Nursing considerations for supporting cancer patients with metastatic spinal cord compression: a literature review.

BACKGROUND: metastatic spinal cord compression (MSCC) is an oncology emergency. Prevalence is increasing. Treatment and care are complex and those diagnosed may be faced with life-changing challenges. AIMS: to review the impact and management of MSCC in patients with cancer, in order to analyse nursing considerations for supporting patients. METHODS: a literature review and thematic analysis of five primary research papers, published between 2009 and 2014. FINDINGS: two themes of prognosis/survival time and independence versus dependence were discovered. CONCLUSIONS: the onset of MSCC may result in paralysis and associated loss of independence, impacting on a patient's quality of life. Understanding individuals' prognosis and treatment/care preferences is fundamental for the sensitive, individualised support of patients with MSCC. The findings reinforce the nurses' role in health education, in order to raise awareness of MSCC and promote early diagnosis so that patients maintain function and independence as long as possible. The findings support the need for nurses to be equipped with appropriate communication skills to initiate and engage in sensitive, difficult and proactive conversations with patients and their families, supporting the delivery of humanised care.

[Intramedullary spinal cord tumors and neurofibromatosis]. / Intramedullyarnye opukholi spinnogo mozga i neirofibromatoz.

The article addresses the issue of a combination and relationship between intramedullary spinal cord tumors (IMSCTs) and neurofibromatosis (NF). AIM: To study, based on large clinical material, features of the prevalence and biological nature of intramedullary spinal cord tumors in neurofibromatosis patients in different age groups. MATERIAL AND METHODS: We analyzed the data of the largest series of patients from all age groups who underwent surgery for spinal cord intramedullary tumors (541 patients; 586 surgeries; age, 2 months to 72 years). RESULTS: Our findings support a potential pathogenetic relationship between intramedullary tumors and neurofibromatosis. Astrocytoma was a predominant intramedullary tumor in patients with NF-1, while ependymoma predominated in patients with NF-2. IMSCTs combined with NF-1 occur predominantly in children and adolescents, while a combination with NF-2 is typical of young adults. Our findings confirm the fact that IMSCT surgery is required for a small number of NF patients.

Quality of life in patients with malignant spinal cord compression: a review of evidence-based literature.

Malignant spinal cord compression (MSCC) is a devastating complication of metastatic cancer. The majority of existing studies focus on treatment guidelines for MSCC, with little emphasis on the impact that MSCC has on quality of life (QoL) for this patient group. This literature review aims to critically appraise available literature focusing on QoL for patients with MSCC. Relevant literature was identified from key electronic databases. A dearth of credible studies representative of the patient population with MSCC was found. Thematic analysis was used as a guide to identify key themes that impact on QoL. Interestingly, patients with MSCC generally report good QoL and low levels of distress in over 50% of cases. However, a significant percentage of patients are distressed. The review concludes that increased awareness and further research into the impact of MSCC is required.

[Development of a systemic teaching method of the family approach in nursing science: report of an educational situation]. / Construction de l'enseignement systémique de l'approche familiale en science infirmière: récit d'une situation éducative.

The purpose of this article is to describe a new educational practice that demonstrates new teaching strategies used to help nursing students better integrate a family systems approach in their clinical practice. This narration emerges from a qualitative study aiming to include the components of teaching practice, facilitating a change in family care approach toward a practice that considers the "person-family" as a unit of care. The methodological course of this qualitative research is guided by interrelationship of action research and introspective analysis globally supported by systemic constructivist perspectives towards the construction of an educational practice for teaching the family systems approach in nursing science, and the development of new knowledge concerning this practice. This article presents one of the six narratives from an educational situation. A partial description of the results demonstrates that the professor-researcher being present in a different manner creates and uses innovative strategies in her teaching, such as narratives, self dialogue and dramatization which helped nursing bachelor students in transforming their thoughts towards acting in a systemic way towards the family.

Issues in families of children with brain tumors.

