Symptom Management and Quality of Life Issues

Psychological well-being
Nursing interventions and support

Depression is experienced frequently by patients with bladder cancer. Psychological distress expressed in such emotions as depression or excessive anxiety have been identified in patients with advanced cancer (Cella, Jacobsen & Lesko, 1990). The frequency of psychological distress in patients with cancer at various disease stages ranges from 30-47% (Spiegel, 1994) and Kaasa et al. (1993) reported that 70% of patients with advanced cancer and high levels of distress had poor performance and more pain. Consequently, the study of depression in patients diagnosed with cancer is an important topic. A study is currently underway to determine if psychological screening and intervention at the time of diagnosis for cancer can improve the patient's well-being. This study uses the Brief Symptom Inventory (BSI) to identify individuals that need psychological intervention.

Enterostomal therapy support. Enterostomal therapy services are provided by a Certified Wound, Ostomy and Continence Nurse (CWOCN). These services include: pre-operative counseling and stoma site marking, inpatient self care teaching and assistance with physical, psychological and social adaptation, community referrals for support and appliances (as needed) and life long follow-up for maintenance issues.

Expert nursing care received by patients at The Brady Urological Institute, Johns Hopkins Hospital makes a difference in the quality of patient care. Post-operatively, patients at the Brady Institute are cared for by the nursing staff on the Marburg 2, Nursing Unit who routinely work with individuals treated surgically for urological conditions. Nurses not only provide clinical and psychological care for patients but also provide important post-operative patient teaching to prepare patients for discharge. Medical oncology nursing is provided by nurses specializing in oncology at the John Hopkins Comprehensive Cancer Center. Medical oncology nurses are involved in functions such as administration of chemotherapy, patient assessment, symptom management, planning of patient care and patient involvement in research protocols. 

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