Cistectomía radical con derivación tipo Bricker / No disponible

La cistectomía radical es la técnica quirúrgica para extirpar la vejiga; su indicación es mayoritariamente el cáncer de vejiga músculo-infiltrante. Existe una amplia clasificación de derivaciones urinarias, en función de la técnica, de los órganos empleados, de la continencia y del reservorio creado en la desviación de la orina. Presentamos una ureteroileostomía tipo Bricker con aparición de una fístula urinaria en el postoperatorio. Se describen cuidados mediante la aplicación del método enfermero durante el ingreso, valoración pre, postoperatoria y al alta según modelo de Virginia Henderson y planificación de cuidados estandarizados, garantizando que éstos son coherentes y centrados en la persona. Taxonomía NANA-NIC-NOC. La colaboración e instrucción del cuidador principal hizo posible el alta hospitalaria, mediante dispositivos con ventana en el manejo de la urostomía y de los catéteres ureterales. El paciente presentó una actitud negativa para el autocuidado

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Problemática periestomal, a propósito de un caso / No disponible

La cistectomía radical tipo Bricker es un proceso quirúrgico que consiste en la extirpación de la vejiga con la derivación de orina al exterior a través de una urostomía.Exponemos el caso de una paciente con diagnóstico de tumor vesical infiltrante. Se le practica dicho procedimiento y posterior reintervención por obstrucción intestinal con resección de íleon terminal.Presenta un estoma bien delimitado con buena coloración. Tras la segunda intervención surge un pliegue cutáneo que dificulta la adhesión del dispositivo, con la consecuente fuga del efluente, desencadenando como complicación una dermatitis periestomal irritativa.Realizamos una valoración basada en los patrones de M. Gordon, identificamos aquellos que son disfuncionales y formulamos diagnósticos enfermeros según la taxonomía NANDA.Para la resolución del problema, seleccionamos los dispositivos y accesorios más adecuados para conseguir una mejora en la calidad de vida de la paciente

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Patient-reported extremity symptoms after robot-assisted laparoscopic cystectomy.

AIMS AND OBJECTIVES: To describe patient-reported extremity symptoms after robot-assisted laparoscopic cystectomy in patients with bladder cancer. BACKGROUND: Preventive activities for remaining patient safety due to correct positioning play an important part in perioperative nursing care.Extremity injuries are well-known after prolonged surgery, especially in robot-assisted urologic surgery in the steep Trendelenburg position. The risk of injury increases due to patient-related and operative risk factors. METHODS: A quantitative prospective observational study was conducted. Patients were followed up with the QuickDASH (Disabilities in the Arm, Shoulder and Hand), Lower Extremity Functional Scale (LEFS) and a study-specific questionnaire 7-10 days and monthly, up to six months after surgery in patients with extremity symptoms. The study adheres to STROBE (strengthening the reporting of observational studies in epidemiology) guidelines, see Supporting information File S1. RESULTS: Out of the 94 included participants, 46.8% (n = 44) experienced extremity symptoms 7-10 days after surgery. Pain, numbness and weakness were the most frequent symptoms. There was a discrepancy between the patients reported symptoms and the documentation in the patient records. Only 13.6% (n = 3) of the reported pain was documented, respectively 27.5% (n = 11) of other symptoms. CONCLUSION: A large proportion of the patients report postoperative extremity symptoms after robot-assisted laparoscopic cystectomy. Prevention of complications in the perioperative setting, are together with follow-ups, important nursing activities for maintaining patient safety and may both prevent and detect postoperative extremity symptoms and injuries. RELEVANCE TO CLINICAL PRACTICE: This study reveals the need of accurate documentation regarding extremity symptoms in digital patient records, as well as continuous follow-ups during the hospital stay and after hospital discharge to enable detection of treatable extremity injuries. The result of this study also indicates the importance of nursing activities such as evidence-based positioning guidelines in the operating theatre for optimal positioning.