PURPOSE/OBJECTIVES: To determine the needs of children with brain tumors and their parents/guardians and siblings during the six stages of illness: diagnosis, hospitalization, posthospitalization, adjuvant treatment, recurrence, and terminal or reported cured. DESIGN: A cross-sectional, qualitative study of families using focus group methodology. SETTING/SAMPLE: Families with a child diagnosed with a brain tumor recruited from the practices and clinics of several major teaching hospitals in the New York metropolitan area. Families traveled as far as 70 miles for the group meeting. Varying ethnic groups and family structures were represented. METHODS: Groups were separated into parents/guardians, siblings, and affected children. The children's groups were divided further into age 10 and older and younger than age 10. During the focus group, moderators followed an outline of topics identified from family interviews, the literature, and content experts that were important to families in similar situations. An assistant moderator took detailed notes, and the entire group meeting was audiotaped. Information was transcribed and analyzed using qualitative analysis techniques. FINDINGS: 11 focus groups met involving 7 affected children, 24 adults, and 19 siblings. Issues identified as important by the group members fell into four categories: Interaction With Healthcare Providers, Medical Information/Education, Healthcare Utilization and Treatment, and Psychosocial Issues. The needs of family members differed at various stages of the illness. CONCLUSIONS: The particular impact of the four major areas of concern differed by family role and stage of illness. IMPLICATIONS FOR NURSING PRACTICE: To provide optimal care, healthcare professionals must be aware of the family's composition and support systems and the impact that the illness has on individual family members at each stage of illness.

Tumors of the spine and spinal cord.

OBJECTIVES: To provide an overview of spinal cord neoplasms with a focus on location, histology, pathophysiology, diagnosis, treatment and nursing assessment and management. DATA SOURCES: Published books and peer-reviewed articles. CONCLUSIONS: Tumors of the spine and spinal cord are rare, and they can have grave implications for the patient. The key in the management of spinal cord tumors is their timely diagnosis and treatment to preserve function. IMPLICATIONS FOR NURSING PRACTICE: A thorough nursing assessment and timely intervention can have a positive impact on the outcome of patients with tumors of the spine and spinal cord.

Central nervous system metastases.

OBJECTIVES: To provide an overview and up-to-date information on the presentation and treatment of central nervous system (CNS) metastases, including brain metastases, spinal cord compression, and leptomeningeal metastases. DATA SOURCES: Published articles, research reports, and book chapters pertaining to CNS metastases. CONCLUSIONS: Most patients with CNS metastases have a limited life expectancy. Therapies are palliative, except in select patients who have improved chances for long-term control or occasional cures. In general, early detection and treatment of CNS metastases prevents devastating neurological disabilities. IMPLICATIONS FOR NURSING PRACTICE: Nurses across all health care settings can play an important role in early recognition of signs and symptoms of CNS metastases, and assist patients and families in preventing devastating neurological disabilities. Nurses are also frontline care providers for patients requiring various treatments and rehabilitation for metastatic CNS disease.

Transoral resection of spinal cord tumors and posterior cervical spine stabilization.

Transoral resection of an anterior spinal cord tumor consists of three major phases: corpectomy (i.e., removal of vertebral bodies), tumor resection, and duraplasty (i.e., repair of the dura mater). A second surgical procedure, posterior stabilization of the occiput to the C3 vertebra, consists of an iliac crest bone graft for cervical spine fusion and the application of a rigid fixation device. This article describes a patient who underwent a transoral resection of an extramedullary intradural tumor at the C2-C3 level of the spinal cord and a posterior cervical spine stabilization procedure. Perioperative nursing concerns and interventions are discussed from the standpoint of the patient's physical and mental postoperative recovery.

Malignant spinal cord tumors: a review and case presentation.

Since malignant spinal cord tumors constitute such a small percentage of spinal cord lesions, nurses may be unaware of the challenging needs of this group of patients. Often young and previously healthy, these people face a rapidly progressive and dismal disease course. Presentation and complaints are related to the location and growth rate of the tumor. Treatment is geared to debulking the tumor mass and preventing its spread. This article discusses the pathophysiology, signs and symptoms, medical management and nursing implications for the patient diagnosed with a malignant spinal cord tumor. A case presentation including examples of nursing diagnosis and interventions follows.