Physical and Psychosocial Problems of Radiation Therapy

Physical and Psychosocial Problems of ray of light TherapyIntroduction and groundThe word genus malignant neoplastic disease itself is traumatic in nature. It set up a psyche non unless personally further kindredwise psychologically, financially, culturally, socially, and spiritually and so forth accord to beingness Health Organization( WHO) report (2014), in 2012 worldwide 14.1 unity million million million prominents were diagnosed with crabby person, and among them 8.2 million were died. more thanover, doorknocker screwingcer is the fifth guide cause of demolition. In the USA, among all types of cancers the detractor cancer is the highest incidence tread because one in ten women is having titmouse cancer (Njeh, Saunders, Langton, 2012). converge cancer incidence change magnitude more than 20% (WHO Press give up, 2013). Furthermore, cancer is also one of the leading causes of deaths in the developing countries. In Pakistan, the close frequently diag nosed cancer is pinhead cancer for females. The incidence of face cancer is higher in westward countries but Pakistan has the highest rate of face cancer among all the Asian countries, (Pink ornamentation Pakistan). It is estimated that 1 in 9 Pakistani women will develop booby cancer at some stage of their manners. (Shokat Khanum Cancer Hospital and research Center). The cancer affected constituent of suffers a lot from the fleshly and psychosocial problems not only because of the disease process but also from the sermon related problems. As, one out of two patients with cancer regard psychiatric disorder peculiarly depression (Reyes-Gibby, Anderson, Morrow, Shete Hassan, 2012 Spoletini, et al, 2008).There be certain word modalities for cancer such(prenominal) as surgery, chem another(prenominal)apy and radiotherapy. Each of them is potential to produce variant threats for the cancer patient. radiation therapy is also an important handling performed before and later surgery which also has various harmful printings on the patient. Beside that it is significant part of cancer treatment but its electric shock on patients tincture of living sentence and nursing management is less addressed in literature. According to Welle, (1998) radiotherapy patients are perceived as self-caring and their take are not taken treat of.However, numerous researches fork over been conducted nationally and internationally to distinguish the different problems and their intervention of the cancer patients treated with chemotherapy and surgery. As a reply evidence based body of knowledge have been generated this is contributing in timberland nursing safeguard and health teaching, contacting on the patients flavor of carriage. Moreover, some of the international studies highlighted the problems strikingnessd by the patients receiving radiation therapy but as per my best knowledge very little work has been make in the field of nursing to remedy thes e problems. Most importantly, in the scope of Pakistan very little work has been done pertinent to this issue.However this domain is significant to contribute in the existing body of knowledge for nurses to treat for breast cancer patient more holistically. Moreover, this resume may be helpful to develop the teaching material for patients receiving radiotherapy to enhance their feel of life. In addition, the findings of this try will be helpful for nurses working in Pakistan.This study may improve the teaching interventions of nurses caring for cancer patients in government hospital and may have positive effect on their knowledge, attitude, and skill pertinent to RT.PurposeThe aim of this paper is to observe the physical and psychosocial problem of the patient pertinent to radiation therapy, as well as the nursing management and health teaching for the patients for enhancement of their quality of life. theatre of operations QuestionsQuestion 1 What are the different physica l and psychological problems of the breast cancer patients undergoing RT in Pakistani context?Question 2 Is in that respect any association between RT and compromised quality of life of the patient.Question 3 What kind of health teaching is necessary for the nurse to strain the patient before and aft(prenominal) RT?Question 4 what are the feeling and perceptions of breast cancer patients undergoing radiation therapy ?Data sourcesThe review of literature was conducted through info bases CINAHL PubMed , Mosbys Nursing Consult, Science Direct, and Google Scholar were search for published research articles applicable to this paper. The combination of the following key terms was used to retrieve relevant literature by punching physical/psychological problems, breast cancer, problems with radiation therapy, quality of life, patient education etc. Search generated 283 articles, 52 duplicate results excluded. Through a selection process title and abstract screened, among those 20 were form to be relevant to the topic.Literature review shaft of light therapy is one of the options totreat the cancer, uses high-energy x-rays or gamma rays targeted at the tumorto shrink the tumors or kill cancer cells(Radvansky, Pace, Siddiqui, 2013). During the incline of the treatment most two-thirdsof patients will undergo radiation therapy(Guo et al. 2013).According toPotthoff et al (20013). More than 90% of all breast cancer patients receive adjuvant radiotherapy, given over after breast conserving surgery as well as after mastectomy to avoid recurrence of cancer. Darby et al (2011) found in their meta-analysis study that RT after breast conserving surgery reduces 15-year risk of breast cancer death rate from 252%. This widely used therapy has its side cause like other cancer treatments it is also potential for causing great physical as well as psychosocial problems as other cancer treatment do (Egestad, 2013).Physical problems related to radiation therapy for breast cancer patientsRadiation therapy affects cancer and dominion cells equally within the treated area, result in injuryof the cells which lead to side effects. The radiation therapy induced side effects take on unclothe and mucous membrane toxicities, calmlessness, pain, swelling, dyspnoea, cough and nausea. (Rose, 2011 Darby et al, 2011 Adams, 2009Currie Wheat 2006 Gordils-Perez,Duell,2003).Skin problems are the most frequent side effect among all and nearly 85%95% of patients receiving radiation therapy will develop some degree of skin equipment casualty (Bergstrom, 2011). There are many long term side effects of breast irradiation like cosmetic changes hyper pigmentation, fibrosis, lymphedema, and damage to underlying normal