Open Access
People with advanced cancer: the process of living well with awareness of dying
(SAGE, 2018-10-12) Arantzamendi, María; García-Rueda, Noelia; Carvajal Valcárcel, Ana; Robinson, Carole A.; Ciencias de la Salud; Osasun Zientziak
Literature suggests that it is possible to live well with advanced cancer but little is known about the process. In this article, we present a secondary analysis of experiences of living with advanced cancer (n = 22) that refines the theory of 'Living Well with Chronic Illness' for a different context and population. The refined theory explains the experience of living well with advanced cancer illuminating a five-phase iterative process: struggling, accepting, living with advanced cancer, sharing the illness experience, and reconstructing life. These five phases revolve around the core concept of Awareness of Dying, which varied from awareness of the possibility of dying, to accepting the possibility of dying, to acceptance that 'I am dying'. Awareness of Dying led to a focus on living well with advanced cancer and movement towards living a life rather than living an illness.
Open Access
Prevalence and characterization of pain in radiation oncology: the PREDORT multicenter cross-sectional study
(Springer, 2024-07-30) Arias, Fernando; Zarandona, Uxue; Ibáñez Beroiz, Berta; Ibánez, Reyes; Campo, Maider; Cacicedo, Jon; García-Rueda, Noelia; Baztán, Beatriz; Villanueva Goyeneche, Raquel; Fresán, Marta; Redín, Iñaki; Osés, Ana T.; Hurtado, Victoria; Villafranca, Inés; Iancu, Vasti; Almeida, Pilar; Moreno, Nieves; Cadena, Soraya; Carruesco, Irene; Allegue, Marián; González, Ana B.; PREDORT Collaborative Group; Ciencias de la Salud; Osasun Zientziak; Gobierno de Navarra / Nafarroako Gobernua
Background Pain in cancer patients has enormous impact on their quality-of-life. Radiation therapy (RT) is a cornerstone in cancer treatment. The objective of the PREDORT study is to estimate the prevalence of pain in patients attending at Radiation Oncology (RO) Services. Methods A prospective, multicenter study was designed for patients treated at the RO Services of reference hospitals. Patients were seen in their initial Nursing consultation, during which key data was collected, including demographic and comorbidities data, medical history, and oncological and pain characteristics. The study has received approval from the Ethics Committee of Navarra, and all patients signed the Informed Consent. Results Of the 860 participating patients, 306 reported some type of pain, which implies a prevalence of 35.6%. Of them, 213 identified a cause of oncological origin. The proportion of pain was similar among sexes, but the proportion of non-cancer pain was higher among women (p<0.05). Regarding pain intensity, the magnitude of breakthrough pain in patients with oncological pain is nearly 1 point greater than in patients with non-oncological pain (7.53 vs 6.81; p=0.064). Cancer pain is more likely to be limiting of normal life than non-cancer pain (59% versus 38%, p<0.001). Regarding analgesic treatment, only 60/306 patients (19.6%) were receiving strong opioids. There were 68 patients with pain without any treatment (22.2%). Conclusions The prevalence of pain in cancer patients referred to RO services is 35.6%, with the prevalence of exclusively oncological pain being 24.8%. Understanding and addressing oncological pain is essential to provide comprehensive care to patients.
