Children derive implicit theories in explaining actions of objects and behaviors of people. Such theories are the foundation for causal learning and much sophisticated understanding of the social and physical worlds. Young children are also keenly responsive in the things they can learn from the words and directions directed to them by other people. Such joint attention capacity is the foundation which allows humans to benefit from culturally transmitted knowledge.
When a child says “thanks” after something is given to him or her, there is an acknowledgement that there is a mutual exchange which is happening; a-give-and-take. As they go through the motions, eventually they come to learn that they should not expect the world on a silver platter. To ensure that children at school treat one another with respect, they should be allowed to get to know one another. Teaching children how to keep an open mind will serve them well throughout their lives; allowing them to discover exciting new friends, unusual activities, and new ways of looking at things. Read online custom writing for more information on this topic.
Chemotherapy Side Effects: Evidence-Based Practice for Reporting Outcomes
Clinical Guideline
Problem Statement
Chemotherapy is a viable treatment choice for many cancer patients. Chemotherapy can have a variety of side effects that range from mild to severe. Dose reductions may be avoided if toxicities are discovered and addressed early, resulting in more effective treatment and disease control or cure. According to Pearce et al. (2017), 84 percent of chemotherapy patients had at least one common side effect, 67 percent of patients had six or more side effects, and 27% of patients had a grade IV, or severe, side effect. Patients encountered more toxicities than professionals recorded throughout clinical studies, according to Di Maio et al. (2015). Patients' symptoms are frequently explored more closely in clinical trials than in ordinary treatment. If doctors fail to notice side effects and toxicities in clinical trial patients, it is alarming to consider how many side effects may be overlooked or under-assessed in patients who are not enrolled in a clinical trial.
EBP Question
Given the importance of early detection of chemotherapy side effects and the disparity between patient-reported and clinician-reported symptoms, optimal strategies for dealing with these difficulties must be found. While it is a clinician's obligation to treat symptoms, they will not have the knowledge they need to prescribe appropriate interventions or alter therapy if those symptoms are not successfully conveyed to or assessed by clinicians. The purpose of this work is to explore the available evidence in order to respond to the following question: What are the most effective techniques for reporting and assessing chemotherapy side effects?
Literature Review
The article by Weaver et al (2014), the researchers detailed their research on utilizing a mobile device to monitor symptoms in patients undergoing oral chemotherapy at home in A pilot study: dosage modification of capecitabine using mobile phone toxicity monitoring- assisting patients in their homes. Chemotherapy oral doses might be adjusted based on side effects experienced while undergoing treatment. The phone featured a pre-installed application that patients could use to answer questions about adverse effects. To participate in the trial, the patients were given phones. With this strategy, a 92.9 percent response rate was obtained. Shears et al. (2016) studied the use of an electronic patient-reported outcomes (ePRO) instrument for lung cancer patients, which they completed in the office on a tablet device prior to consultation.
This study discovered that the ePRO tool was simple to use for both patients and doctors, and that it increased the number and quality of data collected. Basch et al. (2017) conducted research on an ePRO tool that patients utilized in between visits. An email would be sent to an oncology nurse in charge of the patient's treatment when severe or worsening symptoms were recorded. During clinic appointments, a report of symptoms was also prepared for the treating oncologist to evaluate. The findings of this study revealed that patients not only had a higher quality of life, but also had a five-month increase in overall survival compared to the control group.
Research Synthesis
Synthesis of Research A survey of the literature identified numerous critical elements of chemotherapy treatment toxicities. Chemotherapy patients frequently face a variety of side effects, ranging from moderate to severe. When compared to what patients say, clinicians regularly underestimate the toxicities they suffer. Electronic patient-reported outcomes have been proved to be a viable means of making clinicians more aware of patient-reported toxicity. The use of ePROs has been found to improve quality of life and overall survival in chemotherapy patients.
Clinical Guidelines
Patients and clinicians will benefit from the usage of an ePRO tool to discuss toxicities with healthcare workers. This will help patients and doctors manage chemotherapy side effects more quickly (Weaver et al., 2014). Electronic devices such as the iPad and iPhone enable for faster data collection, interpretation, and recording, as well as immediate data capture and tailored self-management recommendations, which could help significant symptoms be handled more effectively and quickly (Weaver et al., 2014).
Implementation Plan
Staff and patients will need to be trained on how to utilize the software application in order to adopt it for electronic patient reporting of outcomes. Patients will require instructions on how to download and navigate the application on their personal electronic device. The oncology nurse in the clinic will provide this help prior to the start of chemotherapy treatment. Clinic staff and clinicians will also need to be trained on how to obtain the information that patients will enter into the app.
When the clinician receives the patient's data, he or she can make judgments about how to control toxicities before they become severe. The patient will be presented with a list of symptoms/toxicities from which they can choose and enter data if they are experiencing those symptoms. Each symptom will be rated as mild, moderate, or severe by the patients. If a patient enters that they are having a serious symptom, the app will advise them to call their provider right away. At home, the nurse has a direct line of communication, and data for symptom levels and clarifications is logged and distributed on a report. This communication allows the nurse to have access to the patient's "logged profile" during treatment and analyze the dose and side effects as needed (Weaver et al., 2014).