Yasemin KARACAN, Hicran YILDIZ, Rıdvan ALİ

Miyelom Zimba Gibi Gelir: Roy Adaptasyon Modeli Bir Olgu Sunumu

Multiple miyelomlu bireylerde semptom yönetimi, kemik hastalığı ve böbrek fonksiyon bozukluğuna bağlı semptomlar başta olmak üzere, enfeksiyon, anemi, ağrı ve pıhtılaşma bozukluğu gibi spesifik sorunları içermektedir. Diğer hastalıklarda olduğu gibi, miyelomlu hastanın tanı ve tedavi sürecinde hemşirelik bakımı önemli bir yer tutmaktadır. Hemşirelik bakım modelleri hastanın sistematik ve kapsamlı şekilde ele alınmasını sağlayarak bakımının kalitesinin arttırılmasına katkıda bulunmaktadır. Roy Adaptasyon Modeli bunlardan biridir. Roy Adaptasyon modelinde fizyolojik, benlik kavramı, rol fonksiyonu ve karşılıklı bağlılık olmak üzere dört uyum alanı vardır ve hemşireler hastalarına bu uyum alanları doğrultusunda bakım vermektedir. Olgu sunumunda, bel ağrısı nedeniyle başvuran radyolojik, laboratuvar, sitogenetik ve kliniği ile Durie Salmon’a göre lambda hafif zincir, evre III B multiple miyeloma tanısı almış ve ayaktan kemoterapi tedavi planı hazırlanmış bir hasta ele alınmaktadır. Bu olgu sunumu, Multiple miyelomlu bir hastaya Roy Adaptasyon Modeli doğrultusunda verilen bakımın North American Nursing Diagnosis Association hemşirelik tanılarıyla birlikte ele alınması konusunda, hematoloji ve onkoloji alanında çalışan hemşirelere rehber olmak amacıyla hazırlanmıştır.

Anahtar Kelimeler:

Hemşirelik, multiple miyelom, Roy Adaptasyon Modeli

Myeloma Comes as a Staple: A Case Report of the Roy Adaptation Model

In individuals with multiple myeloma, symptom management includes specific problems such as infection, anemia, pain and coagulation disorders, especially symptoms related to bone disease and kidney dysfunction. As in other diseases, nursing care has an important place in the diagnosis and treatment process of the patient with myeloma. Nursing care models contribute to increasing the quality of care by providing a systematic and comprehensive treatment of the patient. The Roy Adaptation Model is one of them. In the Roy Adaptation model, there are four areas of adaptation: physiological, self-concept, role function and interdependence, and nurses care for their patients in line with these adaptation areas. In this case report, a patient who was diagnosed with lambda light chain, stage III B multiple myeloma according to Durie Salmon with radiological, laboratory, cytogenetic and clinical findings and who presented with low back pain and an outpatient chemotherapy treatment plan was prepared is discussed. This case report has been prepared to guide nurses working in the field of hematology and oncology about the care given to a patient with multiple myeloma in line with the Roy Adaptation Model, together with the nursing diagnoses of the North American Nursing Diagnosis Association.

Keywords:

