Cancer Ward Research Articles

Comparison of Recurrence and Survival Between Patients With Pathological Stage I Epithelial Ovarian Cancer After Laparoscopic or Laparotomic Surgery: Retrospective Analysis of a Propensity-Matched Cohort

ObjectiveTo compare oncologic outcomes after laparoscopic or laparotomic surgery to treat epithelial ovarian carcinoma in FIGO Stage I. DesignRetrospective cohort study. SettingGynecological cancer ward in a tertiary hospital. ParticipantsA total of 85 patients with FIGO Stage I epithelial ovarian carcinoma who underwent laparoscopic staging surgery and 206 who underwent laparotomic staging surgery at West China Second Hospital, Sichuan University (Chengdu, China) between January 1, 2013 and December 31, 2019. InterventionsLaparoscopic surgery or laparotomic staging surgery. ResultsBefore propensity score-based matching, the laparotomy group showed higher prevalence of preoperative elevated CA125 level (48.5% vs 35.3%, p = .045) and tumors >15 cm (27.2% vs 5.9%, p <.001). Multivariate analysis associated higher body mass index with better overall survival (adjusted HR 0.83, 95% CI 0.70–0.99, p = .043). Among propensity score-matched patients (82 per group) who were matched to each other according to propensity scoring based on age, body mass index, CA125 level, largest tumor diameter, FIGO stage, history of abdominal surgery, and American Society of Anesthesiologists grade, the rate of progression-free survival at 5 years was similar between the laparoscopy group (87.1%, 95% CI 79.3–95.7%) and the laparotomy group (90.9%, 95% CI 84.7–97.6%, p = .524), as was the rate of overall survival at 5 years (93.9%, 95% CI 88.0–100.0% vs 94.7%, 95% CI 89.8–99.9%, p = .900). Regardless of whether patients were matched, the two groups showed similar rates of recurrence of 9–11% during follow-up lasting a median of 54.9 months. ConclusionsRates of recurrence and survival may be similar between laparoscopy or laparotomy to treat Stage I epithelial ovarian cancer. Since laparoscopy is associated with less bleeding and faster recovery, it may be a safe, effective alternative to laparotomy for appropriate patients.

Comparison of Ischemic Compression Combined With Muscle Energy Technique Versus Ischemic Compression Alone on Myofascial Trigger Points of Upper Trapezius in Breast Cancer Survivors

Background: A hyperirritable region, typically located within a taut band of skeletal muscle, is known as a myofascial trigger point. It can cause discomfort upon compression, as well as the typical referred pain, motor dysfunction, and autonomic abnormalities. TrPs may be associated with breast cancer. Symptoms of upper body dysfunction and pain are typical among breast cancer survivors. Noninvasive techniques including massage, spray and stretch, physical therapy, and transcutaneous electrical stimulation can all help reduce trigger points. Ischemic compression and Muscle energy technique (MET) is an intriguing non-invasive treatment that has showed more effect on myofascial trigger points Objectives: Aims and objective of this study was to compare the effect of ischemic compression combined with muscle energy technique and ischemic compression alone on myofascial trigger points in breast cancer survivors. To see improvement in range of cervical flexion, cervical extension and cervical lateral flexion. Method: This was Quasi-experimental study in which convenient sampling was done from breast cancer patient from breast cancer ward of PINUM and Allied hospital Faisalabad for 6 months after meeting inclusion and exclusion criteria. 20 individuals with Myofascial Trigger points were assigned into two groups: Group 1 and Group 2. Group 1 received ischemic compression combined with Muscle Energy Technique for 3 weeks and Group 2 received ischemic compression alone for 3 weeks. Evaluation of pain, range of cervical flexion, cervical extension and cervical lateral flexion was done by Numeric Pain Rating Scale, Goniometer and Neck Pain Disability Index respectively. Results: wilcoxon and Mann whitney tests were applied and results showed p value &lt;0.01. Conclusion: According to data analysis and after applying Mann-whitney test we found that ischemic compression combined with muscle energy technique has more effect on myofascial trigger points in improving pain and range of motion than ischemic compression alone. Keywords: Breast cancer, Goniometer, Ischemic compression, Myofascial Trigger Points, ,Muscle Energy Technique, ROM

Spatial experience of cancer inpatients in the oncology wards: A qualitative study in visual design aspects

