Simulations are of particular advantage in research studies where large samples are necessary to achieve statistical power and the information must be collected under uniform conditions in order to aid interpretation. In the study reported below, simulation was achieved through the use of medical photography accompanied by case studies of the same patients. All information was collected on the same day. The purpose of the study was to determine the validity of the three pressure ulcer risk assessment scales most commonly used in clinical nursing practice in the UK. Each clinical nurse assessed the same four patients using three risk assessment scales and a visual analogue scale designed to capture their own clinical judgement. External validity was assessed by a panel of tissue viability experts who provided independent ratings. Data were obtained from 236 clinical nurses, yielding 941 risk assessments. Experience with this approach to data collection suggests that it requires careful planning. This should include measures to ensure that the simulated information is valid and that all data collectors have been adequately trained and are able to motivate the nurses participating in the study. Providing consideration is given to these issues, the use of simulation can help to collect data that would be difficult to obtain by more conventional means. It is also important to recognize that clinical decisions are de-contextualized in simulations because they are reduced to verbal and visual summaries. The decision to use simulations should thus be taken only if this is acknowledged.
Prostate cancer is a uniquely problematic male health issue. Findings from a study employing an ethnographic approach are presented to describe the ways in which 14 men's lives were changed as a result of this experience. The theoretical basis of the study centered on embodiment to explore the personal impact of prostate cancer, its treatment, and its side effects. The findings suggest that cancer was experienced sequentially, beginning at the time of diagnosis with the problematizing of the normally "silent" male body. This trajectory of experience progressed to emphasize the importance placed on treatment side effects, embodied vulnerability, and the impact of the cancer on men's "embodied" lives. In this article, I focus on the final phase of the illness experience and illustrate how the men confronted existential threat alongside physical changes, and the way each change resulted in a new outlook on life and its priorities following cancer.
Uncertainty influences patients' experiences of their cancer and their coping. Whilst it might be impossible to avoid uncertainty entirely, its negative effects might be ameliorated by understanding patients' specific needs along the disease trajectory of breast, prostate, and colorectal cancer.
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