|
Vol. 18. No. 5 October 2005 |
|
| ORIGINAL CONTRIBUTION | "The cure of the part should not be attempted without treatment of the whole …"
(The psychological background to malignant disease) Rikkerné K. Awareness of the gynaecological prevention opportunities available to women in Hungary
|
| TRAINING | The impact of orally administered (per os) chemotherapy on patients' quality of life
Zatkó J. |
| Hungarian Scientific Society of Nursing | Protocols for oncological screening examinations organised in Hungary and the United States
Németh K., Szabó L., Dér A., Karamánné A. |
| TRAINING | The impact of malignant haematological diseases on the patients' everyday lives
Ujlakánné H., Bognár B. Opportunities for individualised nursing and responsible nursing in hospice wards
|
"The cure of the part should not be attempted without treatment of the whole …"
(The psychological background to malignant disease)
The purpose of the study: To become familiar with those life stages and events, and negative psychological states that are of key importance from the point of view of occurrences of malignant disease.
Study methods and sample: The research followed a qualitative, data-oriented theoretical strategy. A total of 104 patients at the National Oncology Institute participated in the study, as well as a control group of 51 healthy individuals. The results were interpreted through a comparison of the various data units, expressed partly in the form of a descriptive explanation, and partly through a correlative analysis.
Results: The stages of life that have a bearing on malignant disease are as follows: nursery-school age (initiative-guilt), adulthood (creativity-stagnation), and old age (self-integrity-despair). Typical: the so-called object loss[1] that occurs in the last five years, the frequent negative states of mind, as well as - of the various personality traits - a strong need for stability, and a tendency to avoid conflict.
Conclusion: Tumour patients are characterised by a particular psychological and life-history background, and the resulting adaptive (cooperative) difficulties that can be identified prior to the manifestation of the illness. By establishing the concept of the "psycho-social risk group," important results could be achieved in respect of the screening of endangered persons, and the various arenas of prevention.
[1] Object loss: The emotional deficit that occurs upon the loss of a person, relationship, feeling or state (e.g. mourning, illness), which can have temporary or permanent psychological and physical consequences.
Purpose of the study: Our research was aimed at establishing the level of women's awareness, and the knowledge that they possess, regarding gynaecological screening, the frequency with which they perform breast self-examinations, and the methods they use.
Study methods and sample: The sample consisted of nurses at the Zala County Hospital, nursing students at the Zalaegerszeg Training Centre of Pécs University Healthcare College, as well as 207 randomly selected female employees of a large company located in the town of Zalaegerszeg.
Results: In Hungary, the number of women in the threatened age groups that attend gynaecological screening is declining. Some 46% of the study population attend screenings regularly (annually). The National Health Program has facilitated breast screening on a nationwide scale. Preliminary data shows that the participation rate is 40%, and this figure appears to be borne out by the survey, which found that 54% of the 40-59 age group attend such screenings.
Conclusion: In order to further improve the mortality rates, screenings must be continuously and conscientiously performed. There is a need not only for the examinations themselves, but for effective awareness-raising activity. These measures would certainly reduce the still formidable obstacles to ensuring the spread of gynaecological cancer screening. Cooperation that transcends social boundaries, and the implementation of a complex strategy, can offer hope of reductions in the number of tumour patients in Hungary.
Demand is growing for chemotherapy in the course of which the patients receive orally administered medication, since these medicines are as efficacious as the intravenous infusions, but without the limitations and risks. In the author's own experience, too, the use of intravenous chemotherapy is more detrimental to the patient's quality of life, and therefore also increases the workload of nurses on oncology wards.
At the Chemotherapy Clinic of the Oncology-Radiology Centre of the Uzoki Utca Hospital in Budapest, courses of per os Capecitabine therapy have been used to treat certain advanced malignant tumours for more than two years.
Studies are being held to reveal how the patients perceive this method of treatment, and how they view the change to their quality of life during the therapy.
The article contains an analysis of the patient's answers, supplemented with an account of the author's own experiences with regard to treatment.
Abstract:
Aim of the study: The article compares the recommendations of oncological screening examinations organised in Hungary and the United States, based upon literature statistics.
Timeliness: The mortality rates of oncological diseases have shown unfavourable tendencies in the last decades, coming second only to mortality causes with a cardiovascular origin, with a frequency of 25 %.
Method: The author compares the guidelines of the American Cancer Society (ACS) in 2004 with the Hungarian cancer screening recommendations stated in the National Public Health Program. The participation rates of female breast and cervix cancer screenings in Hungary were examined through the data of the National Public Health and Medical Officer services.
Results: The participation rates at the organised female breast and cervix cancer screenings are well below the target 70%. Data shows a 40% rate for the first disease group and a 4% rate for the second, during the study period.
Conclusions: The aim of the National Public Health Program - which aims to achieve a 5-10% reduction in the mortality rates of oncological diseases by 2010 among the under-70s, through organised and targeted public screenings - is unlikely to be achieved, since participation rates are too far below target. This means that the task of promoting public screening opportunities fall to nurses and other healthcare workers.
One of the leading causes of death in Hungary is the group of illnesses known as malignant diseases, which includes tumours as well as malignant haematological diseases. These illnesses have a profound impact on the life of those affected (patients and their relatives). The treatments employed to cure such diseases, such as chemotherapy, cause a great many difficulties for the patients, since they are protracted and unfortunately the results are not always favourable.
A number of haematological diseases are currently incurable, although survival times have lengthened considerably over recent years. Generally, the patient's quality of life deteriorates, working abilities are severely impaired, and often day-to-day living also becomes problematic.
In order to ensure that healthcare services provided to patients have the appropriate effect, it is important to assess the patient's somatic and psychological state before, during and after the chemotherapy.
The authors hope that their essay will contribute to achieving this goal.
The author demonstrates how nursing processes can be implemented in hospice wards, what the use of a responsible nursing system represents from the point of view of patients and the care team, and what conditions are necessary for its realisation.
Act CLIV of 1997 makes nursing documentation a mandatory requirement. However, nursing documentation can only be effectively used within the framework of nursing processes. For this, a new, modern approach needs to be formulated, but one that preserves the traditional values of good nursing practice. The ordered data collection of nursing documentation, with the aim of identifying and establishing the nursing and care requirements of the patient, also support the planning of nursing duties and the proof of performance of nursing services. Another aspect is the clarification and documentation or nursing competencies and responsibilities, which encompasses the appropriate degree of accountability. All of these form the basis for the precise maintenance of the appropriate nursing documentation.