Published on: 31 August 2017
Last Updated on: 16 August 2019
Oncology clinical trials are a huge growth area and there is understandably a great deal of interest in treatments for cancer.
New treatment strategies such as immunotherapy and personalized medicine mean that clinical oncology has moved into an exciting stage. Demand for clinical studies is growing all the time, and clinical development is moving apace.
Interestingly, these developments mean that great progress is being made, but there have been some problems along the way. In August this year, reports emerged that the sheer number of oncology clinical trials means that pharmaceutical companies are having trouble finding enough patients to test new treatments on.
The issue has arisen due to the appetite for getting new cancer treatments to market, and the fact that these revolutionary treatment strategies are only effective in select patients. Drug companies want to get proprietary drugs to market so they can profit from their research, but testing them requires lots of patients.
Consider the fact that there are now more than 1,000 clinical studies of immunotherapy underway and it’s not hard to see why patient supply has become a problem. Fortunately, there are companies who can help researchers find the patients that they need.
One such company is INC Research, which boasts a team of experienced oncology specialists such as project managers, medical directors, CRAs and executive leadership. Over the past five years, INC Research has managed 310 studies at 7,278 sites involving 34,106 patients. If anyone can help researchers find the right patients, it’s an experienced company like INC Research.
Drug companies that have worked with INC Research report that there are real benefits, such as time- and cost-savings and real-time data gathering. The team has worked on incredibly complex trials involving investigational therapies like monoclonal antibodies, so they are ready for anything that you can throw at them.
Choosing the right clinical research organization (CRO) can make or break a study. INC Research offers a full spectrum service which handles data management and operational strategy, and the team also has a deep knowledge of the regulations related to Early Phase Oncology.
INC Research offers regulatory intelligence services to biotech companies across the globe, making sure that new treatments will get approved and make it to market. After all, improving available treatment options is the reason why companies choose to invest in cancer clinical trials.
From planning a trial to sourcing patients and collecting data, INC Research is a leader in its field. In an incredibly competitive environment, it is important to work with the best. With a long list of happy clients and glowing testimonials, drug companies can rest assured that their cancer clinical trial is in good hands with INC Research.
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Any Adult Gerontology Nurse Practitioner (AGNP), or individual considering moving into this booming area, will probably be aware that it involves more than supporting patients through short term illnesses or meeting their needs in a hospital or nursing home.
As a rule, the older a patient gets, the more likely they are to experience chronic health complications which interfere with their day-to-day tasks. For much of history, such patients were written off, encouraged to take to their beds and be supported entirely by others, doing very little. They often didn’t live very long. But all that changed on account of one remarkable nurse, Dorothea Orem, whose legacy continues to shape the nursing profession today. This article examines her groundbreaking self-care deficit theory and looks at how AGNPs might use it for their nursing career.
Dorothea Orem
Dorothea Orem was born in Baltimore in 1914 and studied nursing in the late 1930s. This was a time when nursing schools were still a new phenomenon and there was a lot of experimental thinking in the nascent profession. Though she spent time on the wards as a staff nurse, she also worked as an administrator and consultant over the course of her career, spending her later years focusing on theory.
A naturally focused and attentive person, she soon began recording observations about the patients she worked with, leading to her self-care deficit theory of nursing, for which she strongly advocated for her entire life. It was theory which, in its early years, transformed the way nurses thought about patients and their duties. It laid the foundations for nursing today.
Universal Self-Care Requisites
Orem’s theory recognizes eight universal self-care requisites, or SCRs. Here, universal refers to things every human needs, regardless of circumstance. Air is needed for respiration. Water is needed to maintain a healthy level of hydration. Food is needed to maintain healthy energy levels and prevent starvation. Elimination or toileting, a polite way of referring to the expulsion of urine and feces from the body, is required too.
In addition to these four things, Orem posits that every patient needs a balance of physical activity and rest. Everyone needs social interaction, but also some alone time. People need to manage their lives to avoid or remove hazards, and, finally, they need to promote normality. This means that they need to achieve and maintain a way of living and relating to the world which is normal for them as individuals and does not involve psychosis.
Health Deviation Self-Care Requisites
When patients are recovering from injury or illness, or living with a chronic illness or disability, they can be described as experiencing a health deviation. This is not pejorative – it simply establishes that they differ from the norm. Health deviations are more common in older demographics, as they have additional self-care requisites.
These requisites include following doctors’ instructions (taking medicine on time), identifying problems caused by their conditions and attending to them effectively (sitting down until a dizzy spell passes), and knowing when and how to seek help from a caregiver or healthcare professional.
