Management of a fungating breast wound

Shutler, S.D.; Jones, Matthew; Thomas, Stephen B.

doi:10.12968/jowc.1997.6.5.213

Cited by 7 publications

(3 citation statements)

References 3 publications

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“…Six research-based articles on malignant fungating wounds were found (Grocott, 1997, Thomas et al 1998, Haisfield-Wolfe & Baxendale-Cox 1999, Grocott 2000, Grocott & Cowley 2001, and showed that most guidelines on malignant fungating wounds were developed through experience rather than based on clinical intervention research. Ten were case studies that documented individual trials (Shutler et al 1997, Jones 1998, Price 2000. The identified articles describe, primarily, the physiological consequences of living with a cancer-related wound, including wound related pain (Hallet 1995), exudation (Grocott 2000), infection (Morison et al 1997), bleeding (Haisfield-Wolfe & Rund 1997) and malodour (Haughton & Young 1995, Price 1996, Mallett et al 1999).…”

Section: Introductionmentioning

confidence: 99%

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Malignant wounds in women with breast cancer: feminine and sexual perspectives

Lund-Nielsen¹,

Müller²,

Adamsen³

2005

Journal of Clinical Nursing

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Section: Introductionmentioning

confidence: 99%

“…1998, Haisfield‐Wolfe & Baxendale‐Cox 1999, Grocott 2000, Grocott & Cowley 2001), and showed that most guidelines on malignant fungating wounds were developed through experience rather than based on clinical intervention research. Ten were case studies that documented individual trials (Shutler et al. 1997, Jones 1998, Price 2000).…”

Section: Introductionmentioning

confidence: 99%

Malignant wounds in women with breast cancer: feminine and sexual perspectives

Lund-Nielsen¹,

Müller²,

Adamsen³

2005

Journal of Clinical Nursing

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“…However, this approach had not been evaluated formally. Thirdly, although the role of wound dressings was emphasized, published case histories demonstrated a mismatch between the design of wound dressings and the size, severity and location of the wounds, and identified a need to explore novel approaches to dressing the wounds (Neal, 1991;Saunders, 1997;Shutler et al, 1997;Sweeney et al, 1998). The research questions and study aims developed logically from these three issues.…”

Section: Purpose and Backgroundmentioning

confidence: 99%

Solving Methodological Challenges Using a Theory-driven Evaluation in the Study of Complex Patient Care

Grocott¹,

Cowley²,

Richardson³

2002

Evaluation

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This article draws on two research designs, which were used in a study of the palliative management of malignant wounds, to demonstrate the inherent challenges in producing generalizable knowledge from a complex subject. The designs included quasi-experimentation and a form of theory- driven evaluation. The focus of the study was the performance of dressings to reduce the impact of the wounds on daily life. The convention for evaluating the outcomes of interventions is a controlled study design. This approach is considered the valid way of producing evidence that is generalizable. An experimental design was therefore adopted to conduct a series of n = 1 quasi-experiments on wound dressing performance with qualitative methods to explore individual experiences. Problems with the methods, in particular the failure to capture complex inter-relationships between clinical problems and patient experiences, forced the researcher to abandon the experimental design. An alternative approach to measurement was adopted to maintain the study focus, the TELER® system of treatment evaluation, which includes indicators of patient-centred outcomes of care. The philosophical position of the study was reviewed. Consensus emerged as an unalterable, major in uence on the design and paradigmatic assumptions of the study. A `system of reasoning' was adopted to overcome the inherent relativist position of knowledge derived from this approach. The system abstracts general issues from case study data to construct theoretical explanations that may be consistent with, or challenge, current knowledge. This article is based on the evolution of one particular study. However, it makes a more general contribution to evaluation research by explaining the rationale for a form of theory-driven evaluation that uses evidence, reason and theory to develop generalizable explanations from complex, individual case study data. The methodology is proposed for other complex situations where speci c and rigorous evidence, capable of generalization is needed.

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