Multiple myeloma, nursing, Roy Adaptation Model.,

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1. Sung H, Ferlay J, Siegel RL, et al. Global Cancer Statistics 2020 : GLOBOCAN estimates of ıncidence and mortality worldwide for 36 cancers in 185 countries. 2021;0(0):1-41. doi:10.3322/caac.21660
2. Public Health Institution. 2013 - 2018 National Cancer Control Plan, T.C. Ministry of Health. Page 0-94.
3. Konstantinidis TI, Spinthouri M, Ramoutsaki A, Marnelou A, Kritsotakis G, Govina O. Assessment of unmet supportive care needs in haematological cancer survivors. Asian Pacific J Cancer Prev. 2019;20(5):1487-1495. doi:10.31557/APJCP.2019.20.5.1487
4. Boland EG, Boland JW, Ezaydi Y, Greenfield DM, Ahmedzai SH, Snowden JA. Holistic needs assessment in advanced, intensively treated multiple myeloma patients. Support Care Cancer. 2014;22(10):2615-2620. doi:10.1007/s00520-014-2231-2
5. Rajkumar SV. Multiple myeloma: 2022 update on diagnosis, risk stratification, and management. Am J Hematol. 2022;97(8):1086-1107. doi:10.1002/ajh.26590
6. World Health Organisation. Global multiple myeloma statistics. International Agency for Research on Cancer. Published 2020. Accessed February 23, 2022. https://gco.iarc.fr/today/data/factsheets/cancers/35-Multiple-myeloma-fact-sheet.pdf
7. Rajkumar SV, Kumar S. Multiple myeloma current treatment algorithms. Blood Cancer J. 2020;10(94):1-10. doi:10.1038/s41408-020-00359-2
8. Kleber M, Ntanasis-Stathopoulos I, Terpos E. BCMA in multiple myeloma a promising key to therapy. J Clin Med. 2021;10(18):1-17. doi:10.3390/jcm10184088
9. Aghaee M, Ledzewicz U, Robbins M, Bezman N, Jay H, Moore H. European Journal of Pharmaceutical Sciences Determining optimal combination regimens for patients with multiple myeloma. Eur J Pharm Sci. 2023;187(June):106492. doi:10.1016/j.ejps.2023.106492
10. Gallaher J, Larripa K, Renardy M, et al. Methods for determining key components in a mathematical model for tumor–immune dynamics in multiple myeloma. J Theor Biol. 2018;438(7):31-46.
11.Palumbo A, Cavo M, Bringhen S, et al. Aspirin, warfarin, or enoxaparin thromboprophylaxis in patients with multiple myeloma treated with thalidomide: A phase III, open-label,randomized trial. J Clin Oncol. 2011;29(8):986-993. doi:10.1200/JCO.2010.31.6844
12.NCCN. NCCN Guidelines Version 4.2022 Multiple Myeloma.NCCN Clinical Practice Guidelines in Oncology (NCCNGuidelines® ). Published 2021. www.nccn.org/patients
13.Zeng L, Huang H, Liu Y, et al. The core symptom in multiplemyeloma patients undergoing chemotherapy: a networkanalysis. Support Care Cancer. 2023;31(5):297. doi:10.1007/s00520-023-07759-7
14.Nielsen LK, Larsen RF, Jarlbaek L, Möller S, Jespersen E. Health-related quality of life in patients with multiple myelomaparticipating in a multidisciplinary rehabilitation program. Ann Hematol. 2021;100(9):2311-2323. doi:10.1007/s00277-020-04356-0
15.Ovayolu O, Ovayolu N, Aytac S, Serçe S, Sevinc A. Pain in cancer patients: pain assessment by patients and family caregivers and problems experienced by caregivers. Support Care Cancer. 2015;23(7):1857-1864. doi:10.1007/s00520-014-2540-5
16.Bertolotti P, Colson K, Bilotti E, Curran K, Doss D, Faiman B.Management of side effects of novel therapies for multiple myeloma: consensus statements developed by the International Myeloma Foundation’s Nurse Leadership Board. Clin J Oncol Nurs. 2008;12(30):9-12. doi:10.1188/08.CJON.S1.9-12.
17.Rajkumar SV, Dimopoulos MA, Palumbo A, et al. International Myeloma Working Group updated criteria for the diagnosis of multiple myeloma. Lancet Oncol. 2014;15(12):e538-e548. doi:10.1016/S1470-2045(14)70442-5
