Humanized oncology nursing care in a person with gastric cancer: A case report.

Cancer impacts the person's physical health, psychosocial and spiritual wellbeing. The humanization of care is an essential element to achieve integral wellbeing of the individual. The aim of this article is to present a clinical case, using the nursing process with the NANDA, NOC and NIC taxonomies, and based on the principles of Watson's theory of humanized care. The participant is a 45-year-old woman with gastric cancer in palliative stage. The assessment was performed using Gordon's functional patterns and the Watson Caritas Patient Score scale to evaluate the care received previously in the health system. Eight nursing diagnoses were identified, prioritizing 3 diagnoses using the clinical reasoning web (decisional conflict, anxiety, and ineffective self-management of health). Expected outcomes and nursing interventions were planned and implemented through moments of care using health education through tele-nursing and the intentional use of Caritas processes of care in the transpersonal relationship. The results were evaluated with the scales of the indicators and anxiety was also evaluated with the Beck Anxiety Inventory. Health education in oncology nursing contributed to improve informed decision making, reducing anxiety and providing emotional support to facilitate self-management of health. The participant perceived as humanized care throughout the sessions, reflected in the final evaluation with the Watson Caritas Patient Score scale.

Application of Computed Tomography Imaging in Diagnosis of Endocrine Nerve of Gastric Cancer and Nursing Intervention Effect.

In this article, some parameters and characteristics of computed tomography (CT) images in patients with gastric cancer are analyzed and the application of CT images in the diagnosis of gastric cancer endocrine nerves and the impact of nursing intervention on the quality and mental state of CT images of patients with gastric cancer are discussed. First, all patients were scanned with CT, and the CT values of the normal stomach wall and all lesions at different single-energy levels were recorded separately. Second, the improved back propagation network model was applied to realize the diagnosis of gastric cancer through the analysis of various features of CT images. The effect of nursing intervention on the image quality and mental state of CT imaging of patients with gastric cancer was studied. The results show that the energy spectrum curve of CT images and the improved back propagation network model are helpful for the initial diagnosis and identification of gastric cancer. Nursing intervention has a good influence on the clinical examination, image diagnosis, and psychological state of patients with gastric cancer, and it is easy for patients to undergo image diagnosis and examination according to correct operating procedures.

Effect of high-quality nursing intervention on the psychological disorder in patients with gastric cancer during perioperative period: A protocol of systematic review and meta-analysis.

BACKGROUND: This study will be proposed for investigating the effects of high-quality nursing intervention (HQNI) on the psychological disorder in patients with gastric cancer during perioperative period (GC-PPP). METHODS: A cumulative search from inception up to the March 31, 2020 will be performed in the following databases: Cochrane Library, MEDLINE, EMBASE, Web of Science, VIP database, and China National Knowledge Infrastructure. We will search all potential studies from those electronic databases regardless their language and publication status. We will only consider randomized controlled trials (RCTs) for inclusion, which explores the effect of HQNI on the psychological disorder in patients with GC-PPP. Study identification, information extraction, and study quality appraisal will be independently and respectively done by 2 researchers. Any different opinions between 2 researchers will be disentangled by a third researcher after discussion. Cochrane risk of bias tool will be used for study quality assessment, and RevMan 5.3 software will be utilized for statistical analysis. RESULTS: This study will provide a high-quality synthesis of psychological disorder outcomes to evaluate the effects and safety of HQNI for patients with GC-PPP. CONCLUSION: The findings of this study will provide reference and evidence to appraise whether HQNI is an effective on the psychological disorder in patients with GC-PPP STUDY REGISTRATION NUMBER:: INPLASY202040080.

