Cancer Nursing: A Revolution in Care PDF
Preview Cancer Nursing: A Revolution in Care
Cancer Nursing A Revolution in Care The publishers would like to express their thanks to the organisers of the conference: The Royal Marsden Hospital, London Nursing Times International Society of Nurses in Cancer Care NT Cancer Nursing A Revolution in Care Proceedings of the Fifth International Conference on Cancer Nursing, London, 4th-9th September, 1988 Edited by A. Phylip Pritchard Royal Marsden Hospital, London M Macmillan Press Scientific & Medical ©The Editorand the Contributors 1989 All rights reserved. No reproduction, copy or transmission of this publication may be made without written permission. No paragraphof this publication may be reproduced, copied or transmitted save with written permission or inaccordance with the provisionsof the Copyright Act 1956(as amended), or underthe terms of any licence permitting limited copying issued bythe Copyright Licensing Agency, 33--4Alfred Place, London WCIE7DP. Any person who does any unauthorised act inrelation to this publication may be liable to criminal prosecution and civilclaims for damages. First published 1989 Published by THE MACMILLAN PRESS LTD Houndmills, Basingstoke, Hampshire RG21 2XS and London Companies and representatives throughout the world ISBN978-0-333-48735-8 ISBN978-1-349-10714-8 (eBook) DOI 10.1007/978-1-349-10714-8 Contents Preface viii Part 1. International Perspectives in Cancer Care Cancer Nursing: A Revolution in Care Sally Sims 1 Europe Against Cancer: A Plan for Action Jerzy Einhorn 5 Part 2. Changing Patterns of Health Care and Their Impact on Cancer Nursing Changing Patterns of Health Care and Their Impact on Cancer Nursing Joyce Yasko 7 The Influence of Power and Politics Ginette Rodger 10 Changing Patterns of Health Care and Their Impact on Cancer Nursing Trevor Clay 15 The Cancer Experience-A Patient's View Juliette Evans 17 Part 3. Ethical Dimensionsin Cancer Care Ethics in Cancer Care: A Challenge for Nurses Cornelia Fleming 19 Approaches to Advocacy Constance Donovan 22 Euthanasia-Guidelines for Nursing Practice Cees de Ridder 25 Part 4. Cancer across the LifeSpan Pain and Anxiety Management Programme for Paediatric Cancer Patients Cynthia Stutzer 27 What Does the Schoolteacher Know? Anne Charlton 29 Impact of Cancer on Adolescents Barbara Warren 32 Caring for Dying Adolescents Danai Papadatou 34 Meeting the Rehabilitative Needs of Young Adults with Cancer Lisa Schulmeister 37 FamilyCaregivers of Cancer Patients: Reactions and Assistance Barbara Given, Tim Dwyer JanetVredevoogdand BillGiven 39 Geriatric Oncology: Nursing Concerns Deborah Welch-McCaffery 43 Cancer: A Family Disruption Judi Johnson 45 Part 5. Supportive Care and Symptom Control Needs Assessment of People Living with Cancer in a Canadian Province Mary Vachon and Brenda Conway 49 Developing an Education and Support Programme for Cancer Patients and Their Family Members Gertrude Grahn 53 v Introducing Individual Psychosocial Interventions in an Oncology Setting Robert Tunmore 56 Family Centred Intervention in Promoting Psychological Adjustment MargaretFitch 60 Urostomy Patients: Strategies for Caring and Rehabilitation Gun Nordstrom 63 Part 6. Contemporary Issues Relevant to Cancer Nursing Decision-making in Oncology: The Role of Patients and Nurses Hanneke de Haes 65 Identifying the Major Stressors in Cancer Nursing Susie Wilkinson 68 Health Promotion in Ambulatory Cancer Patients: Focusing on Wellness Marilyn Frank-Stromborg 73 What Do Patients Think about Specialist Cancer Centres? Andrew Thompson 78 Part 7. Management of Cancer Services Using Change to the Advantage of Nursing Sharon Krumm 82 Establishing Standards of Care in the Oncology Setting Moya Berli 84 The Development of a Quality Assurance Index for Oncology Nursing Jill David 86 What Do Cancer Nurses Really Do? - Results of a Comprehensive Activity Analysis Glynis Markham 93 Part 8. AIDS - Its Impact on Cancer Care WHO Global Programme on AIDS Birgit Sylvest Hansen 96 The Challenge Facing Nursing: The HIV Infection in Central Africa Olive Kopolo 98 HIV Infection: Its Impact on Cancer Care Richard Wells 104 Community Out-reach Ann Smits 107 Part 9. Innovative and Alternative Strategies Humour: A Therapeutic Approach Kathleen Smith 109 Music and its Influence on the Side-effects of Chemotherapy Eldri Steen 111 Therapeutic Touch: Its Place in Nursing Practice Pat Turton 114 Hope as a Critical Factor in the Cancer Experience Jane Clark 117 The Role of Traditional Chinese Medicine in the Supportive Care of Cancer Patients Wang Ying 119 Telecommunication-Implications in Cancer Nursing Susan Goddard 121 Informing Patients about Phase One Studies: A Two-year Experience Yvonne Willems 123 Part 10. Transcultural Aspects of Cancer Nursing Cultural Aspects of Oesophageal Cancer Vivienne Pervan 125 A Western Nursing Concept in an Eastern Setting Won Hee Lee-Kim 127 