Massage and reflexology for post-operative cancer cystectomy patients: Evaluation of a pilot service.

BACKGROUND: and purpose: Radical cystectomy is a gold standard treatment for invasive bladder cancer. However the length of the operation is long and recovery is usually slow and painful. There is growing recognition of the importance of health related quality of life among patients undergoing invasive surgical procedures. In response, a massage and reflexology service was piloted and evaluated. MATERIALS AND METHODS: One hour of massage, reflexology or a combination of both was provided twice to 38 cystectomy patients by a trained therapist in their acute post-operative phase (day one and day three). Self-reported concerns, well-being and pain were measured before and immediately after the therapy. Pain was measured once more in the early evening of each therapy day. RESULTS: Self-reported concerns and pain were significantly reduced following the intervention on both days treatments were given. Pain was measured again on the evening of each of the intervention days, and this reduction was maintained on day one but not day three. Well-being scores were also significantly improved pre to post intervention on both day one and day three. Qualitative comments highlighted that this complementary therapy service was viewed both beneficial and relaxing. There were no significant differences between the different therapies used (massage, reflexology, or a combination of the two). CONCLUSION: The findings of this pilot evaluation very tentatively support the benefits of cancer cystectomy patients receiving massage and/or reflexology in their acute postoperative recovery period. There are many limitations to this evaluation. Further research utilising a randomised control methodology alongside medical, independent markers is warranted, and currently in development.

Reducing the risks associated with urinary catheters.

The NHS strives to create and promote a safe environment for patient care in which risks are minimised. Urinary catheterisation is a common healthcare procedure but it is an invasive intervention that carries the risk of infection. Evidence-based guidelines have been developed to minimise the risks associated with these devices and to allow healthcare professionals to implement best practice at all times. This article looks at evidence-based guidance and technological innovations aimed at reducing infection risks and improving patient outcomes.

Safety in urine sampling: maintaining an infection-free environment.

The insertion of an indwelling urinary catheter is thought to be implicated in 80% of all urinary tract infections (UTI). In patients with an indwelling catheter, one of the most effective ways to determine whether or not there is evidence of a UTI is to aspirate a sample of urine for analysis, typically using a syringe and needle. Inevitably this puts the healthcare worker at risk of a percutaneous needle stick injury and accidental exposure to serious and potentially life-threatening viruses. Infection control is now taken increasingly seriously in UK hospitals, and the elimination of infection risk is regarded as a priority. In addition to training, and safer working practices the government recognizes the need for new technological innovation to help further reduce risks. In the urine sampling environment, there is a new needle-free port (EZ-Lok from Bard Ltd), designed specifically to reduce the occupational health risk of needle stick injuries.

Ease of removal of thermo-expandable prostate stents.

OBJECTIVE: To report the ease of removal of the Memokath 028 prostatic stent (Engineers & Doctors A/S, Hornbaek, Denmark), an important attribute of the 'ideal' prostatic stent. PATIENTS AND METHODS: Data on patients who had had a Memokath 028 stent removed in three different centres in Europe over an 8-year period were collected retrospectively. Standardized forms were used to record relevant information from each physician's patient files. RESULTS: Ninety-three patients had their stents removed at the three reporting centres; the mean indwelling time of their stent was 12.9 months, and most stents were inserted for symptomatic benign prostate disease. Reasons for removal included recurrent outlet or storage-type urinary symptoms, migration of the stent, stent-related pain, recurrent urosepsis and detrusor failure. The stents were removed on a day-case basis in 32% of patients. Topical anaesthesia or no anaesthesia was used in 48%. Of these patients, only 9% described moderate discomfort or worse. The procedure took a mean of 11 min and was felt to be easy or fairly easy in 90% of patients. CONCLUSIONS: These data show the ease of removal of the Memokath 028 stent, reinforce its overall success in achieving the requirements of the ideal intraprostatic stent, and further emphasize the advantages of this implant over the epithelializing, permanent intraprostatic stent.