Perfil del paciente con cáncer gástrico del Instituto Nacional del Cáncer / Profile of the patient with gastric cancer of the National Cancer Institute / Perfil do paciente com câncer gástrico do Instituto Nacional do Câncer

OBJETIVO: Levantar y analizar el perfil de los pacientes con cáncer gástrico matriculados en el Instituto Nacional del Cáncer José de Alencar Gomes da Silva (INCA), y los diagnósticos de Enfermería más prevalentes. METODOLOGÍA: Estudio seccional desarrollado en el Hospital de Cáncer I - INCA aprobado por el CEP-INCA, con muestra de datos secundarios de 649 pacientes admitidos entre el 1 de octubre de 2015 al 18 de abril de 2018. Los datos fueron analizados por el software R® - versión 3.4.4. En las pruebas Chi-cuadrado, Kruskal-Wallis y Wilcoxon. Se adoptó el nivel de significancia del 5%. RESULTADOS: El promedio de edad fue de 62.74 años, variando de 21 años hasta 96 años.35.29% de los pacientes presentaban enfermedad avanzada. El adenocarcinoma poco diferenciado fue el más prevalente (42.52%). Había células en anillo de sello en el 32.05% de los pacientes. Se destacó el tipo difuso (17.72%). Hubo predominio del compromiso del tercio medio del estómago (29.74%). Las pruebas de hipótesis demostraron que las variables de estadificación frente a la muerte y el color frente a la defunción mantienen una relación de dependencia. Las variables edad versus óbito y edad versus presencia de anillo de Sinete tienen distribución diferente entre sí, lo que significa que la primera variable puede influenciar la segunda. Los diagnósticos de enfermería más prevalentes estuvieron presentes en el 100% de la muestra y se encontraban en congruencia con el perfil de la clientela identificada. CONCLUSIÓN: El perfil epidemiológico de una población es de gran valor para orientar las políticas de salud de un país, para la planificación interna institucional y para orientar las acciones asistenciales de los equipos multiprofesionales

OBJECTIVE: Search and analyze the profile of patients with gastric cancer enrolled in the National Cancer Institute, José de Alencar Gomes da Silva (INCA), and the most prevalent nursing diagnoses. METHODOLOGY: A sectional study developed at the Cancer Hospital I - INCA, approved by CEP-INCA, with a sample of secondary data from 649 patients admitted from October 1, 2015 to April 18, 2018. Data were analyzed by R® software - version 3.4 .4. In the Chi-square, Kruskal-Wallis and Wilcoxon tests. The level of significance of 5% was adopted. RESULTS: The average age was 62.74 years, ranging from 21 years to 96 years.35.29% of patients had advanced disease. Low adenocarcinoma was the most prevalent (42.52%). Signal ring cells were present in 32.05% of the patients. The diffuse type was highlighted (17.72%). There was predominance of involvement of the middle third of the stomach (29.74%). Hypothesis tests have shown that the staging versus death and color versus death variables maintain a relationship of dependence. The variables age versus death and age versus the presence of the Sinete ring present a distinct distribution among them, which means that the first variable can influence the second. The most prevalent nursing diagnoses were present in 100% of the sample and were in congruence with the profile of the clientele identified. CONCLUSION: The epidemiological profile of a population is of great value to guide the health policies of a country, to the internal institutional planning and to guide the assistance actions of the multiprofessional teams

OBJETIVO: Levantar e analisar o perfil dos pacientes com câncer gástrico matriculados no Instituto Nacional de Câncer José de Alencar Gomes da Silva (INCA), e os diagnósticos de Enfermagem mais prevalentes. METODOLOGIA: Estudo seccional desenvolvido no Hospital de Câncer I - INCA aprovado pelo CEP-INCA, com amostra de dados secundários de 649 pacientes admitidos entre 01 de outubro de 2015 à 18 de abril de 2018. Os dados foram analisados pelo software R® - versão 3.4.4. Nos testes Qui-quadrado, Kruskal-Wallis e Wilcoxon. Foi adotado o nível de significância de 5%. RESULTADOS: A média de idade foi de 62.74 anos, variando de 21 anos até 96 anos.35.29% dos pacientes apresentavam doença avançada. O adenocarcinoma pouco diferenciado foi o mais prevalente (42.52%). Havia células em anel de sinete em 32.05% dos pacientes. Destacou-se o tipo difuso (17.72%). Houve predomínio do comprometimento do terço médio do estômago (29.74%). Os testes de hipóteses demostraram que as variáveis estadiamento versus óbito e cor versus óbito mantêm uma relação de dependência. As variáveis idade versus óbito e idade versus presença de anel de Sinete tem distribuição diferentes entre si, o que significa que a primeira variável pode influenciar a segunda. Os diagnósticos de enfermagem mais prevalentes estiveram presentes em 100% da amostra e encontravam-se em congruência com o perfil da clientela identificada. CONCLUSÃO: O perfil epidemiológico de uma população é de grande valia para orientar as políticas de saúde de um país, para o planejamento interno institucional e para nortear as ações assistenciais das equipes multiprofissionais

The relationships among insecure attachment, social support and psychological experiences in family caregivers of cancer inpatients.