Trayectoria clínica enfermería: cistectomía radical / No disponible

Los tumores vesicales infiltrantes son la segunda neoplasia urológica en España y su tratamiento de elección es la cistectomía radical. Es una cirugía de gran complejidad que aumenta y mejora la calidad de vida de estos pacientes. Gracias al proyecto de rehabilitación multimodal del grupo ERAS, se ha protocolizado el proceso de atención a estos pacientes. Durante el periodo de hospitalización posoperatorio el equipo de enfermería desempeña un papel fundamental. Un plan de cuidados estandarizado de enfermería dará respuesta al protocolo evitando la variabilidad en los cuidados, aumentando la seguridad del paciente y mejorando la eficiencia de los procesos quirúrgicos

Muscle infiltrating bladder cancer constitutes the second urologic neoplasia in Spain and it is treated with radical cystectomy. It is a surgical procedure of great complexity which improves these patients' quality of life. Due to multimodal rehabilitation programme ERAS, the process of attention has been protocolized. During the postoperative period the nursing team performs an essential role. A standardised plan of care will provide answers to protocol while avoiding variability in the treatment and care towards the patient by improving patient safety as well as efficiency of surgical procedure

Recuperación intensificada en cistectomía radical: rol de la enfermera / No disponible

Introducción: La recuperación intensificada en cirugía, Fast-track Surgery o Enhance Recovery After Surgery (ERAS), consiste en la aplicación de una serie de medidas y estrategias pre, intra y posoperatorias con el objetivo de disminuir el estrés secundario a la intervención quirúrgica proporcionando una mejor recuperación del paciente, disminuyendo las complicaciones y la estancia hospitalaria. Las ventajas de la aplicación de programas y protocolos de rehabilitación multimodal han sido ampliamente demostradas en ensayos clínicos y meta análisis. Objetivo: Implementar un programa de recuperación intensificada para cirugía mayor urológica (cistectomía radical) que pretende mejorar la preparación preoperatoria y la recuperación posoperatoria. Material y método: En noviembre de 2016 se creó el programa de rehabilitación multimodal integrado por urólogos, psicólogos, estoma terapeutas, personal administrativo de soporte y la Unidad de Preparación para la Cirugía (UPC),compuesta de anestesiólogos y enfermeras. La muestra estuvo formada por todos los pacientes a los que se les indicó cistectomía radical. Resultados: Los resultados preliminares de una encuesta de satisfacción que cumplimentaron los pacientes un mes después de la cirugía han sido muy satisfactorios. Sobre la información preoperatoria, trato recibido, dolor, alta hospitalaria y satisfacción general se obtuvieron valores altos. Se detectaron aspectos de mejora en la dieta posoperatoria, que fueron evaluados con un menor grado de satisfacción. Se han realizado acciones de mejora que están pendientes de evaluación. Discusión/Conclusión: El éxito del programa está en la participación y estrecha colaboración de las personas implicadas en este proceso: pacientes, familias y/o cuidadores y profesionales del programa de recuperación intensificada. La atención integral, que incluye medidas pre, intra y posoperatorias, y el papel activo de los pacientes que asumen responsabilidades, son claves en la mejora de la preparación y recuperación de la cirugía

Fast-track Surgery or Enhanced Recovery After Surgery (ERAS) is a multidisciplinary approach applied to the care of the surgical patient that requires the application of pre-, intra- and post-strategies. This approach has been designed to achieve early recovery after surgical procedures. ERAS protocol has been shown to lead to a reduction in complications and shorter length of hospital stay. Validated data are available from numerous studies to show the benefits of these protocols for patients. Objective: to implement a recovery program for patients undergoing major urologic surgery (radical cystectomy). Objective: to achieve early recovery after surgical procedures and improve and optimize preoperative preparation. Material and method: in 2016 a multimodal rehabilitation program was formed by urologists, psychologists, stoma therapists, administrative staff and surgical preparation unit (SPU) integrated by anesthetists and nursing staff. The study included patients who underwent radical cystectomy. Results: the results of a patient satisfaction survey were satisfactory after the first month of surgery. Regarding preoperative, adequacy of treatment received by patients, pain, discharge from hospital and general satisfaction. Deficiencies detected are pending evaluation. Patients were less satisfied with preoperative dietary information. Conclusion: the success of the program depends on the participation and collaboration of the persons involved in this process: patient, family and/or staff members. A comprehensive approach is the best key to improve the preparation and recovery of the patient before surgery

