Aspectos de la enfermería en cuidados paliativos en los tiempos de la COVID-19 / Aspects of Palliative Care Nursing in the Time of COVID-19 / Aspectos da enfermagem em cuidados paliativos no contexto da covid-19

Durante a pandemia mundial da covid-19, os pacientes com doenças graves dependem mais do que nunca dos enfermeiros. Assim, oferecer-lhes atenção em um ambiente alterado pode ser estressante tanto para eles quanto para a equipe interdisciplinar. Os enfermeiros enfrentam um desafio extraordinário em um contexto de tempo e recursos limitados, de visitas restringidas de familiares e amigos, e de uma ciência flutuante que influencia nos tratamentos. Por sorte, os enfermeiros podem ser beneficiados da integração das habilidades da enfermagem em cuidados paliativos em todos os níveis de atenção. Devido a que os cuidados paliativos são holísticos, melhoram a qualidade de vida e estão focados não só no paciente, mas também na família, portanto podem ajudar os enfermeiros ­ desde no cuidado agudo até nos ambientes de atendimento domiciliar ­ a controlar sintomas, a comunicar-se com empatia e a analisar as decisões de cuidado. Embora o enorme estresse que a situação de incerteza gera, é importante que os enfermeiros tenham o tempo de se cuidar e encontrem forças para continuar cuidando dos pacientes.

During this COVID-19 global pandemic, seriously ill patients rely on nurses more than ever. Providing care in the altered environment of the pandemic can be stressful for nurses and the interdisciplinary team. Faced with limited time and resources, restricted visiting of family members and loved ones, and the changing science affecting treatments, nurses are extraordinarily challenged. Fortunately, nurses can benefit from integrating palliative care nursing skills into all levels of care. Because palliative care is holistic, improves the quality of life, and focuses on both the patient and the family, it can assist nurses­from acute care to home care settings­in managing symptoms, communicating with empathy, and discussing care decisions. Importantly, despite the enormous stress of these uncertain times, nurses can take the time to care for themselves and thereby find the strength to continue caring for patients.

Durante esta pandemia mundial de la covid-19, los pacientes enfermos de gravedad dependen más que nunca de los enfermeros, así que brindarles atención en un entorno alterado puede ser estresante para ellos y para el equipo interdisciplinario. Los enfermeros enfrentan un desafío extraordinario en un contexto de tiempos y recursos limitados, de visitas restringidas de familiares y seres queridos y de una ciencia cambiante que influye en los tratamientos. Por fortuna, los enfermeros pueden beneficiarse de la integración de las habilidades de la enfermería en cuidados paliativos en todos los niveles de atención. Debido a que los cuidados paliativos son holísticos, mejoran la calidad de vida y se enfocan tanto en el paciente como en la familia, pueden ayudar a los enfermeros, desde cuidados agudos hasta en los entornos de atención domiciliaria, a controlar los síntomas, a comunicarse con empatía y a analizar las decisiones de cuidado. A pesar del enorme estrés que generan estos tiempos inciertos, es importante que los enfermeros se tomen el tiempo de cuidarse a sí mismos y encuentren la fuerza para seguir cuidando a los pacientes.

The Middle-Range Theory of the Adapting Family: From Theory to Practice.

The middle-range theory of the adapting family, derived from the Roy adaptation model, was chosen as the guiding framework for the newly formed Family Center at Holy Family University. The committee governing the Family Center supported the application of this theory to the provision of resources to families through education, counseling, consultation, and advocacy. The concepts of stimuli, coping processes, and outcomes of the middle-range theory of the adapting family are examined. Services offered, including the parenting workshops, retirement workshops, and the cakes for kids program, are explained with detailed examples of how the theory is used in practice.

Hope in patients with cancer transitioning to survivorship: the mid-life directions workshop as a supportive intervention.

PURPOSE/OBJECTIVES: To describe the Mid-Life Directions workshop as an intervention to support hope and quality of life in midlife cancer survivors. DATA SOURCES: Published articles and books. DATA SYNTHESIS: The Mid-Life Directions workshop assists survivors to integrate the cancer experience through conscious awareness and choice, and transition to survivorship with an increased level of adaptation. Quality of life and hope are enhanced through new information and skills allowing participants to direct their lives into a preferred future. CONCLUSIONS: The midlife cancer survivor is challenged to face the fear of recurrence, death, and the crisis of meaning in a developmentally appropriate way. The task of midlife is to navigate the tension of generativity versus stagnation for care to emerge as the predominant strength. The Mid-Life Directions workshop provides the cancer survivor the opportunity to reevaluate goals, reprioritize values, and find one's own answers to these challenges to adapt to life as a cancer survivor. IMPLICATIONS FOR NURSING: This clinically relevant intervention merits formal study. Facilitator preparation, mode of delivery, and other elements for possible research are discussed.

Hope in adults with cancer: state of the science.

PURPOSE/OBJECTIVES: To synthesize the literature regarding research on hope in adults with cancer. DATA SOURCES: CINAHL Plus® and PsycINFO databases. DATA SYNTHESIS: Sixteen articles published from 2005-2009 met the criteria for review. The literature was organized according to Oncology Nursing Society levels of evidence. Research studies on hope in adults with cancer were analyzed, critiqued, and synthesized. CONCLUSIONS: Research evidence continues to grow regarding descriptions of hope and hope attributes in adults with cancer. Although nursing intervention programs have demonstrated positive effects on hope in adults newly diagnosed with cancer, those with a first cancer recurrence, the terminally ill, and survivors of childhood cancer, current studies are small and additional research is indicated. IMPLICATIONS FOR NURSING: Opportunities exist to explain the dynamic process of hope, develop hope interventions that are tailored to meet the developmental needs of adults with cancer, and study existing nursing programs that support hope using larger samples in randomized, controlled trials.