Coping with an exulcerated breast carcinoma: an interpretative phenomenological study

Abstract

Objective: Devising therapy strategies for the care of a malignant fungating wound (MFW) caused by cancer presents significant challenges to patients, their informal carers and health care professionals.The aim of this study is to explore how women living at home with a MFW can cope with such wounds. Method:To explore coping through the lived experiences of patients a methodological framework using Heideggerian hermeneutic phenomenology and semi-structured interviews was used. Nine patients were interviewed from January until November 2009. Results:The results are divided into two categories: "Living with a MFW; and "Feeling different. These categories demonstrate how it is to live with the unpredictability, and uncontrollability of a MFW due to symptoms such as malodour, bleeding, exudate, pain and itching. The loss of control of the body boundary due to uncontrollable symptoms led to significant levels of distress and suffering for the patients. Different coping strategies were used to live with this wound. Conclusion:This study demonstrates how difficult it is to live and cope with a malignant fungating wound. Hiding and denying or going into isolation were the used coping strategies. Strategies that are integrated in a palliative, holistic, empathic approach is needed if taking care of a patient with a MFW.

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).…”

Prescrição E Uso De Metronidazol Para Controle Do Odor Em Feridas Neoplásicas

“…As feridas neoplásicas são definidas como uma infiltração do tumor ou a metástase na pele que pode envolver vasos sanguíneos e linfáticos aferentes e são mais comuns em pacientes com câncer de mama, embora também apresente alta incidência em pacientes com câncer de cabeça e pescoço (1,2) .…”

“…A prevalência destas feridas é desconhecida devido à carência de estudos de base populacional. No entanto, estima-se que as feridas neoplásicas acometam 5% dos pacientes em estágio avançado da doença e 10% dos pacientes com metástase, com uma expectativa de vida média de 6 a 12 meses (2,3) .…”

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

“…(5) Despite the lack of accurate statistics on the incidence, the amount of time spent by nurses caring for these patients is recognized, in terms of evaluation and management of the wound, as well as psychosocial support. (3,4,6) The Nursing Care System (NCS) presents itself as a nursing work organization tool, and the International Classification for Nursing Practice (ICNP®) emerges as a unifying framework of language in this area, providing a standardized terminology of care that facilitates the communication of nurses among themselves and with other health professionals responsible for policy decisions, so that the data and resulting information is used for planning and management of nursing care and the development of policies. (7)(8)(9) Based on identified demand with the patients treated in a high complexity care oncology unit (Unacon), (10) the study aimed to answer the question: "What nursing diagnoses and interventions can be attributed to patients in palliative care with malignant tumor wounds, based on scientific evidence?"…”