PurposeThis paper aims to explore how the visual characteristics of cancer wards' interior spaces can be improved based on the combined visual design themes to help cancer inpatients’ spatial experience and relieved state of mind. Accordingly, we present a visual design framework that can be applied in oncology wards. MethodThis study adopts the Ulrich-supportive design theory as a theoretical framework using two main methodological phases: observation of cancer wards and interviews with professional caregivers. The first phase critically explores hospital cancer wards' interactive aesthetical and visual interior characteristics. Next, we adjusted the visual criteria based on the Post Occupation Evaluation (POE) method to develop the interview questions. Interviews were conducted with experienced nurses, oncologists, and a general physician, all from a cancer ward at McGill University Health Center (MUHC) in Montreal, Canada. ResultsWe presented 11 main themes in the categories of color and light, natural/artistic images, way-finding, and visual clutter. To present and justify our visual design framework, these main themes were then classified based on the common goals, resulting in four combined themes: applying simplicity and usability; developing naturality; creating homeyness and respecting patients’ agency; and promoting trustworthiness. ConclusionOur findings suggest that—apart from the last theme, promoting trustworthiness, the rest are in line with Ulrich's supportive design theory. Therefore, further research is needed to investigate “promoting trustworthiness” in the context of cancer wards. In addition, each aspect of the visual design framework can offer practical design recommendations for future studies.

Lidocaine Needling in Myofascial Pain Syndrome for Palliative Oncologic Care: A Randomized Clinical Study.

Background: Physical pain is highly prevalent and impacts the well-being of patients with advanced oncologic disease. Although myofascial pain syndrome (MPS) can be one of the components of pain in cancer patients on palliative care (PC), so far there is no evidence about the benefit of treatment with 1% lidocaine needling. Objectives: To evaluate the efficacy of MPS treatment with injection of 1% lidocaine on the reduction of pain in cancer patients on PC. Design: Single-blind randomized clinical trial. Subjects: Patients aged 50 years or older with end-stage cancer, admitted to a cancer ward or monitored during radiotherapy in three Brazilian hospitals, with a diagnosis of MPS with a pain intensity of five or more according to the Visual Analog Scale (VAS). The patients were divided into two groups: trigger point (TP) injection with 1% lidocaine and control. Measurements: Pain intensity was assessed with the VAS, pain threshold with an algometer, and the medications being used were determined before and 72 hours after the intervention. Results: Thirty patients (15 per group) were assessed. After 72 hours, there was a reduction in referred pain intensity (p < 0.001) and an increase in pressure threshold (p = 0.007) in the intervention group (IG), with no difference in the control. The frequency of individuals who reduced the doses and/or classes of pain medications was higher in the IG (p = 0.011). Conclusion: One percent lidocaine needling in TPs was an effective therapy for pain reduction in MPS.

Adjuvant Hormonal Therapy and Emotional Freedom Techniques to Improve the Quality of Life of Patients with Breast Cancer: A Review of the Literature

Health-related quality of life (QOL) has been a major concern for both breast cancer survivors and patients seeking treatment. Studies were done to address this issue; however, not much is known about the benefits of the Adjuvant Hormonal Therapy-Emotional Freedom Technique (AH-EFT). The study's objective is to evaluate the therapy's efficacy in breast cancer patients. The Adjuvant Hormonal Treatment-Emotional Freedom Method was examined in the current study using a review of the literature (AH-EFT). The finding indicates that integrating this therapy with conventional treatment improves the patient's quality of life during these times. Nurses working in the cancer ward are advised to use this therapy for clinical improvement. Future studies are required to evaluate the intervention with different populations and dosages or durations.

Protein intake in cancer: Does it improve nutritional status and/or modify tumour response to chemotherapy?

