Urinary continence issues in oncology

Urinary incontinence may occur with many types of cancer and cancer therapies. Symptoms of urinary incontinence negatively may affect patients' lifestyles, self-esteem, and quality of life. Although urinary incontinence is not a new problem, nurses often underestimate its impact on patients. Knowledge of the physiology of micturition and causes of urinary incontinence in patients with cancer may help nurses identify patients at risk and provide a framework for conducting targeted assessments of urinary function.     

Symptom management issues in oncology nursing

Symptoms experienced by patients with cancer can occur as a direct effect of the disease process and be related to side effects of treatment. Many patients with cancer also are older in age and have comorbidities, such as diabetes and heart disease. Comorbid conditions also produce disease and treatment-related symptoms that may have an independent or compounding effect on cancer-related symptoms.     

Phase I clinical trials in oncology: ethical issues

The scientific goal of phase I clinical trials in oncology is to determine and optimise the drug dose and schedule on the basis of the toxicity profile. These trials also respond to a need: they offer the chance of early access to a new therapy for cancer patients who are characterised by both the lack of a therapeutic option and a desire to fulfil personal ambitions. The therapeutic relationship in this context must reconcile unreasonable hopes and anxiety regarding death and follow the same rules as in other doctor-patient relationships, with the triple requirement being that it should be genuine, therapeutic and empathetic.     

Legal and ethical issues confronting oncology nursing

OBJECTIVES: To identify and summarize the legal and ethical issues found in the multiple settings in which oncology nurses practice. DATA SOURCES: Lexis, Medline, Westlaw, federal and state laws, government documents, and nursing and medical textbooks. CONCLUSIONS: Oncology nurses face many legal and ethical dilemmas when delivering care. The best defense against litigation is to be knowledgeable about the specific issues found in each setting, the impact these issues have on practice, and requisite risk reduction practices. IMPLICATIONS FOR NURSING PRACTICE: With the advent of new technology, changing state and federal laws, and new court decisions, the ethical and legal issues nurses will encounter when taking care of cancer patients will not remain the same. Continuing education will be essential if nurses are to remain current, lower their legal liability, and deliver quality care.     

Quality of life issues identified by palliative care clients using two tools

Reported are issues impacting upon the Quality of Life (QoL) of 59 palliative care clients within a district nursing service. These issues reinforce the emerging conceptualisation of QoL as being subjective and multidimensional. The issues were identified during a trial of two QoL assessment and measurement tools, the Client Generated Index (CGI) and the McGill Quality of Life (MQOL). In this era of considerable concern about QoL for the terminally ill, the article's intent is to present the QoL issues identfied, the grades of impact and priority for improvement of the issues according to the clients, and to discuss these aspects. This information can inform the assessment of palliative care clients (the CGI tool was found ideal for such an assessment), and may also inform further research on the QoL of palliative care clients.     

Methodologic issues in exercise intervention research in oncology

OBJECTIVES: To review randomized controlled trials that offered exercise interventions for adults diagnosed and treated for cancer related to design, sample, type of intervention, and outcomes. DATA SOURCES: Several electronic databases were searched and recent review papers were scanned to identify relevant publications. CONCLUSION: Exercise adoption seems clearly feasible for early stage cancer patients, particularly breast cancer patients. Data support positive effects for physical functioning, quality of life, and psychological well-being. Effects for patients with later-stage disease and other cancers are less clear. The impact of exercise adoption on biomarkers of disease status, immune functioning, and hormone levels should also be examined. IMPLICATIONS FOR NURSING PRACTICE: There are many opportunities for nurses to promote exercise in clinical care and in a research context.     