PURPOSE: To explore the psychological experiences of the family caregivers of inpatients with gastric cancer or colorectal cancer, and to identify the relationships among insecure attachment, social support, and psychological experiences. METHODS: The study design is a cross-sectional quantitative study collecting data through the use of four questionnaires, including the Hospital Anxiety & Depression Scale, the Self-esteem subscale of the Caregiver Reaction Assessment Scale, the Experience in Close Relationship Scale and the Social Support Rating Scale. Hierarchical regression analysis and path analysis were used to analyze the collected data. RESULTS: Data from 207 participants was used. Family caregivers had experienced both depression and high self-esteem. Social support has significant direct effects on both depression and self-esteem. Attachment anxiety had direct effects on depression and social support, attachment avoidance had direct effects on self-esteem and social support. Social support has mediated the relationship between adult attachment and psychological experiences. CONCLUSIONS: Caregivers had experienced both negative and positive psychological outcomes. There were differences in the effects of insecure attachment on psychological experiences. Social support plays an important role in the relationships among insecure attachment, depression, and self-esteem. Insecure attachment styles and social support should be considered in tailored interventions for family caregivers to reduce their depression and enhance their self-esteem.

Gastroesophageal cancer patients need earlier palliative intervention - Using data to inform appropriate care.

PURPOSE: To evaluate demographics of survival in patients with gastroesophageal cancer so that it informs nursing practice. METHOD: Data on 2215 patients diagnosed with gastroesophageal cancer who presented to a specialist referral centre between the years 2000 and 2011 were extracted from a Public Health repository. Survival time was calculated and analysed against clinical and lifestyle factors to reveal whether they had an impact on survival outcomes. RESULTS: Over 60% of patients had died within the first year, 39% of these died within the first 6 months. Survival outcomes were reduced in advancing age, and in those patients who present as 'emergency' cases. One quarter of patients were seen by a GP, but were not referred urgently through the two week wait system, to specialist care. Thus, gastroesophageal cancer patients need specific and appropriate treatment options, including earlier referrals to palliative care provision. There is also a need for cancer specific education and information at community and clinical levels. CONCLUSIONS: The globally applied one and five-year statistics applied to cancer survival studies do not adequately capture rates of early demise with gastroesophageal cancer. This study presents a novel approach to statistical analysis, based on patient derived data. It identifies factors linked to earlier deaths. However, rather than a focus on early presentation and diagnosis (which are essential) - it also reveals a significant need to consider early referrals for palliative care and nursing interventions to alleviate pain and suffering in patients with poor prognosis.

Tecnologia educativa sobre câncer gástrico / Educational technology on gastric cancer

Objetivo: descrever o processo de validação de uma tecnologia educativa sobre câncer gástrico como instrumento de educação em saúde. Método: trata-se de um estudo metodológico seguindo o modelo de Echer. Resultados: o trabalho foi desenvolvido em três etapas - revisão de literatura, construção da cartilha educativa e validação de conteúdo da tecnologia educativa. A validação de conteúdo foi realizada por quinze profissionais da Estratégia Saúde da Família de Bela Cruz-Ceará e ele foi avaliado quanto aos objetivos, estrutura, apresentação e relevância. Conclusão: foi validada a cartilha "Conhecendo e descrevendo o Câncer Gástrico" como uma tecnologia educativa.(AU)

Effect of nursing care given at home on the quality of life of patients with stomach cancer and their family caregivers' nursing care.

