1/40. Psychosocial reactions of children with cancer. A program for rehabilitation.The diagnosis of cancer in children challenges all the skills of the pediatric nurse. She utilizes her basic knowledge of development, family dynamics, and disease process. She explores all the implications of long-term illness. She assesses, plans, implements, and evaluates care for the child and his family. She acts as liaison, teacher, and counselor. She is the advocate for the child and his family. As an active member of the team she is instrumental in the process of rehabilitation for the child, physically and emotionally. She can help the child to live with cancer and assure quality of life in the days granted him.- - - - - - - - - - ranking = 1keywords = physical (Clic here for more details about this article) |
2/40. Physical rehabilitation of the cancer patient.Significant numbers of cancer patients have physical limitations as a result of their cancer or its treatment. Most commonly, this impairment results from prolonged bed rest and deconditioning syndrome or neurologic loss frequently coupled with deconditioning. What few studies have been done show that functional improvement through rehabilitation does occur. For many cancer patients, rehabilitation is an appropriate option, viewed favorably by patients and their families. However, as opposed to other causes of impairment, the benefits and goals of rehabilitation must be carefully weighed in concert with the goals of the cancer patient, all in an effort to add to his or her quality of life.- - - - - - - - - - ranking = 1keywords = physical (Clic here for more details about this article) |
3/40. cognition and the cancer experience. Clinical implications.OBJECTIVES: The authors demonstrate the application of cognitive therapy in oncology care by presenting a brief review of theory and relevant case studies. MATERIALS AND methods: In light of the life and death nature of the fears evoked by cancer, it is important for the oncology clinician to recognize the role that cognition plays in patient responses to the diagnosis and treatment of cancer. After presentation of a theory base that creatively links cognition and the cancer experience, key cognitive concepts are defined and discussed. Case material illustrates the application of these concepts and how oncology clinicians can use select interventions adapted from the brief mental health treatment modality of cognitive therapy to promote adjustment to cancer. RESULTS: Patient and family views about cancer have emotional and behavioral consequences, influence ability to cope with diagnosis and treatment, and serve to focus clinical intervention. Cognitive interventions can help patients and families think about cancer in objective, adaptive ways. Focusing on perceptions and questions of meaning, clinicians can be effective using cognitive lines of questioning that expand patient stories and elicit beliefs about cause, control, and responsibility for their cancer. CONCLUSIONS: Cognitive interventions are brief and solution-focused interventions that acknowledge and build on generalist interviewing skills common to each discipline. As such, they are particularly useful in physical health settings where work is fast paced and clinicians are faced with the challenge of dealing in a collaborative manner with patient and family coping responses as they apply to the medical problem and care plan.- - - - - - - - - - ranking = 1keywords = physical (Clic here for more details about this article) |
4/40. The house that's on fire: meaning-centered psychotherapy pilot group for cancer patients.People with advanced cancer face an existential crisis in addition to their physical suffering. The principles of a new group therapy intervention (MCGP) were introduced in another paper in this issue. This paper is a report of some of the themes and issues that arose during the first pilot group.- - - - - - - - - - ranking = 1keywords = physical (Clic here for more details about this article) |
5/40. Pseudo-(tumor-induced) rickets.An athletic 8-year-old boy developed severe muscle weakness over 2 years. At the age of 10 years, investigation for possible neuromuscular disease disclosed hypophosphatemia (1.8 mg/dl) and rickets. There was selective renal tubular wasting of inorganic phosphate (Pi) but no history of toxin exposure, familial bone or kidney disease, or biochemical evidence of vitamin d deficiency. urine amino acid quantitation was unremarkable. serum 1,25-dihydroxyvitamin D [1,25(OH)2D] concentration was in the lower half of the reference range. Our presumptive diagnosis was tumor-induced rickets; however, physical examination and bone scanning in search of a neoplasm were unrevealing. Soon after 1,25(OH)2D3 and Pi treatment began, muscle strength improved considerably. After 6 months of therapy, radiographic abnormalities were substantially better. During the next 6 years, physical examinations, a second bone scan, whole-body and nasal sinus magnetic resonance imaging, and octreotide scintigraphy were unremarkable. When his physes fused at the age of 16 years, assessment of his course showed excellent control of his rickets requiring decreasing doses of medication. Furthermore, fasting serum Pi levels and tubular maximum phosphorus/glomerular filtration (TmP/ GFR) values had increased steadily and normalized after 3 years of treatment. Accordingly, therapy was stopped. Seven months after stopping medication, he continues to feel completely well. fasting serum Pi levels, TmP/GFR, other biochemical parameters of bone and mineral homeostasis, creatinine clearance, and renal sonography are normal. Neither spontaneous or pharmacologic cure of tumor-induced rickets or osteomalacia nor a patient matching ours has been reported. His disorder, which we call pseudo-(tumor-induced) rickets, should be considered when investigation for oncogenic rickets or osteomalacia discloses no causal lesion. Consequently, prolonged medical therapy and futile searches for a neoplasm may be avoided.- - - - - - - - - - ranking = 2keywords = physical (Clic here for more details about this article) |
