Example 1: Implement a Practice New to Temple East Northeastern Hospital Chemotherapy Infusion Center- The Use of Psychoeducational Intervention of Progressive Relaxation to Help in the Prevention and Management of Cancer-related Anxiety
Patients diagnosed with cancer experience anxiety for multiple reasons and at different stages of their illness. Anxiety occurs while awaiting the actual cancer diagnosis and continues throughout cancer treatment. Many patient’s anxieties stem from the fear of the progression of the disease and the reality of death. This added stress and anxiety can affect the patient’s daily life. All health care providers have the responsibility to assess and screen all patients for depression and anxiety. It is only
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Progressive muscle relaxation was first developed by American physician Edmund Jacobson in 1938 and since then has been adapted and utilized by many different disciplines. Progressive relaxation is an intervention that integrates breathing techniques, along with alternating tensing and relaxing various muscle groups to assist a patient in managing anxiety (Jacobson, 1938). The sequencing of the relaxation techniques can start either at the head or at the feet and isolate one side of the body or focus on the body as a whole. The nurse can provide verbal guided imaging during the session, or a pre-recorded audio can be implemented (Chan, Richardson, & Richardson, 2011).
Results of the Questionnaire A qualitative study was performed using six oncology patients. Upon arrival to Dawn’s oncology department, each patient was given the GAD-7 questionnaire. According to the patient’s answer to the questions, the patient was categorized as having mild, moderate or severe anxiety. One patient had mild anxiety, four patients had moderate anxiety, and one patient had severe anxiety. Next, progressive relaxation techniques were provided to each patient. Finally, the GAD-7 questionnaire again was filled out by the patient according to their present state of anxiety and the results proved that the progressive relaxation intervention helped in the management of cancer-related anxiety. Five patients stated they felt extremely relaxed and no longer felt anxious. The patient who had
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
The authors intended to demonstrate and examine whether or not a “guided self-help intervention reduces anxiety in palliative patients, and whether training palliative nurses to deliver guided self-help would improve their routine management of psychological distress.” (Galfin et al., 2011, p. 119-120).
The test will be conducted at the 0.05 level of significance. The correlation coefficient indicates a relationship between hours of study and exam anxiety for the sample tested. The r-value of 0.5654 indicates a positive linear correlation. With a 0.05 alpha and a df of 8, the PPMC table gives a value of 0.632. The two-tailed is significant at the 0.05 level of significance and there is a positive correlation between the number of study hours and the anxiety scores of students.
This study was reviewed, and approved by the institutional review board. This used a functional assessment of the chronic illness therapy, which was abbreviated as, (FACIT). This is a measurement system, which consists of a collection of quality of life questions, concentrated in the management of different chronic illnesses. Patients registered, read, and agreed to the study, and grant permission to participate in the study on the website, www.facit.org. After participants met the criteria for the study, those completed a self-report of questions which had evaluated the fatigue and spiritual well-being of the patient. Within this prospective study, the patients were at one point screened during the time of the cancer being active treatment. (1.
All of the patients were evaluated for ASD within one month of receiving their confirmation of cancer, but prior to getting any primary or adjuvant treatment. The assessment used for the patients was ASDI and SCDI. Seven other questionnaires, the European Organization for Research and Treatment of Cancer-Core Questionnaire, the Mini-Mental Adjustment to Cancer Sale, the Peritraumatic Dissociative Experiences Questionnaire, the Beck Depression Inventory-Second Edition, the State-Trait Anxiety Inventory-Form Y, the Posttraumatic Cognitions Inventory, and the Duke-UNC Functional Social Support Sale, were also given to the patients. Of the 82, 56 had cancer of the head or neck and 26 had cancer of the lungs. 27% were diagnosed with stage 1, 52% with stage 2, and 11% with stage 3 cancer. At the six month follow up of the study, only 63 patients were available to participate further due to the other 19 patents succumbing to their diagnosis, being too ill, or being unable to locate. All were assessed either in person or by telephone, with no differences affecting the study. (Kangas, Henry, & Bryant,
Cancer is usually a terrifying word. Those who have never received a diagnosis of cancer, likely cannot fathom the anxiety such an event produces. Even forms of cancer that are highly treatable often bring about significant and immediate life changes for patients. Hopefully, the ideas from this article can help to demystify cancer, and make it somewhat easier to cope with the disease and its effects.
⎫ Rationale- Client’s anxiety will decrease as he or she can understand the treatment regimen (Ackley & Ladwig, 2014). ⎫ Outcome- Client will verbalize and demonstrate a reduction in level of anxiety experienced and as evidenced by a calm demeanor and cooperative behavior by the end of shift (Ziarina et al., 2014) Works Cited Ackley, B. J., & Ladwig, G. B. (2014). Nursing Diagnosis Handbook (10th ed.). Maryland Heights , MO: Mosby.
