Biomedical subjects
Deborah A Boyle
Publications and source records attributed to Deborah A Boyle.
Delirium in older adults with cancer: implications for practice and research.
PURPOSE/OBJECTIVES: To provide a comprehensive review of the literature and existing evidence-based findings on delirium in older adults with cancer. DATA SOURCES: Published articles, guidelines, and textbooks. DATA SYNTHESIS: Although delirium generally is recognized as a common geriatric syndrome, a paucity of empirical evidence exists to guide early recognition and treatment of this sequelae of cancer and its treatment in older adults. Delirium probably is more prevalent than citations note because the phenomenon is under-recognized in clinical practice across varied settings of cancer care. CONCLUSIONS: Extensive research is needed to formulate clinical guidelines to manage delirium. A focus on delirium in acute care and at the end of life precludes identification of this symptom in ambulatory care, where most cancer therapies are used. Particular emphasis should address the early recognition of prodromal signs of delirium to reduce symptom severity. IMPLICATIONS FOR NURSING: Ongoing assessment opportunities and close proximity to patients' treatment experiences foster oncology nurses' mastery of this common exemplar of altered cognition in older adults with cancer. Increasing awareness of and knowledge delineating characteristics of delirium in older patients with cancer can promote early recognition, optimum treatment, and minimization of untoward consequences associated with the historically ignored example of symptom distress.
Psychological adjustment to the melanoma experience.
OBJECTIVES: To provide a review of the literature on the psychological adjustment to malignant melanoma. DATA SOURCES: Research reports and review articles. CONCLUSIONS: Three prominent themes evolved from the literature: (1) delineation of issues concerning long-term survivorship and quality of life following a diagnosis of melanoma; (2) coping with metastatic and end-stage melanoma; and (3) identification of the possible link between immunomodulation and the evolution of melanoma. IMPLICATIONS FOR NURSING PRACTICE: Oncology nurses must individualize their support and counsel according to the potential trajectory of the patient's melanoma experience. Nurses need to identify an individual's risk for psychological distress and help them enhance coping skills.
Medication misadventure in cancer care.
OBJECTIVES: To describe the nature and scope of the problem of medication errors in health care, with specific implications for error reduction and prevention. DATA SOURCES: Articles and research studies. CONCLUSIONS: Because of the complexity of chemotherapeutic regimens, requirements for supportive care drugs, and the physiologic vulnerability of patients due to their malignancies and intensive therapies, patients with cancer should be the focus of interdisciplinary medication error prevention programs. IMPLICATIONS FOR NURSING PRACTICE: Nurses play a critical role in patient safety and the implementation of preventive and risk-reducing interventions to improve the drug delivery process.
A multifocal education strategy to enhance hospital-based Cultural competency in professional staff.
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Families facing cancer: the forgotten priority.
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Depression in patients with advanced cancer.
Sadness is a normal reaction to the fears, anxieties, and uncertainties during any stage of cancer but is especially problematic during the advanced stage. Depressive symptoms and syndromes frequently coexist during this time and affect quality of life. Depression is an overlooked and undertreated symptom during late-stage cancer. This article provides an overview of the epidemiology, neurophysiology, diagnostic and screening approaches, risk factors, and treatment modalities for depression in patients with advanced cancer.