It is also important that these patients can understand and accept that their bodies have changed and can adjust psychologically to cope with it.
What Is A Self-Care Deficit?
A self-care deficit occurs when people are no longer able to carry out basic tasks. This can be because a disability makes them physically impossible to perform, or a number of other reasons. For example, some people get so overwhelmed by the way their bodies have changed that they stop trying to live. This doesn’t mean that they don’t deserve sympathy – it is an understandable response to an extreme situation – but it might mean that there is potential for improvement.
For some people, self-care deficits are permanent or are likely to worsen due to progressive illnesses. For others, however, they can be temporary, even in extreme old age. Self-care deficits stemming from a broken arm, for example, will normally dissipate after the arm heals, but this is less likely if the patient has learned to feel helpless in the meantime.
Assessment, Diagnosis, And Implementation
When using Orem’s theory, nurses have three steps to work through. The first is undertaken during the initial assessment of a new patient and involves identifying any self-care deficits. These are not always obvious from looking at a patient and the process may require gentle but persistent questioning. Some people may be embarrassed and hesitant to talk if they are unable to care for themselves.
The second involves full diagnosis of the deficits, including establishing causes. The third step is to draw up a treatment plan based on these diagnoses. In her work, Orem stressed the importance of recognizing that every patient is a unique individual, so there is no one-size-fits-all approach to this type of planning. In each case, AGNPs will need to work with the patient to establish the most effective way forward.
Five Ways Nurses Can Help
There are five strategies nurses can use to address self-care deficits when establishing patient care plans:
For the most severely incapacitated patients, it may be necessary to perform actions on their behalf, such as washing or dressing them.
Patients struggling mentally or who lack confidence can be guided through actions, ideally to the point of independence.
Patients can be taught new ways of approaching day to day tasks which make them easier to accomplish, such as taking a break to have a shower in the afternoon if it is too hard to find the energy at other times.
AGNPs can focus on the patient’s environment, making it easier for them to carry out self-care activities, such as suggesting kitchen gadgets to reduce the physical effort involved in preparing meals.
Finally, AGNPs can train a family caregiver to provide appropriate support.
These five strategies involve numerous actions, skills, and tools that nurses can use. Patients may need particular assistance with the following tasks.
Helping With Eating
Patients should always be encouraged to do as much for themselves as is reasonably possible. When it comes to eating, nurses should start with encouragement. Many older people lose their appetite and don’t feel motivated to eat, especially when it requires effort. So, an AGNP can point out that they have more energy when they manage to eat regular meals.
If the patient can get food to their mouth by themselves, nurses should resist the temptation to assist, even if they sometimes drop the food. Instead, nurses can reassure them that this is not uncommon and all they need to do is take a little more time. Nurses should also be alert to the possibility of choking issues and arrange X-rays if concerned. If some food proves difficult to eat, they can discuss the possibility of dietary adjustments.
Helping With Toileting
Nurses should reassure patients that, awkward as they may feel, there is nothing to be embarrassed about. The nurse must ensure they can transfer on and off the toilet safely and consider options like raising the height of the seat or installing grab. If there is a risk of falling, AGNPs may suggest bedpans for use when no caregiver is present. If adult diapers are needed, nurses should ensure that patients know how and when to change them (even if they are not soiled) and how to protect their skin against rashes or bruises caused by wearing them. Finally, nurses can also discuss medical options for softening stools or speeding up or slowing down digestive transit.
Helping With Dressing And Grooming
A balance must be struck between helping patients be more independent in dressing and grooming themselves and enabling them to maintain a style or standard of appearance that is natural for them. Some older men prefer to be clean shaven but end up growing beards because it is easier to trim a beard than it is to shave safely and neatly, for example. Some clothing options can be easier to get into than others, depending on a patient’s particular mobility difficulties. Simple devices such as a stick with a hook on the end can make adjusting the back of a garment or doing up a zip much easier. Nurses should pay particular attention to footwear to make sure patients can stand or walk safely.
Reducing Hazards
Whether a nurse is helping a patient to move around and complete self-care tasks in a hospital ward, a care home, or their own home, they must always pay attention to hazard prevention. Hazards can include mess, a layout created without regard for disability, or other people or pets moving around. Nurses can start by ensuring that the patient is aware of the risks and can recognize dangerous situations.