In Turkey, the high incidences of stomach and oesophageal cancers in East and high incidence of stomach cancer in Northeast regions are remarkable. This study was conducted to identify homecare needs of patients with stomach cancer and their caregivers and the effect of family supportive nursing care on the quality of life of patients and families. The patient and his/her caregiver were assessed with respect to their daily life activities and NANDA was used for the identified nursing diagnoses, NIC for the appropriate interventions and NOC for assessment of the results. This study was conducted in a pre-test, post-test, controlled trial model to identify. The sample of the investigation consisted of 72 patients and 72 caregivers. As a data-collecting instrument, the Quality of Life Scale and Caregiver Quality of Life Index-Cancer were used. The overall quality of life, global health status and emotional and cognitive functions of the patients in the experimental group improved after the interventions. The overall quality of life and global health status was found to be poorer in the control group patients at post-test as compared to pre-test and their physical, role and social functions deteriorated. The caregivers' quality of life in the control group was affected more negatively with respect to the "Disruption in Daily Life" subscale as compared to pre-test values.

Neuroendocrine Tumors and Lanreotide Depot: Clinical Considerations and Nurse and Patient Preferences.

BACKGROUND: Somatostatin analogs (SSAs) are a mainstay therapy for the treatment of carcinoid syndrome associated with neuroendocrine tumors (NETs). They are effective for a range of gastroenteropancreatic NETs (GEP-NETs). Lanreotide depot (Somatuline®) is an SSA that is approved for the treatment of GEP-NETs to improve progression-free survival (PFS). OBJECTIVES: The article reviews the efficacy, safety, and administration of lanreotide depot and relates those attributes to considerations and preferences of oncology nurses and their patients. METHODS: A review of the literature on the use of lanreotide for the treatment of NETs and carcinoid syndrome was conducted. In addition, the literature on drug delivery and routes of administration was surveyed to provide context for comparative studies related to clinical and patient preferences. FINDINGS: Lanreotide depot prolongs PFS and is well tolerated by patients who expressed satisfaction in the ability to control symptoms related to carcinoid syndrome. Nurses cited several benefits to using lanreotide depot in the clinical setting, including more time saved to address other patient care issues. Attributes of lanreotide depot-including its efficacy, safety and tolerability, dosing and administration, and cost-may contribute to healthcare decisions regarding the treatment and management of NETs.

Diretrizes de cuidado na prevenção da dermatite periestomal em clientes oncológicos: proposta educativa compartilhada com enfermeiros

Tratou-se da construção de diretrizes para elaboração de um plano de cuidados ao clienteoncológico recém-estomizado visando à prevenção da dermatite periestomal, tendo comoobjetivos: descrever saberes e práticas de enfermeiros sobre os cuidados básicos à prevençãoda dermatite periestomal em clientes oncológicos recém-estomizados; construir diretrizes paraelaboração de um plano de cuidados de enfermagem voltados à prevenção da dermatiteperiestomal nesses clientes; implementar e avaliar o plano de cuidados junto aos enfermeiros.Pesquisa de campo qualitativa, emprego do Método Convergente-Assistencial, aprovada pelosComitês de Ética em Pesquisa do campo do estudo e da Escola de Enfermagem Anna NeryHospitalEscola São Francisco de Assis. Desenvolvida em quatro enfermarias cirúrgicas de umhospital público oncológico da cidade do Rio de Janeiro, com a participação de dezoitoenfermeiros. Os dados foram produzidos através de entrevista individual semiestruturada;técnica de criatividade e sensibilidade Corpo-Saber; discussão nos grupos de convergência; eobservação participante. Aplicada análise de conteúdo temática. A matriz pedagógicaproblematizadora, de orientação dialogada, subsidiou a discussão com os enfermeiros naconstrução das diretrizes, implementação e avaliação do plano de cuidados, considerando odesenvolvimento da consciência crítica e autônoma dos clientes no cuidado de si. Os resultadosrevelaram experiências dos participantes sustentadas no conhecimento científico e habilidadestécnicas adquiridas durante sua trajetória profissional...

