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By Edward Chow, Joav Merrick

An predicted 166,400 new circumstances of melanoma will take place in Canada in 2008. Bone metastases regrettably stay a typical website of recurrence, with breast and prostate melanoma sufferers representing a considerable share of this inhabitants. Metastatic bone affliction is linked to major morbidity and mortality. discomfort is skilled by way of as much as thirds of sufferers. The diagnosis for sufferers with bone metastases is very inspired by way of tumour sort, functionality prestige, and the presence of extraosseous disorder. The median survival has been considerably longer in breast melanoma sufferers with a primary relapse within the axial skeleton (24 months) as opposed to sufferers with preliminary relapse within the liver (3 months) (2). Survival after prognosis of bone metastases is inspired through the following improvement of extraosseous metastatic websites: 1.6 years as opposed to 2.1 years in sufferers with bone-only ailment.

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Included in the educational intervention was an emphasis on improving communication skills to advocate for needed changes in the analgesic regimen. Our Study To test the effectiveness of the ―Power Over Pain‖ intervention, a longitudinal design was used. After approval was obtained from the appropriate institutional review boards, a sample of fourteen home care agencies were recruited and were randomly assigned to one of the four conditions: 1) nurses, patients, and caregivers received the intervention (NYPY), 2) nurses received the intervention; patients and caregivers did not (NYPN), 3) patients and caregivers received the intervention; nurses did not (NNPY), 4) neither nurses nor patients and caregivers received the intervention (NNPN) (see table 1).

26 April Hazard Vallerand, PhD, RN, FAAN, Susan M Hasenau, PhD, RN, NNP-BC et. al On the visits in weeks 2 and 3, patients were asked to complete the BPI and SDS. During the second visit, following the completion of the questionnaires, the principal investigator presented a 1-hour educational intervention to those patients and caregivers in the intervention group. The content of this POP program was similar to that received by the nurses, but presented at a level appropriate for the layman. Topics included the importance of pain management, misconceptions, analgesics, and side effect management.

London: Jossey-Bass, 1985. [20] Antonovsky A. Unravelling the mystery of health. How people manage stress and stay well. San Francisco: Jossey-Bass, 1987. [21] Ventegodt S, Andersen NJ, Kandel I, Merrick J. The open source protocol of clinical holistic medicine. J Altern Med Res 2009;1(2), in press. In: Advanced Cancer. Pain and Quality of Life Editors: E. Chow, J. Merrick, pp. 19-32 ISBN: 978-1-61668-207-1 © 2010 Nova Science Publishers, Inc. Chapter II Improving Cancer Pain Management in the Home April Hazard Vallerand, PhD, RN, FAAN*1, Susan M Hasenau, PhD, RN, NNP-BC2 and Thomas Templin, PhD1 1 2 Wayne State University College of Nursing, Detroit, Michigan Madonna University College of Nursing, Livonia, Michigan, United States of America The purpose of this chapter was to determine the effect of the ―Power Over Pain‖ intervention, a structured educational intervention for nurses, patients and caregivers managing cancer-related pain in the home.

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