Introduction
Children with cancer repeatedly experience discomfort during their hospitalization (1). One of the significant aspects of care for these children is providing physical comfort and relieving mental pain associated with it (2). Katharine Kolcaba proposed the Theory of Comfort in 1994. Comfort is the state experienced by recipients of comfort interventions. It is the immediate, holistic experience of being strengthened when one’s needs are addressed for three types of comfort (Relief: The state of a patient who has had a specific need met Ease: The state of calm or contentment Transcendence: The state in which one rises above one’s problems or pain) in four contexts (Physical: pertaining to bodily sensations, homeostatic mechanisms,
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In this child’s case, frequent hospitalization, stressful environment of the hospital and frequent injections had become painful and depressing. This restlessness and oppressive condition of the child regarding frequent venipuncture demonstrated a sense of loneliness, helplessness, fatigue and impatience of the child. Previous adaptation strategies of the child and emotional supports of parents (expressing positive terms, distraction, empathy, buying toys and etc) could not satisfy the constant mental stress of this child. Looking at the world through the eyes of the child helped us to utilize appropriate and creative methods to solve this challenge and reduce the emotional suffering and restless spirit of this little child. Although the world of children is simple, it has a specific complexity of meaning and concept for adults. However, children can easily enter each other’s world. Using their common language, they can understand each other's feelings and experiences and help the other children who are in similar situations to their experiences. Therefore, in an innovative intervention based on the Theory of Kolcaba, to create comfort in the child with cancer, another child was asked to assist in relieving his discomfort. Firstly, the older child showed his IV line to the younger child, shared his common experiences with him and stated positively that these conditions are temporary and he will feel better very soon. Then, these two kids started playing video games and drawing pictures together. The older child drew a few flowers in the place of the younger child’s IV line and wrote a beautiful sentence to support him emotionally: “I am strong!”. The younger child was calm during these 30 minutes and was glad to have a sympathetic friend. He stated his feeling on the scale of comfort daisies to be good. He was asked to draw his appreciation of the concept of comfort. His
Comfort care or palliative care is when a terminal patient is placed in a quiet room, where no medical interventions are done except morphine. The patients are not placed on any monitors, no vital signs or given prescription medications. Only the presence of families, periodic turning, swabs for dampening the lips, and perhaps restful music is around the patient. Comfort care is meant to allow a dying person a peaceful end, thus, morphine drip is added for pain relief. Stephens (2012), states that it’s the same medications used to control pain and discomfort, could be used to “help” the patient to stop breathing. The concept of terminal sedation assumes death as an outcome of the intervention.
Being diagnosed with a chronic illness is a life-altering event. During this time, life is not only difficult for the patient, but also for their loved ones. Families must learn to cope together and to work out the best options for the patient and the rest of the family. Although it may not be fair at times, things may need to be centered on or around the patient no matter what the circumstance. (Abbott, 2003) Sacrifices may have to be made during difficult times. Many factors are involved when dealing with chronic illnesses. Coping with chronic illnesses alter many different emotions for the patients and the loved ones. Many changes occur that are very different and difficult to get used to. (Abbott, 2003) It is not easy for someone to sympathize with you when they haven’t been in the situation themselves. No matter how many books they read or people they talk to, they cannot come close to understanding.
Katherine Kolcaba is a nursing theorist who developed the Theory of Comfort in 1990. It is a “middle range theory for health practice, education and research” (Kolcaba, 2011) with a focus on comfort. The three forms of comfort that Kolcaba describes are relief, ease and transcendence. It is these terms that my organization utilizes in documentation of pain and comfort in the electronic health record.
Family centred care and comfort care theory both work for the well being of patient. Family centred care focus to work with family while providing care for the sick child. Family and pediatric staff works in collaboration to make care plan that works the best for sick child (Coyne, O'Neill, Murphy, & Costello, 2011). Similarly, comfort care theory focus on child’s physical, psychospiritual, sociocultural, and environmental aspects. “When comfort needs are addressed in one context, total comfort is enhanced in the remaining context” (Kolcaba & Dimarco, 2005, p. 190). When nurses apply comfort care theory, it is to achieve holistic care of sick children by focusing on all aspects (Kolcaba
Kolcaba, K., Dowd, T., Steiner, R., & Mitzel, A. (2004). Efficacy of hand massage for enhancing the comfort of hospice patients. Journal of Hospice & Palliative Nursing, 6(2), 91-102. Retrieved from http://ehis.ebscohost.com.library.gcu.edu:2048/eds/pdfviewer/pdfviewer?vid=12&sid=2de162ef-afff-4a48-8415-83dcedf9530a%40sessionmgr110&hid=104
3. The relation between the chronically ill patient and the body is of intertwined subjectivity, of one human dignity and human strength. This is made manifest through the patient’s continued struggle for life despite awareness of dwindling quality of health and diminishing quality of life.
