When Patients Ask About Palliative Chemotherapy

Photo © Associated Press. Photo © Associated Press.

Nurses repeatedly witness the suffering of people with advanced, metastasized cancer who are undergoing chemotherapy. These drugs often seem to diminish rather than enhance the quality of the remaining weeks of their lives.

In the first article in a new AJN series on palliative care, author Marianne Matzo points to research indicating that chemotherapy in end-stage cancer does more harm than good. So what should we do when patients ask (as in this article), “Is the chemotherapy going to help me? And if it’s not, why are they offering it?”  […]

2016-11-21T13:01:08-05:00June 14th, 2016|Nursing, patient engagement, patient experience|1 Comment
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Orlando: Another Reminder of Public Health Measures Not Taken

Mary_Magdalene_Crying_StatueOnce again, we’re reading about a mass shooting—this one the deadliest so far, with 50 dead in a nightclub in Orlando, Florida. We’ve learned that the alleged shooter, born in the United States to immigrant parents, appears to have been volatile and prone to angry outbursts.

He’d made threats about killings months earlier, according to news reports of interviews with coworkers and family members. Reports also indicate that he professed a hatred of gays and, during the attack, pledged allegiance to the radical Islamic terrorist group ISIS. He had been investigated by the FBI at earlier dates in conjunction with suspected terrorist activities.

And also once again, we learn that the guns, including an assault-style semiautomatic rifle*, were purchased legally. Assault rifles like the one used in Orlando are often used by mass shooters. Assault weapons had once been banned—but when the ban expired in 2004, it was not renewed by Congress, nor does it seem likely to be. […]

2016-11-21T13:01:08-05:00June 13th, 2016|nursing perspective, Public health|3 Comments
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AJN News: Abortion Misinformation, Premature Death in Rural Areas, Reducing HPV, More

AJN’s monthly news section covers timely and important research and policy stories that are relevant to the nursing world. Here’s a preview of the stories you’ll find in our current issue (news articles in AJN are free access):

The percentages of fetal development booklet inaccuracies by state. Courtesy of Amanda M. Roberti via the Informed Consent Project.

States Providing Inaccurate Clinical Information Before Abortion

Researchers at Rutgers University analyzed the accuracy of state-authored informed-consent materials given to women seeking abortions and found that misinformation was common—especially regarding first-trimester fetal development.

Rates of Premature Death Rise in Rural Counties

While rates of premature death are dropping in urban areas, the opposite is true in rural counties. A new report from County Health Rankings and Roadmaps suggests that these disparities in health outcomes may stem from factors like smoking patterns, diet, and a lack of access to care.

Early Ingestion of Peanuts May Be Effective in Reducing Peanut Allergies

Infants with an elevated risk for peanut allergy were 86% less likely to develop the allergy when they were fed peanut products over a period of years, compared with those fed no peanut-containing foods, according to a new study.

[…]

2016-11-21T13:01:08-05:00June 13th, 2016|Nursing|0 Comments
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Intimate Partner Violence: ‘Troubling Knowledge and Practice Gaps’ among Rural Providers

By Sylvia Foley, AJN senior editor

Table 8. Perceived self-efficacy on a 1-to-5 scale (mean score above 2.5 indicates greater sense of self-efficacy). Table 8. Perceived self-efficacy on a 1-to-5 scale (higher score indicates greater self-efficacy).

Intimate partner violence (IPV) remains a widespread health and social problem in the United States, affecting an estimated one in three women during her lifetime.

Health care providers can make a critical difference in the lives of these women, yet a lack of IPV-related knowledge, negative attitudes and beliefs, and low rates of screening are common. And women in rural areas face particular challenges.

To learn more about rural providers with regard to IPV, nurse researchers Karen Roush and Ann Kurth conducted a study. They report their findings in this month’s CE–Original Research feature, “Intimate Partner Violence: The Knowledge, Attitudes, Beliefs, and Behaviors of Rural Health Care Providers.” Here’s an overview:

Methods: Health care providers working in a large rural health network were asked to complete electronic surveys that examined their IPV-related knowledge, attitudes, beliefs, and behaviors. Descriptive and correlational statistical analyses of the data were conducted.
Results: A total of 93 providers returned completed surveys. In general, the respondents demonstrated good overall knowledge, judicious attitudes, and beliefs congruent with the […]

2016-11-21T13:01:08-05:00June 10th, 2016|health care policy, Nursing, nursing research, Public health|0 Comments
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The Real and Evolving Threat of Superbugs: A Primer

pillsinspaceJust how super is the latest superbug? The good news is that the infected U.S. patient has recovered. The bad news:  mcr-1, the resistance gene identified in this strain of E. coli, has brought us another frightening step closer to a “post-antibiotic” era.

In recent years, antimicrobial resistance among Gram-negative bacteria (E. coli, Klebsiella, Pseudomonas, Acinetobacter, Salmonella, and others) has been a growing public health concern. Most of the increase in resistance has been the result of mobile genetic elements that can easily transfer resistance from one bacterium to another, allowing bacteria to “catch” antibiotic resistance from one another.

To make matters worse, resistance enzymes are often packaged together. One genetic “cassette” can carry multiple resistance determinants, thereby spreading resistance to more than one class of antibiotics at the same time.

Early on, we relied on the carbapenem class of antibiotics to treat infections caused by multidrug-resistant (MDR) organisms such as the “ESBLs” (extended-spectrum beta-lactamase-producing organisms). But carbapenemase-producing organisms soon developed, and resistance to carbapenems spread quickly.

In 2009, the emergence of a “super” kind of carbapenem resistance gene, ndm-1 (New Delhi metallo-beta-lactamase) was found to be highly resistant to many antibiotic classes, including:

  • the carbapenems and other beta-lactams (penicillin derivatives and cephalosporins)
  • the fluoroquinolones (ciprofloxacin, levofloxacin, et al)
  • the aminoglycosides (gentamicin, amikacin, et al).

These antibiotic classes include the main drugs used to treat […]

2016-11-21T13:01:11-05:00June 6th, 2016|infectious diseases, Nursing, Public health|1 Comment
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