CONJ Volume 24 Issue 3 Summer 2014
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VOLUME 24, Issue 3, Summer 2014

Taking an “upstream” approach in the care of dying cancer patients:
The case for a palliative approach

CONJ, 24(3), pages 144-148

by Kelli I. Stajduhar and Carolyn Tayler

Abstract

Advances in technology and drug therapy have resulted in cancer patients living longer with malignant disease. However, most of these patients will face the end of life much sooner than the general population. Adopting a “palliative approach” is one innovation that has the potential to promote anticipatory planning and promote enhanced end-of-life care. Yet, in much of the western world, this upstream orientation has rarely been achieved. An emphasis on providing palliative care late in the illness trajectory has resulted in many challenges for the care of people with advanced cancer. We highlight a nursing research initiative, The Initiative for a Palliative Approach in Nursing: Evidence and Leadership (iPANEL), that aims to develop evidence to inform the integration of a palliative approach into the care of people with advancing chronic life-limiting
conditions. Oncology nurses have an important role to play in facilitating a palliative approach, transforming the ways in which cancer patients are cared for within our health care system.

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Merck Lecture
“I Can’t Sleep!”: Gathering the evidence for an innovative intervention for insomnia in cancer patients

CONJ, 24(3), pages 154-159

by Nancy (Surya) A. Absolon, Tracy L. Truant, Lynda G. Balneaves, Frankie Goodwin, Rosemary L. Cashman, Margurite E.
Wong, and Manisha B. Witmans

Abstract

Sleep-wake disturbances, in particular insomnia, are experienced by 30%–75% of oncology patients, yet no effective interventions have been designed to address this distressing symptom in the ambulatory setting. In response to an identified gap in care, I share the development and evaluation of an innovative sleep intervention designed specifically for the ambulatory setting. Preliminary findings, as well as an informative blueprint for conducting point-of-care research, are described. As a “bedside” nurse it is possible and within our moral imperative and social justice mandate to take action to
find evidence-informed solutions to improve care for populations of patients experiencing gaps in care. The “I” used throughout the article refers to the lead author Surya.

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Rethinking assumptions about cancer survivorship

CONJ, 24(3), pages 166-168

by Svetlana Ristovski-Slijepcevic and Kirsten Bell

Abstract

A growing body of research informed by theories and methods in the social sciences and humanities indicates that certain problematic messages are commonly embedded in popular and oncological representations of cancer. Becoming more aware of these underlying messages has the potential to improve the ways clinicians think about and manage cancer. (Note: A written response to this article appears in Truant, Kohli, & Stephens (2014), Response to “Rethinking Assumptions about Cancer Survivorship”: A Nursing Disciplinary Perspective, Canadian Oncology Nursing Journal, Vol. 24, Issue 3, p. 169)

Keywords: cancer; survivorship; social sciences; humanities

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 Response to “Rethinking Assumptions about Cancer Survivorship”: A nursing disciplinary perspective

CONJ, 24(3), pages 169-173

by Tracy L. Truant, Jagbir K. Kohli, and Jennifer M.L. Stephens

Abstract

In response to our social science and humanities colleagues’ paper,Rethinking Assumptions about Cancer Survivorship (Ristovski-Slijepcevic & Bell. [2014]. CONJ, 24(3), p. 166), we offer a nursing disciplinaryperspective on some of the dominant messages purportedto underpin cancer survivorship. We illuminate points of disjuncturewithin their paper, using nursing’s disciplinary lens to describe andexplain the complexities inherent in the cancer survivorship experienceand its implications for clinical practice. Opportunities for collaborationwith our social science and humanities colleagues areoutlined to foster synergistic knowledge development that will, ultimately,improve the care of those living with, through, and beyondcancer.

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Contribution of the pivot nurse in oncology to the experience of receiving a diagnosis of cancer by the patient and their loved ones

CONJ, 24(3), pages 189-193

by Irène Leboeuf, Dominique Lachapelle, Sylvie Dubois, and Catherine Genest


Abstract
The announcement of a cancer diagnosis represents a difficult situationfor the patient, their loved ones and professionals (Reich, Vennin& Belkacémie, 2008). Until now, few studies have described nurses’contribution to this critical moment along the care trajectory (Tobin,2012) and even fewer, the contribution of the pivot nurse in oncology(OPN) or infirmière pivot en oncologie (PNO) as this specialist is calledin Quebec. This study aims to document the OPN’s contribution to thecancer experience of the patient and their loved ones, from the timethe diagnosis is communicated to the period immediately following(four to six weeks). Fourteen PNOs from a Montreal university healthcentre took part in two individual interviews. Results show that PNOsoffer personalized support which draws on their expertise to betterunderstand the experience lived by patients and their loved ones, andadapt their interventions according to their needs and the timing ofthese interventions. These results support issuing three recommendationsfor nursing practice in the areas of PNOs; development ofexpertise, interprofessional collaboration and environment.

Key words: Pivot nurse in oncology, infirmière pivot en oncologie,nursing contribution, announcement of diagnosis, cancer

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Supporting women with advanced breast cancer: The impact of altered functional status on their social roles

CONJ, 24(3), pages 194-198

by Bai Qi Peggy Chen, Monica P. Parmar, and Kimberley Gartshore

Abstract

Despite early detection of breast cancer and the progress of treatmentmodalities, metastasis-specific symptoms continue to impactwomen’s functional status and daily living. The aim of this study wasto explore the experience of altered functional status and social rolesof women with advanced breast cancer. Using qualitative descriptivemethodology, semi-structured interviews were conducted with10 women diagnosed with advanced breast cancer and altered functionalstatus attending a tertiary care cancer centre. Results illustratedthe adaptive experience of women living with their illness asthey reshaped their social roles to fit with their altered functional statusand advanced disease. These findings highlight the opportunityfor supportive care nursing interventions to facilitate the behaviouraland cognitive transitions that are experienced by women withadvanced breast cancer and altered functional status. These resultsmay have implications for women with other advanced chronic diseases,though more research is required.

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