Beliefs towards a Diagnosis of Cancer: A Transcultural Approach Beverley Nielsen 129 Cultural Perspectives on Cancer of the Breast Joyce Lehoka 133 Part 11. Community, Home and Self Care The Role of Nurses in a Comprehensive Cancer Screening Programme for Women in Finland Kaija Massingberd 135 Self-Care-The Cultural Barriers Miriam Hirschfeld 137 vi Post-discharge Crises for Cancer Patients and Their Families Marilyn Oberst, Diane Scott and Ruth James 139 The Art of Out-patient Oncology Nursing Magi Sque 143 An Experimental Hospital-based Oncology Home-care Nursing System Lu Shu-Chin 145 The Administration of Chemotherapy in the Patient's Home- A New Perspective Jane Richardson 146 An Understanding Voice: The Telephone as a Cancer Counselling Medium Shane Dobbin and Louise Burton 150 A Study of Patients' Drug Self-administration Patterns in a Cancer Hospital Sue Davis 152 Part12. Debates Debate 1: This house believes that nursing models provide a useful tool in the management ofpatientcare Proposer:SteveWright 154 Opposer: Karen Luker 157 Debate 2: This house believes that the nurse is ideally placed to act as the patient's advocate Proposer:DerrynBorley 160 Opposer:KathMelia 162 Part13. Reviews 'We're Different-We're Children': A Symposium on Paediatric Oncology Nursing-Review Lecture Georgina Bru 164 Radiotherapy Symposium-Review Lecture Ann Cattell 166 Nutrition Review PatriciaCrooks 168 'Working Together' :A Symposium on Rehabilitation-Review Lecture Christine Dowding 170 Bone Marrow Transplantation Symposium-Review Lecture Jean Edwards 173 Symposium on Spiritual Issues-Review Lecture Rosette Poletti 175 Symposium on Palliative Care-Review Lecture Jeanne Quint Benoliel 179 Poster Review Lecture Kate Copp 181 Author Index vii Preface Cancer nursing has come a long waysince the First Interna given to cancer nurses both by their nursing colleagues and tional Conference on Cancer Nursing washeld in London in otherhealth-care professionals. 1978.Cancernurses nowhavetheirowninternationalsociety The range oftopicscovered inthese proceedingsisremark (InternationalSocietyofNursesinCancer Care),internation able.Ways'toblowawaypain' (Cynthia Stutzer),euthanasia al journal (Cancer Nursing) and international conference (Cees de Ridder), the WHO's response to AIDS (Birgit (InternationalConferenceonCancerNursing) heldeverytwo Hansen), the telephone as a medium for cancer counselling years. The firstconferencesin1978and 1980were dominated (Shane Dobbin and Louise Burton) and the debunking of bythe UnitedKingdomand North America.In1984and1986 some of the myths surrounding cancer nurses (Glynis Mar thistrend began to change and in1988over 2000nurses from kham) are but a fewof the issuesdiscussed. The papers are 66countriescame to London's Royal Festival Hall to extend published in the same sessions and order as they were theirknowledge and share theirexperiencesofwhat itmeans presentedattheconferenceapartfromthetwodebatesandthe to care for people with cancer. It was fitting that the Fifth symposiareviewswhichappearasseparatesectionsattheend. InternationalConferenceonCancerNursingshould returnto Ihopetheseproceedingswillserveasauniquereminderofthe Londonin1988tocelebrateitstenthanniversarychoosing as wealthofknowledgeandexperiencepossessedbynursesfrom its theme 'Cancer Nursing-A Revolution in Care'. For a the international community working incancer care. revolution has occurred but, as Sally Sims stressed in her Ithank the BoardofDirectorsofthe International Society keynote address,fewrevolutionshavebeenmoresuccessfulin ofNurses inCancer Care forinvitingme to act aseditor, the transforming human suffering than the one that has taken speakers for meeting their deadlines and puttingup with my placeincancercare.Inthenottoodistantpast,cancerpatients often pedantic queries and the remarkable band of were denied the right to know their diagnosis (a practice still secretaries--RubyRambaran,AudreyHooson,DavidProud not unknown insome countries,unfortunately).Nurses have foot, Anne Dean and Patricia Binstead-for delivering the played an important part in ensuring that this right has been impossible time and time again. returnedto thepatientwithcancer. Paperafter paperinthese proceedings reveal the consumate skillswhich cancer nurses A. Phylip Pritchard, BA, RGN, RMN bring tocancercare and validate the rightful recognition now TheRoyal MarsdenHospital, London, October1988 viii Cancer Nursing: A Revolution in Care Sally Sims Lecturer, CatholicCollegeofEducation, Sydney, Australia (1870), 'No system can endure that does not march .. . to INTRODUCTION standstillistogobackwards'. Wecannotafford tostandstill. Madam Chairman, distinguished guests, ladies and gentle Progressincancercare hascreatednewchallengesfor nurses men, it is an honour to have been invited to deliver this and although significant progress has been made, cancer Opening Address, 'Cancer Nursing: A Revolution in