An international collaborative design of clinical nursing practice guidelines for patients with cholangiocarcinoma.

65 Background: Cholangiocarcinoma (CC) accounts for approximately 3% of all gastrointestinal cancers and have a poor incident to mortality rate. The incidence in the United States (US) is 2,000-3,000 cases annually, with this rate steadily increasing during the last twenty years; this trend is not solely observed in US but also seen in Europe, Australia and Japan. The highest incidence is seen in Southeast Asia due to parasitic infection. CC presents many challenges to healthcare professionals due to the anatomic nature of CC (Lowe et al, 2015). The worldwide increase in incidence of CC is indication for the essential development of nursing practice guidelines underpinned by expert evidence and knowledge and regarding the key aspects of care. Methods: A collaboration of nursing professionals representing major cancer research institutions from around the country and the United Kingdom worked together to identify key aspects of care, the aim being to develop Clinical Nursing Practice Guidelines. The process included an exhaustive literature review using Pubmed, Uptodate, Medline, and CINAHL databases; submission of respective institutional practices; group consensus on guideline content, evidence-based scoring assignment and approval by the Cholangiocarcinoma Medical Advisory Board. Results: The guidelines developed include the care of the patient: (1) with external biliary drains and internal bile duct stents, (2) with intractable nausea and vomiting resulting from disease process, (3) with fatigue resulting from disease process, (4) undergoing chemotherapy, (5) undergoing photon radiation, (6) undergoing radiation on a clinical trial, and (7) preparing for liver transplantation. The purpose of the guidelines are to advance the scientific knowledge of the symptoms experienced, quality of life of patients with CCA, establish standards in patient care, and improve quality of care and satisfaction for patients diagnosed with CC. Conclusions: Creation of evidence-based guidelines will provide a springboard for expanded competent knowledge and a model to test for improvement in the care and quality of life of the patient with CC.

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Fecal Incontinence: Nonsurgical Management

10.2310/tywc.19158 ◽

2018 ◽

Author(s):

Madeleine Blank ◽

Lilian Chen

Keyword(s):

Quality Of Life ◽

Fecal Incontinence ◽

Pelvic Floor ◽

Nonoperative Management ◽

Disease Process ◽

The United States ◽

Pelvic Floor Physical Therapy ◽

Nonsurgical Management ◽

Accidental Bowel Leakage

Fecal incontinence is the uncontrolled passage of feces or flatus. It is a debilitating and often unrecognized condition whose prevalence is increasing with our aging population and often carries significant stigmata associated with decreased quality of life. It is also one of the leading causes of nursing home admissions in the United States. The etiology of fecal incontinence is multifactorial, with many risk factors contributing to this disease process. Treatment may be challenging and needs to be individualized. In this review, we discuss the initial evaluation of the patient presenting with fecal incontinence, adjunctive testing modalities, and nonoperative management. This review contains 6 figures, 2 tables and 50 references Key words: accidental bowel leakage, biofeedback, bowel incontinence, fecal incontinence, pelvic floor physical therapy, pelvic floor retraining

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Relevance of quality of life to clinical nursing practice

Seminars in Oncology Nursing ◽

10.1016/0749-2081(90)90027-3 ◽

1990 ◽

Vol 6 (4) ◽

pp. 255-259 ◽

Cited By ~ 17

Author(s):

Claudette G. Varricchio

Keyword(s):

Quality Of Life ◽

Nursing Practice ◽

Clinical Nursing

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Integrative Nursing Management of Nausea

Integrative Nursing ◽

10.1093/med/9780190851040.003.0014 ◽

2018 ◽

pp. 185-205

Author(s):

Susanne M. Cutshall ◽

Lisa M. VanGetson

Keyword(s):

Quality Of Life ◽

Medical Care ◽

Nursing Practice ◽

Vital Role ◽

Integrative Approach ◽

Medical Complications ◽

Evidence Based ◽

Nursing Management ◽

Delayed Recovery

This chapter provides an overview of the background for nausea and the evidence-based integrative approaches for assessment, prevention, and management of nausea and vomiting. Nausea and subsequent vomiting are common symptoms that patients may experience with medical conditions and treatments. There are many causes for nausea including medication and specific conditions and procedures. Nausea can be unpleasant and lead to other medical complications, delayed recovery, and increased medical costs; affect the quality of life and satisfaction with medical care; and contribute to future anticipatory nausea and anxiety with medical care. A multimodal integrative approach to management of nausea is often needed. Nurses trained in integrative nursing practice can play a vital role in assisting patients with strategies to prevent, treat, and manage nausea. This chapter reviews an example of clinical application of these strategies utilizing an integrative nursing approach.