18.Jones & Bartlett Learning L. The Roy Adaption Model: SisterCallista Roy. In: Nursing Theories: A Framework for Professional Practice. Jones-Bartlett Learning, LLC; 1991:127-142. http://samples.jbpub.com/9781449626013/72376_ch10_masters.pdf
19.Maryati I, S S, Mamuroh L. the Application of “Roy Adaptation” theory model in women with early stage ofcervical cancer: a study case. J Matern Care Reprod Heal. 2018;1(2):386-397. doi:10.36780/jmcrh.v1i2.47
20.Jennings KM. The Roy adaptation model: A theoretical framework for nurses providing care to individuals with anorexia nervosa. Adv Nurs Sci. 2017;40(4):370-383. doi:10.1097/ANS.0000000000000175
21.Ursavaş FE, Karayurt Ö, İşeri Ö. Nursing approach based onRoy Adaptation Model in a patient undergoing breast conserving surgery for breast cancer. J Breast Heal. 2014;10:134-140.
22.Akyol E, İbrahimoğlu Ö. Kalp Nakli Olan Hastanın Roy Adaptasyon Modeli’ne göre hemşirelik bakımı. J Cardiovasc Nurs. 2020;11(26):140-148. doi:10.5543/khd.2020.21043
23.Roy C. Extending the roy adaptation model to meet changing global needs. Nurs Sci Q. 2011;24(4):345-351. doi:10.1177/0894318411419210
24.Ramini SK, Brown R, Buckner EB. Embracing changes: adaptation by adolescents with cancer. Pediatr Nurs. 2008;34(1):72-79.
25.Hannon-Engel SL. Knowledge Development: The RoyAdaptation Model and Bulimia nervosa. Nurs Sci Q. 2008;21(2):126-132. doi:10.1177/0894318408315015
26.Yıldız E, Karagözoğlu Ş. Lenfoma tanısı alan yetişkin bireyin roy adaptasyon modeline göre hemşirelik bakımı. J Heal Sci. 2015;90(312):0-2.
27.Menekli T, Çil Eyi S. Use of Roy Adaptation model in nursingcare of a case obesity. Florence Nightingale Hemşirelik Derg. 2017;25(3):237-246. doi:10.17672/fnjn.343263
28.Baksi Şimşek A, Dicle A. Nursing model and care: evaluation with the Roy Adaptation Model of patients with primary brain tumor. Hemşirelikte Eğitim ve Araştırma Derg. 2015;12(3):224-232. doi:10.5222/head.2015.224
29.Özkaraman A, Özer S, Balcı Alpaslan G. Romatoid artritli bir vakanın hemşirelik bakımında Roy Adaptasyon Modelininkullanımı. Gümüşhane Üniversitesi Sağlık Bilim Derg. 2012;1(3):138-152.https://dergipark.org.tr/tr/pub/gumussagbil/98959
30.Wilkinson JM, Barcus L. Pearson Hemş?rel?k Tanıları El K?tabı : NANDA-I Tanılar, NIC G?r?ş?mler?, NOC Çıktıları. 11th ed. (Kapucu S, Akyar I, Korkmaz F, eds.). Pelikan Yayınevi; 2018.
31.Fawcett J. Contemporary nursing knowledge analysis and evoulation of nursing models and theories. 2th ed. Philadelphia: Fa Davis Company; 2005.
32.Longacre ML, Weber-Raley L, Kent EE. Cancer caregiving while employed: caregiving roles, employment adjustments, employer assistance, and preferences for support. https://doi.org/10.1007/s13187-019-01674-4. J Cancer Educ. Published online 2019. doi:10.1007/s13187-019-01674-4
33.Kiyancicek Z, Caydam DO. Spırıtual needs and practıces among famıly caregıvers of patıents wıth cancer. Acta Paul Enferm. 2017;30(6):628-634.
34.Huang MF, Huang WH, Su YC, et al. Coping Strategy and Caregiver Burden among Caregivers of Patients with Dementia. Am J Alzheimers Dis Other Demen. 2015;30(7):694-698. doi:10.1177/1533317513494446
35.Ovayolu Ö, Ovayolu N. Multipl miyelom tanısı alan geriatrik hastalarda ağrı ve yönetimi pain and ıts management in geriatric patients diagnosed with multiple myeloma. J Hacettepe Univ Fac Nurs. 2018;5(3):260-267. https://orcid.org/0000-0002-7335-4032
36.Lennan E, Roe H. Role of nurses in the assessment and management of chemotherapy-related side effects in cancer patients. Nurs Res Rev. 2014;4:103-115. doi:10.2147/nrr.s41845