Preface
The Gap Between Research Findings and Clinical Practice
The Clinical Need for a Conceptual Model of Practice
Why This Book
What the Handbook Offers
How to Use the Handbook
What Distinguishes This Book from Others
Reclaiming Nursing’s Legacy
Acknowledgments
Contents
Part I: The Stress, Healing, and Resilience Nursing Model of Whole Person Care
Introduction
1: Theoretical Underpinnings
1.1 Theoretical Underpinnings
References
2: The Stress, Healing, and Resilience Nursing Model of Whole Person Care
2.1 Introduction
2.2 Objectives
2.3 Core Values and Assumptions of Practice
2.4 Goals of the Practice Model
2.5 The Whole Person and the Environment (See Part II, Chap. 3; Part IV Chaps. 8 and 11)
2.6 Psychological Stress (See Part II Chaps. 3, 4 and 5)
2.7 Health as an Essential Property of the Whole Being
Health-Related Outcomes
Key Internal Processes of Health
Processes of Development
Processes of Resilience (See Part II)
Processes of Innate and Self-Induced Healing (Review Part IV)
2.8 Personal Strengths and Social Resources (Supportive Relationships) (See Part IV, Chaps. 8–11)
Social Resources (Supportive Relationships) (Review Part IV Chaps. 8 and 11)
2.9 Healthy Lifestyle Behaviors
2.10 Epigenetics
2.11 Homeostasis
2.12 Energy and Metabolic Processes
2.13 Sense of Coherence (See Fig. 2.1)
2.14 Nursing Approaches (See Parts IV and V)
Quality of the Nurse–Patient Relationship (Part IV Chaps. 8 and 19)
Timing of Interventions
Format
References
Part II: Resilience
Introduction
3: Psychological Stress
3.1 Introduction
3.2 Definitions
Properties of Psychological Stress
Benefits or Harmful Effects (Review Parts II and III)
3.3 Acute Stressor Effects (Review Part II Chaps. 4 and 5)
3.4 Prolonged Psychological Stress (Review Part III, Chaps. 6 and 7)
Early Childhood Adversity (ECA)
Summary
3.5 Need for Measurable Terminology for “Stress”
3.6 Cumulative Measures of Stress (Table 3.2)
3.7 Nursing Implications
References
4: Biological Processes of Resilience
4.1 Introduction
4.2 Objectives
4.3 Definitions
Resilience
Allostasis
Flexibility
Stressors (Review Part II Chap. 3)
Good Stress and Resilience
Tolerable Stress and Resilience
4.4 Key Neural Structures and Mediators
Brain Plasticity
The Stress-Related Systems and Mediators (Review Also Part III Chap. 6)
Negative Glucocorticoid Feedback System
4.5 The Biphasic Process of Biological Resilience
The First Phase: The Process of Stress-Induced Neural and Physiological Adjustments
The Second Phase, Healing, and Restoration
4.6 Other Processes That Influence Biological Resilience
Age
Sex Differences (Review McEwen [3, 4])
Epigenetics
Circadian Rhythm
Energy
4.7 Nursing Implications
References
5: Psychosocial Processes of Resilience
5.1 Introduction
5.2 Objectives
5.3 Definition: Psychological Resilience
5.4 Theoretical Tenets and Model of Psychological Resilience: The Emotion-Regulating Stress-Coping Adaptation System of Psychological Resilience
Antecedent Factors
Cognitive and Emotional Schemas or Representations
Cognitive and Behavioral Coping Strategies
Hope
Personal Resources, Social Resources, and Risk Factors
Personal Resources (PR)
Social Resources
Risk Factors
Health-Related Outcomes
5.5 Research Findings among the Key Variables of the Stress Adaptation Coping System of Resilience (Review Part IV Chap. 9)
A Meta-Analyses Based on the CSM
The Stress-Coping Adaptive Process of Resilience (e.g., [6, 13, 14, 16])
Stress, Coping Strategies, and Health Outcomes