Sexual issues in special populations: geriatric oncology - sexuality and older adults

OBJECTIVE: To provide an overview of sexuality and sexual expression in older adult cancer survivors and to outline implications for nursing and interdisciplinary practice. DATA SOURCES: Research articles, abstracts, reviews, and clinical expertise. CONCLUSION: Unique features of sexuality in late life provide evidence to support clinical exploration of sexuality for older adult cancer survivors. Approaches to intervention with older adult cancer survivors are predicated on adaptation of best practices in sexuality and sexual health to create care that is sensitive to age and generation. Targeted research in sexuality for older adult cancer survivors includes intimacy, relationship, sexual experience, and imbedded sexual behavior. IMPLICATIONS FOR NURSING PRACTICE: Nurses can improve the care of older adults with cancer by careful consideration of intimacy and sexuality using standards of practice with younger adults integrated with understanding of issues unique to later life.     

Nursing practice issues in Jordan: student-suggested causes and solutions

BACKGROUND: The causes of the worldwide shortage of registered nurses are complex and require a multifaceted approach to the solution. It is imperative that issues of the practice environment are addressed because creating quality practice environments is essential to provide high-quality care and to persuade nurses to remain in practice. AIMS: The aims of this paper are to describe an international collaborative relationship, and to identify, describe and suggest solutions to three nursing practice issues relevant to Jordanian nursing. METHOD: Two faculty members, one from Jordan and one from Canada, collaborated via e-mail to develop a fourth-year course on nursing leadership and management, which was then jointly taught by them. A student assignment required students, working in groups, to identify a nursing practice issue in Jordan and suggest contributing causes and solutions. CONCLUSION: The issues identified by the students were: unclear role expectations, burnout and turnover, all of which were viewed as contributing to problematic practice settings. The students suggested possible solutions to the practice environment issues.     

Critical ethnographic methodology in nursing research: issues and solutions

Five methodological issues were encountered in a study using critical ethnography to investigate nurses' attitudes, knowledge and practices towards patients with alcohol and drug related problems in a general hospital. These issues related to the recording of field notes, over-identification with participants, the role of being a researcher, the effect of the researcher's presence - the Hawthorne effect, and cultural differences. The latter issue was viewed from the personal perspective as an international student from Denmark conducting the research in an Australian setting. This paper discusses the issues in turn and concludes with recommendations on how they might be effectivley addressed by other researchers considering to use critical ethnography.     

肿瘤护理研究热点的共词聚类分析

目的 分析PubMed 2008年一2017年肿瘤护理的研究热点,探索肿瘤护理研究的发展趋势。 方法 通过PubMed检索2008年一2017年发表的肿瘤护理文献,利用书目信息数据挖掘系统软件和图形聚类工具包软件进行文献计量及聚类分析。 结果 共纳入文献2977篇,平均每年刊载297.7篇,发文量排名前3位的国家为美国、英国、加拿 大。通过双向聚类分析,发现2008年一2017年肿瘤护理的研究热点包括6个方面％肿瘤科护士对姑息照护的知信行、癌症幸存者的生活质量、肿瘤科护士的职业倦怠、抗肿瘤药物的职业安全防护、肿瘤患者的延续护理、肿瘤患者的症状管理。 结论 肿瘤护理研究对象、研究主题呈现多样化,但地区发展不平衡。我国应加强肿瘤护理研究的全面性及深入性,探索肿瘤护理发展的信息化、整体化及多学科化发展。     

Coverage with evidence development: ethical issues and policy implications

Coverage with evidence development (CED) is an evolving method of providing provisional access to novel medical interventions while generating the evidence needed to determine whether unconditional coverage is warranted. In this article we review the policy rationale for CED and present a normative analysis that addresses ethical concerns and policy implications.     

Competency, confidence and conflicting evidence: key issues affecting health visitors' use of research evidence in practice

Background  

Health visitors play a pivotal position in providing parents with up-to-date evidence-based care on child health. The recent controversy over the safety of the MMR vaccine has drawn attention to the difficulties they face when new research which raises doubts about current guidelines and practices is published. In the aftermath of the MMR controversy, this paper investigates the sources health visitors use to find out about new research evidence on immunisation and examines barriers and facilitators to using evidence in practice. It also assesses health visitors' confidence in using research evidence.