics, patient-controlled analgesia, psychological interventions, and preventing recurrence of pain. Reinforcing the reporting of pain by the patient is important, as is a respect for the social and cultural differences with respect to pain perception. Individuals with cancer are predisposed to infection and are at a greatly increased risk for death from infection-related illnesses. In addition to the immunosuppressive effects of the cancer itself, individuals with cancer may be at increase risk for infection due to surgery and treatments such as chemotherapy and radiation. Frequent hospital stays and devices such as indwelling catheters
Step one, Geraldine pains will be monitored and documented at a regular interval by asking her to score her pain on a scale of (0-10) with 0 meaning zero pains and 10 being highly in pain. This will help in evaluating her cancer-related pain symptoms, which may involve viscera, nerve, or bone tissue. Use of rating scale aids helps in assessing level of pain and provides a tool for evaluating the effectiveness of analgesics, enhancing patient control of pain. Geraldine’s reported and unreported pain will be assessed. The discrepancy between reported and nonverbal cue can give us clues to the degree of pain, the effectiveness of
When I was fourteen, I went to South Korea and visited my grandmother who was diagnosed with Alzheimer’s. She was staying with one of my aunts in an apartment complex that restricted many of her daily activities and years later, her dementia progressed and passed away. Within the short time I spent with her, it was difficult for me to help her with her daily activities while maintaining her dignity. Therefore, when reflecting her death, I wondered about the type of care my grandmother had received. My potential learner gains from reviewing the literatures on this topic are how to successfully give a patient with dementia complete palliative care.
Within the article, “Pain Intensity and Pain Interference in Patients With Lung Cancer”, the researchers use a combination of surveys, questionnaires, and lab results to conduct their research. All of the tools are given at a certain time, taken within a certain time
Pain is a universal human experience and it is subjective. It is a major concern for those with cancer. One of the priorities of hospice is to provide comfort and a pain free death. It is however a concern that many people are still dying with uncontrolled pain. We are interested in hospice and pain management because hospice is known to be a place of comfort where individuals are provided with relief and allowed to die peacefully without pain. The majority of patients in the hospice settings are older adults with advanced cancer. Our goal is to create an intervention that will appropriately deal with the poor pain management experienced by many in hospice care. In order to help us with this task, four articles have been reviewed with regards to hospice and pain management.
Pain which is referred to as the fifth vital sign is one of the most common reasons why patients seek care. “It can occur at any time, to anyone. Pain can profoundly affect quality of life, interactions with family and friends, sense of well-being and self-esteem, and financial resources” (Jensen,
Opioids are effective for the treatment of acute pain, such as pain following surgery. They have also been found to be important in palliative care (hospice) to help with the severe, chronic, disabling pain that may occur in some terminal conditions such as cancer. In many cases opioids are successful long-term care strategies for those with chronic cancer pain (CCP). There are not many alternatives for those with CCP like there are for those suffering acute or chronic non cancer pain (CNCP). In one study, conducted by Furlan et al. (2006), opioids were effective in the treatment of CNCP overall; they reduced pain and improved functional outcomes better than placebo. Strong opioids (oxycodone and morphine) were significantly superior, to naproxen and nortriptyline (respectively) for pain relief but not for functional outcomes. Unfortunately, Weak opioids (propoxyphene, tramadol and codeine) did not significantly outperform NSAIDs or TCAs for either pain relief or functional outcomes. Overall, if opioids are
Identification of pain has been the most feared and common symptom of cancer (Sloan, et al. 1999). The joint project that includes primary, secondary and tertiary levels of care were successful in breaking down the barriers that crossed traditional boundaries in cancer care. Steering committee member were identified and meetings took place between multi-professional teams and project coordinators to identify their issues and concerns and communication, discharge, pain management and symptom control were identified. Multidisciplinary groups worked were
t is not always possible to recover fully from cancer. When the treatment does not succeed, the disease is called terminal or advanced cancer. Diagnosis is very stressful for many patients to discuss. It is however crucial to have an honest and open discussion with the healthcare team or doctor to express concerns, preferences, and feelings. Patients with advanced cancer and expected to live for less than six months should consider palliative care known as hospice. Hospice care is intended to provide the possible best quality life for people near the end of life. Personally, I chose this topic because I have many friends that smoke or have smoked in their lives and I wanted to prove to them all of the vast impairments and damages that a single
You have made excellent points. I do not believe that health care professionals neglect to treat patients in palliative care in the correct settings. The care one receives is based on what type of locations they are in. Hospitals and hospice centers often have employees with higher education levels and an increased passion for their job. I believe that health care providers want to ensure that one is comfortable at the end of life. I have visited Alive Hospice here in Nashville and was able to see the the great amount of care they provided to their patients. I have attached a link to their website below. I am curious to know your opinion on why you think one would not receive adequate care at the end-of-life phase.
