Readings post-midterm

Question 1

Title: The sources of Stress and Coping in American College Students who have been diagnosed with depression.
Author: Aselton

Answer 1

Methods: Online interviews qualitative
Findings: 
1. Sources of stress included: 
- Roomate issues
- Academic problems
- Financial and career concerns
- Pressure from family
2. Common coping mechanisms: Exercice, talking to friends, self-talk, deep breathing, journaling, marijuana use, and listening to music.  (Nonmedical methods of coping were often cited to be more effective than medication therapy)

Question 2

Title: A qualitative study of nurses’ clinical experience in recognisin low mood and depression in older patients with multiple long-term conditions.
Author:Waterworth and all.

Answer 2

• Telephone interviews with 40 nurses in New Zealand
• Results: Having conversation with older patient about their moods or specifically about depression is not something that all nurses had felt they could have. (some knew they can provide advice, some believe it is not their responsibility/in their scope of practice)
• Advices to detecting change in mood/depression: Being alert, Knowing the patient over a period of time, Asking questions, offering options, Providing time to listen,
• This paper support health promotion and nurses in primary health care.

Question 3

Viewing ovarian cancer as a “chronic disease”: What exactly does this mean?

Answer 3

• fall to “cure”, usually the disease is back, recurrent.
• compare to diabetes
• Tx are aggressive: surgery cytoreduction, platium-taxane cheno, anticipated side-effects, emesis, alopecia, fatige and neuropathy.
• Use the term “chronic” to describe management of ovarian cancer greatly minimizes the difficulties experienced by women with this maliciency. (become a usefull managemetn strategy)
• The fundamental goal of all second-line therapy for ovarian cancer should be to:
  a) optimize the opportunity for extended survival, recognizing long-term disease-free control.
  b) minimize the toxicities of therapy which will negatively impact QOL for the pt.
  c) Individualize tx based on side effect, toxicities of agents, third-party insurance coverage issues and personal choice.

Question 4

Title: Supportive care framework
Author: Fitch

Answer 4

Supportive care framework draws upon the constructs of:

• Human needs
• Cancer as an unexpected life event
• Cancer has more than a physical impact
• Individuals diagnosed with cancer and their families have a wide range of needs
• Assisting individuals who are living with cancer requires tailored interventions
• Provide supportive care (defined as the provision of the necessary services for those living with/affected by cancer to meet their needs diring all the processs)

Question 5

Title: Anticipatory mourning: processes of expected loss in palliative care
Author: Clukey

Answer 5

• Methods: semi-structured interview
• Identification of process:
  1. Realization
  2. Caretaking (managin the situation, the physical aspect of illness, providing support)
  3. Presence (touch,being together,sense of duty, supportive)
  4. Finding meaning (already gone,acceptance,spirituals beliefs)
  5. Transitioning (emotional shifting, numbing, fatigue)
• Characteristics of identified processes (realization):
  1. Having a common knowledge
  2. Acknowledging the terminal status
  3. Sharing
  4. Attending to business
  5. A changed relationship.

Question 6

Title: Why nurses need to understand the principles of bereavement theory
Author: Greenstreet

Answer 6

Propose a new model of gried: The dual process model
Influence of:
-Culture and grief
-Personality and gender in relation with grief
-Culture and caring for the bereaved
-The new model of grief and nursing
-Holistic care and grief
-Supporting the grief

Question 7

Title: Confronting moral distress in Nursing: recognizing nurses as moral agents
Author: Carnevale

Answer 7

Recommandations for adressing moral distress:

• Better recognizing the moral agency of nurses by attending to nurses Voices.
• Clear and safe channels
• Pedagogical approach to inter-professional education
• Develop clinical ethics consultation
• Association of nursing should provide advisory guidance

Question 8

Title: ‘I’m only dealing with the acute issues’: How medical ward ‘busyness’ constrains care of the dying
Author: Chan and all.

Answer 8

According to many studies, challenges are around:
-Emphasis on medical crises and life-prolonging tx
-Attention to routine and task-oriented care at the expense of patient/family focused care
-Lack of emotional engagement
-Distancing from dying patients by both medical and nursing staff
Methods: large ethnographic study, done in montreal, data collected by participant-observation, formal and informal interviews and chart review. Interviews participants was pt,family and staff–>nurses,unit agent, physician, physio, social worker.
Results:
-Understand how the logic of care and the curative/palliative tension shaped care of the dying on the medical ward
-Busyness, teamwork and acute care priorities
-Medical ward staff beliefs in the importance of acute care interventions and an emphasis on diagnosis
-Prognostication and stage of disease: she’s almost palliative

Question 9

Title: A conceptual and Moral Analysis of Suffering
Author: Carnevale

Answer 9

• Epistemological analysis i
• Suffering is not pain
• four types of feeling: 1. tactile perceptions (heat,solidity)
  2. Sensation (localized–> pain or overall body)
  3. Natural appetites (hunger, thirst, sexual) or non-natural appetites (addiction)
  4. Affections (agitation,moods, emotions)
• Empathic attunement
• Humility

Question 10

title: CARES, An acronym organized tool for the care of the dying
Author: Freeman

Answer 10

• CARES tool debuted as a poster pesentation.
• developped through Azuna pacific university for a 300 bed cancer patient.
• Cases study of Mr. F. renal insufficiency + cardiomyopathy