Colorectal cancer is also known as cancer of the colon or bowel cancer. The main reason of this cancer is various changes in the lifestyle of individuals, genetic disorders and it occurs mainly in people in the old age group (Papamichael et al. 2015).The treatment of colorectal cancer includes a wide range of surgeries namely, radiation therapy, targeted and chemotherapy. The cancers that remain confined in the wall of the colon can be cured by using surgical procedures but the ones that have spread to different parts of the body or metastasized cannot be cured permanently leading to the death of the patient. It is reported that Chinese population residing in Singapore is more prone to get diagnosed with colorectal cancer (Chen et al.2015).Individuals who are undertaking hormone replacement therapy and under the medications of aspirin and NSAID’s have a low risk of suffering from colorectal cancer. It is also reported that there have been no known factors in 50 % of the population suffering from colorectal cancer. This report includes critical evaluation of approaches of counseling and helping in patients suffering from colorectal cancer.
It played an important role in providing primary health care to all the individuals in the twentieth century. According to this declaration, primary health care plays an important role in attaining the objective of the proper health care facilities for all the individuals. There is a major difference in the provision of medical facilities among the developing and the developed countries and this is not acceptable as it is the basic right of every individual to avail proper medical facilities (Brown, Fee, and Stepanova 2016).There should be a proper methodology and various strategies should be followed to reduce this gap. Various scientific and technological methods should be developed that can be accessed by the patients and their family members living in rural areas at a reasonable cost. The objective of primary health care for all the individuals was accepted by all the countries who are members of World Health Organization (WHO) after this declaration was made. Initially, it was accepted by the developing countries and by other country after five years.
Equity in primary health care refers to the various reasons that result in different qualities of healthcare in different populations residing in regions. This differentiation is done on the basis of caste, creed, sex, and financial status of the populations. It involves a lack of proper medical facilities such as lack of medicines to the people and is completely injustice to them. Health inequity leads to decrease in life expectancy of the individuals and increase in mortality rate. A lack of proper healthcare facilities leads to depression, anger, sadness and low self-esteem in the individuals. Health equity is of two types, horizontal health equity and vertical health equity.
Horizontal health equity refers to the balance in the provision of medical treatment facilities under the same conditions to people who are single, or in groups. Vertical equity is based on the fact that people who have differences on the basis of caste, religion, sex should be provided different healthcare facilities according to their requirement. Health equity is important in primary health care because every individual has the right to avail proper medical facilities irrespective of their differences like caste and financial status. This will help them in improving their health condition and keep them contented.
There are various factors which lead to Colorectal Cancer that include being overweight and obese, lack of physical exercise, lack of nutritious diet and a diet that is rich in red meat, smoking for a longer time period and heavy intake of alcohol. There are other factors also that cannot be changed such as old age, genetic or family history of colorectal Cancer and type 2 diabetes. The social factors of Colorectal Cancer include low socioeconomic background and poverty and the individuals having a weak financial status do not proper access to healthcare and treatment facilities (Peabody 2015).
Various measures are advised to patients suffering from colorectal cancer such as increase in physical exercise, a well balanced diet rich in fibers, reduction in the consumption of smoke and alcohol. Palliative care is recommended to patients, which is specialized care to get relieved from pain and stress, both physical and mental. It involves various doctors, nurses and other healthcare professionals to work in collaboration to help the patient in managing the disease and the treatment by him .They should be given a proper counseling and psychosocial care to improve their emotional health and get rid of pain, anxiety, distress and low self esteem developed due to the disease (Balasooriya-Smeekens, Scott and Walter 2015).
