Everything from Burnout to Drugstore Hopping

Dr. RW wrote an interesting grand rounds this week at Notes to Dr. RW He discusses everything from burnout to drug store hopping this week. The grand rounds was serious but light. He even mentioned my piece on how to deal with the holidays if you are on oxygen.

Permalink | 0 Comments| Email Post

Post your comment

Surviving the Holidays

With Thanksgiving approaching this week it is important to talk about the holidays. Society teaches us and we often feel we must be happy and joyous at all holiday times, but especially between Thanksgiving and New Years. This can be a difficult expectation for many individuals with cancer and their loved ones.
Some individuals have recently been diagnosed with cancer and are devastated, others remember how they were diagnosed or severly ill during this holiday time and sometimes family and friends are helping care for an individual with cancer who is seriously ill or terminally ill at holiday time. This makes it difficult to want to celebrate.

There are some things individuals with cancer and their loved ones can do to survive this holiday season. Here are some tips:
1) Do not feel you must be "happy" all season. It is reasonable that you may have some "sad" hours or days and this is normal.
2) Be reasonable about what you realistically physically and emotionally do this holiday season. Maybe a quiet holiday at home will be better this year than traveling to BIG parties.
3) Only attend a few functions intead of EVEYTHING this season.
4) Be sure to get adequate rest before and after going to social events or having family and friends into visit.
5) Try to remember some 2-3 things you are grateful for or special experiences you have had in the past. You may even want to get out an old scapebook.
6) Downsize. If you want to cook a meal or have a Christmas tree, then make a smaller meal (turkey breast instead of whole turkey and 2-4 side dishes) or a smaller tree so it does not take all of your energy.
7) Understand that it is normal and OK for you to have many emotions this season.
8) If you would like to then go talk to a counselor or a pastor or priest. They can help you deal with the holidays by discussing your emotions and helping you set realistic expectations.

Permalink | 1 Comments| Email Post

Post your comment

How Understanding Cancer Patient's Internet Design Preferences Affect Patient Education

Valerie R. Vestal, MSN, FNP, RN read an article in the Oncology Nursing Forum that was recently written by authors C. Chernecky,D. Macklin, & J. Waller. The authors believe that understanding the computer experience of individuals with cancer and their design preferences can enhance patient satisfaction and improve patient education.

The authors included 22 cancer patients residing in the United States with a venous access devices and explored the patients opinions and preferences on the lay out and design of multimedia education. Participants were drawn from three outpatient cancer centers in the southeast.

The authors developed the Computer Experience Questionnaire to explore the participant’s computer experience. All participants were also asked to evaluate if the computer was beneficial in helping them learn about venous access devices. The participants were also provided hands on computer experience to determine their preferences in terms of computer design and layout. After each participant completed the hands on session their preferences were evaluated using the Computer Preference Form. The computer preference form is an exact duplication of the screen layout.

During the hands on session participants with little or no computer experience were paired with participants who were familiar with the computer. Participants were asked to evaluate color, menu buttons, text, background, photo size, icons, and sample layouts. Findings indicate that 82% of patients had computer experience, 64% had experience with the internet and 100% had a home computer.

The results showed that colors of blue and green hues were preferred. Serif text was preferred. Participants favored backgrounds with light background, bold text and larger size text. Participants opted for a large photo size, measuring at least 1”x0.75. The most well liked graph icons illustrating a metaphor was “911” indicating emergency, “skull and crossbones” for danger and a “string on a finger to represent reminder.

The authors concluded that understanding and accommodating patient choices in computer designs can increase patient’s knowledge and overall health care understanding. In the future Health care providers should recognize the importance of patient preferences and increase patient involvement when developing internet and multimedia education.

Permalink | 0 Comments| Email Post

Post your comment

Myths About Cancer

Despite the many advances in cancer care in the past few decades I still hear people continuing to pass on myths about cancer. It is important that everyone (family, friends, health care providers) help dispel these rumors.

For example, I still hear people saying that the diagnosis of "cancer" is equal to pain, suffering and death for all patients. With all the advances in cancer treatment in the past several decades this is no longer true.

Another myth is that cancer is a "contagious" illness that spreads when anyone has contact with a cancer patient. There is not any type of cancer that can be spread by simply touching a cancer patient. And most individuals with cancer feel isolated enough that you do not want to make them feel worse by not hugging, kissing or touching them.

The third one I heard recently is that being diagnosed with cancer is a "punishment" for bad deeds. I think every person has done some "bad deed" in his/her past, but not everone develops cancer. So this certainly could not be true.

