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Symptom Management and Quality-of-Life Issues

Psychological Well-Being

Patients with bladder cancer frequently experience depression. Psychological distress expressed as depression or excessive anxiety has been identified in patients with advanced cancer (Cella, Jacobsen and Lesko, 1990). The frequency of psychological distress in patients with cancer at various disease stages ranges from 30 percent to 47 percent. Spiegel (1994) and Kaasa et al. (1993) reported that 70 percent 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: preoperative 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 lifelong follow-up for maintenance issues.

Nursing Interventions and Support

Expert nursing care received by patients at the Brady Urological Institute at The Johns Hopkins Hospital makes a difference in the quality of patient care. Postoperatively, 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 postoperative patient teaching to prepare patients for discharge. Medical oncology nursing is provided by nurses specializing in oncology at the Sidney Kimmel Comprehensive Cancer Center. Medical oncology nurses are involved in functions like administration of chemotherapy, patient assessment, symptom management, planning of patient care and patient involvement in research protocols.

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