The patients should be advised to follow certain remedies to manage the emotional issues like proper relaxation and sleep, seeking support and advice with patients who were diagnosed with colorectal cancer, counseling with a healthcare professional and sharing their feelings that will help them and make them feel positive (Chew et al. 2015). Some patients suffer from severe depression so they can take the help of antidepressants, which is very helpful, and make them feel good about themselves. Antidepressants can be used for a longer period or a shorter depending on the situation of patients diagnosed with colorectal cancer
Cognitive behavioral therapy can be provided to patients who would help to change his behavior and thinking. The main aim of this therapy is it focuses majorly on the issues and the problems rather than the causes of the symptoms faced by the cancer patient. Many patients who are diagnosed with colorectal cancer face problems in concentration, memory, thinking, multitasking, learning and organization of new ideas. These cognitive problems arise because of the stress they face during the diagnosis of the disease. The main reason of cognitive issues is that the information that brain tries to encode does not get encoded and stored in a proper manner.
Recurrence of colorectal cancer occurs when a few cancer cells do not die and survive the treatment and gradually develop again in to tumors. It can spread in to the liver, lungs, bones or to the other parts of the body. There are various signs and symptoms of the recurrence of colorectal cancer that include pain in the abdomen along with gas, bloating and cramps, constipation, inconsistent stool that means watery or loose, presence of blood in the stool or dark colored stools, irregular bowel movements, loss in weight and fatigue or lack of energy in the body. If there are symptoms of recurrence of colorectal cancer he should be provided proper care and treatment and should be explained with the help of written material or a video to help him understand in a better manner (Wong et al.2013).
The patients should be provided proper information regarding the prevention measures and the strategies that are appropriate for them and should be followed to get cured from colorectal cancer. They should be provided proper support and guidance to manage their disease. They will be educated in an effective manner to take proper rest and precautionary measures to improve their health condition. The family members of the patients should also be taken care of and helped whenever in need regarding to the treatment of patients and other issues related to accommodation and transport (Mosher et al. 2016).They should be provided special treatment to avoid issues related to sexuality, image of the body that leads to distress. He will be given proper counseling and guidance to handle new relationships and overcome the difficulties he would be facing. He will also be provided financial support if required and helped in improving his socioeconomic status, to handle social situations effectively and to cope with the side effects of the chemotherapy he has undergone. He will also be provided proper follow ups after the treatment to keep a track on the progress of the disease.
It includes five stages including Precontemplation (Not Ready), Contemplation (Getting Ready), Preparation (Ready), Action, and Maintenance. Individuals in the Precontemplation stage do not wish to take any action in future that is in the six months and they are not informed about the effects of his or her behavior. This stage includes individuals having characteristics of not being motivated and not ready for any help. Contemplation stage involves individuals who wish to change in the next six months. There are both aware of the advantages and the disadvantages associated with change. People in this stage are not ready to initiate programs that are action oriented in a traditional manner .Preparation phase is the stage in which people wish to take any action in the future especially in the next month. Individuals belonging to this phase have a proper action plan such as consultation with the doctor or any other health care professional and depending on the approach to change himself (Prochaska 2013.).These people should be taken into consideration for programs that are action oriented. Action stage involves individuals who have made specific changes in their lifestyle in the last 6 months. It is one of the stages in which all the changes in the behavior are recognized as actions. Maintenance stage also involves people who have done specific changes in their lifestyles but not as frequently as the individuals do in the action stage. They become more confident with time and hence can continue on with various modifications.
It refers to the protective measures taken by the health organizations to avoid various kinds of infection, injuries or accidents. It is a top priority in many hospitals but some hospitals are not able to avoid errors during their treatment. It leads to serious complications, slow recovery, increased length of hospitalization and also unnecessary deaths of patients. For example, if there is a gas bubble in blood during surgery it will block the flow of blood to all the parts of the body leading to heart attack and death. There should be proper teams to handle in order to ensure patient safety (Doyle, Lennox and Bell 2013). Patient safety can be ensured by identifying patients correctly by mentioning their name and date of birth, improved staff communication, safe use of medicines by labeling them carefully, use of alarms safely, preventing mistakes in various surgical processes, identifying safety risks in patients, preventing various kinds of infections caused by different pathogens such as bacteria and viruses. It is compromised if the important information is not available to all the members of the team.
