Discuss about the Symptom Cluster and Management.
Human body is complicated and is still a mystery to mankind. 70 percent of human body is yet to discover. With the world running on smart path, diseases are also prevalent and has been creating resistance in human life. Deadly diseases are one of major cause to worry. Lots of research and resources are used to cure diseases. Diseases like cancer comes with multiple symptoms and dealing with these symptom is itself a painful and tedious work. Symptoms are the purpose that patients seek health care. Indications of illness are foremost reason to worry. Many people are in dilemma as if they are doing right thing and their planning for symptom management strategies are appropriate and their result would be effective. Symptom cluster can be defined as “three or more concurrent symptoms that are related to each other.” (Miaskowski ,Paul 2001).
If symptom control management is not fulfilled frequently individual’s value of life is adversely affected. It is also difficult situation for health care provider to develop symptom management strategies that can be applied in the serious care of a patient. Patients with serious illness has to bear more than one symptoms at a time. The majority of clinical studies associated with pain, fatigue and depression are focused on one symptom. Although it is important to continue to focus on one symptom but with serious diseases symptom cluster is common and it lead to complications. Research in symptom cluster is although an at infant stage. (Christine, Marylin 2004). Though the researches have been done but advance management needs more specific studies and technology to deal with symptom cluster. Symptom management can be more effective with trained and advance nurses.
Managing symptom is core business for palliative care. One of the main work done by nurses are to take care of symptoms which can be physical, mental and spiritual. Working with patients on daily basis, nurses are trained to assess and monitor pain that patients are in regard to their care and management. An effective symptom care management includes proper study of symptoms, efficient nurses and advance technology.
People suffering from cancer also goes through psychological and social distress. So palliative care is one of the important area to understand in management of symptom management and can be effective evidence supporting symptom management.
Palliative care is a team approach to comfort patients with the serious and life threatening illness. The approach aims to create a blanket of support for patients who are suffering from serious and incurable illness. WHO defines Palliative care as, an approach that seeks to improve the quality of the life of individual patients and their families facing life limiting associated problems. It received appreciation as a specialty area after World health Organisation (WHO) published a definition of palliative care in 1990. Complete model of care that last throughout the course of illness regardless of outcome is the motive of this approach.
Active palliative care needs a vast and cumulative methodology that includes the family and makes use of available assets. Different age group patient needs care in different ways. So age specific palliative care is one of the important points to be kept in consideration while providing palliative care to a patient.
Nursing care with the palliative approach has been successful in recent years. Palliative care team consists of paediatrics, nurses, social workers and councillors. It makes a holistic approach to help the child to live his remaining life with dignity and ease. The approach can be more effective if nurses are provided with training. (Bertero ,2002) The hindrance in successful caregiving has been observed at many places, especially in developing countries.
Positive care for patient, understanding of disease and death by the patient and effective application of technology are really helpful for patient and their family. Home care also affect the palliative care method positively. The palliative paediatric care focus not only painless death but also helps patients to make peace with his physical condition. Symptom management and palliative care can be effective for patients with cancer.
In this assignment we are discussing symptom management of cancer patients. People suffering from cancer brawl with the physical and emotional effects of their illness and treatment. The whole journey of illness comes with pain, nausea anxiety and other symptoms resulting into difficult life style. Symptom management of cancer patients is itself a challenging job. Patients experience a number of signs as a result of their disease. The treatment process also results into variety of symptoms effecting lifestyle.These symptoms are major problems for patients and their family. This can effect to the quality of life of patient and family.
‘Research on symptom clusters in patients with cancer is cutting edge technology. National cancer institute spend a lot on caner symptom management research. The study of symptom clusters in patients with cancer represents a new frontline in symptom management research. A firm commitment is needed to provide the financial as well as the infrastructure, support to conduct research on the occurrence of assessment of and intervention for pain, fatigue and depression either a single symptom or symptom cluster.’ (Miaskowski, Paul 2001).
Evidence based management assimilates profound scientific findings with clinical skill, knowledge of pathophysiology, psychological details and decision making inclinations of patients. Patients with evidence management can help patient’s safety.
It has been seen that oncology nursing workforce has been disappearing. There is need of trained working nurses. Different kind of barrier like lack of scientific knowledge, conflict research results, lack of supervision and theory to practice have created problems for efficient symptom management. To overcome these barriers different task can be prepared. Involvement of colleagues, establishment of plan with the boss, information and feedback are major areas to work on. We are going to discuss a case study of a man Mr Carter aged 70 suffering from lungs cancer. His medical history shows that he was a chain smoker with 30 packs a day. He used to take alcohol on daily basis for minimum thirty years.
On July 12, 2007 Mr. Carter showed some symptoms. It includes constant coughing and it get worse day by day. Blood is excluded while coughing. Mr. Carter felt chest pain , tiredness, and could not breathe properly. He was experiencing shortness of breath. The patient started to lose appetite and gradually started to lose weight. (MedlinePlus, 1999)
He started to feel problem in breathing while wheezing. He was tired and weak. His daily life was affected. The patient required medical attention and was test for hemoptysis and chest x-ray. He was understanding and supportive with the nurses and other medical csre giver. He was given the knowledge of lobectomy. (Rodger M. & Bruce R.N., 2008).
After lobectomy patient was feeling better. In this case the patient required lobectomy but also required radiation therapy. Mr Carter’s body is still recovering the cancer tissues. He still feels ill and weak. He withdraws himself from the family by not participating in family affairs. He could not enjoy sport activities and indoor games. Patient still does not have appetite for any kind of food but he is trying to eat to gain some energy. He feels helpless and demotivated. He feels irritated every time. His wife tries to help him to come out and want to provide him care. But he does not like it also. He was feeling unwanted because he couldnot do any work at home.
Home care giver was appointed and symptom management was provided to Mr Carter. It helped him to develop better understanding of his illness and helped him to make peace with his physical condition. Appointment with nurses and therapist made him better and easy to live his life. After evidence based symptom management program his appointment with the doctor was better. He mentioned that he feels better and more energized. He can change his clothes and takes bathe. He would take rest frequently during his daily activities.
Hence it is concluded that palliative care is an important part of symptom management and has both direct and indirect effect of patients and his family. Cluster symptom management has helped nurses across the globe for better understanding of disease related symptoms
References
Bertero. C. (November 2002, “District nurse’s perceptions of Palliative care in the home”, American Journal of Hospice and palliative care, vol 19.
Jennifer K, Clark,MD, and Karen. F ( 2015 ) ,Young adult Palliative Care: challenges and opportunities ,American Journal of Hospice, vol 32.
“Lung Cancer: Cancer of the Lungs.” Merck Manual Home Edition.1995-2008. 29
Miaskowski,C.Dodd, M (2004). Symptom clusters :The New Frontier in symptom Management research.
Rodger M. & Bruce R.N. “WHISSL – Worldwide Health Information System Simulation
Walshe C, Luker K.A, (2010) “District nurses role in Palliative care provision”, International Journal of nursing studies (1178).
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