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Team communication assignment: An Annotated Bibliography


Task: Case study information:
Following each treatment, Betty experiences severe nausea and vomiting, sore mouth, fatigue and episodes of diarrhea. Betty has been following the protocol of taking her temperature each day in order to monitor for infection. She has been advised that during chemotherapy the usual signs and symptoms of infection could often be often absent because the treatment commonly affects the immune system, which therefore does not display the normal signs of infection such as redness, pus, pain, etc. However the presence of infection will display as an increase in temperature.

On day 9 post cycle three of her chemotherapy Betty's temperature has risen to 38.6oC. As she has been instructed, she waits 20 minutes and takes her temperature again. The reading has increased to 38.9oC. Betty's husband Bob, calls the chemotherapy unit. Bob is advised to take Betty straight to their local hospital.

On arrival, Betty identifies herself as a chemotherapy patient. She is admitted and a series of tests is undertaken to identify the source of infection. Betty is found to have a urinary tract infection. A course of the appropriate antibiotics is begun, together with close monitoring.

6 months have passed since Betty commenced her chemotherapy treatment. Although she continued to have some unpleasant side effects of treatment she managed to complete all 12 cycles of treatment, with the ongoing support of her husband Bob and regular support visits by Dr Glasson.

2 months after completing her chemotherapy treatments, Betty still experiences fatigue and residual peripheral neuropathy, especially in her hands. Although this is not painful she does have some lingering loss of sensation in both hands and feet as a result of one of the chemotherapeutic agents.

Betty now takes tricylic antidepressants to help manage residual peripheral neuropathy which she feels makes this symptom manageable and she has now come to terms with the fact that this symptom may not go away completely.

Betty and Bob are slowly adjusting to their lifestyle changes following recovery from surgery and chemotherapy. Although she has fully recovered from her treatment she feels that she is not as strong as you was before her diagnosis and still worries that the cancer may recur. Betty is compliant with her regular GP check ups, every 3 months and additionally as needed. Betty also is aware that she needs to have annual colonoscopies to monitor for recurrence, but she is hopeful that this is unlikely. As part of her ongoing management, Betty attends a regular support group for colorectal cancer survivors in a town nearby. She has made several friends from this group and has also started to volunteer some of her time to visiting the local hospital to meet and support other people who have been newly diagnosed with colorectal cancer.

Although Betty and Bob don't travel overseas quite so often anymore, she is relieved that she has had successful treatment and that she has a good quality of life.

Assignment Tasks:
1) Discuss the assessments including associated assessment tools for assessing Betty's nausea and vomiting. Your discussion should include information from the Betty case study (approx 250 words).

2) Identify two health care team members (other than nurses and doctors) involved in Betty's care in the community and discuss their primary role in the management of Betty's condition. Your discussion should include information from the Betty case study (approx 250 words).

3) Briefly outline key health promotion and prevention strategies that are in place in Australia to address cancer as a public health issue. Your discussion should focus on Cancers in general and consider the most prevalent strategies to address modifiable risk factors for the development of cancer (approx 250 words).


Patient assessments including associated assessment tools
Cancer patients are a unique group of patients who are made undergo several cycles of toxic chemotherapeutic medications in a bid to cure cancer. Chemotherapy is a treatment modality that has several associated class-specific adverse effects that affect the quality of life that patients live (Tervonen et al., 2019).

Betty is a cancer patient who has undergone bowel surgery and is still having chemotherapy sessions scheduled. She is experiencing various adverse effects, including nausea and vomiting, as well as peripheral neuropathy. Her current symptoms are very common in cancer patients undergoing chemotherapy or even radiotherapy.

Nausea and vomiting, if left untreated, can lead to life-threatening conditions in cancer patients. As such, there is a need to have objective measures that can be used as assessment tools when evaluating patients with nausea and vomiting following chemotherapy. The current guidelines rely on the use of various assessment tools, including The Rhodes index for nausea, vomiting, or the MASCC Antiemesis Tool (Navari & Aapro, 2016).

The assessment tools all evaluate the occurrence,the number of episodes, onset following chemotherapy as well as the severity of the episodes recorded. The cancer patients are then scored using either of the assessment tools in order to inform the choice of management. It is, however, important to note that the currently available tools do not fully capture the nature and characteristics of the vomiting experiences as described by the cancer patients. This, therefore, creates the need for better nausea and vomiting assessment tools that would provide comprehensive results.