In 1998, the most common cause of child and adolescents death claimed approximately 2500 young lives in the United States alone. The cause of this dreadful loss of life was due to childhood cancers. This paper explores the changes in the life of children dealing with cancer, families that have been affected by these diseases (also known as pediatric cancer) and a small part of the journey they experience. Cancer does not discriminate and affects all members of the family unit. This paper investigates the challenges that a family will experience from the first diagnoses through palliative care. It examines research and statistic about childhood cancer from organization as the American Society of Clinical Oncology (ASCO), the National Cancer Institute's (NCI), Children’s Cancer Research Fund (CCRF), and other cancer research organization. Although there are 12 major types of cancers that affect children, the main focus in this paper will be acute lymphocytic leukemia (ALL). It will also include an interview, the personal experiences of a family, real life emotions, and the effect on the parents and sibling of the (Ashtyn) child presently facing acute lymphocytic leukemia (ALL). Life is no longer what formerly was known as being normal. Life with cancer becomes a new journey, the new normal family life that, unfortunately is not normal, but a life that includes cancer.
In addition, one of them was 10 year old girl, who was just diagnosed with type 1 diabetes. Patient was a young girl, from different culture and religion, and parents had language barrier; however, while taking care of the child, I could see that family had really good interaction with each other. Parents were at bedside all the time, and they were very supportive and attentive. Patient and family did well with diabetic care. The mother was participated in cares and eager to learn. Moreover, to provide highest quality of care, nurses did a lot of great job. They provided information about the child’s chronic illness and taught about insulin administration. Consequently, from caring that patient I understood that most important nursing interventions are to assess patient's ability to copy with new life and role change, patient’s reaction to chronic illness, support system, cultural issues, and available
There are several aspects that shape children experience of childhood, such as environmental factors, biological factors and interpersonal relationship which includes parenting aspects. From the writer’s perception, environmental factors, mainly speak about the child surrounding while biological factors include everything about gender, physical and mental health of child and the upbringing of a child. Based on the writer’s understanding, interpersonal relationship is children relationship or communication with others. The writer chooses to focus and discuss the parenting and environmental factor that shape child’s experience of childhood throughout the essay.
...tional support to parents, develop their positive self-image, and helps parents explore the situation so that they can not only understand, but also predict the development within the specifics of the disease and its course. Helping parents build interaction with a child and provide him or her with emotional support in order to improve a child’s emotional state will also improve quality and safe care in the clinical practice.
Medical procedures are a common part of life and elicit a great deal of anxiety among people of all ages. Anxiety is defined as a “diffuse apprehension that is vague in nature and is associated with feelings of uncertainty and helplessness” (Townsend, 2009, p. 15). Children experience high levels of procedural anxiety because they do not understand what to expect and they fear the pain they may experience. I was therefore interested in researching whether the presence of parents during painful procedures decreases anxiety in pediatric patients. My desire to someday work with the pediatric population has intrigued me to further understand the importance of this issue to best meet the needs of the patient and family. The topics to be discussed include the benefits of having parents present during painful procedures, the disadvantages of having parents present, and doctors and nurses attitudes regarding the presence of parents.
Compassion is a type of meditation therapy which is used recently. As a new topic, at least for me, this encouraged me to learn about this topic and gave me the idea for my paper. Compassion has many definitions, one of these definitions is the feeling that emerges in witnessing another's suffering and that motivates a following desire to help (Goetz, Keltner, & Thomas, 2010). Hofmann, Grossman, and Hinton (2011) describe compassion as a path leading to greater awareness, aimed to focus awareness upon alleviation of the suffering of all sensitive beings. Moreover, compassion is thought to have arisen as the affective element of a caregiving system, designed to help raise vulnerable progeny to the age of viability (Goetz, Keltner, & Thomas, 2010).
Papadatou, D., & Bellali, T. (2002). Greek nurse and physician grief as a result of caring for children dying of cancer. Pediatric Nursing, 28(4), 345-53, 363-4. doi: 2003016885
...f another patient, two year old Monthati Makofane. The child was “frightened” and “overwhelmed” , however, his parents were thrilled at the idea that their son would grow up and have what they deemed a “normal life”, submitting to the ideas of the medical perspective.
Using semi-structured interviews, the authors explored, using inductive analysis, how parents cope with the moral burden of decision-making. The broad generalizations or themes generated are factors affecting parents’ decision-making. Parents of children with cancer are encumbered with many medical decisions. When parents experience decision-making, they are under very intense levels of stress. The research suggests this stress is not addressed with parents, and therefore, impedes their clarity when it is necessary to make decisions. With health care professionals, such as physician and nurses, providing clear communication as it relates to diagnosis, treatments, side effects, all the while offering emotional support, decision-making may be improved. This is crucial for planning the interventions that meet their child’s needs. The component needed to assist parents during this difficult time include nurses and physicians assessing parents’ information needs as the prognosis changes over time. Research suggests factors such as cultural, spiritual, and holistic care for parents is necessary for them to cope. Not only does this journal article inform how parents cope with and manage their child’s cancer care, but also provide strategies for the health care team to offer support so parents coping skills are adequate to collaborate with their child’s medical team (Kilicarslan-Toruner & Akgun-Citak,