They should discuss simple measures like installing handrails or changing routines to make it easier to keep the area tidy. Nurses can also ensure that the patient can summon help if something goes wrong, by persuading them to install an alarm system or carry a charged mobile phone at all times, for example.
Care With Communication
Often, older patients who have self-care deficits also have difficulty with communication, whether due to physical or cognitive disability. Depending on their lifestyle in recent years, they may also be unfamiliar with modern technologies, but shy about admitting this. It is important for nurses to make sure that when they are addressing issues around essential needs, the patient understand them properly and vice versa.
It can be helpful to use pictures in communication, which are often available in support materials. When meeting a patient in the place they are going to be living, the nurse and patient can explore it together (in stages, if necessary) so both parties can directly identify issues.
Seeing Each Patient As An Individual
An essential tenet of Orem’s theory is that patients must be treated as individuals. This increases the chance that they will stick to treatment plans, as well as directly improving their psychological wellbeing.
Any nurse that’s interested in Orem’s theory and is considering joining this field will be looking into gerontology nurse practitioner programs online. The best courses place a lot of emphasis on adaptability and on learning how to manage different types of patients in different environments. The program at the University of Indianapolis, for example, encourages students to develop the patience and listening skills essential to getting to know patients and making them a part of the process. This communication and relationship building is essential to developing plans which will really benefit patients over the long term. The course at the University of Indianapolis is an eight-semester program designed for working nurses, involving part-time study and an intensive clinical placement.
The Nursing Profession Continues To Benefit
Thanks to Orem and her self-care deficit theory, patients are no longer left to waste away as they begin to struggle with old age. Generations of nurses who have practiced this theory have observed that, even in later life, patients can often improve and regain their self- care abilities with the right support. Advances in assistive technologies continue to make this even easier.
The right support, focused on facilitating and encouraging independence, enables seniors to go on living satisfying lives on their own terms for much longer. Even when they need extensive practical support, giving them more control helps to maintain their morale and ability to navigate the final chapter of their lives. In the process of providing this support, AGNPs also get what they really want; to see their patients thrive, no matter what they must overcome to achieve it.
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When you're in the depths of an addiction or someone you love is, you don't know where to turn. It's a scary, confusing, dark, and overwhelming time for everyone involved.
How do you get help? Where do you get help? Can you afford it? Those are all valid questions. Especially if you don't know if you can convince your loved one to go to rehab!
All those factors can lead you down a road of what ifs, but there's only one what if that matters. What if you find the best rehabilitation center?
Then things will start looking up. Get our guide on where to start and what questions to ask here.
What Makes the Best Rehabilitation Center The Best?
We can't give you one answer, or one center, that's definitively best. That's because the right rehabilitation center for your loved one isn't the same as the right one for someone else.
Some people need a single-gender environment, some need more of a detox, and others need a holistic offering. We'll get more into what all that means and how to tell what they need below.
Before we analyze them and their needs, don't take their opinion completely out of the picture. They may be on drugs, but they should get a say in their treatment (except, you know, the sobriety part).
1. Ask A Professional:
If you think your loved one needs treatment for addiction, try to get them to a doctor or a professional. There the doctor can diagnose the specifics of the addiction.
Maybe they'll run some vitals and decide that your loved one needs a more medically-oriented care setting. Or they can see patterns in their addiction, that the untrained eye can't.
You can ask your doctor or professional for a recommendation of the best treatment center. If they don't know any specifics, ask them some of the following questions.
2. How Long of Treatment Do They Need?
In theory, the only person who decides how long treatment takes is the addict. The classic programs last ninety days, which gives people time to reform their body, mind, and attitude.
But some people can't afford a whole ninety-day stay or maybe their addiction isn't that developed. A thirty-day stay may be more appropriate for a budding addict.
Ask your doctor their opinion on length, so you know what programs to look for.
If you can't get the addict to a doctor and you've known them a while, think about how they learn and function. Has your addict done well in highly-structured environments?
Or do they do better working at their own pace? Think back to school days and the challenges they had in that setting. This can tell you how long and arduous of a program they need.
3. What's The Treatment Approach?
On that last note, there are as many types of treatment approaches as there are to teaching or parenting. That's to say, each person believes in a slightly different version than someone else.
If you're the addict's mother or family member, this gives you good insight on the type of treatment approach they'll thrive under. Someone who's sensitive and needs coddling won't do well in an orders-barked center.
However, someone who went to military school or likes the idea of having structure may like the rules-are-law approach.
4. Counseling Services:
What kind of counseling services does the rehabilitation center offer? This, again, is all about the right fit for the addict in your life.
