Instruction in the techniques and concept of supportive care in oncology

Cancer education merits a coordinated, vertical curriculum and an integrated planning strategy. It has become clear that it is as important to teach the techniques of supportive care in oncology as it is to teach the concepts of cancer biology, pathology, epidemiology, prevention, detection and aggressive treatments. Our aim is to determine whether the medical school and nursing school curricula give the students an introduction to the concepts of supportive care of the cancer patient. The spectrum of such supportive care encompasses a wide range of issues working towards a common goal of providing overall comfort with an emphasis on quality of life, and runs parallel with specific therapeutic strategies and associated problems. Do the graduate medical studient and nursing student under-stand that cancer management is multidisciplinary and team-based? That the approach to pain management not only includes the administration of pain medications, but should also evaluate pain assessment and anesthetic, neurosurgical and behavioral approaches? That nausea and vomiting associated with chemotherapy can be ameliorated to a certain extent? That infections are common but algorithms exist for prevention and therapy? That certain metabolic complications are unique to cancer patients? That transfusions are vital procedures in patients with neoplasms undergoind aggressive treatments but are associated with certain risks and complications? That there are serious psychosocial, ethical and legal needs to be considered? To address these issues, the American Cancer Society Professors of Clinical Oncology, the American Cancer Cociety Professors of Oncology Nursing and the United States Cancer Center Directors were surveyed. In general, professors perceived that education in cancer and its supportive care was well done at their schools of medicine and nursing; however, students' perceptions of their education differed from that of the professors. The paper includes suggestions to curriculum directors of medical and nursing schools for constructive changes with regard to instruction in the techniques of supportive care in oncology.     

Core measures for developmentally supportive care in neonatal intensive care units: theory, precedence and practice

Title. Core measures for developmentally supportive care in neonatal intensive care units: theory, precedence and practice. Aim. This paper is a discussion of evidence‐based core measures for developmental care in neonatal intensive care units. Background. Inconsistent definition, application and evaluation of developmental care have resulted in criticism of its scientific merit. The key concept guiding data organization in this paper is the United States of America’s Joint Commission’s concept of ‘core measures’ for evaluating and accrediting healthcare organizations. This concept is applied to five disease‐ and procedure‐independent measures based on the Universe of Developmental Care model. Data sources. Electronically accessible, peer reviewed studies on developmental care published in English were culled for data supporting the selected objective core measures between 1978 and 2008. The quality of evidence was based on a structured predetermined format that included three independent reviewers. Systematic reviews and randomized control trials were considered the strongest level of evidence. When unavailable, cohort, case control, consensus statements and qualitative methods were considered the strongest level of evidence for a particular clinical issue. Discussion. Five core measure sets for evidence‐based developmental care were evaluated: (1) protected sleep, (2) pain and stress assessment and management, (3) developmental activities of daily living, (4) family‐centred care, and (5) the healing environment. These five categories reflect recurring themes that emerged from the literature review regarding developmentally supportive care and quality caring practices in neonatal populations. This practice model provides clear metrics for nursing actions having an impact on the hospital experience of infant‐family dyads. Conclusion. Standardized disease‐independent core measures for developmental care establish minimum evidence‐based practice expectations and offer an objective basis for cross‐institutional comparison of developmental care programmes.     

发育支持性护理在早产儿中的应用

[目的]探讨发育支持性护理在早产中的应用效果。[方法]随机将66例早产儿分为实验组和对照组，实验组早产儿出生后提供发育支持性护理，对照组早产儿按常规进行护理。比较两组患儿在进奶量、体重、胎粪转黄时间及黄疸指数方面的差异。[结果]实验组早产儿在进奶量、体重、胎粪转黄时间及黄疸指数方面优于对照组。[结论]发育支持性护理可促进早产儿生长发育，提高生活质量。     

妇科恶性肿瘤患者不同治疗阶段支持性照顾需求的调查分析

目的了解不同治疗阶段妇科恶性肿瘤患者支持性照顾需求变化,为制订针对性干预策略提供依据。方法采用一般资料调查表和支持性照顾需求问卷对重庆市3所三级甲等医院的138例初诊妇科恶性肿瘤患者于确诊时、确诊后3个月、确诊后6个月进行跟踪调查。结果妇科恶性肿瘤患者支持性照顾需求各维度除生理与日常生活需求、心理需求维度外,各维度得分在确诊后3个月均呈下降趋势,照顾与支持需求及性需求维度在确诊后6个月出现回升趋势,各维度3个时间点差异均具有统计学意义(P0.01或P0.05)。结论妇科恶性肿瘤患者在疾病进展和治疗过程中支持性照顾需求呈现动态变化趋势,建议动态评估患者需求,做好每一阶段相关症状的预防和针对性护理工作。     