Abordaje integral de un caso complejo de continuidad de cuidados a un paciente cistectomizado / No disponible

El manejo inefectivo del régimen terapéutico es uno de los diagnósticos que con más frecuencia se le presenta al profesional enfermero durante su desarrollo profesional. Es fundamental que el enfermero desarrolle un plan de cuidados de forma óptima para que el paciente adquiera una correcta adhesión al tratamiento terapéutico y mejore su calidad de vida, así como prevenir las posibles complicaciones ante el no cumplimiento de tal tratamiento. Atendimos en nuestra unidad a un paciente de 56 años con diagnóstico de carcinoma infiltrante de vejiga que iba a ser intervenido de cistectomía. Controla su diabetes sin seguir con el plan terapéutico de su médico de familia, tampoco ha conseguido dejar su hábito tabáquico. Esto nos pone alerta de los posibles problemas posquirúrgicos y al alta

Nursing staff is exposed to ineffective management of therapeutic regimen during their professional development. It is essential for the nursing staff to develop an optimum self-care plan so that the patient can adhere to treatment and improve his quality of life. This will help the patient to anticipate possible complications related to non-compliance for treatment of the disease. A 56 years old patient with an infiltrating bladder cancer was admitted to our unit. The patient poorly controls diabetes, does not follow an appropriate treatment plan and has not stopped smoking. This is putting the patient at great danger due to post-operative complications and problems as a result of discharge from hospital

Cystectomy-Enhanced Recovery Program: Nursing Implications.

Cystectomy is a complex procedure with a tenuous perioperative course. Enhanced recovery programs (ERPs) are bundle strategies, developed to enhance the recovery of surgical patients. This article outlines the components of an ERP for cystectomy patients from a nursing implementation perspective.

Cuidados de enfermería en un paciente intervenido de neovejiga ileal ortotópica tipo Hautmann. Caso clínico / No disponible

Entre las derivaciones urinarias en pacientes sometidos a una cistectomía radical por cáncer vesical infiltrante, la neovejiga ileal ortotópica, tipo Hautmann, es una excelente alternativa. Como objetivos nos planteamos: 1) exponer los cuidados de enfermería en pacientes intervenidos de cistectomía radical por cáncer vesical infiltrante a los que se les ha construido una neovejiga ileal tipo Hautmann, y 2) señalar el importante papel que juega enfermería, tanto hospitalaria como de atención primaria, en este tipo de intervención quirúrgica. Se expone un caso clínico de un paciente diagnosticado de cáncer urotelial papilar de alto grado con infiltración perineural al que se le ha construido una neovejiga. Se muestra el procedimiento seguido en el servicio, así como los protocolos empleados y actuaciones de enfermería. Como complicación presentó un íleo paralítico. La bibliografía especializada señala que el íleo paralítico es una de las complicaciones inmediatas que se da con más frecuencia en la cistectomía radical por cáncer vesical infiltrante, junto con la fístula urinaria, retención urinaria por mucus y urosepsis. Estudios de seguimientos de casos de neovejiga ileal tipo Hautmann muestran buenos resultados funcionales, una baja tasa de complicaciones, tanto inmediatas como tardías, y, sobre todo, una buena calidad de vida de estos pacientes

