Caring for a loved one with a malignant fungating wound

Abstract

Purpose: Caring for a loved one with a malignant fungating wound is very challenging and causes extreme physical and psychological distress. The aim of this study was to explore the experiences of carers who care for a loved one with a fungating breast wound.Method: To explore the lived experiences of carers a methodological framework using Heideggerian hermeneutic phenomenology and semi-structured interviews was used. Seven carers were interviewed from January until November 2009.Results: Having to deal with a situation of a loved one with a visible cancer was hard for all the carers.The visibility of the cancer was one of the most shocking aspects to deal with from the perspective of the patient and the carer. The presence of the visible wound and a cancer at an advanced stage contributed to a change in the relationship and extreme suffering for both the patient and the carer.Despite many problems such as wound odour and copious discharge from the wound, which was difficult to control carers did their best to help their loved one with the wound. Gradually the wound became the centre of the patient and carer's life and a great deal of time was spent trying to control the wound symptoms. All carers managed the wound on their own without help and advice from health care practitioners. For all of them it was a major burden and they felt isolated.Conclusion: This study contributes to an understanding that the care of women and their carers needs strategies that are integrated in palliative wound care, that takes a holistic and empathic approach that responds to patients and carers psychosocial and emotional needs and a practical need for information to help carers assist in managing the wound related symptoms.

Coping with an exulcerated breast carcinoma: an interpretative phenomenological study

“…Patients with MFW who described delaying seeking medical help report a sense of shame and blame by putting the experience of a MFW to the side and ignoring the changes occurring to their breast until their situation became unmanageable 6 . MFWs create an immense challenge and burden for patients and their carers 7 . One of the worst aspects is the shame and embarrassment resulting from the unpleasant odour from the wound.…”

Subconjunto terminológico CIPE® para pacientes em cuidados paliativos com feridas tumorais malignas

“…The time spent trying to manage the signs and symptoms, the constant and visible reminder of the progression of cancer and terminal illness, exhibited by the wound, bring important repercussions on various aspects of their lives (physical, psychological, social, spiritual and economic). (4,5,13) Stigma, anger, anguish and shame are aspects mentioned by authors that permeate the experience of having a malignant tumor wound, resulting in an impact on mental and emotional well-being, and loss of patient dignity, (3,13,14) which indicate the need of further reflection on these aspects by nurses involved in the care of these patients.…”

“…(2)(3)(4)(5)(13)(14)(15) It is a challenge for nurses to use appropriate interventions for the management of a malignant tumor wound, providing functional dressings, with comfort and relief to the patient. (2)(3)(4)(5)(13)(14)(15) Knowing the treatment options increases the safety of the nurse at the time of evaluation and development of the care plan. The evolution of these wounds is very fast, which implies constant assessment and possible changes for every dressing.…”

“…The evolution of these wounds is very fast, which implies constant assessment and possible changes for every dressing. (2)(3)(4)(5)(13)(14)(15) Using the subset constructed by means of study, the nurse may have a tool for clinical decision making and managing care decisions, which enables better organization of work and greater effectiveness in nursing actions.…”

Intervenções de enfermagem para pacientes oncológicos com odor fétido em ferida tumoral

“…Estudos indicam que cuidadores estão despreparados para a tarefa de cuidar deste tipo de ferida, muitas vezes em pessoas queridas ou membros da família (56)(57)(58). O baixo nível de informação e a ausência de ajuda profissional podem levar alguns pacientes a usarem estratégias que podem exacerbar os sinais e os sintomas (20,41).…”