发育支持性护理在早产儿中的应用

[目的]探讨发育支持性护理在早产中的应用效果。[方法]随机将66例早产儿分为实验组和对照组,实验组早产儿出生后提供发育支持性护理,对照组早产儿按常规进行护理。比较两组患儿在进奶量、体重、胎粪转黄时间及黄疸指数方面的差异。[结果]实验组早产儿在进奶量、体重、胎粪转黄时间及黄疸指数方面优于对照组。[结论]发育支持性护理可促进早产儿生长发育,提高生活质量。     

卵巢癌患者支持性照护需求的质性研究

目的 深入了解卵巢癌患者在诊疗和康复阶段的支持性照护需求,为制定全程的支持性照护服务方案提供依据。方法 采用描述性质性研究方法,应用最大差异抽样法,选取2021年11月—2022年3月上海某三级甲等妇产科医院的18名卵巢癌患者进行个人半结构式深入访谈,运用内容分析法对访谈资料进行整理分析。结果 卵巢癌患者支持性照护需求可归纳为5个主题,即信息需求：了解疾病常规诊疗信息与诊疗前沿信息、获取早期康复指导信息;社会支持需求：家庭支持、同伴支持、延续性专业照护支持;生理需求：改善疾病躯体症状需求、缓解疾病特异性症状负担;心理需求：专业心理咨询、维护尊严需求、遗传风险担忧;实际需求：子女照护需求、经济需求。结论 卵巢癌患者在整个疾病过程中面临多维度的支持性照护需求,医护人员通过动态评估和管理,构建基于需求的支持性照护方案,优化卵巢癌患者管理模式,以期改善患者健康结局。     

对NICU早产儿实施发育支持护理的效果评价

目的 探讨发育支持护理对早产儿特别是极低出生体质量儿及病重儿的影响.方法 将NICU住院的120例早产儿按收住顺序分为实验组和对照组各60例,对照组予以传统常规护理,实验组在此基础上制订照顾计划、优化治疗环境、减轻疼痛、鸟巢式护理和袋鼠式护理、实施非营养性吸吮,并比较两组早产儿在体质量、进奶量、平均住院时间方面的差异....     

54例新生儿危重先天性心脏病术前发育支持护理

本文回顾了2015年1月至2017年12月复旦大学附属儿科医院新生儿重症监护室收治的54例危重先天性心脏病患儿发育支持护理实施情况,总结了危重先天性心脏病患儿发育支持护理的重点,主要包括为患儿创造有利于发育的环境、疼痛管理、以家庭为中心的护理、营养支持、发育支持性体位管理和皮肤护理等,旨在为危重先天性心脏病患儿护理提供借鉴和参考。     

支持性照顾对妇科恶性肿瘤病人焦虑、抑郁的影响1）

[目的]探讨支持性照顾对妇科恶性肿瘤病人焦虑、抑郁的影响。[方法]将64例妇科恶性肿瘤伴焦虑、抑郁病人随机分为对照组和观察组各32例,对照组给予常规护理,观察组在常规护理基础上给予支持性照顾。于治疗前、治疗2周、治疗6周后采用焦虑自评量表（SAS）、抑郁自评量表（SDS）进行评估。[结果]两组病人治疗前 SAS 及 SDS 评分比较差异无统计学意义（P〉0.05）,观察组治疗2周后与治疗6周后 SAS、SDS评分均明显低于对照组（P〈0.05）,观察组治疗6周后 SAS、SDS 评分明显低于治疗2周后（P〈0.05）。[结论]支持性照顾能有效改善妇科恶性肿瘤病人焦虑、抑郁情绪,提高治疗效果和生活质量。     

急性白血病患者生活质量与支持性照顾需求的相关性研究

目的调查急性白血病住院患者生活质量、支持性照顾需求的现状并探讨其相关性。方法采用一般资料调查表、白血病生活质量评估量表、支持性照顾需求量表对西安市5所三级甲等医院血液内科的急性白血病患者311例进行调查,将所得资料进行统计学分析。结果急性白血病患者生活质量总分为(112.39±24.31)分;在支持性照顾需求的5个维度中,健康信息需求维度得分最高,性需求维度得分最低;生活质量各维度除社会/家庭状况外,其余各维度与支持性照顾需求各维度呈负相关(P0.01或P0.05)。结论急性白血病患者总体生活质量较差,患者支持性照顾需求各维度存在未满足需求情况,且患者的未满足需求越多生活质量越差。临床医护人员应尽量满足患者的生理及心理方面的需求,进而改善其生活质量。     