Additional health care team members
Cancer care is a multidisciplinary concept that relies on input from various specialized healthcare providers. Each of these specialized healthcare personnel is entrusted with the responsibility of ensuring that patients do not unnecessarily suffer during and after the cancer treatment regimen (Reynolds et al., 2019).Patients who have undergone chemotherapy or those still going through the cycles form a very special group of patients. The latter need additional attention from select healthcare teams rather than nurses and doctors.The following additional health care team members will be essential:

Nutritionist / Dietician:Betty has been identified to be experiencing increased episodes of nausea and vomiting following her treatments. This is a widespread phenomenon observed in cancer patients who are undergoing chemotherapy, and it is largely alluded to the chemotherapeutic agents used and exposure to radiation (Paul, 2017).Continued nausea and vomitingeventually lead to malnutrition as the patient is unable to retain any ingested food substance.This, therefore, makesit important to have a nutritionist as part of the healthcareteam that will be entrusted with following through Betty's recovery. The fact that she had a bowel surgery further makes it important to have guidance on the type of food that she can eat as she recovers. The sole of the nutritionist will be to ensure that Betty is well-fed, having the correct type of feed in the correct quantities. Physiotherapist: Betty is reportedly suffering from peripheral neuropathy following her cancer treatment. This has resulted in the weakening of her hands and mild loss of sensation extending to her feet. Peripheral neuropathy in cancer patients is not uncommon and, in extreme cases, can lead to loss of function and pain (Gebremedhn, Shortland & Mahns, 2019). The role of a physiotherapist would be to ensure that Betty is strained on how to slowly start using her limbs as she copes with her condition.

Key health promotion and prevention
Health promotion is part of primary healthcare that aims towards educating the public on various healthcare-related issues. Health promotion and prevention strategies are in line with the recent healthcare trend to focusing on disease prevention rather than cure (Smith, Crawford & Signal, 2016).The core of such an approach to public health is to offer low literacy patient education on relevant health issues in order to equip the masses with the required knowledge on prevention and management.The Australian government has been at the forefront of health promotion and cancer prevention strategies that have seen the country realize gains in public health.

There have been increased Screening campaigns initiated by the Australian government for the general public. The cancer screening campaign and exercises have led to the formulation of the National Cancer Screening Register that tracts the cancer screening data ("Department of Health | National Cancer Screening Register (NCSR)," 2020). The government funds various initiatives that are aimed towards educating the public on the need for early cancer detection.

In addition to the screening program, there have been provisions by the government to enhance public education on cancer prevention. The government, through the respective agencies, has created forum avenues through which the public is educated on cancer. The core of the education is aimed at educating patients on measures of avoiding cancer, including lifestyle modification and the need for increased exercise as part of healthy living("Cancer Australia | A national government agency working to reduce the impact of cancer on all Australians," 2020).

Cancer Australia | A national government agency working to reduce the impact of cancer on all Australians. (2020). Retrieved 28 April 2020, from
Department of Health | National Cancer Screening Register (NCSR). (2020). Retrieved 28 April 2020, from
Gebremedhn, E. G., Shortland, P. J., & Mahns, D. A. (2019). Variability of Oxaliplatin-Induced Neuropathic Pain Symptoms in Each Cycle and Its Implications on the Management of Colorectal Cancer Patients: A Retrospective Study in South Western Sydney Local Health District Hospitals, Sydney, Australia. Journal of oncology, 2019.
Navari, R. M., & Aapro, M. (2016). Antiemetic prophylaxis for chemotherapy-induced nausea and vomiting. New England Journal of Medicine, 374(14), 1356-1367.
Paul, R. J. (2017). Exercise promotion during chemotherapy treatment: Recommendations for the Australian oncology nurse. Australian Journal of Cancer Nursing, The, 18(1), 15.
Reynolds, N. L., Cole, A. M., Walmsley, B. D., & Poulos, C. J. (2019). Multidisciplinary healthcare providers' experience of working in an inpatient cancer rehabilitation unit in Sydney, Australia. European Journal of Cancer Care, 28(6), e13162.
Smith, J. A., Crawford, G., & Signal, L. (2016). The case of national health promotion policy in Australia: where to now. Health Promotion Journal of Australia, 27(1), 61-65.
Tervonen, H. E., Chen, T. Y., Lin, E., Boyle, F. M., Moylan, E. J., Della Fiorentina, S. A., ... & Currow, D. C. (2019). Risk of emergency hospitalisation and survival outcomes following adjuvant chemotherapy for early breast cancer in New South Wales, Australia. European Journal of Cancer Care, 28(5), e13125.


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