Coping Clusters Over Time
Personal Resources
Mediating and Interactional Coping Effects
Social Resources (Support) (See Part IV Chap. 11)
Support and Personal Resources
5.6 Nursing Implications
References
Part III: Poor Resilience
Introduction
6: Poor Resilience
6.1 Introduction
6.2 Objectives
6.3 Definitions
Poor Resilience
Allostatic Load (AL) [2–5] (See Table 6.1)
Allostatic Overload (See Part II Chap. 3)
6.4 The Four Conditions of Chronic Stress
6.5 Pervasive Neurobiological Maladaptive Disruptions (Review [1, 29])
Brain, Neural Circuitry, and Threat to Brain’s Plasticity
Prefrontal Cortex (PFC)
Amygdala
Hippocampus
6.6 Impaired HPA Axis, ANS, and Immune Functioning
Impaired Negative Feedback Inhibition System and Damaged Glucocorticoid (GR) Receptors
Impaired PNS Healing Processes
Dysregulated Immune System
6.7 Other Dysregulated Mediators
6.8 The Impaired Dopaminergic Reward System
6.9 Dysregulated Circadian Rhythm
6.10 Chronically Stress-Induced Epigenetic Changes
6.11 Systemic Inflammation
6.12 Metabolic Oxidative Stress
6.13 Weakened Bioelectromagnetic Field
6.14 Behavioral Indicators of Poor Resilience [11, 48] (Review Part II Chaps. 3–5)
6.15 Nursing Implications
References
7: Cancer
7.1 Introduction
7.2 Objectives
7.3 Chronic Illness
7.4 Cancer
Definition
7.5 Factors Conducive to the Development of Cancer
The Microbiome
7.6 The Development of Cancer
Cancer Stem Cells (CSCs)
The Role of ROS in Tumorigenesis and Cancer Progression (Review [13, 22])
Cancer and Antioxidant Capabilities
The Tumor Microenvironment (TME)
Cancer-Associated Fibroblasts (CAFs) (See Table 7.5 for Definitions)
Immune Evasion
7.7 Progression, Invasion, and Metastases
Chemoresistance
Epithelial-to-Mesenchymal Transition (EMT) in Tumor Progression and Recurrence
Metastases
7.8 Nursing Implications
References
Part IV: Fostering Healing and Resilience
1.1 Introduction
8: The Quality of the Nurse–Patient Relationship
8.1 Introduction
8.2 Objectives
8.3 Why Patients Need a Quality Relationship with the Nurse
8.4 Definition
8.5 The Quality of the Nurse–Patient Relationship
Clinical Research
8.6 Relational Characteristics of the Nurse–Patient Relationship
Being Present
Communication
Skills of Communication (Table 8.2)
Facilitating Personal Narratives
Clinical Research
Compassion
Clinical Research
A Sense of Connectedness with Patients and Family Caregivers
Being Known
Momentary Encounters
Enhancing Support (See Part IV, Chap. 11)
Evidence-Based Practice (EBP) (Review Part V, Chap. 19)
References
9: Promoting Emotion-Regulating Coping Resilience
9.1 Introduction
9.2 Objectives
9.3 Definitions: The Emotion/Self-Regulating Coping System of Psychological Resilience (Review Part II, Chaps. 4 and 5; Appendix in this Chapter and Appendices A and B)
9.4 Randomized Controlled Intervention Studies (RCTs): Enhancing Coping Efforts (Appendix in this Chapter, Appendix in Chaps. 10, 11, 13, and 14, and Appendices A–C)
Cognitive–Behavioral Strategies (CBS) (Review Appendix in this Chapter)
Self-Management Interventions (SMI) (Appendix A)
9.5 Suggested Nursing Approaches
Nursing Assessment
Emotional Distress
Coping Efforts (Review Appendix B)
Self-Management Interventions
Other Relevant Contextual Patient and Caregiver Information to Assess
A Clinical Assessment Strategy: Patient/Caregiver Narratives (Also Review Patient Narratives in Part IV Chap. 10, Section “Cognitive Restructuring and Distorted Beliefs” and Table 10.2)