We would like to consider this patient as a whole instead of 2 different illnesses. This patient is chronically depressed and recently being diagnosed with stage 3a Non Small Cell Lung Cancer. It is very difficult to formulate long term management plan after 45min consultation because information available about patient expectations and concerns are limited. In order to arrange patient centered management , patient participation is very important, because patient had stopped antidepressant and counselling prematurely, it could have been due to lack of patient involvement during the treatment choices and poor therapeutic relationship with the physician. Firs all, It is very important to establish a good rapport with the patient , because this patients doesn’t have pleasant experience with the conventional medical treatment, considering severity of his condition and available treatment modalities, conventional treatments are the first line options to be considered. Alternative treatments can be considered as an adjuvant therapies to conventional plan to minimize adverse effects or improve the quality of life.
Cancer is one of the top leading causes of terminal illness and death, and it takes the support of family and friends to help overcome many of the feelings that can occur before, during, and after a diagnosis. It is often difficult to understand how to cope with the feelings associated with losing people that you love and care about and watching other people that are affected suffer emotionally along with the ailing family member or friends. Emotional challenges are faced regarding what can be done to help the patient, family, and friends handle personal emotions throughout the duration of the illness and the stages of grief. A person that is dealing with a terminal illness, a family member, or friend must find a way to effectively handle and overcome the devastating feelings associated with having a loved one being diagnosed or passing away after a long terminal illness. There are different stages of grief and options available for any negative feelings associated with handling the illness and acknowledging the anticipated loss of a loved one. The grieving and coping process involves behavioral and emotional reactions, like shock and sadness, and then acceptance and understanding while working towards healing or rebuilding life.
The reference list itself was small and some of the articles were dated. This particular study was published in 1996 and three of the references used were from the years 1981 through 1983. Reference two on the list was not used in the literature search, even though the primary focus of this reference was in the critical care arena it would have been nice to see how those authors used the techniques. The dependent variables in this study are anxiety level and chemotherapy side effects.
When a person is diagnosed with terminal cancer can respond in different manners. Initially, there are patients that enter in a phase of denial, where he or she does not want to accept that the cancer is the cause of all the symptoms and consequently refuse the appropriate treatment. Depression is another and one of the most significant factors during this illness. In this moments the recurrent thoughts about death and the hopeless idea that there is not anything to do originate sadness, restlessness, and insomnia. Other symptoms can be added in the third case where the patient suffers from acute anxiety, inducing agitation, tachycardia, hyperventilation, panic disorder, etc. Anger for the injustice of being sick and a fighting determination are the resting two reactions in a person with a terminal decease.
Today, many psychologists feel that psychological therapy can give cancer patients’ a longer life. The first to take this stance was Psychiatrist David Spiegel M.D., of Stanford University School of Medicine, in a 1989 study Spiegel gathered patients once a week to discuss there feelings about the cancer and here they received support from other cancer sufferers. “When Spiegel followed up a decade later, he discovered that patients who had participated in the sessions had survived an average of 18 months longer than those in the control group” (Clay,2000). It is felt that if you can tap into a patients mind and help them deal with the cancer by dealing in the mental aspect of it that it will be
Cancer survivorship transitioning is a process for the patient and family unit. Patients and families navigate to a “new normal”. Current transitioning from oncology care to primary care leaves a gap in continuity of care. Patients must adapt to a change in the health care regimen. Patients and their families may feel anxiety, returning to primary care, or patients and their families may have psychological distress as vigilance becomes more ominous in primary care. Cancer survivors transitioning from oncology care to primary care at a rural Minnesota health care facility may not receive the same vigilance of all the biopsychosocial elements obtained in oncology care; there is no standardization of screening for psychological distress by a cancer survivor in primary care unless patient and/or family self-reports or provider recognizes apparent symptoms of the psychological distress.
Dealing with any life threatening disease can play a huge tool on your life. Having a disease such as cancer can leave those affected by it to look at life from a totally different prospective. It tends to lead people to examine their life and look for its meaning. To some, this aspect of having cancer may be the most valuable. It gives patients the ability to seek a positive meaning of their life. Quality of life can mean different things to different individuals. For some cancer patients it may mean to gain support from people. Cancer patients may also use the quality of life to help take one day at a time and regain as much control of their life as they reasonable could. Cancer can demonstrate multiple symptoms. Some symptoms are subtle and some are not considered to be subtle at all. Some symptoms of cancer affecting quality of life in patients would be cancer type and stage, as some types of cancer do not present any symptoms until they are in advanced stages, time since diagnosis, patient acceptance, intensity of the disease and the level of psychological distress experienced by caregivers (Heydarnejad, M., Hassanpour, D. A., & Solati, 2011).
Mindfulness based stress reduction states that most of our stress comes from ruminating on the past, judging the present and worrying about our future (Lopez et al., 2015). Mindfulness is especially important for those dealing with huge life events or stressors. An individual dealing with cancer could easily feel stressed about the past, wondering if they did something to get cancer. They will never know what would have happened if they drank less, or exercised more. Dealing with cancer is a roller coaster, day by day things can change dramatically and its important that individuals take life by the moment and acknowledge all the feelings and changes that are happening without judgement. It is hard not to think about the future when dealing with a potentially deadly diagnosis. Its important to practice mindfulness and not worry about the future, it is what it is. Living in the moment while dealing with cancer or any other stressor is very important. Mindfulness allows individuals to feel every emotion but move past it head without being too critical. Cancer patients have shown a decrease in mood disturbances when practicing mindfulness (Lopez et al., 2015).