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      Análisis de la Teoría de los Síntomas Desagradables en el Cuidado de la Enfermería Paliativa Oncológica Translated title: Analysis of the unpleasant symptoms theory in the oncologic palliative nursing care

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          Abstract

          Objetivo: analizar la Teoría de Rango Medio de los Síntomas Desagradables y examinar las directrices del cuidado que plantea la teoría en el campo de la enfermería paliativa, de acuerdo con la evidencia existente. Desarrollo: corresponde a los profesionales de enfermería elegir una teoría que se ajuste al foco de cuidado específico de su área profesional. Para la enfermería constituye un desafío permanente la interpretación de la teoría de enfermería para su aplicación tanto en la práctica como en la investigación. Las teorías de enfermería propias de la disciplina, permiten observar las diferentes situaciones en la salud y guiar los cuidados, generar vínculos más directos con la investigación y la práctica, además otorga una explicación más específica y organizada a la observación del fenómeno de interés de la disciplina, facilitando guiar la práctica y la investigación. La Teoría de Rango Medio de los Síntomas Desagradables es una de ellas, que puede ser aplicada al control de las manifestaciones en los Cuidados de Enfermería Paliativos. Conclusiones: su utilización en la práctica puede orientar la estructuración de guías o protocolos de cuidados propios de enfermería. Esta teoría estimula un pensamiento integrador frente al abordaje y manejo de las manifestaciones. La forma de abordarla es sencilla y fácil de entender. Implicancias: A través de la práctica se pone a prueba la construcción teórica y gracias a ello puede continuar incrementándose y/o aplicándose el conocimiento de la disciplina.

          Translated abstract

          Aims: To analyze the Middle-Range Theory of Unpleasant Symptoms and to examine the care guidelines, that the theorist considers in the field of palliative nursing, according to the existing evidence. Development: it corresponds to nursing professionals to choose a theory that fits the specific care focus of their professional area. The interpretation of nursing theory constitutes a challenge for nursing professionals for its application to both practice and research. Nursing theories, proper of the discipline, allow to observe the different situations and guide health care, create more direct links to research and practice, as well as providing a more specific and organized explication to the observation of the phenomenon of interest in the discipline, providing guided practice and research. The middle-range theory of unpleasant symptoms is one of them, which can be applied to control the demonstrations in the Palliative Nursing Cares. Conclusions: its use in practice can guide the structuring of guidelines or protocols of nursing care. This theory encourages integrative thinking against the approach and handling of the demonstrations. The form to address it is simple and easy to understand. Implications: Through practice tests the theoretical construction may continue to increase and/or apply the knowledge of the discipline.

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          The development of the EORTC QLQ-C15-PAL: a shortened questionnaire for cancer patients in palliative care.

          This study aimed at developing a shortened version of the EORTC QLQ-C30, one of the most widely used health-related quality of life questionnaires in oncology, for palliative care research. The study included interviews with 41 patients and 66 health care professionals in palliative care to determine the appropriateness, relevance and importance of the various domains of the QLQ-C30. Item response theory methods were used to shorten scales. Patients and health care professionals rated pain, physical function, emotional function, fatigue, global health status/quality of life, nausea/vomiting, appetite, dyspnoea, constipation, and sleep as most important. Therefore, these scales/items were retained in the questionnaire. Four scales were shortened without reducing measurement precision. Important dimensions not covered by the questionnaire were identified. The resulting 15-item EORTC QLQ-C15-PAL is a 'core questionnaire' for palliative care. Depending on the research questions, it may be supplemented by additional items, modules or questionnaires.
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            Evaluating the quality of dying and death.

            We propose a model for evaluating the quality of dying and death based on concepts elicited from literature review, qualitative interviews with persons with and without chronic and terminal conditions, and consideration of desirable measurement properties. We define quality of dying and death as the degree to which a person's preferences for dying and the moment of death agree with observations of how the person actually died, as reported by others. Expected level of agreement is modified by circumstances surrounding death that may prevent following patient's prior preferences. Qualitative data analysis yielded six conceptual domains: symptoms and personal care, preparation for death, moment of death, family, treatment preferences, and whole person concerns. These domains encompass 31 aspects that can be rated by patients and others as to their importance prior to death and assessed by significant others or clinicians after death to assess the quality of the dying experience. The proposed model uses personal preferences about the dying experience to inform evaluation of this experience by others after death. This operational definition will guide validation of after-death reports of the quality of dying experience and evaluation of interventions to improve quality of end-of-life care.
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              Cancer pain relief and palliative care

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                Author and article information

                Contributors
                Role: ND
                Role: ND
                Journal
                enf
                Revista Cubana de Enfermería
                Rev Cubana Enfermer
                Editorial Ciencias Médicas (Ciudad de la Habana )
                1561-2961
                June 2011
                : 27
                : 2
                : 141-150
                Affiliations
                [1 ] Universidad de Concepción Chile
                Article
                S0864-03192011000200006
                8f3ce42f-7ba6-444a-b332-7dda8191b31b

                http://creativecommons.org/licenses/by/4.0/

                History
                Product

                SciELO Cuba

                Self URI (journal page): http://scielo.sld.cu/scielo.php?script=sci_serial&pid=0864-0319&lng=en
                Categories
                NURSING

                Nursing
                Nursing theory,nursing,palliative cares,Teoría de enfermería,enfermería,cuidados paliativos
                Nursing
                Nursing theory, nursing, palliative cares, Teoría de enfermería, enfermería, cuidados paliativos

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