It refers to putting the patients and their families in the centre and considering their desires, families, family situations, lifestyle which will lead to a positive outcome. It is about being respectful and compassionate towards them and also thinking them from their point of view by solving all their queries regarding the treatment prescribed. There are also various aspects of patient centered care like providing them emotional support, giving them courage and encouragement to fight with the disease they are suffering from, making sure they are physically safe and comfortable and they are receiving timely care, involving family and friends in the discussion, sharing responsibility and power, making sure that the healthcare services are flexible, easy to access and follow, making sure that they have a well trained and supportive staff. This will have a positive impact on the well being and the emotional health of the patients.
According to researchers, patient centered care leads patients to live longer and reduces the pressure on health care organizations. It also improves the quality of the services offered by them and makes people active to get rid of various diseases and look after them by following a healthy lifestyle. This reduces the overall cost of the treatment, improves the overall experience and help them to be more independent. The clinicians have to be transparent and provide proper information on healthcare. Clinicians practicing patient care should have a sense of responsibility towards their patients
It plays an important role in healthcare industry. It ensures better treatment to patients as they can share their problems with the doctors and nurses. Proper information regarding the illness, medications and the preventive measures to be followed should be given to the patients. It will develop a strong relation between the patient and the clinician. The clinician should be compassionate enough to listen to his or her patient. This will help them to develop a trustworthy relation between the two (Dabney and Kalisch, 2015). The connection a patient feels with his or her clinician develops a positive thinking and reduces the stress about the treatment given to him. It also leads to increase in patient satisfaction, confidence, health and wellbeing. It reduces the complications in patients that lead to decrease in post operative complications. It also decreases the cost and the duration for which the patient is hospitalized.
Professional communication in healthcare is an important tool to facilitate patient satisfaction and care. Healthcare professionals and should train their team properly to avoid any misunderstandings regarding the treatment and overcome all the barriers in communication. They should cater to the needs of patients and his family members; solve their queries by being an active listener in a proactive manner. The main aim is to have a strong relation between the patient and the clinician (Palmer et al.2014). Nurses who work alongside need to ensure that the patients receive timely care and medications during the treatment.
Ineffective communication leads to delayed treatment and sometimes may cause adverse conditions in patients. This reduces their trust in healthcare, misunderstanding and confusion about the treatment given by the clinicians. It may lead to distress and anxiety and have a negative impact on the psychological status of the patients. This can cause increased mortality rate and the length of the patients hospitalized (Ahluwalia et al.2015). Various examples of ineffective communication are failing to clarify all the queries of the patients regarding the treatment, preventive measures to be followed and failure to disclose serious complications to patients and their family members.
Documentation in nursing is a very important role in healthcare and it is generated electronically to record information about the patient undergoing treatment. Documenting care refers to creating an electronic record that includes basic information of the patient, medical illness and its treatment procedure. It also includes various other reports like Magnetic Resonance Imaging, electrocardiograms and computerized tomography. It helps in the identification, evaluation, planning and analysis of the health problems in patients. The main objective of these systems is that it helps in decision analysis and facilitates treatment. The information is recorded in clinical database and can be used as future reference and evidence.
Nursing documentation should be legible, objective and free of errors. Correction and late entries should be as per procedure and policy and charting should not be done beforehand. It also can lead to a sense of achievement and job satisfaction in health care professionals. There are various advantages of electronic health records like the patient records can be accessed more quickly and efficiently. It enables the doctors to diagnose a disease more efficiently and reduces the chances of medical errors during surgical procedures. It also lowers the healthcare costs by proper coordination of the healthcare services by reduction in redundant and useless tests. It also provides better health care by improving all aspects of patient care like proper communication, being patient–centric and other important aspects of patient care.
