RESUMO
A single-center, prospective, non-randomized clinical study was performed to examine the safety and feasibility of early discharge in patients undergoing consolidation chemotherapy for acute leukemia, or autologous stem cell transplant for lymphoma or multiple myeloma. Patients were discharged into ambulatory care the day after the last chemotherapy administration and were subsequently seen at the ambulatory care unit three times a week. One hundred and one of 224 patients were ineligible for the program, mostly because of their medical situation, the lack of a caregiver or the travel time to the hospital. The remaining 123 patients were able to spend more than 70% of the time at home. In 44% of cycles they were never readmitted. This study demonstrates the safety, feasibility and benefits of managing carefully selected patients. Patients and their caregivers felt safe and comfortable at home, and the vast majority preferred home care to in-hospital treatment.
Assuntos
Protocolos de Quimioterapia Combinada Antineoplásica/uso terapêutico , Neoplasias Hematológicas/tratamento farmacológico , Alta do Paciente , Readmissão do Paciente/estatística & dados numéricos , Adulto , Idoso , Estudos de Casos e Controles , Relação Dose-Resposta a Droga , Estudos de Viabilidade , Feminino , Seguimentos , Neoplasias Hematológicas/patologia , Serviços de Assistência Domiciliar , Humanos , Masculino , Pessoa de Meia-Idade , Estadiamento de Neoplasias , Prognóstico , Estudos Prospectivos , Fatores de TempoRESUMO
BACKGROUND: Nurses often encounter serious events during their work, which can lead to traumatic stress. OBJECTIVE: To examine how serious events, demographic variables, and coping strategies are associated with traumatic stress in a sample of nurses working in the medical department of a university teaching hospital. DESIGN: The data for this survey were collected in 2003. Two questionnaires were completed by nurses: the Utrecht Coping List (UCL) and the List of Serious Events and Traumatic Stress in Nursing (Nursing LIST). RESULTS: The 69 nurses who participated in the study had experienced a mean of 8 serious events in the past 5 years. In all, 98% of all nurses reported traumatic stress. Active coping, social support, and comforting cognitions were independently associated with traumatic stress. CONCLUSION: The participating nurses had experienced multiple serious events, and many felt traumatized. Active coping decreased the risk of experiencing traumatic stress, whereas comforting cognitions and social support increased the likelihood of appraising a serious event as traumatic. More research needs to be conducted to support these findings and to develop strategies to support nurses after serious events.
