Uloga sestre u predoperativnoj pripremi bolesnika oboljelih od malignog melanoma na smanjenu anksioznost

master's thesis

• Title (english): Association between nursing preoperative preparation of patients with malignant melanoma and reduced anxiety
• Author: Željkica Čubrilović
• Mentor: Mirko Ivkić (mentor)
• Committee member: Vladimir Bedeković (predsjednik povjerenstva)
• Committee member: Dražen Begić (član povjerenstva)
• Committee member: Mirko Ivkić (član povjerenstva)
• Granter: University of Zagreb; School of Medicine; (Department of Othorhinolaryngology and Head and Neck Surgery); Zagreb
• Defense date and country: 2014-10-06, Croatia
• Scientific / art field, discipline and subdiscipline: BIOMEDICINE AND HEALTHCARE; Clinical Medical Sciences; Otorhinolaryngology

Abstract

Zloćudni tumori kože potencijalno su najopasniji oblik raka kože i uzrokuju 90% smrtnosti. Dijagnoza se postavlja klinički i temelji se na AJCC klasifikaciji. Prema podacima Svjetske zdravstvene organizacije, oko 20.000 ljudi u svijetu umre od melanoma svake godine. Jedan od najvažnijih kliničkih pokazatelja melanoma je velika razlika incidencije između osoba svijetle i tamne kože. Prema podacima iz AJCC Melanoma Database, debljina melanoma najvažniji je prognostički čimbenik u sveukupnom preživljenju, ali je revidirani sustav određivanja stadija prepoznao i prisutnost metastaza u regionalnim limfnim čvorovima kao snažan neovisan prognostički čimbenik u 5-godišnjoj stopi preživljenja u stadijima I. i II. Melanom ima različite limfne putove u limfnoj drenaži, poglavito melanomi smješteni na trupu, glavi i vratu. Prije više od dvadeset godina uveden je nov pristup u liječenju kožnog melanoma. Limfoscintigrafija (LS) i biopsija sentinel limfnog čvora (SLNB) su postale dio standardne skrbi za pacijente s novom ili opetovanom dijagnozom melanoma, pomažu odrediti status regionalnih limfnih čvorova. Točan identifikacijski sentinel limfnog čvora (SLN) omogućuje kirurgu da dodatno razgraniči stupanj malignosti. Izvođenje limfoscintigrafije prije planiranog rada omogućuje ograničenu operaciju s manje opsežnog poslijeoperacijskog morbiditeta. Ovaj rad donosi pregled današnjih spoznaja, primjene limfoscintigrafije (LS) i biopsije sentinel limfnog čvora (SLNB) kod kožnog melanoma i sestrinskom ulogom u predoperativnoj pripremi pacijenta jer većina ljudi bolest ili stanje koje zahtijeva operativni zahvat doživljava izrazito stresnim događajem, što za posljedicu ima porast razine straha i predoperativne anksioznosti. Istraživanja do danas su ukazala na činjenicu da se stres može ublažiti davanjem obavijesti o predstojećem zahvatu, a jedan od najboljih primjera takvog načina djelovanja je predoperativna priprema pacijenata.

Abstract (english)

Cutaneous melanoma is potentially the most dangerous form of skin tumour and causes 90% of skin cancer mortality. Diagnosis is made clinically and staging is based upon the AJCC system. According to the World Health Organization, approximately 20,000 people worldwide die from melanoma each year. One of the most striking clinical aspects of melanoma is the profound difference in incidence between persons of fair and dark skin complexions. Based on the AJCC Melanoma Database, the thickness of the melanoma is the most important prognostic factor in overall survival is melanoma thickness, however, the revised staging system recognized the presence of metastases in regional lymph nodes as an independent powerful prognostic factor in 5-year survival rate in stages I and II. Melanoma has a variable lymphatic drainage pathways, particulary those lesions located in the trunk, head and neck. In the past 15 years, a novel approach has been introduced in the management of cutaneous melanoma. Lymphoscintigraphy (LS) and sentinel lymph node biopsy (SLNB) has become part of the standard of care for patients with a new or recurrent diagnosis of melanoma, in helping determine the status of regional lymph nodes. Correct identification of sentinel lymph nodes (SLN) enables the surgeon to further delineate the extent of malignancy by allowing sampling of the appropriate nodal group. Performing the lymphoscintigraphy prior to the planned operation allows limited surgery with less extensive postoperative morbidity.
This paper presents an overview of present knowledge, the application of the LS and SLNB in cutaneous melanoma and nurse role in the preoperative preparation of the patient, because to most people the disease or condition that requires surgery is extremely stressful event, which can results with increased level of fear and preoperative anxiety. Studies to date have pointed to the fact that stress can be alleviated by giving notice of the impending surgery, and one of the best examples of this kind of action on the stress and the patient's perception of pain is the preoperative preparation of the patient.

• Keywords: maligni melanom; sentinel biopsija; sestrinska predoperativna priprema
• Keywords (english): malignant melanoma; sentinel biopsy; nursing preoperative preparation
• Language: croatian
• URN:NBN: urn:nbn:hr:105:398144
• Study programme: Title: Studies in Nursing; Study programme type: university; Study level: graduate; Academic / professional title: magistar/magistra sestrinstva (magistar/magistra sestrinstva)
• Type of resource: Text
• File origin: Born digital
• Access conditions: Open access
• Created on: 2015-11-05 11:02:43