When a patient leaves for his home from the hospital after the surgery and last stage of chemotherapy, he experiences a lot of changes in his body and various emotional issues due to the negative impact of the cancer surgery. They need a proper guidance and education to manage their daily lives after the discharge process (Papastavrou, Andreou and Efstathiou 2014).There are various strategies that can be followed to provide proper education to patients for a successful discharge and improve patient care and satisfaction. Patients should be provided proper instructions regarding the medicaments and other measures to be followed to prevent the recurrence of colorectal cancer. There are various precautions that should be advised to patients to get cured from the disease such they should be provided with a separate toilet at home if possible or should flush the toilets every time they use them. The caregivers at home should be provided with gloves while handling the blood, stool or urine sample of the patient. This would help him or her to get rid of infection (Mosher et al. 2016).
An appropriate discharge planning process will enable the readmission of the patient in the hospital and save his time and money. Providing information and educating the patient about the discharge process will help him to manage the disease at his home after he leaves from the hospital. The patients can be called in groups of 4-5 people after the discharge process, from the patient bed to another room and can be provided education related to discharge and self management of the disease (Reeve et al. 2017).This will help to avoid any confusion in the patients in relation to the disease that is colorectal cancer and will make them comfortable. The patients are informed that if they observe any symptoms such as fever, constipation, diarrhea, nausea, vomiting, pain in the abdomen, and blood in the stool and cough, pain in the chest while breathing or coughing, respiratory issues or breathing problems, swelling and pain in arms and legs, they should immediately contact the oncologist for further treatment .The nurses can explain briefly about the instructions related to discharge process to the patient and their family members.
The clinician along with nurses, dieticians and other health care professionals should provide various strategies for self-management of the disease (Street 2013). They should work in teams or in collaboration to provide proper communication to patients after they are discharged from the hospital and go back home. This will help in enhancing the safety of the patients and avoid any mishappening with the patient that may occur due to ineffective communication. The patients should be motivated to ask any queries or doubts related to the disease that will help in improving satisfaction and confidence in them. They should be provided regular follow-ups to keep a track on the progress made and also if there are any symptoms of recurrence of colorectal cancer.
They play an important role improving their health condition in the key populations and various other patients include proper counseling of patient affected by colorectal cancer and providing them psychosocial support to boost their confidence and improve their self-esteem. They and their family members should be given proper information about the disease, its symptoms, treatment plan and preventive measures to avoid any confusion and to tackle the disease (Doenges, Moorhouse and Murr 2016).
Sometimes a lack of effective communication can result in misinterpretation by the patients as they understand it partially and it leads to adverse conditions. The criteria that can be used to evaluate the success of the education session are proper environment for the patients without any disturbances, printed materials, a proper set for power point presentation and other audio-visual methods, comfortable seating arrangement and empathetic clinicians, nurses and other health care professionals to cater to all the needs and demands of the patients suffering from colorectal cancer (Little et al. 2015). A proper education of patients leads to improvement in the hospital journey and reduces the anxiety, stress and pain in them.
Conclusion
It can be concluded that patients suffering from colorectal cancer should follow all the preventive measures in an appropriate manner as prescribed by the doctors and the nurses. He should be provided with a person centered care that refers to putting the patients and their families in the centre and considering their desires, families, family situations, lifestyle which will lead to a positive outcome (Zaid et al. 2016). The Cancer Care Coordinator and the other staff members of the hospital should be respectful and compassionate towards patients and also think from their point of view by solving all his queries regarding the treatment prescribed. There are also various aspects of patient centered care like providing him emotional support, giving him courage and encouragement to fight with the disease he is suffering from, making sure he is physically safe and comfortable and is receiving timely care, involving his wife in the discussion, sharing responsibility and power. The clinicians have to be transparent and provide proper information on healthcare. Clinicians practicing patient care should have a sense of responsibility towards their patients. The health care professionals should also make sure that the healthcare services are flexible, easy to access and follow and have a well trained and supportive staff. This will have a positive impact on the well being and the emotional health of patients and help him get cured in a less amount of time.
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