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Fecal Incontinence: Nonsurgical Management

10.2310/obg.19158 ◽

2017 ◽

Author(s):

Madeleine Blank ◽

Lilian Chen

Keyword(s):

Quality Of Life ◽

Fecal Incontinence ◽

Pelvic Floor ◽

Nonoperative Management ◽

Disease Process ◽

The United States ◽

Pelvic Floor Physical Therapy ◽

Nonsurgical Management ◽

Accidental Bowel Leakage

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Anxiety

10.1093/med/9780190204709.003.0006 ◽

2017 ◽

Author(s):

Maria Gatto ◽

Patricia Thomas ◽

Ann Berger

Keyword(s):

Quality Of Life ◽

Palliative Care ◽

Clinical Practice ◽

Chronic Diseases ◽

Practice Guidelines ◽

Evidence Based ◽

Family Coping ◽

Specific Symptom ◽

Disease States

Anxiety is an inherent aspect of human existence. Anxiety and chronic diseases are interchangeable in their causal relationship: chronic diseases can exacerbate symptoms of anxiety, and anxiety disorders can lead to chronic diseases. Anxiety is a specific symptom emphasized in the National Consensus Project for Quality Palliative Care Clinical Practice Guidelines. Assessment is interdisciplinary and must address both the psychological and psychiatric aspects of care. To assure appropriate management, an understanding of etiologies for anxiety across populations and disease states is essential. Treatment relies on evidence-based pharmacological and nonpharmacological strategies to maximize patient and family coping and quality of life.

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Recognition of Immune Response for the Early Diagnosis and Treatment of Osteoarthritis

Journal of Immunology Research ◽

10.1155/2015/192415 ◽

2015 ◽

Vol 2015 ◽

pp. 1-13 ◽

Cited By ~ 29

Author(s):

Adrese M. Kandahari ◽

Xinlin Yang ◽

Abhijit S. Dighe ◽

Dongfeng Pan ◽

Quanjun Cui

Keyword(s):

Quality Of Life ◽

Immune Response ◽

Early Diagnosis ◽

Imaging Techniques ◽

Disease Process ◽

Inflammatory Cells ◽

The United States ◽

Diagnosis And Treatment ◽

Joint Disease

Osteoarthritis is a common and debilitating joint disease that affects up to 30 million Americans, leading to significant disability, reduction in quality of life, and costing the United States tens of billions of dollars annually. Classically, osteoarthritis has been characterized as a degenerative, wear-and-tear disease, but recent research has identified it as an immunopathological disease on a spectrum between healthy condition and rheumatoid arthritis. A systematic literature review demonstrates that the disease pathogenesis is driven by an early innate immune response which progressively catalyzes degenerative changes that ultimately lead to an altered joint microenvironment. It is feasible to detect this infiltration of cells in the early, and presumably asymptomatic, phase of the disease through noninvasive imaging techniques. This screening can serve to aid clinicians in potentially identifying high-risk patients, hopefully leading to early effective management, vast improvements in quality of life, and significant reductions in disability, morbidity, and cost related to osteoarthritis. Although the diagnosis and treatment of osteoarthritis routinely utilize both invasive and non-invasive strategies, imaging techniques specific to inflammatory cells are not commonly employed for these purposes. This review discusses this paradigm and aims to shift the focus of future osteoarthritis-related research towards early diagnosis of the disease process.

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Misophonia: An Evidence-Based Case Report

American Journal of Audiology ◽

10.1044/2020_aja-19-00111 ◽

2020 ◽

Vol 29 (4) ◽

pp. 685-690

Author(s):

C. S. Vanaja ◽

Miriam Soni Abigail

Keyword(s):

