EXPERIENCING AHEALTHCHALLENGE: THE EFFECTS ON CLIENTS

822-913-679

Experiencing a Health Challenge: the Effects on Clients

Student name: Ying Liang
Student No: 822 913 679
Section: 26
Date Submitted: Nov 17, 2014
NURS360: Practical Nursing Theory
Professor: Eva Hearn
Humber College ITAL

EXPERIENCING AHEALTHCHALLENGE: THE EFFECTS ON CLIENTS

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Summary
50/50 is an original story about friendship, love, survival and finding humor which happened
to a cancer patient named Adam Lerner. Drawing materials from real life of its screenwriter, this
movie talks about Adams transformative journey of fighting against a rare malignant spinal
tumor and the chances of winning are fifty-fifty. During this tough period, the 27-year-old man
undergoes chemotherapy and breaking up with his lover. Fortunately, he receives crucial support
from a knuckleheaded pal and his worrywart mother. Meanwhile, a tender psychotherapist with
whom he builds rapport in and outside of the sessions endeavors to help him. At the end of this
tragicomedy, the great healers of friendship and love help him go through the precarious surgery
and thus gain the 50 percent chance of living.
Significant physical effects
Pain Cancer treatment can bring up significant physical side effects. Pain is the most
prevalent suffering among cancer patients. The original and referred pain may be caused by
tumor progression, the related pathological process, or physical limitations (Potter & Perry,
2014). It can cause impairments in physical and psychological well-being and result in life
quality degradation. In Adam case, he suffers from a rare type of malignant Schwannoma along
his spine. This discomfort feeling interferes with his daily life including sexual activities. Pain
medications are effective tools to manage this unpleasant feeling. However, if improperly
controlled, pain can have a profound adverse impact on the patient and family members .
Therefore, how to manage pain is of critical importance.
Nausea and vomiting When chemo drugs enter the body, nervous system senses this foreign
subject. It triggers the vomiting center and cause nausea and vomiting reflex (Griffin, 2009).

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For instance, on the first night of chemotherapy, Adam feels nausea and undergoes vomiting.
Some patients could not endure the gastrointestinal (GI) disturbance and thus limit food and fluid
intake which cause malnutrition and dehydration. Furthermore, the patients internal homeostasis
is broken and it results in electrolytes and acid-base imbalance.
Alopecia The finding of hair loss would upset the patients and their intimates as well. It can
immensely influence patients' physical appearance and self-esteem especially for the female
patients (Schreier & Williams, 2004). Forty-seven percent of female cancer patients consider hair
loss to be the most traumatic aspect of chemotherapy (McGarvey, Baum & Pinkerton, 2001). In
Adams case, his friend feels scared to shave for him. Also, the two girls he meets at the night
club are shocked at his bold head.
Significant psychosocial effects
Anxiety Anxiety is a normal reaction to cancer. When being informed of a cancer diagnosis,
Patients would be anxious and afraid of the future treatment and prognosis. Both the patients and
caregivers suffer from the negative mood. If left untreated, severe anxiety may even shorten a
patient's life. Anyone involved in the situation would be shocked in the similar situation because
the disease can totally change a persons life (Berk, 2010). Adams anxious mother, who is
already the care giver of an Alzheimer husband, seeks help from a supportive group to cope with
the intense situation.
Isolation Due to physical weakness, cancer patients may feel isolated from their normal
physical activity, working and living environment. In the movie of 50/50, the boss let Adam do
his favorite topic without time limitation. There are so many people at the party, but Adam still
has intensive feeling of loneliness. The feeling of being isolated from the normal world
contributes negatively to the disease.

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Depression Being depressed beyond a certain period could impair a persons capability and
motivation of carrying out daily activities. In fact, up to 25 percent of cancer patients have
clinical depression (Jacobsen & Jim, 2008). The lowest moment and the unbearable process can
constrain the patients and the loved ones. In this movie, Adams ex-girlfriend refuses to
participate in the chemotherapy procedure because she is afraid of the depression caused by the
mix of the two world. Clinical depression leads to feeling blue, not following treatment plan
and may lead to the desire to commit suicide.
Priority for nursing care
Psychological nursing care Anxiety is a normal reaction among cancer patients. One may
experience various degree of anxiety for different reasons. They may be afraid of physical
discomfort of cancer including cancer-related pain, may be scared at the progressive growth of
tumor, or worried about changes of social life. In the movie, Adam is too nervous to follow the
doctor when he is informed the cancer diagnosis. During his appointment of psychotherapy, he
refuses to admit he is anxious but keeps on biting his finger nails which is really signs of anxiety.
Anxiety has many negative effects on patients. It can increase feelings of pain, suppress immune
system, disturb sleep pattern. If left untreated, severe anxiety may even shorten or deprive a
patient's life. Consequently, how to manage anxiety is the priority area that nursing care should
focus on when caring for cancer patients. Once nurses detect clinical anxiety, they should
analyze the possible causes rather than hold limited view on the disease itself (Jacobsen & Jim,
2008). Anxiety increases or declines at different periods. One persons experience may differ
from others when confronted with similar situation according to various coping ability.
Therefore, nursing care should be dynamic, individualized, and holistic.