Nursing Interventions: Promoting Emotion-Regulating Coping Efforts (Review Part IV Chap. 10; Appendix in this Chapter and Appendix B)
The Nurse’s Essential “Resilient-Promoting Toolbox”
Reframing [6]
Cognitive Restructuring and Distorted Beliefs [6, 67]
Cognitive Restructuring Steps Typically Involve [6, 67]
Identifying Distorted Beliefs
Help the Person Distinguish between a Belief and a Fact
Link Thoughts to Emotions (and to Behaviors)
Another Use of Cognitive Restructuring (for Illustrative Purposes)
Explore the Patient’s Assumptions and Beliefs about the World and Self
Explore the Emotional and Behavioral Costs Versus Benefits of Holding onto a Distorted Belief (Review Chap. 12)
Based on This Clinic Anecdote, the Nurse May Consider Many Clinical Strategies
Summary of Coping-Promoting Strategies
Break Down Generalizations into Smaller Manageable Components (Fig. 9.2) [6]
Use Metaphors and Literary or Music-Related References
Encourage Positive Affirmations [6, 67]
Commendations [6, 67]
Protecting Patient Hope (See Part II, Chap. 5; Part V Chap. 18)
Promote a Sense of Personal Control
Acceptance
Facilitating Self-Management Strategies [1, 14]
9.6 Final Thoughts
Appendix: Psychosocial Interventions—Cognitive–Behavioral Therapy/Cognitive–Behavioral Stress Management Interventions/Self-Efficacy
References
10: Fostering Meaning Making
10.1 Introduction
10.2 Objectives
10.3 Definitions
10.4 Emotional and Existential Distress (See Part II Chap. 3)
Emotional Distress
Existential Distress
10.5 Conceptual Underpinnings
Global Meaning-Orienting System
Situational Meaning
Search for Meaning: Adjusted Global and Situational Meanings
Cognitive Processing: Assimilation and Accommodation
The Search for Meaning Can Fail
Found Meaning or Meaning Made
Meaning-Made and Physiological Outcomes
Meaning-Made and Posttraumatic Growth
Moderators and Mediators of Meaning
Coping-Related Mediators
Cognitive Processing, Personal Resources (Optimism and Faith), Social Support, and Meaning-Focused Coping Strategies
10.6 Meaning-Making Clinical Interventions (Review Appendix in this Chapter and Appendix B)
The Life Review (See Appendix B)
Meaning-Made Interventions (Appendix B)
10.7 Nursing Approaches
Nursing Assessment
Nursing Interventions: Global Assumptions, Situational Meanings, and Meaning Making
Meaning-Making Strategies
Encourage Cognitive Shift toward Neutral or Positive Reappraisals (Review Part IV Chap. 9)
Encourage the Meaning-Making Narrative
Facilitating Deliberate Rumination [100] (Chap. 9)
A Word About Causal Attributions
A Matter of Personal Choice
10.8 Final Thoughts
Appendix: Psychosocial Interventions—Meaning-Related Studies
References
11: Strengthening Supportive Relationships
11.1 Introduction
11.2 Objectives
11.3 Definitions (Review Appendix in this Chapter and Appendix B)
Family Support
Partner and Spousal Support
11.4 Models of Support and Clinical Findings
Stress-Buffering Model
Main Effects Model
Mediating Effects
11.5 Support and Personal Resources
Support and Attachment
Support and Self-Efficacy (See Part II, Chap. 5)
Support and Optimism
Support and Resilience
Support and Coping Behaviors
Not All Support Is Supportive
When Patients Lack Support
Support and Neurobiological Effects (Part III Chap. 7)
11.6 The Importance of a Patient- Family Caregiver Dyad as the Focus of a Supportive Intervention
11.7 Controlled Trials: Supportive Expressive Intervention Studies (Review Appendix in this Chapter and Appendix B)
SEGT and Survivability
11.8 Nursing Approaches