Quality Of Life ◽

Case Report ◽

Case History ◽

Pure Tone ◽

Physiological Responses ◽

Evidence Based ◽

Management Option ◽

Pure Tone Audiogram

Purpose Misophonia is a sound tolerance disorder condition in certain sounds that trigger intense emotional or physiological responses. While some persons may experience misophonia, a few patients suffer from misophonia. However, there is a dearth of literature on audiological assessment and management of persons with misophonia. The purpose of this report is to discuss the assessment of misophonia and highlight the management option that helped a patient with misophonia. Method A case study of a 26-year-old woman with the complaint of decreased tolerance to specific sounds affecting quality of life is reported. Audiological assessment differentiated misophonia from hyperacusis. Management included retraining counseling as well as desensitization and habituation therapy based on the principles described by P. J. Jastreboff and Jastreboff (2014). A misophonia questionnaire was administered at regular intervals to monitor the effectiveness of therapy. Results A detailed case history and audiological evaluations including pure-tone audiogram and Johnson Hyperacusis Index revealed the presence of misophonia. The patient benefitted from intervention, and the scores of the misophonia questionnaire indicated a decrease in the severity of the problem. Conclusions It is important to differentially diagnose misophonia and hyperacusis in persons with sound tolerance disorders. Retraining counseling as well as desensitization and habituation therapy can help patients who suffer from misophonia.

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Biopsychosocial Patterning of Multimorbidity and Its Consequences

The Oxford Handbook of Integrative Health Science ◽

10.1093/oxfordhb/9780190676384.013.14 ◽

2018 ◽

pp. 220-236

Author(s):

Elliot Friedman ◽

Beth LeBreton ◽

Lindsay Fuzzell ◽

Elizabeth Wehrpsann

Keyword(s):

Quality Of Life ◽

Older Adults ◽

Functional Outcomes ◽

The United States ◽

Chronic Medical Conditions ◽

Quality Of Life Research ◽

Increased Risk ◽

Over Time

By many estimates the majority of adults over age 65 have two or more chronic medical conditions (multimorbidity) and are consequently at increased risk of adverse functional outcomes. Nonetheless, many older adults with multimorbidity are able to maintain high levels of function and retain good quality of life. Research presented here is designed to understand the influences that help ensure better functional outcomes in these older adults. This chapter presents findings that draw on data from the Midlife in the United States study. The independent and interactive contributions of diverse factors to multimorbidity and changes in multimorbidity over time are reviewed. The degree that multimorbidity increases risk of cognitive impairment and disability is examined. The role of inflammation as a mediator is considered. Multimorbidity is increasingly the norm for older adults, so better understanding of factors contributing to variability in multimorbidity-related outcomes can lead to improved quality of life.

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Inquiry Based Stress Reduction (IBSR) Improves Overall Stuttering Experience among Adults Who Stutter: A Randomized Controlled Trial

Journal of Clinical Medicine ◽

10.3390/jcm10102187 ◽

2021 ◽

Vol 10 (10) ◽

pp. 2187

Author(s):

Omrit Feldman ◽

Eran Goldstien ◽

Benjamin Rolnik ◽

Ariel B. Ganz ◽

Shahar Lev-Ari

Keyword(s):

Quality Of Life ◽

Stress Reduction ◽

Satisfaction With Life ◽

Psychological Flexibility ◽

Well Being ◽

The United States ◽

Control Group ◽

Randomized Controlled ◽

Adults Who Stutter

Stuttering is a speech disorder that can cause disturbances in the timing and flow of speech. In addition to being a communication disorder, stuttering is often accompanied by a reduction in the quality of life and has impacts on social status, mental well-being, self-acceptance, and the chances of integration into the labor market. The Inquiry Based Stress Reduction (IBSR) program, developed in the United States by Byron Katie in 1986, is the clinical application of “The Work” method (Thework.com) and represents an emerging mindfulness and cognitive-reframing method. IBSR has been demonstrated to improve mental health and well-being in adults and may alleviate psychological and psychosocial symptoms of stuttering. The purpose of this trial was to examine the effect of a 12-week IBSR intervention on the overall stuttering experience and indicators of anxiety, psychological flexibility, and well-being among adults who stutter (AWS). This study was a randomized controlled clinical trial. Participants were randomized to IBSR (n = 28) and control (n = 28) groups. Validated questionnaires of overall stuttering experience (OASES-A), anxiety (STAI), psychological flexibility (PFQ), and satisfaction with life (SWLS) were completed before, after, and one month after the intervention. An intention-to-treat approach was implemented for analysis. Our results show that participants in the IBSR intervention group exhibited a greater improvement in their overall stuttering experience as compared to the control group, as well as in general information on stuttering awareness and perception, reactions to stuttering, communication in daily situations, and quality of life. In addition, we found a greater reduction in anxiety levels and an increase in satisfaction-with-life scores in the IBSR group. These results indicate that IBSR can improve the overall stuttering experience.

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