Combating malnutrition and cachexia is a core challenge in oncology. To limit muscle mass loss, the use of proteins in cancer is encouraged by experts in the field, but it is still debated due to their antagonist effects. Indeed, a high protein intake could preserve lean body mass but may promote tumour growth, whereas a low-protein diet could reduce tumour size but without addressing cachexia. Here we used a realistic rodent model of cancer and chemotherapy to evaluate the influence of different protein intakes on cachexia, tumour response to chemotherapy and immune system response. The goal is to gain a closer understanding of the effect of protein intake in cancer patients undergoing chemotherapy. Female Fischer 344 rats were divided into six groups: five groups (n=14 per group) with cancer (Ward colon tumour) and chemotherapy were fed with isocaloric diets with 8%, 12%, 16%, 24% or 32% of caloric intake from protein and one healthy control group (n=8) fed a 16% protein diet, considered as a standard diet. Chemotherapy included two cycles, 1week apart, each consisting of an injection of CPT-11 (50mg/kg) followed by 5-fluorouracil (50mg/kg) the day after. Food intake, body weight, and tumour size were measured daily. On day 9, the rats were euthanized and organs were weighed. Body composition was determined and protein content and protein synthesis (SUnSET method) were measured in the muscle, liver, intestine, and tumour. Immune function was explored by flow cytometry. Cancer and chemotherapy led to a decrease in body weight characterized by a decrease of both fat mass (-56±3%, P<0.05) and fat-free mass (-8±1%, P<0.05). Surprisingly, there was no effect of protein diet on body composition, muscle or tumour parameters (weight, protein content, or protein synthesis) but a high cumulative protein intake was positively associated with a high relative body weight and high fat-free mass. The immune system was impacted by cancer and chemotherapy but not by the different amount of protein intake. Using a realistic model of cancer and chemotherapy, we demonstrated for the first time that protein intake did not positively or negatively modulate tumour growth. Moreover, our results suggested that a high cumulative protein intake was able to improve moderately nutritional status in chemotherapy treated cancer rodents. Although this work cannot be evaluated clinically for ethical reasons, it nevertheless brings an essential contribution to nutrition management for cancer patients.

Evaluation of Antibiotic Resistance in Pediatric Patients Suffering from Cancer

Introduction: The discovery of antibiotics has revolutionized the field of healthcare since many lethal infections which were previously impossible to treat are now have become much curable. However, a high reliance of the clinicians on antibiotics have led to their irrational use which has given rise to a serious problem in the form of Antimicrobial Resistance (AMR) a phenomenon where the microbes develop the capacity to neutralize the antimicrobial capacity of the antibiotics. In cancer patient AMR is not so frequent as compared to other patients who suffer from infectious diseases but still if cancer patients during their chemotherapy encounter the issue of AMR their cancer treatment becomes highly challenging. Objective: To evaluate the prevalence of AMR in the cancer affected pediatric patients being treated with antibiotics. Materials and Methods: In this cross-sectional study 300 pediatric patients who received prescriptions with at least one antibiotic suffering from cancer and were treated with at least one antibiotic were included. The data was collected with the consent of their guardians from the cancer ward of The Children’s hospital and The Institute of Child Health, Lahore, Pakistan by utilizing non-probability sampling technique (convenient sampling) for the period of 6-months. Results: The study findings depicted that the children aged between 4 to 7 years got affected by various cancers and lymphoblastic leukemia (47%) was the most frequently occurring cancer. Urine, blood and mucosal swabs were used for sampling but majority of the samples were the blood (29%) samples that were used to detect the occurrence of AMR. It was observed that the study population was more susceptible to gram-negative bacteria than gram-positive bacteria. The incidence of AMR was higher in gram-negative bacteria than that of gram-positive bacteria. Among the collected samples the bacteria showed sensitivity for ciprofloxacin (23%), amikacin (21%), piperacillin (24%) and ceftazidime (23%). Considering the resistance patterns among the tested antibiotics that were prescribed to the cancer patients various penicillin antibiotics and ceftazidime showed a higher incidence of the AMR. Conclusion: The AMR is a serious problem that is encountered during the treatment of infections in the pediatric patients affected by cancer thus, the appropriate selection of antibiotics by the clinicians is a matter of serious concern so as to prevent AMR and to obtain maximum therapeutic outcomes of the chemotherapy.