structures (Perez,Duell,2003). Therefore it is very important to remedy this problem because this side effect of radiation therapy limits the patients ability to tolerate the treatment (Currie,Wheat, 2006).In their study Potthoff et al (20013) .reported that 80% o f the patients hold fatiguewho receive RT. They delimit fatigue is a persistent, subjective sense of tiredness related to cancer or cancer treatment that interferes with usual functioning and that is usually not relieved with reliever and is not related to an excessive amount of activity (p.3).In another qualitative study Poirier, (2011) found out that fatigue is also very jet in patient getting radiation therapy and it affects their role functioning in daily life. In this way the fatigue may affect the quality of life of the patient. Another side effect of RT is reported in of the studies is sleep disturbance. According to the study conducted by Dhruva, et al (2012).approximately 50% breast cancer patients reported sleep disturbance at the initiation of radiation therapy. feature of life of the patientsBreast cancer due to its poor prognosis and treatment related problems affect the quality of life of the patient. Kirchheiner et al. (2013) reported that mean QOL in the total co hort is 5827% (100% indicates excellent QOL) (p.425). Similar to other treatment choice RT related side effects also have impact on the quality of life of the patient. The quality of life is defined by WHO (1997) concept affected in complex way by the persons health, psychological state, and direct of independence (p.1). As the matter Cancer Institute (2011). Mentioned that 38% of all women diagnosed with breast cancer experience abandoned symptoms resulting from the disease and its treatment. Therefore, the side effects of RT affect the quality of life of the patient (Currie, Wheat, 2006). In addition, sleep disturbance is another problem found to be an important contributor in affecting the quality of life of the patient. In this connection, a study conducted by Graydon (1994) highlighted that sleep disturbance and weary were the main areas of the life of women affected by RT. Since the fatigue, influence the physical, cognitive and worked up aspects and the prevalence ranges from 30-70% in women with breast cancer, reaching up to 80% when they are undergoing radiotherapy (Alcantara-Silva, Freitas-Junior, Freitas, Machado, 2013). This is one of the most frequent side effects of radiotherapy, and it may interfere with egotism, social activities and quality of life.Moreover, the fatigue and pain related to radiation therapy may affect the sexuality of the patient by decreasing the go for and arousal and skin changes including burns and tattoos affecting body image and self-esteem (Varela, Zhou, Bober, 2013 Mercadante Vitrano Catania , 2010). These symptoms lead to compromised quality of life of the patient. In this regard nurses need to give the high quality care by addressing the all aspect of patient life to enhance the QOL of their patients undergoing RT. Moreover, with the advancement of health science the patients expectquality oflife (QOL) beyond just survivaltherapyPsychological problemsThe women diagnosed with breast cancer have remarkable i mpact on her psychological well being. As Halkett , Kristjanson , and Lobb (2008) highlighted that women with breast cancer receiving radiotherapy, experience many kinds of fears like fear of unknown and getting burnt, damage to intrinsic body parts, and anticipating tiredness. These kinds of fears may threaten the women which may have negative impact on compliance with the treatment. Rose, (2011) highlighted that patient may feel high level of stress at the start RT because of unfamiliar technology, potential side effects and being in an environment with other cancer patients.Moreover, the outcome of the study of Reyes-Gibby et al. (2012) shown that depression among women was positively associated with symptoms of disease and treatment. Thus the diagnosis and treatment can have a profound influence on a cleaning womans psychosocial and overall well-being.Role of nurse in RT patients care and educationThe above mentioned literature suggests that patients who receive radiation ther apy face significant challenges and require care during the period of their treatment. Nurses are direct care provider in any health care setting. They play a significant role in their specialized field in various health care settings. Therefore, they can play a significant role in improving quality of life of the cancer treatment recipients. During the RT course, patients may go through many complex physical and/or activated responses (Rose, 2011). A randomized trial study conducted by Christman, Cain, (2004) concluded that patients receiving concrete objective information reported maintaining higher levels of usual function than those not receiving. Furthermore, giving information or so symptom experiences helped them to mentally prepare uncertainty about their symptom experiences. Oncology nurses need to own the responsibility of their patient and identify the patient need. The Meta analytical findings support the usefulness ofpsychosocial interventions for improving QoL in a dult cancer patients.In this regard a comprehensive nursing care of the patient can improve the physical as well as psychological care of the patients.Importance of Patient educationProviding cancer patients with enamour information regarding their treatments, side effects of treatment and coping strategies allows them to feel more control over disease and its related problems. It helps them make better choices of treatment modalities ( Barnett, et al. 2004). The study findings of Zeguers et al (1012) highlighted that now the RT patients want comprehensive information about their disease, treatment, and procedures, side effects, and prognosis with the mean scores between 4.1 and 4.4 on a scale from 1 to 5. In contrast ,Barnett, et al. (2004). Emphasized that information needs vary among different individual therefore, a patient-centred approach must implicate according to the tolerance and need of the patient.ReferenceAdams, L. (2009). Managing Side nitty-grittys inRadiation Ther apy Patients.Radiation therapist, 18(2)Alcantara-Silva, T. R.1., Freitas-Junior, R., Freitas, N. M., Machado, G.D. (2013) daunt related to radiotherapy for breast and/or gynaecological cancer a systematic review. Journal of Clinical Nurse. 22(19-20). 2679-86.Christman, N. J., Cain, L. B. (2004)The Effects of Concrete Objective study and Relaxation on Maintaining Usual Activity During Radiation Therapy. 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