RESUMO
Gastrointestinal and biliary obstructive disorders are complications encountered in advanced cancer nursing that are associated with significant morbidity and mortality. Patients with bowel gastric, or hepatobiliary obstruction require prompt and accurate diagnosis, so that appropriate care is initiated to treat the obstruction and related symptoms. Intensive nursing care aimed at comfort, psychological support, and patient/family education is essential for the well-being of patients suffering from a gastrointestinal obstructive disorder.
Assuntos
Colestase Extra-Hepática/terapia , Colestase Intra-Hepática/terapia , Obstrução da Saída Gástrica/terapia , Obstrução Intestinal/terapia , Neoplasias/enfermagem , Colestase Extra-Hepática/diagnóstico , Colestase Extra-Hepática/etiologia , Colestase Extra-Hepática/enfermagem , Colestase Extra-Hepática/fisiopatologia , Colestase Intra-Hepática/diagnóstico , Colestase Intra-Hepática/etiologia , Colestase Intra-Hepática/enfermagem , Colestase Intra-Hepática/fisiopatologia , Obstrução da Saída Gástrica/diagnóstico , Obstrução da Saída Gástrica/etiologia , Obstrução da Saída Gástrica/enfermagem , Obstrução da Saída Gástrica/fisiopatologia , Humanos , Obstrução Intestinal/diagnóstico , Obstrução Intestinal/etiologia , Obstrução Intestinal/enfermagem , Obstrução Intestinal/fisiopatologia , Neoplasias/complicações , Cuidados PaliativosRESUMO
The goal of palliative care is to provide comprehensive and intense symptom management and psychological, educational, social, and spiritual support. Barriers to palliative care that nurses encounter may be conceptualized into three main levels: the patient/family, professional, and system barriers. Recommendations for nurses, health care policy makers, and other health professionals to address the barriers are discussed. Future research and work needs to be implemented at all three levels to optimize the quality end-of-life care.
Assuntos
Atitude Frente a Saúde , Tomada de Decisões , Neoplasias/enfermagem , Cuidados Paliativos , Educação em Enfermagem , Humanos , Neoplasias/complicações , Política Organizacional , Dor/etiologia , Dor/prevenção & controleRESUMO
PURPOSE/OBJECTIVES: To ascertain the critical issues in current advanced practice nurse (APN) roles in oncology. DESIGN: Descriptive. SETTING: National. SAMPLE: 368 Oncology Nursing Society (ONS) APNs in oncology practice. METHODS: Subjects completed an 11-page self-administered questionnaire comprised of 62 multiple-choice and open-ended questions. Subjects were asked to identify level of importance for ONS to address selected issues in each section. MAIN RESEARCH VARIABLES: Demographic information and APN issues regarding practice, outcomes, prescriptive authority, reimbursement, education, continuing education, licensure and certification, legislation, and challenges facing oncology APNs. FINDINGS: The majority of APNs were nurse practitioners working in a hematology/oncology practice in an urban setting providing direct patient care. Priority practice issues were lack of agreement among state boards of nursing related to privileges, lack of understanding of the role by patients and healthcare professionals, and lack of an APN definition. Important APN outcomes were symptom management, quality of life, patient/family satisfaction, and cost of care. Priority educational topics were oncology disease management, pharmacology, advanced physical assessment, and reimbursement. Challenges facing oncology APNs were lack of an APN definition, reimbursement issues, documentation of outcomes, prescriptive authority, variance in education, merging of current roles, certification, loss of cancer specialty, and second licensure. CONCLUSIONS: Numerous APN issues continue to be unresolved. APN outcomes research is needed to validate the oncology APN role in cancer care. IMPLICATIONS FOR NURSING PRACTICE: Survey results and specific recommendations have been forwarded to the ONS Steering Council and Board of Directors for implementation decisions.