Nursing Assessment of Patients and Family Caregivers
Social Resources
Support Functions
The Quality of the Patient-Family Caregiver Relationship
Quality of Communication (Review Part IV Chap. 8)
Nursing Interventions (Review Appendix in this Chapter and Appendix B)
Encourage Open Communication and Emotional Expression [97, 110, 98]
Strengthen the Patient’s and Family Caregiver’s Sense of Connectedness with One Another (as well as More Broadly with Their Family/Significant Others)
Heighten Awareness of the Unspoken Meanings Conveyed by Patient-Caregiver’s Respective Behaviors
Closing the Gap
Supportive Needs of Family Caregivers (Review Appendix B)
Obtaining Needed Support from the Nurse and Physician
11.9 Final Thoughts
Appendix: Psychosocial Support-Related Interventions
References
12: Psychological Healing and Leveraging the Placebo Effect
12.1 Introduction
12.2 Objectives
12.3 Definitions
12.4 How Cognitive Expectations Are Formed (See “Mechanisms” of Action in Sect. 12.6)
Positive and Negative Expectations: Side Effects
Cognitive Expectations Affect the Pharmacodynamics Associated with Drug Efficacy
Cognitive Expectations: Drug Conditioning
12.5 Unconscious Conditioning Associated with Treatment-Induced Immunosuppression
12.6 Mechanisms of Action: Psychosocial-Neurobiological Systems of Healing
Learning and Conditioning
The Brain’s Reward System
Dopamine Release
Opioid and Related Pathways
Neuroimaging and the Stress Response System and Immune Responses
Genes and the Placebo
MOA and Nocebo Pathways
12.7 Nursing Approaches
The Quality of the Nurse-Patient Relationship (Review Part IV Chap. 8)
Shared Beliefs
Verbal Suggestions and Open/Closed Treatments (Review Sect. 12.4)
Open/Hidden Clinical Condition
Promoting Cognitive Expectations: RCTs
Strategies to Minimize the Nocebo Effect
Managing Informed Consent
Modulating Unconscious Conditioning (Review Sect. 12.5)
12.8 Final Comments
References
13: Mindfulness-Based Practice and Eliciting the Relaxation Response
13.1 Introduction
13.2 Objectives
13.3 Definitions
13.4 Mindful Meditation
Benson’s Relaxation Response (RR) Technique
Mindfulness-Based Cancer Recovery (MBCR)
13.5 Mechanism of Action
13.6 Research Findings
Mindful Techniques on Neural Structural Regions (Review Fox [42])
Physiological Outcomes
Immune Functions
Molecular Changes
Psychological and Behavioral Outcomes
Cognitive Functions
13.7 MM as a Self-Care Skill for Nurses
13.8 Nursing Implications
13.9 Final Thoughts
Appendix: MBSR. Psychosocial and Behavioral Interventions—Mindful Meditation (MM), Relaxation Response Technique (RR), Mindfulness-Based Stress Reduction Intervention (MBSR), and Mindfulness-Based Cancer Recovery (MBCR)
References
14: Physical Touch and Healing Touch
14.1 Introduction
14.2 Objectives
14.3 Physical Touch
Definitions
Physical Touch
Affective Touch
The intention of affective touch is to convey caring and an emotional connection with the patient [9, 10]. It refers to a gentle, tactile pleasant touch containing an emotional component within a “cognitive-relational” human context [11–13]. Aff
Tactile Touch or Effleurage
Procedural Touch
Affectionate Touch
14.4 Contextual Factors
14.5 Attachment and Embodiment Theories (Review [27, 28])
14.6 Buffering and Main Effects
14.7 Neurobiological Processes of Physical Touch
14.8 Experimental Research
Touch and Healthy Volunteers
14.9 Clinical Research Findings
Physical Touch Within the Context of the Nurse-Patient Relationship