Orthopic ileal neobladder, type Hautmann, is currently the preferred method for urinary derivation in patients undergoing radical cystectomy for muscle-infiltrating bladder cancer. We set goals such as: 1) to supply useful information to patients with neobladder, specifically Hautmann neobladder about patients who underwent radical cystectomy due to infiltrating bladder cancer. 2) to highlight the important role that nursing staff plays by promoting quality in nursing care in this type of surgical intervention. It is described the case of a patient diagnosed with high-grade papillary urothelial carcinoma with evidence of perineural invasion. This patient underwent a radical cystectomy with neobladder reconstruction. The patient presented paralytic ileus. Paralytic ileus is a severe complication resulting from a variety of disorders, which is most commonly associated with radical cystectomy due to infiltrating bladder cancer. Other complications are urinary fistula, urinary retention due to mucus and urosepsis. Surveys aimed at monitoring the Hautmann neobladder show good functional outcomes, a low rate of complications of both immediate and late responses, and therefore, the quality of life for these patients was good

Papel de enfermería de consultas en la implantación de un protocolo ERAS en cistectomía radical / No disponible

La cistectomía radical (CR) es un procedimiento con una elevada tasa de complicaciones. Los protocolos de rehabilitación multimodal (ERAS) optimizan al paciente para acelerar la recuperación posquirúrgica combinando estrategias pre, intra y posoperatorias. El objetivo principal de este estudio es dar a conocer el papel de la enfermera y remarcar su importancia dentro del equipo multidisciplinar. Para ello hemos elaborado una vía clínica siguiendo los protocolos ERAS, donde se estandarizan los cuidados, marcando todas las actividades donde interviene enfermería, tanto los enfocados al paciente como a la recogida de datos para la investigación y mejora de nuestra función. Entre junio de 2015 y julio de 2016 se han realizado 14 CR incluidas en vía clínica. Como conclusión, contar con el papel de la enfermería es básico para el buen desarrollo e implantación de un protocolo ERAS

Radical Cystectomy (RC) is a highly complex procedure with multiple risks for complication. Enhanced Recovery Surgery (ERAS) protocols are designed to achieve early recovery after surgical procedures by combining pre, intra and post-operative protocols. The main aim of this research is to get a better knowledge of the urology nurse and emphasize their role in multi-disciplinary teams. To do this, we elaborated a nursing care plan at following ERAS protocol, including standardized care protocols, focusing on the everyday actions of nursing practice, not only activities addressed to the patient but also data collection for medical research and capacity for improvement work. Between June 2016 and July 2016 14 RC have been performed and are included in the clinical guideline. In conclusion, it is recommended to consider the value of staff nurse involvement in decision making since it is necessary for the proper implementation of ERAS protocol in order to get a good outcome

Efficacy of preoperative uro-stoma education on self-efficacy after Radical Cystectomy; secondary outcome of a prospective randomized controlled trial.

PURPOSE: Radical Cystectomy with a creation of an uro-stoma is first line treatment in advanced bladder-cancer. Enhancing or maintaining an individual's condition, skills and physical wellbeing before surgery has been defined as prehabilitation. Whether preoperative stoma-education is an effective element in prehabilitation is yet to be documented. In a prospective randomized controlled design (RCT) the aim was to investigate the efficacy of a standardised preoperative stoma-education program on an individual's ability to independently change a stoma-appliance. METHODS: A parent RCT-study investigated the efficacy of a multidisciplinary rehabilitation program on length of stay following cystectomy. A total of 107 patients were included in the intension-to-treat-population. Preoperatively, the intervention-group was instructed to a standardized stoma-education program consisting of areas recognized necessary to change a stoma appliance. The Urostomy Education Scale was used to measure stoma self-care at day 35, 120 and 365 postoperatively. Efficacy was expressed as a positive difference in UES-score between treatment-groups. RESULTS: A significant difference in mean score was found in the intervention group compared to standard of 2.7 (95% CI: 0.9; 4.5), 4.3 (95% CI: 2.1; 6.5) and 5.1 (95% CI: 2.3; 7.8) at day 35, 120 and 365 postoperatively. CONCLUSIONS: For the first time a study in a RCT-design have reported a positive efficacy of a short-term preoperative stoma intervention. Preoperative stoma-education is an effective intervention and adds to the evidence base of prehabilitation. Further RCT-studies powered with self-efficacy as the primer outcome are requested.