GOD AND GOD’S WORLD IN A. I. SOLZHENITSYN’S SHORT NOVEL (POVEST’) “CANCER WARD”

The research is devoted to revealing the features of understanding of God and God’s world in A. I. Solzhenitsyn’s “Cancer Ward.” The heroes of the short novel travel a difficult path on which they have to think about God. At the beginning of the short novel there is a parable illustrating a legalistic understanding of God as Allah who punishes man, and at the end of the work the image of the Lamb, that is, Christ going to his death, appears, which means that the protagonist rises to the realization of Grace. A. I. Solzhenitsyn demonstrates how, having consciously separated himself from God, a person turns into an animal. The zoo visited at the end of the story by Kostoglotov is a model of the animal world that shows how people can turn into animals. An important place in the short novel is occupied by the parable about God endowing a person with extra years of life, taking them from a horse, a dog and a monkey. Images-symbols of these three animals are of great importance for understanding the characters of the key heroes of the story: Kostoglotov and Rusanov (dog), Vadim, Efrem, Roan, Doctor Dontsova and Asya (horse), Zoey (monkey). Turning away from God, man renounces his immortal soul and becomes similar to an animal immersed in incessant movement and leading a biological existence. He becomes a hostage to the cyclical model of time, which is steadily moving towards death. The symbol of this movement is a squirrel in a wheel, which Kostoglotov sees in the zoo. However, the short novel also sets a different trajectory of time: from the meat-eater through Maslenitsa and Lent to Easter, that is, to the Resurrection that awaits the immortal human soul. Aunt Stepha, cancer ward patient who believes in God, talks about this model of time. Images of plants also play an important role, serving as a reminder to a person about the happiness and harmony of God’s world. The short novel of A. I. Solzhenitsyn calls for understanding God as a merciful, Grace-giving Creator and calls for acceptance of God’s world.

암 병동 간호사의 간호업무성과에 미치는 영향요인

This study is a descriptive research study to understand the relationship between professional autonomy, moral distress, and nursing performance of nurses working in cancer wards, and to identify factors affecting nursing performance of nurses in cancer wards. The subjects of the study were conveniently extracted from 180 nurses with more than 6 months of experience in nursing cancer patients receiving chemotherapy treatment at a university hospital in Gyeonggi-do. The data collection period was from July 11, 2022 to July 29, 2022, when the clinical research review committee of the medical institution where the study was conducted, and a self-fill survey was conducted by distributing structured questionnaires. The collected data were analyzed using the SPSS window 21.0 statistical program. The reliability of the measurement tool was analyzed using Cronbach's alpha. The general characteristics of the subject, the subject's professional autonomy, moral distress, and nursing performance were analyzed by technical statistics. Professional autonomy, moral distress, and nursing performance according to the general characteristics of the subject were analyzed by t-test and ANOVA, and post-test was analyzed by Scheffé test. The factors influencing professional autonomy and moral distress on nursing performance were analyzed using regression analysis. As a result of the study, the subject's professional autonomy was 2.65 points out of 5, moral distress was 2.83 points, and nursing performance was 3.75 points. As a result of analyzing professional autonomy, moral distress, and nursing performance according to general characteristics such as gender, marital status, religious status, position, and total clinical experience, there was no statistically significant difference in professional autonomy. Nurses over the 3rd year were found to have higher moral distress than nurses under 1~3 years, and nursing performance was higher when married, responsible nurse or more, and when total clinical experience was more than 5 years. As a result of verifying the regression model to confirm the factors affecting the subject's nursing performance, it was statistically significant, and the total explanatory power was 23.8%. Clinical experience and professional autonomy were significant influencing factors on nursing performance. Based on the results of this study, a strategy is needed to develop and support individual nurses' nursing capabilities through the development of a career development system within the nursing organization to improve the nursing performance of cancer ward nurses. These efforts will have a positive effect on the management of human resources of nursing organizations as well as on the improvement of nursing performance of nurses in cancer wards.

Cancer-Oriented Comprehensive Nursing Services in Republic of Korea: Lessons from an Oncologist’s Perspective