Facilitating Affectionate Touch Within a Close Patient-Family Caregiver Relationship
14.10 Nursing Implications
Nursing Take-aways
14.11 Final Comments
14.12 Biofield Modalities: Therapeutic Touch (TT), Healing Touch, and Reiki
Ms X was in the terminal phase of her life, and despite being heavily sedated for pain, she was clearly suffering. Ms X would recoil and cry out each time the nurse gently touched her or tried to reposition her body. Her husband sat helplessly nearby w
The Electromagnetic Field
“Subtle” Energy
14.13 Conceptual Underpinnings
14.14 Research Findings
Symptom Relief
Quality of Life (QOL)
Healthcare Providers and Reiki
Experimental Animal Research
14.15 Clinical Research Caveats
14.16 Final Thoughts
Appendix: Mind-Body (MBSR). Psychosocial Interventions—Multimodal Interventions—Mind-body (MBSR), Energy, and Other CTs
References
Part V: Nursing Approaches
Introduction
15: The Diagnostic Phase
15.1 Introduction
15.2 Objectives
15.3 Definitions: The Diagnostic Prehabilitation Phase
15.4 Emotional Distress (Review Part II Chap. 3; Part IV Chaps. 9 and 10)
Factors Underlying Patient and Caregiver Distress
15.5 Physical Functioning, Fitness, and Activity (Review Part V Chap. 16)
15.6 Neurophysiological Dysregulation (Review Part III Chaps. 6 and 7)
15.7 Clinical Research Findings: Prehabilitation Interventions
Presurgery
Multimodal Interventions
Exercise
Diet/Nutrition
Exercise and Nutrition
Psychosocial Interventions
15.8 Nursing Implications
Nursing Assessment (Review Part IV Chaps. 9–11)
Emotional Distress (Review Part II Chap. 3)
Establishing a Nurse-Patient/Caregiver Relationship (Review Part IV Chap. 8)
Provide Relevant Information
Philosophy of Care
Roles and Functions
Accessing Reliable Health-Related Resources
Information About the Cancer and Treatment (Review Chap. 12)
Cognitive Beliefs and Expectations (Review Part IV Chap. 12)
Enhancing Positive Expectations About Treatment
Counter Negative Treatment Expectations
Strategies to Redress Distorted Beliefs (Review Part IV Chap. 9)
Enhancing Cognitive-Behavioral and Meaning-Making Coping Strategies (Review Part IV Chaps. 9 and 10; Appendix in Chap. 9; Appendix in Chap. 10; Appendix B)
Problem-Focused Coping Strategies [39, 40]
Emotion-Focused Strategies (Part IV Chaps. 9–11; Part V Chaps. 16 and 18; Review Appendix B)
Meaning-Focused Coping Strategies [45] (Review Part IV Chaps. 9 and 10)
Facilitate Deliberate Rumination (See Part IV Chap. 10)
Promote Behavioral Coping Strategies (See Part IV Chap. 13)
Self-Management Interventions (Review Part IV Chap. 9; Appendices A and B)
Strengthening Supportive Relationships (Review Part III Chap. 6; Part IV Chap. 11; Appendix B)
Healthy Lifestyle Behaviors with a Focus on Physical Fitness, Physical Activity, Healthy Diet, and Nutrition (Review Appendix C; Part V Chap. 16)
Physical Exercise (PE) [22]
Diet (Review Part V Chap. 16)
15.9 Managing Consent
References
16: Treatment Phase
16.1 Introduction
16.2 Objectives
16.3 Definition
16.4 Clinical Issues
Lifestyle Health-Related Risks
16.5 Treatment: Chemotherapy and Radiation-Related Therapy and Surgery (Review Part III Chaps. 6 and 7)
Perisurgical Phase Review [1]
Symptoms and Side Effects (Review Part III Chaps. 6 and 7)
Body Image Impairments
16.6 Psychosocial Interventions and Related Research
Perceived Support (Review Chap. 11)
Cognitive-Behavioral Interventions (CB) (Review Chaps. 5 and 9; Appendix in Chap. 9)
MBSR/MBCTs (Review Appendix in Chap. 9; Appendix in Chap. 13)