This was the guidelines elaboration of a care plan to recent ostomized cancer patientaiming to prevent peristomal dermatitis, having as purposes: to describe nurses´ knowledgeand practices about basic care in the prevention of peristomal dermatitis in recent ostomizedcancer patient; to build guidelines for elaboration of a nursing care plan with respect to theprevention of the peristomal dermatitis in these clients; to implement and evaluate the care plantogether with the nurses. Qualitative field research which used the Convergent-AssistentialMethodology, approved by the Research Ethics Committee of the study field and of the AnnaNery School of Nursing- St. Francis of Assis Teaching Hospital. Developed in four surgicalnurseries of an oncological public hospital of the Rio de Janeiro city, with the participation ofeighteen nurses. The data were collected using semi-structured individual interview; Dynamicsof Creativity and Sensitivity Body knowledge; discussion convergence groups; and participantobservation. Applied thematic content analysis.The Problem-Dialogical Matrix fostered thediscussion with the nurses in the elaboration of the guidelines, implementation and evaluationof the care plan, considering the development of the critical and autonomous conscientiousnessof the clients in the Self Care. The findings revealed participants’ experiences supported byscientific knowledge and technical abilities acquired during its professional trajectory...

Se trató de la construcción de directrices para elaboración de un plan de cuidados alcliente oncológico recién ostomizado visando a la prevención de la dermatitis periestomal,teniendo como objetivos: describir saberes y prácticas de enfermeros sobre los cuidados básicosa la prevención de la dermatitis periestomal en clientes oncológicos recién estomizados;construir directrices para elaboración de un plan de cuidados de enfermería dirigidos a laprevención de la dermatitis periestomal en eses clientes; implementar y evaluar el plan decuidados junto a los enfermeros. Pesquisa de campo cualitativa, empleo del MétodoConvergente Asistencial, aprobada por los Comités de Ética en Pesquisa del campo del estudioy de la Escuela de Enfermería Anna Nery-Hospital Escuela São Francisco de Assis.Desarrollada en cuatro enfermerías quirúrgicas de un hospital público oncológico de la ciudaddel Rio de Janeiro, con la participación de dieciocho enfermeros. Los datos fueron producidosa través de entrevista individual semiestructurada; técnica de creatividad y sensibilidad CuerpoSaber;discusión en los grupos de convergencia; y observación participante. Aplicada análisisde contenido temático. La matriz pedagógica problematizadora, de orientación dialogada,subsidió la discusión con los enfermeros en la construcción de las directrices, implementacióny evaluación del plan de cuidados, considerando el desarrollo de la consciencia crítica yautónoma de los clientes en el cuidado de sí. Los resultados revelaron experiencias de losparticipantes sustentadas en el conocimiento científico y habilidades técnicas adquiridasdurante suya trayectoria profesional...

Influencia de la dieta en la prevención primaria del cáncer gástrico en pacientes con infección por Helicobacter Pylori / Influence of diet in primary prevention of gastric cancer in patients infected with Helicobacter Pylori

Objetivo. Revisar la influencia de la dieta en la prevención primaria del cáncer gástrico, en pacientes con infección por Helicobacter pylori. Metodología. Revisión sistemática. Seleccionando «Helicobacter pylori», «diet» y «stomach neoplasms» del vocabulario estructurado DeCS y MeSH. Se consultaron fuentes de bases de datos primarias y secundarias, estableciendo límites. Resultado. La infección por H. pylori y los factores dietéticos pueden actuar de forma sinérgica en el desarrollo de cáncer gástrico, así como algunas prácticas de cocinado. Los factores dietéticos que pueden incrementar el riesgo de cáncer gástrico son el consumo elevado de sal, alimentos salados, grasas saturadas, carnes rojas y procesadas. En cambio, el de frutas y verduras sería un factor protector, en especial el de las del género allium y de la familia de las crucíferas. Conclusiones. Los estilos de vida y hábitos dietéticos pueden influir en el desarrollo de cáncer gástrico, especialmente en pacientes con infección por H. pylori . Disminuir el consumo de alimentos salados, procesados, ahumados o escabechados, carnes rojas y grasas saturadas, evitar tóxicos y tener una dieta rica en frutas y verduras, además de erradicar la bacteria, puede considerarse la estrategia preventiva más efectiva frente al riesgo de desarrollar cáncer gástrico (AU)