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Nursing specific interventions

Nursing education is an effective tool to alleviate anxiety. Most patients are able to reduce
their anxiety by obtaining more information about cancer, the treatment procedure, and the
possible prognosis (Sheard et al., 1999). Nurses can achieve the goal by giving understandable
knowledge, and encourage questions and clarification of information provided.
Listening, touching and talking to patients and let them feel they are being cared for.

The

patients should be encouraged to express their worries and this is a good opportunity for the
nurse to early detect anxiety. Nurses gentle touch is subtle compared with the power of
chemicals, but it has profound emotional and spiritual healing effect (Taranto, Melinda &
LICSW, 2011). Besides this, talking with patients and family members can produce a feeling of
being cared for. Once a better understanding of the patients is achieved and the therapeutic
relationship is established, nurses can play a more active role in psychological care.
Another nursing intervention for anxiety is searching for approachable community
resources, provide a social service referral and assist clients to contact. If nurses realized some
problems are beyond their practical scope, they can refer the patients to counselor or to
survivorship programs as appropriate. This is not limited to the patients, but applicable for their
care givers. Both of them are too fragile to be supported (Middleton, 2014).
Interprofessional collaborative care strategies
Doctor

As we know, the journey through cancer treatment involves the support and

expertise of an entire healthcare team. Doctors can ease the patients anxiety by providing
comfort communication and appropriate treatment. When a patient is first informed the diagnosis
of cancer, effective communication between the doctor and the patient and family members is

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highly expected for them to cope with the shock and guide them to make the right decisions
(Molleman, et al 1984). However, Adams doctor is lacking in professional communication skills
and that makes the master and the mother more anxious. Luckily, Adam finally goes through the
complicated surgery due to the surgeons superb skill.
Nurse Nursing interventions play an important role in coping with anxiety. Being in close
contact with patients during daily care, nurses are usually the first to detect the symptoms of
anxiety. Nurses need the necessary skills and knowledge to be more alert to the psychological
problems. For example, if the patients are afraid of their altered self image caused by hair loss,
the nurses may educate the patient Alopecia is a temporary outcome and hair would grow after
finishing chemotherapy. In doing so, the worrying about self-esteem is going to be eased. Nurses
can also offer support either by filling the patients with hope or referring them to supportive
programs. In short, the goal is meeting the psychological care needs of patients with cancer
(Middleton, 2014).
Psychotherapist

Psychotherapists can help the patients to overcome anxiety by

psychotherapy. The professional treatments can reduce suffering and improve quality of life.
Statistics show that nearly 50% of patients with cancer undergo major psychological distress
(Sheard, & Maguire, 1999). Psychotherapy interventions have significant impact on improving
quality of life. From the movie, we can see how Adam benefits from psychotherapy. The
relationship they build up help to ease the painful treatment.
Community resources
In Toronto, there are also many types of support available to patients with cancer and their
families. For example, UHN (University Health Network) psychosocial oncology program at
Princess Margaret Cancer Centre. Their services range from help with the physical side effects of

EXPERIENCING AHEALTHCHALLENGE: THE EFFECTS ON CLIENTS

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treatment to emotional and practical support. It holds classes and activities for patients, family
members and friends (Princess Margaret Cancer Centre, 2014). Their anxiety can be relieved
through active learning, receiving support and meeting others with similar experience. Another
cancer Patient and Family Support Program is the Patient and Family Support Program held by
Odette Cancer Centre at Sunnybrook. There, the Patient and Family Support Program see beyond
cancer diagnosis. The physical, nutritional, social, emotional and practical wellbeing are highly
expected. The access to care given by patient and family support professionals can help to
provide needs that go beyond medical treatment (Sunnybrook Odette Cancer Centre , 2014).
Conclusion
The movie 50/50 demonstrates how health challenges physically and psychologically
impact patients, their families and friends. Though cancer can be lethal, the health care
professionals can utilize solid knowledge to provide holistic care. Nurses should play a crucial
role within the interprofessional group and pay more attention to the psychological side effect of
anxiety. It can help the patient in coping with the critical situation, fighting against cancer and
improve their life quality.

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References
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