Improving patient care and quality of life after laryngectomy/glossectomy

Economic Soundness and Interdisciplinary Teamwork in the UK

This article is chiefly concerned with the question is nursing, particularly oncology nursing, both improved and more affordable when persons are honored in the manner suggested by Rosemarie Rizzo Parse’s humanbecoming school of thought and when nurses are respected members of multidisciplinary teams? The authors offer a theoretical article on the evolution of cancer multidisciplinary teams and examine current thinking on teamwork in the hospital setting.

Changes Experienced in Quality of Life for Skull Base Surgical Patients: A Qualitative Case Study

Objective Skull base tumors are associated with quality of life (QOL) changes. A qualitative case-study approach may help better understand patients' experiences. Methods A total of 34 skull base surgery patients were selected into focus groups using a criterion-based maximum variation sampling strategy from a sampling frame of 138 patients. Eight groups were organized based on a factorial design of surgical approach (endoscopic/pen) and tumor location (anterior/central). Data were analyzed using a conceptual framework. Qualitative analysis was performed on focus group transcripts to identify major themes and determine if surgical approach or tumor location had differential effects on QOL. Concepts were quantitatively tallied from written workbooks. Results The 34 participants (19 men, 15 women; mean age: 48 years, standard deviation: 14 years) had mixed reactions to their diagnosis ranging from relief to fear. Participants reported physical and nonphysical changes in QOL with some variation in physical complaints by tumor location. Several major themes emerged from the analysis. Skull base tumors are associated with fear and frustration, loss of physical senses and self-identity, social isolation, and coping mechanisms. Conclusions Skull base surgery may impact patients' lives. Qualitative study of patient experiences can provide rich information to better understand this disease.

Health Economics and Informatics

The provision of healthcare is a major global preoccupation and there is a continuing challenge due to a growing demand with finite resources. The tensions at play mean that people and their quality of life, which ought to be the main value considered, can be given lower priority than aspects of health economics and informatics. In this paper the authors demystify the economics and informatics of healthcare, and challenge policy makers and project managers to put nursing care in the fore in their decision-making. As an illustration of the non-negotiable patient-centric values Parse’s contributions to nursing are suggested.

[Communication of needs in laryngectomized patients: Pictorrino]

OBJECTIVE

To design, create and validate a pictogram, called Pictorrino, as a tool to obtain direct and simple communication with laryngectomized patients.

PATIENTS AND METHODS

In a prospective sample of 10 laryngectomized patients within the first postoperative week, their principal needs and demands were evaluated, and were confirmed in a retrospective second sample of 10 laryngectomized patients who attended reviews in the outpatient clinic. Thereafter, pictograms were created to state such needs in as clear a fashion as possible.

RESULTS

A pictogram was designed and validated, named and registered as Pictorrino, consisting of a board, which showed these pictograms on one of its sides, and a visual analogue scale of pain, with the aim of enabling the patient to express the demand or need at every moment.

CONCLUSIONS

With Pictorrino we have achieved a multicultural tool that allows a more direct communication with laryngectomized patients.