The last myth is that individuals with depression are more likely to develop cancer. Like the third myth probably everyone has felt "down" or depressed at some point in his/her life, but not everyone develops cancer. There may be some environmental or genetic factors that might predispose an individual to cancer, but certainly having depression does not make anyone more likely to develop cancer.

Hopefully, with continued advances in cancer and empowering individuals with cancer and their families will help us dispel these myths or rumors in the future and provide HOPE instead.

Permalink | 0 Comments| Email Post

Post your comment

Laughing is One of the Best Medicines

Thanks to Rita for making me laugh in this week's grand rounds at msspnexus where she highlighted my post on whether cancer patients should discuss using complementary therapies with their physician

Permalink | 0 Comments| Email Post

Post your comment

Thank You to A Surprising Grand Rounds at Dr Hebert's Medical Gumbo

Thank you to Dr. Hebert's Medical Gumbo for including my post, How Can All Family Members Obtain Important Information from the Doctor?, in last week’s Grand Rounds. Grand Rounds is a weekly hosted event where a medical blogger recommends posts from the prior week from other medical bloggers. Last week's Grand Rounds was hosted by Michael C. Hebert, M.D., who writes about pediatrics, internal medicine, and philosophy.

Permalink | 0 Comments| Email Post

Post your comment

9 Simple Ways to Live Well with Cancer

One of my nursing colleagues Katen Moore has written a book with Libbyu Schmals called “Living Well with Cancer” (2001, Berkley Publishing Group, NY, NY). In this helpful book designed for patients and families they list the following 9 simple ways for living well with cancer.

1. Drink enough fluid every day
2. Wash your hands thoroughly and often
3. Let yourself have a bad day
4. Communicate your needs
5. Ask questions when you don’t understand something
6. Don’t tough it out
7. Eat
8. Rest
9. Enjoy yourself

This may not be David Letterman’s top 10, but these are all important ways in which you can take care of yourself while living with cancer.

Permalink | 0 Comments| Email Post

Post your comment

How Do You Prefer Orientation/Education about Cancer?

The following is a review written by a nurse, Valerie R. Vestal, MSN, FNP, RN, at our institution on a study related to orientation for individuals with cancer and their primary support person.

Because of the unfamiliar surroundings and unpredictable events first time visits to a cancer center may contribute to added stress and anxiety for patients and their support system. Currently research is limited to studying the impact of face to face orientation programs and no one has explored the impact of alternative orientation programs.

On the other hand the authors of one study wanted to decide if the format of a cancer orientation program plays a role in increased levels of satisfaction and decreased anxiety for newly diagnosed cancer patients and their support person. The authors believed that providing patients with knowledge about their environment and available resources will decrease potential stress and enhance satisfaction. The researchers randomly assigned (like a flip of a coin) 428 patient and their caregivers from the National Cancer Institute into one of four orientation arms: 1. class instruction, 2. drop-in, 3. mail home or 4. standard orientation

Patients who were newly registered in the Division of Medical Oncology were asked if they would participate if they were at least 18 years of age, able to read and write English, making their fist visit as patients to the Division of Medical Oncology, had a biopsy –proven cancer diagnosis and a minimum of 72 hours between patient registration and physician consultation.

The secondary target group was the primary support person for each person with cancer. The support person had to: be at least 18 years of age, able to read and write English, and they had to be identified by the patient as the primary support person accompanying them to appointments. Patients were able to participate in the study regardless if their support person participated; however, a support person was not eligible to participate if the patient was not enrolled in the study.

The intervention required that participants receive a orientation video and a booklet via different delivery methods. The standard group did not receive an orientation booklet or video. All participants were provided with a pre-intervention and a three month follow up survey to evaluate anxiety, awareness and use of resources, coping, and understanding of the cancer center.

The overall number of patients who completed all aspects of each arm was very low. Mail (n=23), Control (n=18), drop in (n=7) and class (n=6). Due to low participation the authors opted not to report findings on the class and drop-in orientation. Results indicated that the mail group reported higher satisfaction with the cancer center. The support person acknowledged benefits to a lesser degree than the patients.

The researchers concluded that the mailing orientation materials was the superior delivery method and could be linked to improving patient outcomes and decreasing anxiety.

This study raises a goo question - how do you prefer to receive orientation and education about cancer? Do you like reading materials or videos/DVDs? Do you like it in small increments or all at 1 meeting. Be sure to let you health care provider let you know how you liketo be educated.

Reference
Deshler, A. M., Fee-Schroeder, K. C., Dowdy, J. L., & Mettler, T. A. (2006). A patient orientaton program at a comphrensive cancer center. Oncology Nursing Forum, 33(3), 569-578.

Permalink | 0 Comments| Email Post

Post your comment