Biomedical subjects
Publications and source records attributed to R Wickham.
Advances in genetics are changing approaches to detecting and treating breast and ovarian cancer. Scientific breakthroughs and thus implications for clinical care and patient education are essential areas of knowledge for all medical-surgical nurses. Future discoveries promise to change drastically the prevention and treatment of these diseases.
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Long-term central venous catheters allow the safe administration of chemotherapy, blood and blood products, total parenteral nutrition, fluids, and other medications. Despite their benefits, the risk of certain complications (e.g., fibrin sleeve and mural thrombus formation, infection, catheter occlusion, extravasation, and catheter malposition) exist for every person who has a catheter. Thus, preventative measures, recognition of early signs and symptoms of complications, and adequate care of utmost importance.
The research role of the clinical nurse specialist is often the most difficult to implement. At the masters level, efforts are generally directed at utilization and evaluation of research more than design and implementation. Collaboration between several investigators, however, is an efficient and effective method of pooling the resources of a variety of researchers, allowing the actualization of all aspects of the research process. A collaborative effort to look at the clinical problem of fatigue was undertaken by a group of masters-prepared oncology nurses. Strategies for effective collaboration are outlined. Issues related to gaining group commitment and to delineating roles at the onset, voluntary participation, and timely communication are discussed. A realistic timetable and regular informal meetings helped to sustain the momentum of the study. All members were able to contribute a part of the completed project and to experience the professional and personal satisfaction of "owning" a research project from start to finish.
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Fatigue is regarded as a universal and unavoidable side effect of cancer therapy, yet its epidemiology and prevalence in populations of people with cancer have not been well-documented. Using the conceptual framework of Piper, et al., this study examined and described the perception and manifestations of fatigue and its physiological, biochemical, and behavioral correlates. A convenience sample (N = 77) of people with lung (n = 33) or breast cancer (n = 44) completed several instruments: a brief questionnaire, the Rhoten Fatigue Scale, a visual analogue scale (VAS), the Rhoten Fatigue Checklist, and the shortened version of the Profile of Mood States (POMS). Data on other factors thought to influence fatigue were collected via medical record audit. Seventy-five of 76 people (99%) completing the VAS experienced some level of fatigue. Significant correlates of fatigue included level of pain and POMS scores. Preliminary findings suggest that fatigue is a common problem with a complex etiology and that nurses must consider potential contributing factors when assessing fatigue and its impact on the individual.
The consequences of inadequately controlled chemotherapy-related nausea and vomiting range from minor discomfort to dose-limiting toxicity. Physical complications may occur secondary to protracted nausea and emesis. Furthermore, patient discomfort may be reflected in altered quality of life or noncompliance with therapy. As a primary caregiver, the nurse takes an active role in collaborating with the physician to prevent and/or minimize these side effects and their sequelae. An understanding of the patterns, mechanisms, and risk of chemotherapy-related nausea and vomiting is crucial to providing optimal patient care. Concepts of drug therapy are emphasized as the cornerstone of antiemetic management.
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