Background and objectives: As is well known, cancer patients require extensive medical attention as they undergo surgery, chemotherapy, radiotherapy, and supportive care. The importance of high-quality cancer-directed nursing, combined with precision medicine, to maximize their survival outcomes and help them achieve a better quality of life cannot be overemphasized. In this context, we offered a new cancer-oriented comprehensive nursing system to our inpatients and reviewed its clinical outcomes in comparison with those from the preexisting general cancer ward. Materials and Methods: From March 2019 to February 2020, a total of 102 cancer patients and 42 nurses were enrolled in this pilot study. We aimed to analyze their performance in three main categories: structure, process, and patient/nurse outcomes. Results: First, structural (nurse staffing and environment) upgrades were installed in the cancer-oriented comprehensive nursing ward, including an improved nurse-patient ratio (1:8 in the comprehensive ward as compared with 1:14 in the general ward), wider space between beds (1.5 m versus 1.0 m), fully automatic beds with fall prevention sensors, etc. Second, the nursing process was improved (missed care 0.1 event/month vs. 1.3 event/month). Third, both patient and nurse outcomes showed preferable results in the comprehensive ward. The patient satisfaction level was higher in the comprehensive nursing ward than in the general ward (willing to revisit: 91.7% and 78.4%, respectively; willing to recommend to others: 95.0% and 76.8%, respectively). Pressure ulcers, as a patient safety indicator, were also decreased (0.3 events/month vs. 0.8 events/month). However, the fall incidence was similar in both groups (1.6 events/month vs. 1.5 events/month). In terms of nurse outcomes, turnover intention was stabilized and nurses' job satisfaction in the comprehensive ward was superior to that of their counterparts. Conclusions: Our study was a pilot study to demonstrate that cancer patient-oriented comprehensive nursing services can be helpful in improving the quality of cancer treatment and nurses' job satisfaction. Continued interest in and efforts to improve nursing care delivery are also crucial in achieving and maintaining the best possible cancer patient care.

Case Report on Malignant Peripheral Nerve Sheath Tumor

Malignant peripheral nerve sheath tumours (MPNST) are an uncommon type of cancer that spreads from the brain stem into the body and affects the covering of the nerves. Anywhere in the body can develop MPNST, but the deep tissues of the arms, legs, and trunk are where they most frequently occur. They result in discomfort and lethargy, mostly in the affected region, and it may develop a bulge or tumour. A 22-year-old woman presented in cancer ward with the complaints of right lower limb pain with the pain score of 4/10, the intensity of pain aggravates while sitting or performing activity and relieves while at rest, also felt heaviness since 7 months. A vast blood investigation was carried out. MRI and Biopsy were done to make her diagnosis. After following investigations, she was diagnosed as a “malignant peripheral nerve sheath tumours”. Initially she was started on I.V. fluids, analgesics and injectables on the day of admission. Retroperitoneal mass excision was performed under general anaesthesia. Patient’s prognosis remains good.

Factors Affecting Nurses' Performance of Cancer Pain Management in a Tertiary Hospital.

More than 60% of patients with advanced cancer experience pain, and uncontrolled pain reduces the quality of life. Nurses are the closest healthcare providers to the patient and are suitable for managing cancer pain using pharmacological and non-pharmacological interventions. This study aimed to identify factors affecting the performance of cancer pain management among nurses. This study was conducted among 155 participating nurses working at a tertiary hospital who had experience with cancer pain management. Data collection was performed between October 18, 2021 and October 25, 2021. Data analysis was conducted using descriptive statistics, the independent-sample t-test, one-way analysis of variance, and hierarchical regression analysis. There were 110 subjects (71.0%) who had no experience of cancer pain management education. The results of regression analysis indicated that barriers included medical staff, patients, and the hospital system for cancer pain management (β=0.28, P<0.001). The performance of cancer pain management was also affected by experience of cancer pain management training (β=0.22, P=0.007), and cancer pain management knowledge (β=0.21, P=0.006). The explanatory power of the variable was 16.6%. It is crucial to assess system-related obstacles, as well as patients and medical staff, in order to improve nurses' cancer pain management performance. A systematic approach incorporating multidisciplinary interventions from interprofessional teams is required for effective pain management. Furthermore, pain management education is required both for cancer ward nurses and nurses in other wards.

Reading Chekhov on the Cancer Ward.

Studies have shown that nonmedical reading is associated with low burnout and that small group study sections can promote wellness. Burnout and other psychosocial distress are common among health care professionals, necessitating additional measures to promote well-being. The field of narrative medicine is one proposed solution. We added small narrative medicine group discussions of nonmedical fiction to our hematology oncology clinical program to promote physician resilience and decrease risk for burnout. We explored how reading and reflecting would result in profound changes in thinking and feeling and noted 7 different ways by which reading and reflecting together can increase well-being. We describe how stories led us to increase bonding, improve empathy, and promote meaning in medicine. Our small group discussions showed that the intervention was feasible, improved empathy and fulfillment at work, and resulted in greater appreciation for the human dimensions of health care.

