ABSTRACT
We present the case of an infant with oral cancer that developed in the 3rd month of life, following which oral feeding became difficult. In the 11th month of life, the right side of the mandible was resected surgically and movement on the right side of the mandible was restricted because of the compression caused by the rectus abdominis myocutaneous flap used for reconstruction. We initiated rehabilitation for the initial acquisition of eating functions so that the patient would be able to ingest baby food despite having an organic disorder in the oral cavity.Postoperative dysphagia in adult oral cancer is an organic disorder that occurs after acquisition of a normal swallowing pattern, whereas postoperative dysphagia in pediatric oral cancer is an organic disorder that occurs during the initial acquisition of eating functions. At present, the rehabilitation approach has not been established.From 12 months of age in this patient, we evaluated training methods that were easily accepted by children, including postoperative oral function evaluation, with the goal of the initial acquisition of eating functions. We approached postoperative wound contracture prevention with a focus on approaches to lip insufficiency, predation, and tongue/mandibular movements. In addition, we focused on family guidance and tried to support the caretaker's correct use of methods established during training.
ABSTRACT
The aim of this study was to investigate the practical abilities of discharge planning nurses to support discharge of terminal cancer patients. A survey was mailed to 477 discharge planning nurses (DPNs) who were employed at 120 designated regional cancer centers in Japan. Responses from 198 (valid response rate 41.5%) DPNs were subjected to analysis. The median number of years of DPN experience of the subjects was 2.5 years, and 90.2% of them had more than 10 years of nursing experience. Among the discharge planning abilities, “To Coordinate Post-discharge Care Balance” was significantly higher in the group with more nursing experience and in the group with longer DPN experience; “To Estimate Post-discharge Care Balance” and “To Prepare for Transition from the Hospital to a Care Facility” was significantly higher in the group with longer DPN experience and in the group with more experience working in home and community care. But “To make an agreement with the patient and their families” was not significantly different for experienced DPNs. It was suggested that in order to improve the quality of discharge planning, it is necessary to create a system that allows staffing based on individual experience and sharing of knowledge and experience of veteran DPNs.