Effects of Home Nursing Intervention on the Quality of Life of Patients with Nasopharyngeal Carcinoma after Radiotherapy and Chemotherapy.

BACKGROUND: The effects of home nursing intervention on the quality of life in patients with nasopharyngeal carcinoma (NPC) after radiotherapy and chemotherapy are unclear. According to the characteristics of nursing home patients with nasopharyngeal carcinoma, we should continuously improve the nursing plan and improve the quality of life of patients at home. MATERIALS AND METHODS: We selected 180 patients at home with NPC after radiotherapy and chemotherapy. The patients were randomly divided into experimental and control groups (90 patients each). The experimental group featured intervention with an NPC home nursing plan, while the control group was given routine discharge and outpatient review. Nursing intervention for patients was mainly achieved by regular telephone follow-up and home visits. We use the quality of life scale (QOL-C30), anxiety scale (SAS) and depression scale (SDS) to evaluate these patients before intervention, and during follow-up at 1 month and 3 months after the intervention. RESULTS: Overall health and quality of life were significantly different between the groups (p<0.05), Emotional function score was significantly higher after intervention (p<0.05), as were cognitive function and social function scores after 3 months of intervention (p<0.05). Scores of fatigue, nausea and vomiting, pain, appetite and constipation were also significantly different between the two groups (p<0.05). Rates of anxiety and depression after 3 months of intervention were 11.1%, 22.2% and 34.4%, 53.3%, the differences being significant (p<0.05). CONCLUSIONS: NPC home nursing plan could effectively improve overall quality of life, cognitive function, social function (after 3 months) of patients, but improvement regarding body function is not suggested. Fatigue, nausea and vomiting, pain, appetite, constipation were clearly improved. We should further pursue a personalized, comprehensive measurements for nursing interventions and try to improve the quality of life of NPC patients at home.

[Caring for a terminal patient with nasopharyngeal carcinoma in the ICU who refuses treatment: a nurse's experience].

This article describes the experience of a nurse directly responsible for the care of a patient with terminal stage nasopharyngeal carcinoma who refused all medical treatment. Tumor bleeding had caused loss of consciousness, which led to the family arranging ICU admission. While in the ICU, the patient was overwhelmed by feelings of hopelessness regarding his disease and believed his family was not emotionally supportive. The patient was verbally non-responsive, angry and lethargic. He also refused to accept any medical care or treatment. The author collected data through observation, physical assessment, interviews and written communication between May 9th, 2007 and May 23rd, 2007. The author confirmed the diagnosis and found that the patient had some related mental health problems, including imbalanced nutrition (less than body requirements), chronic feelings of hopelessness and anxiety. The author established a positive relationship with the patient utilizing Watson's caring theory and case-establishment trust in the nursing process. The author provided disease-related information to the patient, worked as an intermediary to encourage greater family member support and encouragement, helped the patient interact with visitors and encouraged development of the patient's self-esteem. This experience can benefit nursing professionals by fostering a greater understanding of patient self-esteem and the benefits of a positive treatment environment.

Clinical encounter experiences of patients with nasopharyngeal carcinoma.

Nasopharyngeal carcinoma (NPC) is a commonly occurring cancer among Hong Kong Chinese, especially in the relatively young population group. Since the disease carries a favorable prognosis, sequelae following treatment have become an important concern for patients suffering from NPC, particularly because of the strong interplay of psychological, social, and biological issues during their rehabilitation. In this qualitative study, in-depth, semistructured audiotaped interviews were undertaken with 32 patients receiving rehabilitation at the physiotherapy department of a regional teaching hospital in Hong Kong. The objective of the study was to examine the rehabilitation experiences of NPC survivors to identify factors that contributed to a satisfying clinical encounter experience. During the study, data collection and analysis using a grounded theory approach were concurrently conducted. The 3 main themes that shaped the rehabilitation experiences of NPC survivors were the patient-clinician relationship, participation in therapeutic alliance, and quality rehabilitation service provision. These, together with the identified needs of the participants, contributed to the participants' perceived health-related quality of life. A constructive clinical experience was perceived when their needs were met. The findings highlight the importance of patient-centeredness in the treatment delivery and a multifaceted role of clinicians in meeting the needs of this group of cancer survivors.

Nasopharyngeal angiofibroma: a case study.

Juvenile angiofibromas, most commonly found in adolescent males, are vascular lesions that occur in the nasopharynx and extend into other areas of the skull. Presenting signs and symptoms include epistaxis, nasal obstruction and nasal drainage. Computed tomography and magnetic resonance imaging are the primary diagnostic tests. Angiography is used for vascular mapping and preoperative embolization. Total surgical resection is the goal of treatment. Nursing care includes developmental considerations with a focus on comfort, neurological assessment and patient and family education.