Introduction. Helicobacter pylori infection is the main risk factor for developing gastric cancer, with the influence of genetic, toxic and dietary factors. It is the fourth most common cancer and the second most deadly worldwide, so its prevention is important specially focusing on dietary habits, to be approached from the primary care setting. Aim. Evaluate the influence of diet on the primary prevention of gastric cancer in patients with Helicobacter pylori infection. Methods. Systematic review, the keywords «Helicobacter pylori», «diet» and «stomach neoplasms» were previously selected from the DeCS and MeSH structured vocabulary. Sources of primary and secondary databases were consulted, limits were established. Results. H. pylori infection and dietary factors may act synergistically in the development of gastric cancer and some cooking practices. Dietary factors may increase the risk of gastric cancer like the high consumption of salt, salty foods, saturated fat, red and processed meats, while fruits and vegetables may be considered as a protective factor, especially the high consumption of Allium and the cruciferous family. Conclusions. The lifestyle and dietary habits may influence the development of gastric cancer, especially in patients with H. pylori infection. Decreasing consumption of salty, processed, smoked or pickled foods, red meat and saturated fat, avoiding toxins, and carrying out a diet rich in fruits and vegetables, in addition to eradicating the bacteria, can be considered the most effective preventive strategy against the risk of developing gastric cancer (AU)

Preoperative psychological distress, coping and quality of life in Chinese patients with newly diagnosed gastric cancer.

AIMS AND OBJECTIVES: The purpose of this study was to investigate the prevalence of preoperative psychological distress and its relationship with coping style and quality of life in Chinese patients with newly diagnosed gastric cancer. BACKGROUND: Being newly diagnosed with cancer can be a source of psychological distress. Understanding the preoperative psychological distress may contribute to the development of appropriate interventions. DESIGN: This is a descriptive correlational survey study. METHODS: The study was conducted in two teaching hospitals in Anhui province, China. A total of 165 patients with gastric cancer completed a battery of self-report questionnaires including the Distress Thermometer, the revised Chinese version of the Quality of Life Questionnaire-Stomach 22 and the Cancer Coping Modes Questionnaire. RESULTS: The prevalence of clinically significant preoperative psychological distress was 76·97% in this group. Statistically significant correlations were identified between the distress score and stomach pain, eating restrictions and anxiety subscale. Positive associations were found between the distress scores and four subdimensions of coping (avoidance and suppression, resignation, fantasy and catharsis), whereas a negative association was found between the distress scores and one subdimension of coping (Confrontation). There were also significant differences in the quality of life and coping style of patients who had different psychological distress statuses. CONCLUSION: These findings indicate a relatively high prevalence of preoperative psychological distress among Chinese patients with gastric cancer. Patients with clinically psychological distress were more likely to have poor quality of life and to demonstrate negative coping styles. RELEVANCE TO CLINICAL PRACTICE: Nursing professionals need to carefully assess the psychological status of patients with gastric cancer. Tailored interventions can be administered to help these patients appropriately cope with the disease and to enhance their quality of life.

Clinical supervision in the palliative care team setting: a concrete approach to team wellness.

Clinical supervision is a structured, case-based approach to learning that is used most often in the mental health field. An established palliative care consultation service at a large, academic medical center implemented a modified clinical supervision model in an effort to improve team members' awareness of their own emotions and the way those emotions impact behavior during, primarily, clinical encounters. This report discusses clinical supervision in detail and, by way of a case, illustrates the power of this intervention as a source of self-care and a concrete approach to managing palliative care team well-being.

DPC in acute-phase inpatient hospital care. Visualization of amount of nursing care provided and accessibility to nursing care.

