Introduction
The management of chronic diseases, such as heart failure and cancer, requires the understanding of factors that contribute to a poor prognosis. Since heart failure has debilitating effects on both patients and their families, Ivany and While (2013) suggest the application of palliative care as an effective intervention of alleviating suffering and improving quality of life. Allen (2018) advocates for the empowerment of oncology nurses to educate populations at risk regarding preventive strategies and provide personalized medicine to patients with cancer. Moreover, oncology nurses ought to deal with the fear of cancer recurrence among survivors of cancer, particularly ovarian (Kyriacou, Black, Drummond, Power, & Maheu, 2017). Hence, this assignment summarizes the contents of the above articles regarding the management interventions of chronic diseases and offers a critical reflection on the role of genetic testing in one of the articles.
Article One
The first article examines the role of genetic testing of molecular markers that determine the occurrence and progression of cancer in individuals. According to Allen (2018), the prevalence of mutations in tumor protein 53 (TP53), which is a tumor suppressor gene, contributes to the occurrence of most types of cancers, such as breast cancer, pancreatic cancer, and prostate cancer, and colorectal cancer. Racial and ethnic disparities of mutations in TP53 reflect the survivorship of cancer patients.
The genome-wide analysis demonstrated that the use of genetic testing reveals the underlying trends of cancer occurrence and progression. Allen (2018) asserts that early screening of individuals for appropriate markers would provide the basis of personalized medicine, as well as offering education to population at-risk concerning available screening tests and preventive strategies. With appropriate diagnostic results, oncology nurses would in a position to provide personalized medicine, advise populations at-risk, and devise preventive strategies.
Article Two
The second article focuses on the use of palliative care in improving health outcomes among patients with heart failure. In the United Kingdom, heart failure has a prevalence of 1% with poor prognosis since patients die within a short period of one year following diagnosis (Ivany & While, 2013). Moreover, heart failure has severe debilitating effects on patients and their families, resulting in high rates of morbidity and mortality. Some of the common symptoms of heart failure are orthopnea, dyspnea, and cachexia.
The use of palliative care in the management of chronic conditions has proved to be effective in the improvement of quality of life among patients. Ivany and Whie (2013) highlight that patients with heart failure require health education, psychosocial support, symptom management, and caregivers. However, complicated prognosis and chronic cardiac conditions prevent clinicians from providing specific palliative care to patients with heart failure. To provide effective palliative care, the primary and secondary forms of care should consider the social, physical, and psychological needs of patients.
Article Three
The objective of the third article is to examine how the fear of cancer recurrence influence survivorship among patients with gynecological cancers. Cancers of the ovaries and fallopian tubes have a high probability of recurrence due to late diagnosis. Lack of screening, late diagnosis, and delayed treatment interventions make gynecological cancers have a high remission rate of 10-45% within five years (Kyriacou et al., 2017). Consequently, the high remission rate of ovarian and fallopian forms of cancer creates the fear of cancer recurrence among patients.
In-depth interviews conducted among twelve survivors of ovarian and fallopian tube cancers revealed that the fear of cancer recurrence is their primary issue. Thematic analysis of interviews shows that diverse beliefs and sources of anxiety, the uncertainty of recurrence, perceived health risk, and management of fear are primary factors that patients factor in fear of cancer recurrence (Kyriacou et al., 2017). As the implication of these findings, nurses need to improve survivorship experience of patients by detecting the fear of cancer recurrence, providing social and psychological support, educating, and enhancing coping strategies in patients with gynecological cancers.
Critical Reflection
Key Concepts
The selected article is “Genetic Testing: How Genetics and Genomics Can Affect Healthcare Disparities,” by Allen (2018). Key concepts learned from the article are genomic analysis, TP53 mutations, personalized medicine, and the role of oncology nurses. The genomic analysis provides an accurate approach for screening populations to determine their vulnerability to cancer, while TP53 mutations are significant molecular targets because they explain the disparity in the racial and ethnic occurrence of various forms of cancer. Outcomes of genomic analysis enable healthcare personnel to offer personalized medicine to individuals with cancer, as well as devise customized preventive strategies. Ultimately, oncology nurses empower populations by educating populations concerning the importance of early screening of cancer, the role of genetics, and the relevance of personalized treatment and preventive interventions.
Newness of Concepts
These concepts are new because they focus on the significance of genetic screening in the treatment, management, and prevention of cancer. While my knowledge and experience focus on the provision of primary care to patients, genetic testing offers additional roles to nursing. In this view, the article enhances my present learning of oncology nursing.
Patient Care
The information presented promotes the nursing practice of patient care because it highlights the key duties of oncology nurses. The article recommends oncology nurses to keep abreast of advances in genomics for them to educate patients and populations. Moreover, oncology nurses ought to advocate screening for cancer and providing care to vulnerable populations, as well as implementing preventive strategies. To increase cancer survivorship, oncology nurses should customize treatments to match individual genetics.
Future Application
The presented contents suggest the future application of genetic testing in the development of personalized treatment regimens for cancer. Identification of molecular markers for each type of cancer would allow oncology nurses to undertake the genomic analysis of the target population and establish vulnerable populations and individuals. For instance, mutations in TP53 point out the vulnerability of individuals to breast cancer and colon cancer. Therefore, future research questions would aim to identify the nature of personalized medications for various types of cancer in the population.
Molloy Value System
The content of the article relates to the value system of Molloy because it considers study, service, community, and spirituality in the treatment of cancer. The article recommends oncology nurses to study advances in oncology, provide personalized treatments, and protect communities by devising preventive strategies. Regarding spirituality, the article requires oncology nurses to provide appropriate education, which matches the racial, ethnic, and cultural needs of the population.
Conclusion
The analysis of the articles shows that effective management of chronic diseases requires the application of multiple approaches, including palliative care, genetic screening, personalized medicine, and psychosocial care. A critical reflection of the article reveals that genetic testing is a new avenue in nursing practice that allows the personalization of medicine and care to patients with cancer. The existence of mutations in critical genes that regulate the expression of proteins and the growth of cells acts as molecular markers that determine the occurrence of cancer. Thus, the article recommends oncology nurses to update their knowledge so that they can provide adequate services in the treatment and management of cancer.
References
Allen, D. H. (2018). Genetic testing: How genetics and genomics can affect healthcare disparities. Clinical Journal of Oncology Nursing, 22(1), 116-118. Web.
Ivany, E., & While, A. (2013). Understanding the palliative care needs of heart failure patients. British Journal of Community Nursing, 18(9), 441-445. Web.
Kyriacou, J., Black, A., Drummond, N., Power, J., & Maheu, C. (2017). Fear of cancer recurrence: A study of the experience of survivors of ovarian cancer. Canadian Oncology Nursing Journal, 27(3), 236-250. Web.