Testing inter-rater reliability of the Urostomy Education Scale.

PURPOSE: Previous research has validated the Urostomy Education Scale as a standardised evidence based tool to document patients' level of stoma self-care skills. The aim of this study was to test the scale's inter-rater reliability among urology nurses in a continuous validation of the Urostomy Education Scale. METHODS: During the study period from June 2011 to September 2012, 38 ward nurses performing standard stoma care attended 150 validation sessions evaluating 70 patients' level of stoma self-care skills using the Urostomy Education Scale. In pairs, the nurses randomly observed the patients during a training episode involving change of a stoma appliance. Data were categorised into three groups to investigate the impact of nurses' experience on reliability: comparing two inexperienced nurses, two experienced or one of each. Data were compared for agreement by testing variation between groups and analysing Bland Altman Plots with Limits of Agreement. RESULTS: The variation in scores was not influenced by the nurses' level of experience (p > 0.05). Reliability was found to be high with Bland Altman Plot and Limits of Agreement documenting that 84% of scores (95% CI (Confidence interval): 74; 89) were within a range of 2 points. CONCLUSION: The Urostomy Education Scale demonstrates high reliability irrespective of nurses' different levels of experience. The results are clinically relevant and contribute to a precise documentation of stoma self-care skills. The tool ensures evidence based patient education and can provide a high standard of communication in transitions between sectors.

Extravasación de mitomicina tras instilación postoperatoria / Mitomycin extravasation after postoperative instillation

OBJETIVO: Presentar el manejo terapéutico de complicaciones graves relacionadas con la extravasación de mitomicina postoperatoria. MÉTODOS: Descripción de los casos clínicos, el manejo médico y quirúrgico, y los resultados anatomopatológicos de las piezas quirúrgicas. RESULTADOS: Presentamos dos casos de pacientes con fuga extravesical de mitomicina tras su instilación en el postoperatorio. No se evidenció perforación de vejiga durante la cirugía del tumor. En ambos casos fue necesaria la realización de cistectomía radical. CONCLUSIONES: El uso de mitomicina en el postoperatorio puede tener consecuencias no deseables. Deben conocerse los problemas que pueden derivar de su administración e individualizar cada caso antes de administrar este quimioterápico

OBJECTIVE: To present the therapeutic management of severe complications related to postoperative mitomycin extravasation. METHODS: Description of clinical cases, medical and surgical management and pathologic results of surgical specimens. RESULTS: We report two cases of patients with extravesical mitomycin leakage after postoperative instillation. No bladder perforation was evident during tumor surgery. In both cases radical cystectomy was required. CONCLUSIONS: Postoperative mitomycin instillation may have undesirable consequences. The possible problems derived from its administration must be known, and each case must be individualized before administering this chemotherapy

Plan de cuidados de cistectomía: variaciones y adaptación a la Unidad de Cirugía/Especialidades / No disponible

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Use of urostomy bags in the management of perioperative urine leakage after radical cystectomy.

BACKGROUND: Urine leakage is a common complication in patients with bladder cancer after radical cystectomy and neobladder reconstruction. OBJECTIVE: The aim of this study was to evaluate the clinical value of the use of urostomy bags in the management of urine leakage in patients with bladder cancer after radical cystectomy. METHODS: Urine leakage during the perioperative period was retrospectively analyzed in 483 patients with bladder cancer who underwent radical cystectomy from 2004 to 2010. Before 2008, all patients with urine leakages were treated by routine dressing changes (group A). After 2008, the leakages were managed with urostomy bags (group B). The perioperative quality of life (EQ-5D) and cost for urine leakage for both groups were compared in this controlled study. RESULTS: The average cost in management of preoperative urine leakage was significantly higher in group A than in group B as well as the patients with extravasations of urine or lymphoceles. Patients in group B had an overall better perioperative life quality compared with group A. In particular, the score for pain/discomfort was significantly higher in group A than in group B. CONCLUSIONS: The management of perioperative urine leakage with urostomy bags avoided constant body wetness and significantly increased the quality of life and reduced the special costs of urine leakage in patients with bladder cancer after cystectomy. IMPLICATIONS FOR PRACTICE: Early use of urostomy bag is a good choice for perioperative urine leakage in patients with bladder cancer after radical cystectomy and neobladder reconstruction.

