Knowledge gaps in prostate cancer treatment between physicians and clinical nurse specialists
Delphi consultations, a method of gaining consensus by gathering expert opinion, were conducted in order to understand the role of degarelix as a treatment option for advanced hormone-dependent prostate cancer. During the Delphi consultations, differences were identified between physicians and clinical nurse specialists in terms of their knowledge of therapeutic developments. We argue that disparities in knowledge between physicians and nurse specialists could limit the effectiveness of multi-disciplinary teams in providing optimal patient care. When such situations arise, communication between patients and nurse specialists, often the patient's primary point of contact, may conflict with information they have received from the physician. This could lead to confusion and uncertainty among patients about whether they are receiving the best possible care. Time and resources should be provided to address the continuing educational needs of nurses, which will ultimately result in the improved care and experience of patients.
Low-fidelity simulation for patients and caregivers in the use of lubricants in clean intermittent catheterization
Can low-fidelity simulation improve the knowledge and skills of patients undergoing clean intermittent catheterization (CIC) and their caregivers to prevent complications? Patients undergoing CIC are exposed to risks, such as urethral trauma and urinary tract infections. Objective of this paper was to assess the implications of low-fidelity simulations for patients and caregivers in the use of clean intermittent catheterization in the event of urethral trauma and for its prevention. A quasi-experimental study carried out between November 2015 and February 2016 in the rehabilitation centre of a university hospital, with patients undergoing CIC and/or their caregivers. Following the ethical precepts, data collection was performed during nursing consultations by means of interviews, structured observation, and a knowledge test applied before and after the low-fidelity simulation. Patients undergoing CIC and/or caregivers underwent a low-fidelity simulation of CIC with urethral trauma and then they were guided by the researchers following the protocol established in the department. They then underwent another simulation with the same characteristics. Fifty-five patients participated in this study, in which most of them (33 [60·0%]) were men, with an average age of 31·7 years. Bleeding was reported by 19 patients (34·5%), of which 18 were men. The performance of low-fidelity simulations proved to be effective for patients or caregivers in adverse situations, such as bleeding, resistance to the introduction of the catheter and negative urine drainage. The performance of low-fidelity simulation is easily accessible and shows efficiency when used in teaching-learning processes of health education and development of skills and competencies.
The long-term quality of life and information needs of prostate cancer survivors
What are the quality of life (QoL) and information needs of long-term prostate cancer survivors? Numbers of prostate cancer survivors are increasing and it is vital that their QoL issues and information needs are understood. The long-term effects of surviving prostate cancer is poorly understood. Specialist nurses play a key role in their management. A cross-sectional survey was used. The study questionnaire [(European Organization for Research and Treatment of Cancer-Quality of Life Questionnaire) EORTC-QLQ-30 and EORTC QOL-INFO25] was posted to 398 prostate cancer survivors attending an Irish centre managed by a clinical nurse specialist and consultant. Completed questionnaires (n = 195) were returned (response rate 49%). Overall, the men demonstrated a Global Health Status/QoL score of 77·6 (SD 20·7), demonstrating a high or healthy level of functioning. Men on hormonal therapy demonstrated inferior physical function in comparison to other treatment options. Fatigue and insomnia were the most frequent symptom experienced, while age was the most significant demographic variable affecting symptom scales. Men undergoing active surveillance for prostate cancer management were least happy with information received (p = 0·019). Comparison with EORTC QLQ-C30 international reference values suggests that this cohort report a high/healthy QoL. However, a significant proportion of men expressed a need for the receipt of further information, especially men on active surveillance. Specialist nurses are in a unique position to meet the information needs of long-term prostate cancer patients. However, planning is needed to ensure there are enough specialist nurses to meet the information needs of a growing number of men surviving prostate cancer.
Changes in the health-related quality of life of patients with prostate cancer and their spouses
The purpose of this study was to determine how the health-related quality of life (HRQoL) of patients with prostate cancer and their spouses change during the 6 months after diagnosis and which factors explain the changes. Patients with prostate cancer and their spouses have reported a decrease in HRQoL, but simultaneous follow-up of the HRQoL of patients with prostate cancer and their spouses is rare. The sample consisted of 186 couples. The participants personally filled in the RAND-36-Item Health Survey, both at the time of diagnosis and 6 months later. Changes in the HRQoL were analysed statistically using descriptive statistics and non-parametric tests. Linear regression models were used to identify the factors associated with the changes in HRQoL in the patients and their spouses. The HRQoL of patients with prostate cancer and their spouses did not change significantly during the first 6 months after diagnosis. Changes in the patients’ bodily pain and physical functioning were explained by their background variables. The spouses’ background variables did not explain the changes in HRQoL during the follow-up period. In addition, the changes in the HRQoL of patients and their spouses are very similar. There is a need for long-term assessment of changes in the HRQoL of patients with prostate cancer and their spouses. The findings indicate that attention should be paid to spouses with regard to the nursing of patients with prostate cancer, as spouses seem to be an important resource for patients with prostate cancer.
Nursing assessment of TURP syndrome: a pilot study
How can the signs and symptoms of transurethral resection prostate (TURP) syndrome be identified by nurses? This study aimed to develop a nursing instrument to assess TURP syndrome. TURP syndrome is a complication that potentially occurs during TURP surgery. It is a water intoxication related to hyponatremia and acid-based imbalance. This syndrome should be recognized early in order to prevent fatality. This pilot study employed a participatory action research combined with statistical analysis for validity and reliability testing. Twenty-eight Indonesian urological nurses and one urologist medical doctor were engaged in this study. Informed consent was obtained before study outset. The study was entirely accomplished at Muhammadiyah Hospital I and II, Yogyakarta, Indonesia. Pearson's correlations test of each item was measured with correlation coefficient greater than 0·40 considered as evidence of satisfactory item convergence validity. The instrument reliability test was confirmed by Cronbach's α coefficients with score greater than 0·433 supposed as a reliable instrument. This study obtained a nursing instrument to assess TURP syndrome which involved 15 aspects as follows: disorientation, headaches, altered states of consciousness, visual disturbances, nausea and vomiting, hypertension, rhonchi sound, tachycardia, abnormal capillary refill-time, tachypnea, hyponatremia, hyperkalemia, anaemia, increased urea and creatinine, and lower-extremities oedema. A nursing instrument to assess TURP syndrome was established. Nevertheless, further investigation is required among patients who are suspected of having TURP syndrome to increase instrument accuracy.
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