In general, there are two types of behavioral therapy: cognitive (ct) and cognitive behavioral therapy (CBT).
Cognitive only therapy (CT) is a theory from the 1960's that looks at how the patient interprets the situation. It's the more classic, lay on the couch and talk about what's bothering your type of therapy.
Cognitive Behavioral Therapy is different, but only slightly. CBT therapists look at how behaviors and perceptions work together to create interpretations.
CBT usually uses more hands-on approaches, if the situation calls for it, like the empty chair technique.
They may not get into the specifics of this on their website, so if you care, call and ask. Most therapists use a mix of both theories, while others use different ones altogether.
An up and coming method is called kinetic therapy, where the professional urges the client to connect feelings in their mind to parts of their body.
If the addict has had luck with therapy before, even if it's not addiction related, this can help you choose the path that's right for them.
5. Medical Comforts:
We all know that apart from the emotional turmoil of addiction, the hardest part is the detox. Detoxification symptoms differ by substance.
For opioids and painkillers, the addict can feel like they have the flu for five to seven days, fevers and all.
For Benzodiazepines such as Xanax, seizures and an increase in anxiety attacks are common.
Cocaine withdrawal looks like depression and restlessness, while alcohol withdrawal symptoms include seizures or tremors.
The effects of benzos and alcohol can last for weeks, if not months.
That said, you may want to choose a rehabilitation center that offers symptom relief. Having a doctor on-site to prescribe non-psychoactive drugs can help ease the detox process.
You need to ask this before-hand. Some centers believe in a completely drug-free approach.
6. Residential or Outpatient care:
Whether or not your addict needs to be on site all the time is up to them you and your budget.
Residential programs are the most expensive since they have to provide things like meals and housing. However, they're also the most full-service and some think the best for advanced addicts.
Other things to take into consideration about residential care is the types of patients. Do they only take opioid patients or do they mix people with different addictions?
This is another personal preference area. Some people believe that the similarity of the experience leads to a better rehab, while others believe that addicts of the same kind egg each other on.
There's no right or wrong answer.
7. Budget:
A lot of the time, when you see rehabilitation centers advertised, they say things like "luxury" and "all inclusive". These are centers that charge an arm and a leg - that have money left over for marketing.
Their calls of luxury don't mean their the best. They could be, but they could also spend all their money on the amenities and not pay or pick high-quality staff.
You want to find rehab centers that have a balance of both. Obviously, you don't want your addict in a falling-apart facility, but is a waterfall in their room really going to aid recovery?
Don't over-spend or over-shoot your budget because one looks fancier than the other. A grand pool or beautiful location won't heal your loved one any quicker.
8. Co-Occurring Disorders:
The statistics and correlation between people with addiction issues and people with mental illness are staggering. Approx 7.9 million adults in the united states suffer from substance abuse with a co-occurring illness.
We call this a "co-occurring" disorder and most drug treatments won't work unless you also treat the other issue. Someone may do a lot of cocaine because they're depressed and cocaine gives them energy.
If you take the cocaine away from them, but they don't address the depression, they're going to turn back to cocaine for energy.
Find a center that treats co-occurring disorders along with addictions. This combination gives your loved one a better shot at lasting recovery.
9. Visitation Policies:
When you pick a center for your loved one, will they allow you to visit them? Some centers believe in isolation from outside sources.
Others don't. Figure out which situation will be best for your addict - and your own sanity as someone as that loves them.
10. Financing Options:
Does your rehabilitation center offer a payment plan? Most do these days, but some will ask for half or a deposit up front. You know your finances and there's only so much you can do.
Most insurance carriers don't cover rehab, but it's worth a call to see if they'll cover a percentage.
11. Ask the Addict:
If you've gotten the addict to agree to rehab, good for you and for them! The biggest success factor in rehab situations is whether or not the addict wants to recover.
Ask them what kind of treatment center they see themselves in. It'll give you an idea of what to look for.
Rehab Centers: Finding The Right One:
Did you know that you can tour some rehabilitation centers before you commit to one? The tours may be short or only show you a bit of the facility to protect patient privacy.
At the very least, the best rehabilitation centers should offer a consultation with a therapist or an intake specialist. There you can ask them the questions we talked about in this list and any others burning on your mind.
We hope you've gotten some good information out of this eleven part guide and that you'll trust us for more advice in the future.