Pediatric cancer and the environment: a fifty-year perspective

In 1970, when I was the final months of my pediatric residency at Boston Children’s Hospital, I spent four weeks on the children’s cancer ward. This was a service staffed by some of the most dedicated physicians and nurses in that storied institution, and the care they provided the children was superb. However, the ward … Continued

Development and Feasibility of an Inpatient Cancer-Related Sarcopenia Pathway at a Major Cancer Centre.

Cancer-related sarcopenia is a complex condition; however, no cancer-specific clinical model is available to guide clinical practice. This study aims to (1) develop an evidence-based care pathway for the management of cancer-related sarcopenia (“sarc-pathway”) and (2) pilot test the feasibility (reach, intervention fidelity, patient and clinician acceptability) of the sarc-pathway in an inpatient cancer ward. The sarc-pathway was developed using a care pathway format and informed by the current literature. Patients admitted to a 32-bed inpatient cancer ward were recruited to receive sarc-pathway care and the feasibility outcomes were assessed. Of the 317 participants admitted, 159 were recruited over 3.5-months (median age 61 years; 56.0% males). Participant consent was high (99.4% of those approached) and 30.2% were at risk of/had sarcopenia. The sarc-pathway screening, assessment and treatment components were delivered as intended; however, low completion of clinical assessment measures were observed for muscle mass (bioimpedance spectroscopy, 20.5%) and muscle function (5-times chair stand test, 50.0%). The sarc-pathway was demonstrated to be acceptable to patients and multidisciplinary clinicians. In an inpatient cancer ward, the sarc-pathway is a feasible and acceptable clinical model and method to deliver and adhere to the sarcopenia clinical parameters specified, albeit with further exploration of appropriate clinical assessment measures.

“THE NAKED PERSON” AND “THE UNBEARABLE WORLD”: VARIATIONS OF EXODUS (BASED ON EARLY PROSE BY A. I. SOLZHENITSYN)

This paper analyses the motif of “the naked person” in Alexander Solzhenitsyn’s early work. Epic tales which belong to the so called “labour camp prose”, such as One Day in the Life of Ivan Denisovich (1959) and The Cancer Ward (1968), stand out in the context of this motif. Moreover, the “unbearable world” and the “naked person” have been structurally significant for the “labour camp prose” since Fyodor Dostoevsky and Anton Chekhov. All of them imply that these elements bring the reader closer to understanding the ontology of a person who is forbidden to wear a cross on his chest and thus seek protection from God and cultural myths. The paper examines historical developments of the “naked person” imagery in Russian literature from the seventeenth century to the Avant-garde and postmodernism by analysing relations between reality and the “unbearable world” (the space of labour camps) in which nakedness and misery are deemed to be charisma, gifts from God. The Cancer Ward is still one of Solzhenitsyn’s most widely read works in Europe and America. Unlike the peasants in the story, Kostoglotov, an intellectual, reflects on the value of freedom, prospects of choice and the nature of evil – something which Ivan Denisovich touches upon only vaguely. The author is interested in mechanisms of self-identity in horrendous living conditions. Solzhenitsyn’s The Cancer Ward is a variation of the classic “non-finito” narrative. The protagonist, who has endured hardship and overcome limits of the “unbearable world”, moves towards the house-ark as his life is just beginning. In fact, by employing terrible history, a labour camp and the hospital ward of the doomed, Solzhenitsyn’s text explores the driving forces behind a person’s self-identity, the most important of which are moral elevation, will, mercy and belief in life.

The Linguistic Person of Vadim Zatsyrko from ‘‘Cancer Ward’’ by A. I. Solzhenitsyn

The Linguistic Person of Vadim Zatsyrko from ‘‘Cancer Ward’’ by A. I. Solzhenitsyn

The anthropology of the reader’s experience in the story Cancer Ward by A. I. Solzhenitsyn