What is pain? Generally, it is an unpleasant sensory feeling that is triggered by the body's nervous system in response to an adverse affect and is often categorized as acute or chronic. Because of the many different aspects of pain, it varies from each individual. Experiences that may cause pain in one individual may or may not cause pain at the same level which makes this a highly subjective symptom. Previously, medical professionals relied solely on their patients report of pain. However, as time and medicine have evolved, pain has been incorporated into general patient assessments and has further been referred to as the fifth vital sign,
Chronic, acute, somatic and oncologic are all types pain - each with their own symptoms, reliefs, and evaluations. As pain has been explored, we have learned more about it; however, it remains an anomaly. In the postoperative setting, nurses are the first line of pain management. Their assessments of the patient’s pain, including questions and scaling is imperative when dosing medications and evaluating the patient. Studies continue to determine that healthcare providers undertreat and mismanage pain control and assessment. According, to the American Society of Interventional Pain Physicians, “80% to 90% of physicians have had no formal training in prescribing controlled substances, and only five out of one hundred thirty-three medical schools in the U.S. have required courses on pain management” (Glowacki, p. 37). The American Nurse Credentialing Center reported that “as of 2013, only one thousand six hundred seventy two registered nurses in the U.S. were certified in pain management” (Glowacki, p. 37). According to the CDC, about 50% of postoperative patients report unrelieved pain (Centers for Disease Control and Prevention, 2013). Effective postoperative pain control is necessary for successful care and treatment. Inadequate relief of postoperative pain can contribute to postoperative complications such as atelectasis, deep vein thrombosis, and delayed wound healing (Francis &
A comprehensive assessment of breakthrough cancer pain which also examines whether the pain is caused by uncontrolled background pain should be completed for every patient at every incident of pain (European Oncology Nursing Society, 2013). It is important to distinguish breakthrough cancer pain from uncontrolled background pain, as the two types of pain are different and require individual assessment and therapy (Davies et al. 2009; Mercadante et al, 2002; Mercadante, 2011). Davies et al. (2009) have adapted a previous diagnostic algorithm created by Portenoy et al (1999), which aids practitioners to distinguish between breakthrough cancer pain and uncontrolled background pain- see figure 3.
The United States needs to provide more hospice care awareness. Hospice care provides services for individuals who have six months or less to live. They are able to enjoy the end of their lives rather than using physician assisted suicide.
305). The abstract of this article is instrumental in providing the reader with a clear summary of the study. A brief overview, the aim to explore the experiences of breakthrough pain among palliative patients, is followed by the research problem, palliative patients are experiencing significant suffering because of breakthrough pain (Pathmawathi, Beng, Li, Rosli, Sharwend, Kavitha, & Christopher, 2015, p.552). Pathmawathi et al, (2015), describes the study design as qualitative study, of 21 palliative patient’s suffering from breakthrough pain, based open-ended interviews that generated five (5) different major themes (discussed in research findings) (p. 552). Additionally, the authors made recommendations to assess the five major themes discovered to include using non-pharmacologic approaches, education and guidance on pain management and the use of more sensitive approaches related to pain perception by healthcare workers (Pathmawathi et al., 2015,
Treating pain associated with cancer is very complex. Significant factors with the initial intensity of pain are metastasis to the bony area, temporary pain despite administering other pain medications, below the age of 60-year-old and bad result in the (KPS) Karnofsky performance scale (Caraceni & Portenoy, 1999).