OBJECTIVE: The purpose of this study was to improve accessibility to nursing care by clarifying the relationship between patient characteristics and the amount of nursing care for the Diagnosis Procedure Combination system (DPC). METHOD: The subjects included 528 lung cancer patients; 170 gastric cancer patients; and 91 colon cancer patients, who were hospitalized from July 1, 2008, to March 31, 2010, at a university hospital. The patients were categorized into groups according to factors that could affect the amount of nursing care. Next, the relationship between the patient characteristics and the amount of nursing care was analyzed. Then the results from this study were used to classify patient characteristics according to the patient type and the amount nursing care required. RESULTS: The patient characteristics, which affected the amount of nursing care, varied according to each DPC code. The major factors affecting the amount of nursing care were whether the patient had received a surgical (under general anesthetics) treatment or a non-surgical treatment and the level of activities of daily living (ADL) of the hospitalized patients. For those who had received a surgical operation for colon cancer, the patient's age also affected the amount of nursing care. CONCLUSIONS: The findings show that the method for the visualization of the amount of nursing care based on the classification of patient characteristics can be implemented into the electronic health record system. This method can then be used as a management tool to assure appropriate distribution of nursing resources.

Prognostic items for the last 10 and 3 days of life of cancer patients at home.

BACKGROUND: Prognostic indices are needed to optimize end-of-life care for cancer patients at home, but few prognostic indices predict the last 10 days. OBJECTIVE: The purpose of this study was to identify predictors for the last 10 and 3 days of life in patients with lung, gastric, or colorectal cancer at home. METHODS: Symptoms and signs were initially identified by literature review, and questionnaire was developed. Evaluation of these items and identification of additional items were then performed by 72 visiting nurses using the 3-round Delphi approach. RESULTS: The evaluation of 31 third-round responses is reported. The items for gastric and colorectal cancers were almost same; these cancers were treated as gastrointestinal cancer. To predict the last 10 and 3 days, there were 6 and 0 specific items for lung cancer, respectively, and 5 and 13 specific items for gastrointestinal cancer, respectively. There were 9 common items to predict the last 10 days and 29 common items to predict the last 3 days. CONCLUSION: The specific and common items that could be used to predict the last 10 and 3 days in patients with lung or gastrointestinal cancer were identified. The prognostic items for the last 3 days of life were more numerous among the gastrointestinal cancers than those for the last 10 days. IMPLICATIONS FOR PRACTICE: Specific prognostic items for each cancer are useful for visiting nurses to offer individualized care to patients and families. Using the specific and common prognostic items, end-of-life care may be improved.

The effect of home healthcare on quality of life in patients diagnosed with gastrointestinal cancer.

This study was undertaken to determine the effect of home healthcare on the quality of life (QOL) in patients diagnosed with gastrointestinal cancer. A total of 42 patients, who met eligibility criteria, were enrolled in the study and randomly assigned to either a control group or an experimental group. Control group patients received "usual care" defined as pain control and management through the pain clinic. Experimental group patients received pain control through the clinic plus three home visits. During the home visits, their nursing care was guided by an evidence-based protocol developed by the research team. Data were collected on pain, performance, symptoms, and QOL by using previously developed and validated instruments.Significant differences were found between the two groups on physiological function, psychological concerns, and total stress. In the experimental group, there was a significant decrease in pain and increase in performance from baseline to the final data collection period. For the control group, a significant decrease in QOL over the study period was observed. There were no significant differences between the two groups on pain, performance, QOL, and QOL subscales at the final visit.

[Home chemotherapy experience of an elderly male gastric cancer patient].

This article presents the author's experience providing nursing care to an unaccompanied elderly male patient with gastric cancer who was undergoing initial home chemotherapy. Nursing care problems identified included "anticipation anxiety", "inability to care properly for wound", and "deficits in knowledge and skills necessary for successful home chemotherapy." A therapeutic relationship between the author and patient was established during home chemotherapy from December 6, 2006 to January 31, 2007. Health education and nursing interventions were provided through pamphlet-based and verbal instructions, reverse demonstration to offer timely emotional support, disease information, and self-care strategies. Aims of care included enhancing patient chemotherapy knowledge, increasing self-care ability skills, and improving patient confidence in being able to control successfully his cancer and chemotherapy regimen. After 12 author-mentored home chemotherapy sessions were completed, patient quality of life was maintained. Hopefully, this case report can provide an illustrative experience with home chemotherapy that will help healthcare nurses improve their approach to health education and home care for cancer patients.