Turbulent Waiting: Rural Families Experiencing Chemotherapy-Induced Neutropenia

Meiers, Sonja J; Eggenberger, Sandra; Murray, Shirley; Bliesmer, Mary; Earle, Patricia; Andros, Dave; Harman, G. S.; Rydholm, Karl

doi:10.1188/04.onf.1145-1152

Cited by 13 publications

(8 citation statements)

References 23 publications

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“…Family Information Keeper (Davidson et al, 2016;Denham, 2003;Martinez, D'Artois, & Rennick, 2007;McGoldrick, Gerson, & Petry, 2008 explored these family constructs during illness experiences Eggenberger, Meiers, Krumwiede, Bliesmer, & Earle, 2011;Eggenberger & Nelms, 2007;Krumwiede, Meiers, Eggenberger, Murray, Bliesmer, Earle, & Rydholm, 2004;Meiers, Eggenberger, Krumwiede, Bliesmer, & Earle, 2010;Nelms & Eggenberger, 2010). The ongoing process of balancing family life in response to the inevitable transitions and changes linked to illness and life events (Meiers et al, 2010;Meleis, 2010) is addressed primarily in the first course (Table 5).…”

Section: Family Constructmentioning

confidence: 99%

Development and Implementation of a Family-Focused Undergraduate Nursing Curriculum: Minnesota State University, Mankato

Meiers

Eggenberger

2018

J Fam Nurs

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Nurse educators have the responsibility to create learning experiences centered on the scientific and praxis foci of the nursing discipline to advance nursing practice with families. Although the nursing profession has ample knowledge about the importance of family nursing and the value of family-focused actions, there is a lack of curricular and teaching models that address nursing practice with families in numerous courses and learning experiences. This article describes the development of a family-focused undergraduate curriculum and teaching-learning practices at Minnesota State University, Mankato in the United States. A vision and mission centered on the nursing of families, a family care teaching model, a framework of family constructs, and taxonomy of significant learning strategies guided faculty in creating learner-centered experiences. Course objectives, competencies, and teaching-learning practices in this curriculum are described. This manuscript may guide the development of innovative teaching-learning practices that integrate family nursing constructs and family nursing actions from a variety of family nursing models and theories. Initial evaluation suggests that this curriculum can increase students' knowledge of family and instill a passion for family care in undergraduate programs.

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Section: Family Constructmentioning

confidence: 99%

Development and Implementation of a Family-Focused Undergraduate Nursing Curriculum: Minnesota State University, Mankato

Meiers

Eggenberger

2018

J Fam Nurs

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“…Themes of waiting , vigilance and of discordance between primary support persons and health professionals have also been documented. Waiting has been found to contribute to a sense of turbulence, uncertainty and powerlessness in carers , while vigilance requires constant energy and effort .…”

Section: Discussionmentioning

confidence: 99%

‘Shadowing’ as a management strategy for chemotherapy outpatient primary support persons

McKenzie

White

Hayes

et al. 2017

Scandinavian Caring Sciences

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Despite growing numbers of patients with cancer receiving chemotherapy in outpatient settings and the corresponding increase in care demands on family and close friends, little is known about the experiences of those informal carers supporting people with cancer during their chemotherapy trajectories. Using an interpretivist theoretical framework, this study explored the experiences of primary support persons of chemotherapy outpatients through in-depth interviews with 17 participants nominated as their primary support persons by people receiving chemotherapy at a large tertiary hospital in Australia. The study demonstrates that primary support persons of chemotherapy outpatients face distinct challenges, being at the frontline of treatment and managing side effects with minimal support at home. This role involves sensitive provision of complex medical and social care in circumstances that profoundly challenge the everyday worlds of both patient and carer. From the moment of diagnosis, informal carers in this context face the 'double whammy' of needing to 'manage' the cancer diagnosis experience as well as the chemotherapy trajectory experience. This study points to the significant level of responsibility that primary support persons take on, and the extent to which patients and clinicians rely on their support and management skills. It also points, however, to the lack of recognition they receive for assuming this role, and their sense of frustration in the face of this invisibility. The conceptualisation of the informal carer role as a 'shadowing' role explicitly represents the protective, vigilant, but almost invisible, support role described by the participants in this study.

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“…Patients who are hospitalized for FN may fear additional nosocomial infections and be concerned about the numerous procedures that they will undergo (Dale; Lyman & Kuderer). Patients and their families also may feel more vulnerable after chemotherapy-induced neutropenia while waiting for the next cycle of chemotherapy to begin Krumwiede et al, 2004). Patients and families may feel a greater connection with healthcare providers and may need more support from nurses during this time.…”

Section: Nursing Implicationsmentioning

confidence: 92%

Hematopoietic Support With Moderately Myelosuppressive Chemotherapy Regimens: A Nursing Perspective

Moore¹,

Crom²

2006

Clinical Journal of Oncology Nursing

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The proactive use of granulocyte-colony-stimulating factors (G-CSFs) in patients with cancer treated with chemotherapy reduces the incidence of hospitalizations for febrile neutropenia (FN) as well as minimizes chemotherapy dose reductions and delays that could compromise treatment outcomes. In accordance with earlier economic analyses, the guidelines of the American Society of Clinical Oncology recommended the use of G-CSF in the fi rst cycle only with chemotherapy regimens associated with a 40% or greater risk of FN. However, more recent guidelines by the National Comprehensive Cancer Network (NCCN) recommended that the use of G-CSF in the fi rst cycle of chemotherapy be considered for patients at a 20% or higher risk of developing FN or other neutropenic complications. The results of a clinical trial, which led to NCCN's recommendations, are reviewed in this article. Patients with breast cancer were treated with single-agent docetaxel, a regimen that is associated with a risk of approximately 20% for developing FN. The use of pegfi lgrastim in all cycles of chemotherapy caused a signifi cantly lower incidence of FN, fewer hospitalizations as a result of FN, and lowered use of IV anti-infectives than placebo. Thus, when assessing patients before treatment, nurses should consider discussing with the multidisciplinary team the use of growth factor support even with moderately myelosuppressive chemotherapy regimens. Hematopoietic Support With Moderately Myelosuppressive Chemotherapy Regimens:A Nursing Perspective At a Glance ✦ The proactive use of granulocyte-colony-stimulating factors (G-CSFs) in patients with cancer treated with myelosuppressive chemotherapy reduces neutropenic complications and allows for delivery of chemotherapy at full dose and on schedule.✦ Recent economic analyses indicate that the cost of G-CSF is offset when the risk of febrile neutropenia is lower than 20%.✦ In clinical trials, benefi ts of G-CSF have been observed with moderately myelosuppressive regimens associated with a risk of febrile neutropenia of approximately 20%.Kelley Moore, RN, is vice president of clinical projects at Supportive Oncology Services, Inc., in Memphis, TN, and Debbie Crom, RN, is a research coordinator in the practice of Robert R. Carroll, MD, PA, in Gainesville, FL. No signifi cant fi nancial relationship to disclose.

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Turbulent Waiting: Rural Families Experiencing Chemotherapy-Induced Neutropenia

Cited by 13 publications

References 23 publications

Development and Implementation of a Family-Focused Undergraduate Nursing Curriculum: Minnesota State University, Mankato

Development and Implementation of a Family-Focused Undergraduate Nursing Curriculum: Minnesota State University, Mankato

‘Shadowing’ as a management strategy for chemotherapy outpatient primary support persons

Hematopoietic Support With Moderately Myelosuppressive Chemotherapy Regimens: A Nursing Perspective

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