Self-Management Interventions (SMI) (Review Appendix A)
Progressive Relaxation and Imagery
Massage, Foot Reflexology
Exercise, Weight, and Nutrition (Review Appendix C)
Exercise
Diet and Nutrition
Therapeutic Healing (Review Part IV Chap. 14; Appendix in Chap. 14)
16.7 Family Caregivers
Cognitive-Behavioral Strategies CBT (Appendix in Chap. 9)
Mindfulness-Based Interventions (MB) (Review Part IV Chap. 13; Appendix in Chap. 9; Appendix in Chap. 13)
16.8 Nursing Approaches
The Nurse–Patient Relationship (Review Part IV Chap. 8)
Promoting Self-Management (Problem-Solving) Capabilities (Review Part IV Chap. 9; Appendices A and B)
Cognitive-Behavioral Coping Approaches (Review Part IV Chaps. 9 and 10; Part IV Chap. 13; Appendix in Chap. 9; Appendix in Chap. 13; Appendix B)
Enhancing the Quality of Supportive Relationships (Review Part IV Chap. 11; Appendix B)
Managing Positive/Negative Expectations of Treatment (Please Review Part IV Chap. 12)
Promoting Immune Functioning (Review Part IV Chaps. 9, 11, 12, and 14)
Unconscious Conditioning During Chemotherapy (See Part IV Chap. 12)
Supporting Diet, Relevant Nutrition, and Physical Activity (Review Part V Chap. 15)
Diet and Nutrition
Physical Activity (Review Part V Chap. 15)
Facilitating Wound Healing in the Perioperative Period (Review Sect. “Body Image Impairments”)
Symptom/Side Effects
Pain (Review Part IV Chaps. 9, 12, 13, and 14; Part V Chap. 18; Appendix A)
Peripheral Neuropathy
Fatigue (Review Appendix C)
Sleep Disturbances (Review Part IV Chaps. 9 and 14; Appendix in Chap. 9; Appendix in Chap. 14)
Body Image Impairments
Lymphedema (LE)
Family Caregivers (Review Part V Chap. 18)
References
17: The Transition to Survivorship
17.1 Introduction
17.2 Objectives
17.3 Definition
17.4 Common Patient Concerns
Feelings of Medical Abandonment (Review Part IV Chaps. 8, and 11)
An Altered Self-Identity
Fear of a Cancer Recurrence (FCR)
Changes in Family Support (Review Part IV Chap. 11)
Enduring Symptoms and Side Effects of Treatment or Cancer (Review Chaps. 6 and 7)
Lifestyle Behaviors (Review Part V Chap. 16)
17.5 Clinical Research: Psychosocial Interventions
Cognitive-Behavioral (CB) Strategies (Review Appendix in Part IV Chap. 9 and Appendix B)
Mind–Body Stress Reduction (MBSR) and Mindfulness-Based Cancer Recovery (MBCR) (Review Appendix in Part IV Chap. 13)
Massage and Foot Reflexology (Review Part V Chap. 20; Review Appendix in Chap. 14)
Self-Management Interventions (SMI) (Review Part V, Chap. 16; Appendix A)
Health-Related Education (Review Appendices A and B)
Health-Promoting Lifestyle Interventions (Review Appendix C)
Nutrition and Diet
Exercise/Physical Activity
17.6 Proposed Nursing Approaches (See Part IV, Chaps. 8–14; Part V Chap. 16)
Maintain a Sense of Connectedness between Nurse and Individual and Family (Part IV, Chap. 8)
Promote Self-Management Capabilities (Review Content in Part IV Chap. 9; Review Appendix A)
Fear of a Cancer Recurrence (Part IV, Chap. 10)
The Quality and Quantity of Informal Support (See Part IV, Chaps. 10 and 11)
Managing Symptoms and Side Effects of Treatment and the Cancer (See Part V, Chap. 16)
Specific Side Effects (Review Part III, Chaps. 6 and 7)
Finding Meaning in the New Normal Life (See Part IV Chap. 10; Part V Chap. 18; Appendix B)
Promoting a Healthy Lifestyle (Review Part V, Chaps. 15 and 16 Sections on Healthy Lifestyle Behaviors, Physical Activity, Diet) (Tables 17.2, 17.3 and 17.4)