Care', continues to be a universal health problem. Methods are and a privilege to be able to attend the Fifth International available to prevent one-third of all cancers and, provided Conference on Cancer Nursing. detectiontakes place early enoughand appropriatetreatment IamnotsureifThe RoyalFestival Hallisafittingplacefora isgiven,one-thirdofallcancerscan now becured. Inspite of revolutionarygatheringbutregardlessofwhetherornotthisis this,eachyearnearly 6millionnewcancercasesarediagnosed so,itistrue tosaythat inone sense weare allrevolutionaries. and more than 4 million or one in ten deaths are caused by Each one of us has a part to play in ensuring a continuing cancerworld-wide (WHO 1984). revolution in cancer care. Through the pioneering work of the hospice movement, Revolutions conjure up images of violence, conflict and methodsare availabletoalleviatedistressingsymptomsand to forced political change asinthe American War of Independ provideappropriatepsychologicalsupportforindividualswith ence (1775-1783) and the French Revolution (1789-1798) of progressive cancer and their families. In spite of this, it has the 18thCentury.Althoughimagessuchastheseareportrayed been estimated that at least 3.5 million people suffer cancer inpaintings and historical literature, let usnot forget that the pain every dayand thatasmany as50-80% ofcancerpatients other side of revolution is the transformation of human do not have satisfactory pain relief (WHO 1986). suffering, the sweeping away of oppression and accelerated These statistics indicate that the need for nurses to be social progress.Therecan be few revolutions that have been knowledgeable about cancer prevention, treatment, rehabi more successful in transforming human suffering than the litationand palliationhasneverbeen moreurgent.Wecannot revolutionwhichhastakenplaceincancercare.Iwouldliketo afford tostandstillifweare tomeet thesechallengesand ifwe begin by considering briefly the need for a continuing are to be adequately prepared to meet the challenges of the revolution incancercare beforegoing on to discussourmost future. powerful weapon inensuring an on-going revolution. I shall Ifpresenttrendscontinue,theincidenceofcancerwillrisein then consider some of the revolutionary forces which are almostallpartsoftheworld,principallybecauseofincreasesin shaping cancer nursing as we know it and will conclude by the mean age of the world population but also because of reflecting upon three revolutionary ideals which have great lifestyle factors such as tobaccoconsumption. Between 1960 significance for ourown revolution. and 1980,the death rate from lung cancerrose 76% for men and 135% for women, an unnecessary and preventable increase (Stjernsward 1986). Although there isevidencethat smokingbehaviourischanging,changeisslowandlungcancer THE NEED FOR ACONTINUING REVOLUTION IN remains a major health problem. The need for a continuing CANCER CARE revolutionincancercare isparamount.Thequestionwemust The development ofcancernursing as a specialtyhas been a seek toanswer is:howcanweensureanon-goingrevolution? significant factor behindthe revolutionthathastakenplacein cancercare.Inhisbook TheAnatomyofRevolution,Brinton ENSURING ANON-GOING REVOLUTION IN (1965) asserts that, 'Revolutions are born of hope and their CANCERCARE philosophiesareformallyoptimistic'.The revolutionaryvision ofcancernursing asaspecialistareaofcare wasborn ofhope The word 'revolution' was first used by the astronomer and the philosophy of the early cancer nurses was one of Copernicus in his De Revolutionibus (1543), the theory that optimism. the sun, not the earth, is the centre of the universe. Thatoptimismcontinuestoday.Wedonotshare acommon 'Revolution'originallymeant'rotation'or'turn'anddescribed languageor health care system but cancernurses throughout the regular revolving motion of the stars (Bullock and theworldshareacommonoptimismthatcontinuedeffortwill Stallybrass 1977). achieve newlevelsofexcellenceincancercare. Lookingback Just as education was a major factor behind the early just10years,cancernursing hascomealongwaysincethefirst advances in cancercare,we must 'turn back to' and reinvest international conference in London in 1978. We have seen ourenergy ineducation,asthesinglelargest factor inensuring many ofthe seeds ofhope ofthe early cancernursing leaders acontinuingrevolutionincancercareandacceleratedprogress come to fruition and will learn of new hopes for the future against cancer. during the course of the coming week. Jan Stjernsward (1986), Chief of the World Health Although we have seen rapid developments in cancer Organization's CancerUnit, has stated that, 'Nothing would nursing over the past decade,hope must be the driving force have a greater impact on cancer today than acting on the behind continued effort. To quote Florence Nightingale knowledge we have already accumulated'. 1
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