Rutledge D N, Engelking C
Zalmen A. Arlin Cancer Institute, Westchester Medical Center, Valhalla, NY, USA.
Oncol Nurs Forum. 1998 Jun;25(5):861-73.
PURPOSE/OBJECTIVES: To describe oncology nurse experiences with disease- and treatment-related diarrhea in patients with cancer, including assessment methods and pharmacologic/supportive care.
Descriptive.
SAMPLE/SETTING: 1,288 (26%) of 5,000 randomly selected Oncology Nursing Society members employed full-time in adult clinical settings in the United States.
Mailed survey with scannable booklets.
Nurse perceptions of disease and treatment-related issues associated with diarrhea in patients with cancer, along with currently used assessment criteria and nursing care.
Nurses in this sample routinely encounter diarrhea in their patients with cancer. They commonly assess/document diarrhea by noting its presence or absence, with a minority of nurses using a rating tool. When indicated, most nurses prepare patients for probable diarrhea. This preparation includes both verbal and written instructions about diet, skin care, drug therapy, and treatment of severe diarrhea. Nurses report that primary drug therapy for diarrhea consists of over-the-counter agents. Supportive care consists of fluid/electrolyte replacement, skin care and diet modifications, and also bowel rest and parenteral nutrition for severe diarrhea. For these nurses, the most important factors influencing choice of management strategies are symptom relief and physician and patient preference.
Although the majority of nurses in this study report providing anticipatory guidance, patient education, and supportive diarrhea management, they are not assessing diarrhea systematically. They report common use of nonprescription medications, with pharmacologic interventions varying with severity of diarrhea.
Targeted education is needed to help nurses implement systematic assessment and documentation. Efficacy of diarrhea-management strategies and protocols must be tested-specifically, optimal timing and types of skin care, dietary changes, and bowel rest.
目的/目标：描述肿瘤护理人员对癌症患者疾病及治疗相关腹泻的护理经验，包括评估方法以及药物/支持性护理。
描述性研究。
样本/背景：从5000名美国成人临床机构全职工作的肿瘤护理学会成员中随机抽取1288名（26%）。
邮寄带有可扫描小册子的调查问卷。
护理人员对癌症患者腹泻相关疾病及治疗问题的看法，以及目前使用的评估标准和护理措施。
该样本中的护理人员在癌症患者中经常遇到腹泻情况。他们通常通过记录腹泻的有无来评估/记录腹泻情况，少数护理人员使用评分工具。在有必要时，大多数护理人员会让患者为可能出现的腹泻做好准备。这种准备包括关于饮食、皮肤护理、药物治疗以及严重腹泻治疗的口头和书面指导。护理人员报告说，腹泻的主要药物治疗包括非处方药物。支持性护理包括补充液体/电解质、皮肤护理和饮食调整，对于严重腹泻还包括肠道休息和肠外营养。对这些护理人员来说，影响管理策略选择的最重要因素是症状缓解以及医生和患者的偏好。
尽管本研究中的大多数护理人员报告提供了预防性指导、患者教育以及支持性腹泻管理，但他们并未对腹泻进行系统评估。他们报告经常使用非处方药，药物干预措施因腹泻严重程度而异。
需要有针对性的教育来帮助护理人员实施系统评估和记录。必须测试腹泻管理策略和方案的有效性——特别是皮肤护理、饮食改变和肠道休息的最佳时机和类型。