References
18: Supportive Care and End of Life
18.1 Introduction
18.2 Objectives
18.3 Definition
18.4 Cessation of Treatment
18.5 Transition to Supportive Care Services
Nature of Transition and Lack of Information
Timing
18.6 Patient Concerns, Distress, and Symptom Burden
Emotional Distress and Existential Suffering (Review Part IV Chap. 10)
Symptom Burden
18.7 Family Caregiver Concerns
18.8 Clinical Benefits of Early Integrated Oncology-Supportive Care Services
18.9 RCTs: Psychosocial Interventions
Patient-Focused Studies (Appendix A)
Focus on Patient and Caregiver Dyads
Focus on the Family Caregiver
18.10 Nursing Approaches (Review Part IV Chaps. 8–14; Also, Part III, Chaps. 6 and 7; Appendix in Chaps. 9, 10, 11, 13, and 14, Appendices A–C)
Quality of the Nurse–Patient/Family Relationship (Review Part IV Chap. 8; Appendix B)
Cognitive-Behavioral Emotion-Regulating Coping Strategies (Review Part IV Chaps. 9 and 10; Appendix B)
More Cognitive Strategies (Review Part IV, Chaps. 8, 9, and 10)
Strengthening Supportive Relationships (Review Part IV Chap. 11)
Symptom Management (Review Part V Chap. 16; Part IV Chaps. 9, 12, 13 and 14; Part III Chaps. 6 and 7)
Pain (e.g., Cognitive-Behavioral Strategies, Mindful Meditation, Relaxation Response Technique, Leveraging Cognitive Expectations, and Acupuncture)
Pain Assessment
Nursing Goals
Nursing Approaches
Dyspnea Review [148] Mindfulness Techniques, Music Therapy, Breathing Retraining, Relaxation, Acupressure, and Acupuncture
Nursing Assessment
Nursing Goals
Nursing Approaches
Other Nonpharmacological Interventions for Symptom Management (also Review Chaps. 9, 12, and 14)
Health Education (Review Part V Chap. 16; Appendix C)
Self-Management Interventions (Review Part IV Chap. 9; Appendices A and B)
18.11 Unique Needs of Caregivers [22, 57] (Review Part IV; Appendix A)
Bereavement
References
19: Is It Feasible
19.1 Introduction
19.2 Nursing Objectives
19.3 Definitions
19.4 Barriers to Evidence-Based Nursing Practice
Peer-Reviewed Research Versus Clinical Nursing Journals
A Paucity of Patient-Centered Conceptual Practice Models
Definitions of Evidence-Based Practice
Work-Related Stress
The Quality of the Nurse–Patient Relationship
A Lack of Scientific Knowledge and Psychosocial Skills Among Clinical Nurses
19.5 Toward Academic Practice
The Nursing Leadership
Implementing the Model
Team Values
Critical Analytic Research Skills
Clinical Skills
The 1- to 10-min Nursing Interventions (Table 19.3)
The 30- to 40-min Nursing Interventions
Regularly Scheduled Nurse-Led Group Workshops (Appendix in Chap. 9; Appendix in Chap. 13; Appendix A)
Staffing, Schedules, and Assignments
Nurse Qualifications
Staff Scheduling
Carve Out Protected Time for Nurses to Engage in Therapeutic Patient/Caregiver
A University-Affiliated Clinical Learning Environment
Nurturing the Nurse’s Wholeness
References
Closing Remarks
Epilogue
Clinical Approaches: Appendices
Appendix A
Psychosocial Interventions, Self-Management (SMI) Approaches
Appendix B
Nursing Strategies (Review chaps. 12, 13 and 14)
Psychosocial Interventions that facilitate Psychological Adjustment to the Cancer or Treatment-Related Threat
Appendix C
Clinical Interventions to Promote Healthy Lifestyle Behaviors
Cancer Survivors
During Treatment
Exercise Before, During, and/or After Treatment
Prehabilitation
Prehabilitation with Neoadjuvant Treatment
During Chemotherapy
Adjuvant Chemotherapy
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