Read Also:
5 Reasons Why It’s Not Too Late To Get Help
Is A Loved One Addicted To Opiates? Here Are Common Signs Of Opiate Use
Resistance bands :
These brightly-colored rubber bands are the perfect choice for any home gym.
Whether you’ve got a full weight-training setup or you prefer bodyweight exercise, the resistance band is a versatile tool to improve everything from mobility to maximum strength.
Stick with us because in this short article you’re going to learn everything you need to know about the why and how of resistance bands!
Resistance Bands: What Are They?
Resistance bands are basically tough, elastic bands that are designed to be used in exercise and sports training.
They can be any length, but the main two are “loops” that are put around body parts – such as the hip circle – or full-length bands that can also be used with weight training equipment.
They’re used for a variety of reasons:
Stretching
Bodyweight strengthening
Resistance training
We’re going to break these down one by one, so you know what you can expect from a high-quality resistance band.
Why We Love Resistance Bands So Much
Home gyms require you to be space-efficient. When you’re in charge of buying and storing everything, you need to get the most out of equipment.
Resistance bands are the perfect bang-for-your-buck purchase. They have many uses, they’re cheap, you can store them easily, and they make everything you do in training better.
You can also take resistance bands anywhere – making it possible to get a great workout on the road, on camping trips, or when enduring the in-laws. This makes them unique among workout tools: good luck doing this with a barbell!
Stretching
Bands make the perfect stretching tool for many reasons.
To start with, they apply gradual resistance. You’re subjecting your muscles to an increasingly more challenging stretch using bands. This is going to make it easier t get into the right positions and combat stubborn, tight muscles.
A great example of this is the shoulder dislocates. The point of this exercise is to warm up the shoulders and loosen off tight muscles in the chest. Bands are much better than a wooden rod for this, as they’ll actively open your chest up and force you to improve on the stretch.
Flexibility is good, but it isn’t much use if you can’t control your shoulders:
“flexibility without strength may predispose the individual to joint injury”
– David Joyce
Elastic resistance forces you to control the movement while you develop greater flexibility. This is crucial for reducing injury and strengthening connective tissues!
Elastic resistance is popular with the world’s best weightlifters and, if it’s good enough for them, it’s good enough for us!
Advanced Mobility
Resistance bands play a big part in advanced mobility techniques and rehabilitation after injury.
Kelly Starrett’s approach to mobility involves bands to improve stretching exponentially. There are dozens of examples of this from improving hip stretches to building ankle mobility. If you’re serious about your mobility, bands can take it to the next level and save you hundreds of hours in the long-run!
They’re also a key part in physiotherapy and rehab. Bands are great for stability and strengthening work – allowing you to improve movement quality and strengthen neglected muscles. These all add up to mean healthier, safer joints.
Bodyweight Strengthening
Are pull-ups too difficult? Add a band.
Are push-ups too easy? Add a band!
Bodyweight strengthening is amazing: gymnastic strength training should be a part of everyone’s exercise routine. However, because you’re using your own body weight it can be hard to scale this to get easier or more difficult since you can’t add/lose weight that fasts.
Resistance bands can be used to assist exercises by attaching them to something that reduces the effect of gravity on you. Dips are a great example – you can put your knees in a band to make the exercise much easier and build towards full dips.
On the other hand, you can make exercises more difficult by adding a band. When performing a push-up, you can put the band in either hand and around your back so that it adds resistance towards the top of a push-up.
This is a great example of how versatile the resistance band is: it can make exercises easier or harder. It’s an easy way of scaling any exercise you can think of!
Resistance Training
If you’re training for strength, power, or sports performance, resistance bands are perfect.
Adding bands to exercises like squats, deadlifts, and even sprints can provide amazing benefits for explosive power. By overloading the top of the movement (when the bands are elongated and provide most resistance) you can develop power in the knee- and hip extension.
Put simply, it makes these exercises easier at the bits that are usually easy. This ensures you’re putting maximum effort into the movements that build strength and power for other sports like Olympic lifting, sprinting, jumping and field sports (like rugby).
Closing Remarks
Resistance bands are great because they’re versatile, compliment every other type of training, and they’re amazingly practical.
With a key role in building strength, improving mobility, and preventing injury, resistance bands are amazing for your health and fitness goals.
If you’re short on money or you’re not sure what to buy for your home gym to get maximum value, they’re the right choice for you.
Read Also :
What Are Popular Mind And Body Exercises Available At A Gym?
8 Home Gym Systems You’ll Want To Try Out
6 Ways To Promote Healthy Brain
7 Healthy Habits That Make Us Look Younger
