RESUMO
Open-heart surgery and conservative medical treatments have been the traditional, mainstay treatments for patients with severe mitral regurgitation (MR). Transcatheter edge-to-edge mitral repair is a novel technique. Using the transcatheter approach allows delivery of the clip into the left ventricle and the clipping of the orifice of the MR. The heart failure symptoms and outcomes of patients improve after this procedure. Compared to open-heart surgery, the mitral clip achieves similar MR reduction results with a significantly lower rate of complications. Since 2016, MitraClip has been available for clinical use in Taiwan. The aim of this report is to introduce this new treatment with a focus on nursing care in order to provide a reference for clinical care.
Assuntos
Implante de Prótese de Valva Cardíaca/métodos , Insuficiência da Valva Mitral/cirurgia , Valva Mitral/cirurgia , Cateterismo Cardíaco , Implante de Prótese de Valva Cardíaca/enfermagem , Humanos , Cuidados Pós-OperatóriosRESUMO
AIMS AND OBJECTIVES: To explore the essence of the illness experiences of middle-aged men with oral cancer. BACKGROUND: Having oral cancer creates great challenges in the lives of middle-aged men and their families. Understanding patients' experiences provides a sound basis for patient-centred and individualised care. Research is limited regarding the illness experience of middle-aged men with oral cancer with regard to facing both the invasion of disease and the responsibilities of middle age. DESIGN: A phenomenology approach was used. METHODS: Nine men diagnosed with oral cancer within one year were recruited during 2009 and 2010. Data were collected through individual in-depth interviews and analysed using Colaizzi's phenomenological analysis procedures. RESULTS: The following five themes emerged from the patterns of categorised interview data: the psychological journey in facing oral cancer, the question of how patients can control their disease as well as the sequelae of cancer treatment, the continuous disturbance and turmoil resulting from the disease, the appreciation of the support from family and friends, and the ability to learn to actively face the future. CONCLUSIONS: Patients with oral cancer experienced tremendous physical, psychosocial and financial challenges. Although burdened with multiple stressors, these middle-aged men were able to learn from their experiences and exhibit positive growth in life. RELEVANCE TO CLINICAL PRACTICE: Patients with oral cancer have to constantly adjust to the impact of their disease. The study results may serve as a reference for improving clinical practice and the quality of care among patients with oral cancer. Cancer care is multidimensional and holistic. Healthcare professionals should develop a set of plans by which patients receive complete medical care and support, as well as assistance from professionals and family members, as their treatment progresses to help patients face the challenges of cancer.
Assuntos
Neoplasias Bucais/fisiopatologia , Adaptação Psicológica , Idoso , Humanos , Masculino , Pessoa de Meia-Idade , Neoplasias Bucais/psicologia , Apoio SocialRESUMO
OBJECTIVE: Head-and-neck cancer (HNC) and its treatment impact patients' quality of life (QoL) and survival. The symptom burden of HNC survivors severely affects QoL, while hope serves as an impetus for adjustment that enables survivors to sustain basic QoL. This study investigated the change of QoL, symptom burden, and hope and the predictors of QoL change in HNC survivors from diagnosis to 3 months after concurrent chemoradiotherapy (CCRT) completing. METHODS: This was a prospective, correlational study conducted between January 2016 and April 2017 at a medical center in northern Taiwan. Purposive sampling 54 adults newly diagnosed with HNC had completed the first CCRT. The questionnaires of Functional Assessment of Cancer Therapy-HNC Scale, M. D. Anderson Symptom Inventory, and Herth Hope Index were collected. The five measuring times were before CCRT (T1), the 3rd-4th week of CCRT (T2), the last week of CCRT (T3), and 1 month (T4) and 3 months (T5) after the completion of CCRT. RESULTS: The change of QoL first declined and then rose at T2-T5. The change of symptom burden increased initially and then declined at T2-T5. The change of hope remained steady between T1 and T5. The change of symptom burden and hope significantly predicted the change of QOL over time. CONCLUSIONS: Clinicians are suggested to assess symptom burden and hope regularly in HNC during their CCRT and, if needed, promptly provide interprofessional care in time. Reducing symptom burden and maintaining a mindful hope could improve QoL in HNC survivors during CCRT.
RESUMO
The purpose of this study was to evaluate our self-developed scheduling plan support system in terms of performance and nurses' perception of easiness to use and usefulness. The results showed that thought the head nurse needed to averagely take half hour to modify the system scheduling plan, it was much better than four hours needed before. Nurses were also satisfied with the system. We believed nurses could design very useful and easy-to-use systems if trained and equipped with the right information tools.
Assuntos
Difusão de Inovações , Recursos Humanos de Enfermagem Hospitalar , Admissão e Escalonamento de Pessoal/organização & administração , Análise e Desempenho de Tarefas , Eficiência Organizacional , Humanos , TaiwanRESUMO
The purpose of this study was to develop a nurse-self-made scheduling support system based on the heuristic approach. A Pediatric ICU unit, staffed with 35 nurses, was taken as the case in this study. Nurses' preferred scheduling principles were surveyed. The Excel VBA was used to develop the support system by an informatics nurse. The system was composed of five components: personal scheduling request setting, auto-scheduling, shift modification, report generating and inquiry. The scheduling results were widely accepted by the nurses and the time to plan a monthly schedule was reduced from 4-5 hours to 30 minutes.