6/40. survivors of childhood cancers: implications for obstetric anaesthesia.Treatment of many childhood malignancies involves surgery, radiotherapy and chemotherapy. If the child survives, normal physical development can be impaired and abnormalities with anaesthetic implications may be present. We discuss two women with a range of problems who presented for obstetric anaesthesia, having survived childhood malignancies. Common features included anthracycline cardiotoxicity and short stature. Both patients received incremental spinal anaesthesia in order to titrate the dose of local anaesthetic required to produce an adequate block height and to minimize cardiovascular instability.- - - - - - - - - - ranking = 1keywords = physical (Clic here for more details about this article) |
7/40. Integrating complementary and conventional symptom management in a cancer center.One goal of oncology nursing is to help patients achieve the best possible quality of life. In the conventional care perspective, quality of life has four aspects: physical, emotional, social, and spiritual. From the complementary care perspective, it is defined as harmony of body, mind, and spirit. Integrating these perspectives of quality of life allows us to have a fuller and richer view of the patient, accentuating the core of his or her being: values, beliefs, and goals. The pain and Symptom Management Service has embraced this integrated view and, by doing so, has improved symptom management outcomes for patients and their families.- - - - - - - - - - ranking = 1keywords = physical (Clic here for more details about this article) |
8/40. Terminal sedation for existential distress.Although sedation for existential distress has been actively discussed in the palliative care literature, empirical reports are limited. A retrospective cohort study was performed to clarify the physical conditions of terminally ill cancer patients who expressed existential distress and received sedation. Of 248 consecutive hospice inpatients, 20 patients expressed a belief that their lives were meaningless and received sedation. The target symptoms for sedation were dyspnea (n = 10), agitated delirium (n = 8), and pain (n = 1). Only one patient received sedation for psychological distress alone, although physical symptoms were acceptably relieved. The Palliative Performance Scale just before sedation was 10 (n = 7), 20 (n = 11), 30(n = 1), and 40(n = 1). All but one patient could take nourishment orally of only mouthfuls or less. edema, dyspnea at rest, and delirium were observed in 10, 13, and 14 cases, respectively. The Palliative Prognostic Index was greater than 6.0 in all but one case with a mean of 12 /- 3.3. In conclusion, in our practice, sedation was principally performed for physical symptoms of cancer patients in very late stages. Further research is encouraged to establish standard therapy for existential distress of the terminally ill.- - - - - - - - - - ranking = 3keywords = physical (Clic here for more details about this article) |
9/40. Dual-modality PET/CT tomography for clinical oncology.diagnosis and follow-up in clinical oncology are traditionally based on computed tomography (CT). In recent years, however, functional imaging using positron emission tomography (PET) has been recognized as an important imaging modality and adjunct to CT that provides complementary metabolic information in many oncology applications. To overcome the challenges of aligning independently acquired PET and CT image sets several ad hoc concepts of integrating PET and CT imaging in a single device have been proposed. This article comments on the development of the first combined dual-modality PET/CT prototype at the University of Pittsburgh, and illustrates commercial advances to dual-modality PET/CT tomography. The current PET/CT designs from the major manufacturers comprise a commercial CT scanner in tandem with a commercial PET scanner. While the level of physical integration is actually less than that of the original prototype it is fair to assume that current PET/CT models may serve as intermediate solutions towards near-future design concepts that aim at greatly reduced costs of the dual-modality tomographs and offer a greater level of physical integration. The goal of the next generation of PET/CT systems is to design and build a device specifically for imaging the function and anatomy of cancer in the most informative and effective way without necessarily conceptualizing it as combined PET and CT scanners. Such a concept of a diagnostic imaging device relates more to a disease management approach rather than the usual division into medical specialities such as radiology and nuclear medicine.- - - - - - - - - - ranking = 2keywords = physical (Clic here for more details about this article) |
10/40. Cancer rehabilitation: does it make a difference?Cancer is a significant cause of physical and cognitive disability. The concept of cancer rehabilitation was developed in the 1970s; it was a concept that led to funding support and to significant contributions to symptom management. A recent trend has been an increase in the number of cancer diagnoses and an increase in cancer survival rate. This suggests that more persons with cancer are living longer despite cancer-caused impairments. Interdisciplinary cancer rehabilitation programs are designed to help cancer patients achieve maximal functional ability and adapt to disabilities resulting from cancer or its treatments. Currently, there are few cancer rehabilitation programs in the united states. Information about the role of rehabilitation nursing in cancer patient care is scarce. The purposes of this article were to review the history of cancer rehabilitation; review functional outcomes that have been reported in current research; and identify the multiple, complex challenges that illustrate the role of a cancer rehabilitation clinical nurse specialist in the rehabilitation of cancer patients.- - - - - - - - - - ranking = 1keywords = physical (Clic here for more details about this article) |
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