This article studies reader’s experience of A. I. Solzhenitsyn a means of characterizing the consciousness and behavior of the characters in the story Cancer Ward. Different researchers have already paid attention to the role of a book, reading, and a person reading verbal and artistic texts in the artistic world (Don Quixote by Cervantes, Eugene Onegin by A. S. Pushkin, Poor Folk by F. M. Dostoevsky, Madame Bovary by G. Flaubert); however, these works were fragmentary. The relevant aspects of 20th century literature, including Solzhenitsyn’s texts, have been studied even less. The author of this article shows that the appeal to the reader’s experience of the characters is an essential facet of the objective world of the story Cancer Ward. The analysis focuses on the question how a book which has been read becomes a part of a character’s existential and cultural experience, evidence of either their insights, discoveries, or delusions, dead ends. The article substantiates the discussion of the book in the depiction of Solzhenitsyn’s characters from the point of view of cultural anthropology, which studies the relationship of a person with cultural tradition and society, and psychological — with its interest in forms of thinking and communication. Experiences in interpreting what Solzhenitsyn’s characters read are important not only for characterizing individual characters, but also for society as a whole. This article emphasizes that the cultural problems of the Soviet era were due to the “archaeological” type of hermeneutics, which alienated a person from the classical tradition, which is enduringly valuable for the self-determination of a person. There are two types of eventfulness in the narrative organization of the text: plot and existential. A special place in the overall picture belongs to a semi-autobiographical character — Oleg Kostoglotov, whose path from death to resurrection includes the experience of reading and comprehending reality through artistic and philosophical texts. The methodological foundation of the work includes the approaches developed by comparative literature, intertext theory, as well as anthropological, historical, and cultural studies.

Mothers’ Lived Experiences in Caring for Adolescents with Leukemia in the Northeast of Thailand

Aim: This research was to explored the lived experiences of the mothers caring for adolescents with leukemia, using a qualitative research method based on the concept of interpretative phenomenology/ hermeneutic phenomenology. Methods: Data were collected by in-depth interviews with 15 mothers of the adolescents with leukemia who had been treated or followed up for treatment in the pediatric cancer ward and the pediatric outpatient department in a tertiary hospital in the northeastern region of Thailand. The qualitative data were analyzed based on the technique of Diekelmann and Allen. Results: The study results revealed the meanings of mothers caring for adolescents with leukemia and experience of leukemia, which can be summarized into the following key points. 1) The meaning of life as mothers of adolescents with leukemia was defined as a suffer life. 2) The lived experiences of mothers of adolescents with leukemia consisted of 3 sub-themes: (1) caring with patience (providing care based on the symptoms, strengthening the mind, need to be the ones who suffer instead of seeing their children suffer), (2) a life of struggle (financial struggles, psychological struggles, supporting received) and (3) beliefs and care (beliefs -based care and beliefs -based parenting). Conclusion: The results of this research led to a clearer understanding about the experiences of mothers of adolescents with leukemia. The data from the study can be used to support practice and management of nursing education and research in the future. Keywords: Mothers’ Lived Experiences, Caring, Adolescents with Leukemia, Phenomenology

Development and use of an innovative Gap Finding Tool to create a Pharmaceutical Care Model within a paediatric oncology setting.

A paediatric cancer ward is a setting where pharmacists participate in direct patient care, acting as coordinators between the patient, caregivers and healthcare professionals. The aim of the study was to develop a Gap Finding Tool to support the setting up of a pharmaceutical care model at a Paediatric-Adolescent Cancer Ward. The Standards of Practice for Clinical Pharmacy Services by the Society of Hospital Pharmacists of Australia Committee of Specialty Practice in Clinical Pharmacy (2013), the American College of Clinical Pharmacy (2014) and the European Association of Hospital Pharmacists (2014) were used to compile the Gap Finding Tool. The developed Tool was tested for content validity by a panel of experts and subsequently implemented over 2 months. The Gap Finding Tool comprised of nine sections with an average of eight statements each about pharmacy services that should be provided at ward level. For each statement, the rater indicates whether these contributions are provided. When the Tool was implemented at the Paediatric-Adolescent Cancer Ward, four major gaps were identified, namely, absence of a clinical pharmacist, lack of medicines information, vetting of chemotherapy prescriptions by pharmacist with limited access to patient data and lack of pharmacist-input on medicines availability. Processes requiring optimisation included discharge medication advice and documentation processes. The developed Gap Finding Tool is an innovative tool which is versatile and can be used in ward or ambulatory clinical settings to identify gaps in pharmaceutical processes and services and compare national or regional practices to international standards.