The Urostomy Education Scale: a reliable and valid tool to evaluate urostomy self-care skills among cystectomy patients.

AIM: : The purpose of this study was to validate a quantitative scale for nurses to evaluate self-care skills among patients undergoing cystectomy with creation of a urostomy. SUBJECTS AND SETTINGS: Twelve patients undergoing cystectomy with formation of a urostomy participated in the research. The study took place at Aarhus University Hospital, Denmark-a bladder cancer center performing approximately 100 cystectomies annually. INSTRUMENT: The Urostomy Education Scale was developed in 2010 based on review of stoma care literature. Areas recognized as standard procedure in urostomy care were identified and categorized into 7 self-care skills necessary for changing the pouching system. The 7 skills were reaction to the stoma, removing the pouching system, measuring the stoma diameter, adjusting the size of the urostomy diameter in a new stoma appliance, skin care, fitting a new stoma appliance, and emptying procedure. Each skill is rated on a 4-point scale according to the patient's need of assistance from the nurse. Higher scores indicate a higher level of patient self-care skills related to changing a urostomy pouching system. METHODS: Content, criterion, and construct validity were evaluated by a panel of experts using the Delphi method in 2010. To test interrater reliability and criterion validity, 4 nurses attended 12 patient training sessions at different postoperative days. Each patient was taught how to change a urostomy appliance using a standardized approach. One experienced enterostomal therapy nurse acted as the instructor and 3 other nurses observed and scored the patient's self-care skills. The 3 nurses' scores were analyzed using Bland Altman Plots with Limits of Agreements.To test construct validity, patients were categorized into 3 groups. The mean score in each group was used to analyze differences between groups using one way analysis of variance. RESULTS: Analysis revealed that the Urostomy Education Scale distinguished urostomy self-care skills practice by beginners versus experienced patients (P= .01). Comparison of scores among the 3 nurses revealed no statistically significant differences. In addition, the Urostomy Education Scale demonstrated satisfactory reliability with Limits of Agreements ranging from -3 to 3; 86% of scores differed by 2 points or less. CONCLUSIONS: To our knowledge, the Urostomy Education Scale is the first validated tool for nurses to document the patient's level of urostomy self-care skills.

Orthotopic bladder substitution (Neobladder): part II: postoperative complications, management, and long-term follow-up.

Bladder replacement following radical cystectomy is widely practiced and in some centers has become the standard method of urinary diversion when possible, rather than the traditional ileal conduit. To minimize the impact of cystectomy and bladder replacement on quality of life and to obtain optimal functional results, postoperative care must be comprehensive and multidisciplinary. Critical team members include the surgeon, urologic nurses, WOC nurses, and allied health care providers such as physiotherapists. This article highlights postoperative considerations for patients undergoing radical cystectomy with orthotopic neobladder construction. The common issues and complications that arise are discussed with a focus on strategies to optimize outcomes.

Cuidados enfermeros en la ureteroileostomía(tipo Bricker). Estudio de un caso clínico / No disponible

Se exponen los cuidados enfermeros llevados a cabo en nuestro servicio en un caso de derivación urinaria con asa ileal, desde su ingresohasta el alta hospitalaria, veinte días después. Se trata de un paciente de 63 años, diagnosticado de carcinoma vesical al que se le ha practicadouna ureteroileostomía (Bricker). Se muestran, asimismo, las complicaciones postoperatorias más frecuentes que este tipo de intervencionesquirúrgicas suelen presentar. Tras la elaboración del correspondiente caso clínico se abordan los diagnósticos enfermeros, criteriosde resultados (NOC) y las intervenciones de enfermería (NIC), así como los cuidados enfermeros administrados, basados en elmodelo de los once patrones funcionales de Majori Gordon. Por último se resalta el importante papel que tanto Enfermería Domiciliariacomo Atención Primaria juegan tras el alta del paciente (AU)

