Evidence and Practice
Why you should read this article: • To understand that the assessment and management of pain in acute hospitals is often suboptimal • To be aware that gaps in healthcare professionals’ knowledge contribute to inadequate pain management • To emphasise the importance of targeted education in improving knowledge of pain assessment and management The assessment and management of pain in acute hospitals has been shown to be suboptimal in literature dating back to the 1950s. Inadequate pain management is thought to be partly due to knowledge gaps and suboptimal attitudes among healthcare professionals regarding pain assessment and management. The literature focuses on measuring and comparing knowledge scores, but it is necessary to understand where the knowledge gaps are and how to fill them. This article presents the findings of an evaluation project conducted across the acute sector of a district general teaching hospital. The project aimed to improve knowledge and attitudes, among nurses, regarding pain assessment and management with a targeted educational intervention.
Nursing care requires nurses to work intimately and closely with the bodies of others
This article describes the assessment and initial and long-term management of diarrhoea
Why you should read this article • To gain an in-depth understanding of patients’ lived experiences of chemotherapy • To appreciate the importance of the psychological, emotional, social and spiritual aspects of cancer care • To explore the role of hope as a coping mechanism for patients undergoing chemotherapy Background Chemotherapy is one of the main systemic therapies for cancer, but often has significant negative effects on the physical, psychological, emotional, spiritual and social aspects of patients’ lives. Therefore, it is important for nurses to understand patients’ experiences of chemotherapy to provide effective care and management. Aim To explore Iranian patients’ lived experiences of chemotherapy. Methods Nine hospital inpatients who had undergone at least one whole course of chemotherapy participated in 14 in-depth, semi-structured interviews. Qualitative data were analysed using a phenomenological approach and themes were generated. Findings Participants described a broad range of experiences of chemotherapy. They perceived chemotherapy as altering their lives; causing physical and psychosocial suffering; bringing about uncertainty, but also hope; and representing a crucial means of fighting cancer – and, for some, a gift from God. Conclusion Being aware of the effects of chemotherapy on patients’ lives is important in planning nursing interventions. Nurses need to develop strategies that will moderate the negative effects of chemotherapy, identify patients’ support systems and potential sources of hope, and use these to assist patients in coping with the disease and its treatment.
Psychological care for people with cancer and their carers is not meeting demand
A review of evidence around potential medicinal use in treating cancer-related pain
A systematic approach for nurses at any level or experience to engage with service evaluation
Receiving a new diagnosis of cancer or of its recurrence is distressing and there are increasing numbers of people living with the disease, some taking continuous treatment, as well as others who have been cured. Living with cancer and the possibility of recurrence requires psychological strength to deal with the treatment, effects of the illness and uncertainty about the future. The attributes of self-efficacy and psychological well-being can reduce the effects of chronic stress. Excellent symptom control is essential and fatigue, the most prevalent and often most distressing symptom for those with cancer, requires targeted support. Well-being and psychological resilience may be improved by specific actions and psychological approaches, some of which are encompassed by Foresight Mental Capital and Well-being Project’s (2008) five ways to well-being framework, which can be used to deliver personalised care. This is the second of a two-part article that reviews interventions promoting well-being and resilience in patients living with cancer. It describes the framework and suggests practical ways in which clinicians can integrate it and other interventions into clinical practice. It also offers time out exercises and a multiple choice quiz to aid readers’ learning and test their knowledge.
There is increasing recognition of the importance of making the Recovery Package available to more people affected by cancer. The cancer treatment summary is one of the core components of the Recovery Package and aims to improve communication between secondary and primary care, and help patients manage their care following treatment. The Somerset, Wiltshire, Avon and Gloucestershire Cancer Alliance is developing a suite of best practice treatment summary templates for each cancer site to improve the quality of the information in the documents, and to support cancer teams to begin the process of introducing them to practice.
Oral vinorelbine has been a well-established cytotoxic treatment for non-small cell lung cancer and metastatic breast cancer since 2004. This article summarises the applications of the drug, the advantages and challenges of using an oral agent in palliative oncology settings and how oral vinorelbine has been used to develop nurse-led services and chemotherapy outside traditional hospital environments. The article includes two case studies to place this treatment in a clinical context.
Advance care planning (ACP) is a process of establishing a person’s preferences and wishes, which can then be used to inform future care. These conversations are often held with a healthcare professional and may include a family member. ACP is one method of promoting person-centred care and respecting choice when a person may have lost capacity and be unable to communicate what matters to them. This article aims to explore the advantages of, and challenges to, the ACP process in the context of end of life care. It examines the practicalities of establishing patients’ preferences and wishes from a clinical perspective. Fictitious case studies based on numerous clinical encounters are used to illustrate the complexities of this process.