宫颈癌患者支持性照顾需求的调查

目的调查宫颈癌患者治疗期间支持性照顾需求及影响因素。方法采用癌症患者支持性照顾需求调查问卷对正在接受治疗的200例宫颈癌患者进行调查。结果宫颈癌患者支持性照顾需求各维度得分由高到低依次是心理需求、健康信息需求、支持和照顾需求、生理和日常生活需求、性需求。年龄、民族、是否知晓诊断、文化程度和发病情况是宫颈癌患者支持性照顾需求的影响因素(P0.01)。结论医护人员在临床工作中要注意宫颈癌患者文化程度、年龄和民族等差异,重视患者的需求,为患者提供针对性护理服务。     

Adolescent cancer survivors' experiences of supportive care needs: A qualitative content analysis

Supportive care is an important strategy that can help cancer survivors manage changes and problems during their follow‐up care. Identifying patients' care needs is one of the primary steps of the nursing process to plan effective nursing interventions. The aim of this study was to explore adolescent cancer survivors' supportive care needs. Purposeful sampling was adopted to select 49 participants from hospitals to participate in face‐to‐face, semistructured interviews. The qualitative content analysis method was conducted for data analysis. Ten subcategories and four main categories – empathetic care, information about survival period, instrumental support, and cooperation in care – were extracted from the data. These four categories formed a major theme, “supportive care”, as the primary healthcare need. This study highlights that supportive care should be developed collaboratively by family and healthcare providers to meet the needs of adolescent cancer survivors. Survivors' strengths and limitations should be identified, and then supportive care can be provided, such as giving appropriate information, enabling survivors to access supportive networks, and improving survivors’ confidence and autonomy with their self‐management.     

A concept analysis of renal supportive care: the changing world of nephrology

AIM: This paper is a report of a concept analysis of renal supportive care. BACKGROUND: Approximately 1.5 million people worldwide are kept alive by renal dialysis. As services are required to support patients who decide not to start or to withdraw from dialysis, the term renal supportive care is emerging. Being similar to the terms palliative care, end-of-life care, terminal care and conservative management, there is a need for conceptual clarity. METHOD: Rodgers' evolutionary method was used as the organizing framework for this concept analysis. Data were collected from a review of CINAHL, Medline, PsycINFO, British Nursing Index, International Bibliography of the Social Sciences and ASSIA (1806-2006) using, 'renal' and 'supportive care' as keywords. All articles with an abstract were considered. The World Wide Web was also searched in English utilizing the phrase 'renal supportive care'. RESULTS: Five attributes of renal supportive care were identified: available from diagnosis to death with an emphasis on honesty regarding prognosis and impact of disease; interdisciplinary approach to care; restorative care; family and carer support and effective, lucid communication to ensure informed choice and clear lines of decision-making. CONCLUSION: Renal supportive care is a dynamic and emerging concept relevant, but not limited to, the end phase of life. It suggests a central philosophy underpinning renal service development that allows patients, carers and the multidisciplinary team time to work together to realize complex goals. It has relevance for the renal community and is likely to be integrated increasingly into everyday nephrology practice.     

信息支持联合家庭访视对早产儿进行发育支持护理的效果分析

目的:探讨早产儿回归家庭后实施发育支持护理对早产儿健康状况的影响。方法:将76例早产儿按出院顺序分为干预组和对照组各38例。干预组给予信息支持联合家庭访视进行发育支持护理;对照组给予信息支持进行发育支持护理,均干预3个月,比较两组干预效果。结果:干预组早产儿在体重、纯母乳喂养情况、常见疾病发生情况与对照组比较,差异有统计学意义(P<0.05)。结论:早产儿回归家庭后采用信息支持联合家庭访视进行发育支持护理,提高早产儿健康水平。     

结肠癌、直肠癌病人术后支持性照顾需求差异研究

目的：比较结直肠癌病人术后支持性照顾需求的不同,为护理人员开展健康指导提供依据和指导。方法：选择2012年37月在某三级甲等肿瘤专科医院通过病理检查确诊的结直肠癌接受手术的161例病人,在癌症病人支持性照顾需求调查问卷（SCNS）的基础上,设计增加未保肛病人适用的造口支持需求维度进行问卷调查,共6个维度70个条目。结果：结肠癌和直肠癌病人术后心理需求和照顾与支持需求无差异,健康信息需求、生理及日常生活需求、性需求、造口需求有统计学差异（P〈0．05）。有无造口病人的健康信息需求、造口需求有统计学差异（P〈0．05）。结论：直肠癌病人术后支持性照顾需求高,应给予更多重视和指导,医务人员是结直肠癌病人最需要的社会支持力量,应利用这种信赖关系给予系统的健康指导,帮助病人实现生理-心理-社会的全面康复,提高生活质量,早日重返社会。