We expose nursing cares carried out in our service on a case of ileodiversion, from their hospitalization until discharge, twenty days later.It is a 63 years old patient, diagnosed by vesical carcinoma which was performed an ureteroileostomy (Bricker).We also show post-intervention complications more prevalent among this kind of surgical interventions. After the clinical case elaboration,nursing diagnoses, outcomes criteria and intervention criteria, as well as administered nursing care are explained, based on the elevenfunctional patterns model of Majory Gordon.It is also outstanded the important role of home-based nursing intervention and primary attention nursing plays after patient’s discharge (AU)

Efectividad de las recomendaciones al altaen los pacientes con derivación urinaria Brickeren el Hospital Santiago de Vitoria. Un reto en los cuidados / No disponible

La cistectomía radical es el tratamiento de elección en pacientes con cáncer vesical infiltrante siendo, la derivación urinaria tipo Bricker latécnica más utilizada en nuestra unidad.Con el fin de conocer el grado de información de los pacientes intervenidos de cistectomía Bricker hemos evaluado tanto la informaciónoral como escrita sobre los cuidados que reciben nuestros pacientes durante el ingreso con el fin de lograr un mayor autocuidado al altahospitalaria.Para ello hemos realizado un estudio descriptivo transversal mediante entrevistas personales. El cuestionario constaba de 7 ítems relacionadoscon hábitos higiénicos, cuidados del estoma, valoración de la hoja de recomendaciones al alta, cambios en sus hábitos de vida ydificultades que encontraron una vez en su domicilio. El resultado de este estudio evidencia que para un alto porcentaje de pacientes lainformación dada durante el ingreso de cara al alta les ha sido de utilidad. Por el contrario, un porcentaje menor demanda más informaciónde la recibida. Dado que hay variables que pueden influir en la adecuada recepción de la información y que la hoja de recomendacionesno cumple las expectativas esperadas, creemos necesario reforzar la información mediante la elaboración de una guía de actuación (AU)

Radical cystectomy is the treatment of choice in patients with invasive bladder cancer, being the urinary diversion Bricker type, the mostcommon technique used in our unit.In order to meet the grade of information patients have about Bricker cystectomy interventions, we had evaluated oral and written informationabout the care that receive our patients during hospitalization in order to achieve greater self-care at discharge.Therefore, we had carried out a cross-sectional study by personal interviews. Questionnaire was made by 7 items related to hygienehabits, stoma’s care, discharge recommendation booklet assessment, changes in life habits and troubles found once they are at their homes.The result of this study shows that a high percentage of patients found useful data given during their hospitalization to face discharge properly.By contrast, a smaller percentage claim received more information.As there are many variables that can modify properly patient’ perception on information and recommendation booklet does not meetthe expectation expects, we believe that there’s need to enforce information by actuation guidelines elaboration (AU)

Radical cystectomy for bladder cancer: a qualitative study of patient experiences and implications for practice.

Patients being treated for bladder cancer share issues in common with other cancer patients, but also experience issues that are unique to their surgical treatment. This study used a descriptive qualitative approach to explore the experiences of patients who had undergone radical cystectomy for bladder cancer Twenty-two participants were interviewed in-depth on one occasion and were invited to attend a focus group session following the analysis of the interview transcripts. Participants described the shock of their diagnosis, their lack of information about bladder cancer, the importance of clear communication with care providers, and the types of adjustments they had to make following surgery. Specifically, changes in bodily function, body image, sexual relationships, and intimacy presented challenges for these participants. Although there was a sense of acceptance about the treatment-related events, there were still significant adjustments required by individuals following their surgery. Information, open communication, and support from family and friends were seen as important factors in helping patients adjust after surgery. Patients require clear, concise and consistent information about their cancer, treatment options, and course of care. Nurses caring for patients following surgery for bladder cancer need to understand the unique needs of these patients.