Open Access
La relación enfermera-paciente con enfermedad avanzada y terminal: revisión bibliográfica y análisis conceptual
(Elsevier, 2016-07-01) García-Rueda, Noelia; Errasti-Ibarrondo, Begoña; Arantzamendi, María; Ciencias de la Salud; Osasun Zientziak
Introducción: En cuidados paliativos la relación enfermera-paciente supone una parte indispensable del cuidado, ya que mediante ella se puede dar una respuesta humana al sufrimiento que experimenta la persona enferma. Hay una falta de consenso en la literatura a la hora de aludir la relación enfermera-paciente, por lo que es un concepto nebuloso. A pesar de ello, es esencial comprender la relación enfermera-paciente para poder proporcionar unos cuidados de calidad al paciente con enfermedad avanzada y terminal. Objetivo: Explorar y comprender el significado de la relación enfermera-paciente con enfermedad avanzada y terminal y sus beneficios a través de la literatura disponible. Método: Revisión de la evidencia mediante búsquedas sistematizadas en las bases de datos Cochrane Library Plus, PubMed, UNIKA, PsycInfo y CINAHL, y mediante la técnica bola de nieve. La estrategia de búsqueda de palabras clave se dividió en 3 grandes bloques (relación enfermerapaciente, enfermería y persona cuidada con enfermedad avanzada y terminal). Tras la revisión bibliográfica se realizó un análisis conceptual de la bibliografía identificada para explorar el significado de los términos empleados, las diferencias y similitudes y las características que se le atribuyen a la relación enfermera-paciente en la literatura, así como sus beneficios y los requisitos previos para establecerla. Resultados: Se incluyeron en el estudio 10 artículos y a través del análisis conceptual se exploró el significado de los términos empleados para aludir a la relación enfermera-paciente. Asimismo se identificaron las principales características que se le atribuyen a dicha relación: comunicación, confianza, comprensión y presencia, además de empatía y compasión. Del mismo modo se identificaron los requisitos previos necesarios para establecer la relación enfermera-paciente con enfermedad avanzada y terminal: conocimiento, percepción, voluntad de hacer el bien y autenticidad. Y por último, se identificaron los beneficios de la relación para el paciente, siendo los más destacados: mantener la dignidad, la autonomía y la salud psicológica, obtener ayuda en la búsqueda de significado de la vida, contribuir a una buena muerte y aliviar el sufrimiento. Se vio que la enfermera también se beneficia de un aumento de la autoestima en el trabajo y de su capacidad de reflexión a través de la relación enfermera-paciente, beneficiando al mismo tiempo al paciente, proporcionándole unos cuidados de mayor calidad. Conclusiones: La relación enfermera-paciente es un concepto complejo para el cual no existe una definición consensuada. En la literatura adquiere especial importancia la parte humana de la relación, destacándose valores humanos, en vez de las destrezas técnicas de la enfermera. Esta relación aporta beneficios tanto al paciente como a la enfermera y facilita el cuidado. Es necesario continuarinvestigando la relación enfermera-paciente,tanto sus características como su alcance y beneficios. Una mayor comprensión de la importancia de la relación enfermerapaciente podría suponer un aumento de la calidad de los cuidados de los pacientes y, por tanto, de su calidad de vida.
Open Access
Innovative teaching strategies in palliative care: reading of a phenomenological text on the experience of living with advanced cancer
(Elsevier, 2021) Carvajal Valcárcel, Ana ; Aradilla Herrero, Amor; Edo Gual, Montserrat; García-Rueda, Noelia; Arantzamendi, María; Ciencias de la Salud; Osasun Zientziak
Background: pedagogical strategies in palliative care are diverse and mainly aimed to understand patients with advanced disease and improving their care. Phenomenological texts are stories intended to evoke lived experiences and help understand complex situations. Aim: to determine what thoughts, experiences and feelings nursing students have when reading a phenomenological text about the experience of a person living with advanced cancer. Design and method: a descriptive qualitative study with palliative care students of the nursing degree at two university centres. The students reflected on a phenomenological text. A thematic analysis of the 14 reflections was performed. The reflections were analysed inductively and independently, and periodic sessions were held to discuss the identified categories and topics. Results: the students' writings showed that reading the phenomenological text caused them to reflect and feel moved and challenged. The impact on the students is grouped into three categories: the experience of the corporeality of patients with advanced disease makes students aware of the importance of the body; the disease as an individual transformative process challenges students; and the experiences of people with advanced cancer make students aware of the importance of how they care for patients and their families. Conclusion: the reading of a phenomenological text on the experience of living with advanced cancer may be a teaching method that can generate experiences that promote reflective and experiential learning in nursing students. It seems to be a useful tool for teaching in subjects focusing on person-centred care.
Open Access
The experience of living with advanced-stage cancer: a thematic synthesis of the literature
(Wiley, 2016-06-14) García-Rueda, Noelia; Carvajal Valcárcel, Ana; Saracibar Razquin, María Isabel; Arantzamendi, María; Ciencias de la Salud; Osasun Zientziak
The aim of the study was to understand the experience of people living with advanced-stage cancer through literature. The search included The Cochrane Library, PubMed, PsycInfo, CINAHL and Cuiden. Thirteen studies were included. A qualitative meta-synthesis was conducted. One thread emerged from the thematic synthesis: the desire to live as normally as possible, despite being aware of the proximity of death. Three themes also emerged: 'a process that is unique' with its four sub-themes; 'support network' and 'health context', each of them having two sub-themes. This study concludes that living with advanced-stage cancer is a unique and complex process which has both positive and negative aspects. The review provides a comprehensive view of the experience, which considers the importance of the support network and the health context in which the person lives. In this study, 'normalcy' is the adjustment to the new reality and living as closely as possible to the way one lived before the disease, while developing a new relationship with being finite and death. A better understanding of the experience of living with advanced-stage cancer will help health professionals to identify the needs of the patients in order to plan individual, high-quality care.