Kate Angeli G.

Cruz
RLE 4 3NUR2

The prognostic impact of the amount of tobacco smoking in non-small cell lung
cancer- Differences between adenocarcinoma and squamous cell carcinoma

Background

Many studies have tackled smoking, its effects and relationship to cancer but only few
studies have described the influence of the amount of smoking on patient prognoses
and its relationship with respect to histological cell types.

Statement of the problem

General
Is the amount of tobacco smoking affects the prognosis of the lung
cancer?

Specific
Is there any significant difference in the prognosis of Adenocarcinoma
between the non-smokers, light-smokers and heavy smokers?

Is there any significant difference in the prognosis of Squamous cell
carcinoma between the non-smoker, light-smokers and heavy
smokers?

Summary

The respondents for the Adenocarcinoma group were 441 men and 309
women. On the other hand, Squamous cell carcinoma included 310 men and 44
women. In each histological characteristics, respondents were grouped according to
their use of cigarettes. The group were non-smoker, light-smoker and heavy smoker.
The prognosis was measured by the survival rate after years of surgery. The results
gathered were never-smokers had better prognosis than ever smokers in Ad patients
and light-smokers had a worse prognosis than heavy-smokers in Sq patients.

Findings:

In Adenocarcinoma patients, those who have never smoke were more likely to be
female, to have less advanced stage tumors, and to have significantly better prognosis
than those who had ever smoked. In squamous cell carcinoma, among ever-smokers,
light smokers were associated with more advanced stage tumors and significantly
worse prognoses than were the heavy smokers. Analysis showed that light smoking
was related to a worse prognosis compared with heavy smoking.

Conclusion:

The never-smokers had a significantly better prognosis then ever-smokers among
Adenocarcinoma patients, whereas the light-smokers had a significantly worse
prognosis than heavy smokers among Squamous cell carcinoma patients. There may
be factors other than tobacco carcinogens that influence the development of squamous
cell carcinoma in never and/or light smokers.

Implications:

Nursing practice:
The campaign to stop smoking should always be implemented as for the
reason that smoking does not only affect the lungs but it affects all our body.
Complete smoking cessation should be encouraged, as the study has shown,
light-smoking can have worse prognosis than heavy-smoking and never-
smokers tends to have less advanced tumors. Smoking is not beneficial to any
patient therefore must be stopped.
Cigarette smoking among youths has been rampant and even in our university,
it is evident. Nurses as a health promoter and educator should not be
participating in the trend but thats not the case. Student nurses are the future
of the college and the future nurses. We should be disciplined enough to take
care of ourselves, not only for ourselves but for our patients as well. The
student nurses should learn to walk their talk and prevent smoking as they are
preaching.

Nursing Administration
With the rise of smoking rates among youths, we should strengthen the
campaign against it. Around the university, some student nurses can be seen
smoking in full uniform. The issue of smoking is in the college, and I hope is
not ignored. Nurses even student nurses should be a living example for healthy
living and promoters of health. Student nurses are aware of the implications
but they are not reinforced. Effective reinforcement might be the key to stop
this pressing issue.

Nursing Education
Proper education is the key to knowledge and knowledge may bring about
change. The knowledge of new finding about smoking will help the prevention
and cessation. As a student nurse, I can use the results of the study in
educating the future patients that I may handle.

Nursing Research
Nurses and nurse researchers are in key positions to educate, detect and refer,
intervene, and create new strategies. We should always be involved in research
to further improve not just ourselves but also our care to the patients.

Nursing Theories

Seven Nursing Role by Hildegard Peplau
1. Stranger role: establishes rapport first before any intervention to be done to the
patient. If the rapport is established, behavior change can easily result from
the health teaching of the nurse.
2. Resource role: gives information and answers patients questions. In this case,
if the patient has questions about the risk and dangers of smoking, the nurse
should be able to relay the necessary information.
3. Teaching role: The nurse should perform his or her health teaching about the
risks and how to stop smoking.
4. Counseling role: offers not just physical help but also emotional help. The
nurse should provides guidance and encouragement to make changes.
5. Surrogate role: helps the patient be independent and be self-responsible for his
health
6. Active leadership: helps patient to independently achieve own goals towards
behavior change
7. Technical expert role: provides physical care by clinical skills

Transcultural nursing Theory by Madeleine Leininger
Behavior change e.g. stop smoking, can happen more effectively if the nurse
has considered the cultural background of the patient. Nurses should personalize care
for each of the patient, considering his or \her beliefs, values and culture.
Need theory by Virginia Henderson
The theory states that the nurse will continue to care for the patient until the
patient can independently take care of himself. Nurses only facilitate the behavioral
change. Nurses can help the patient to start the change but it will be the patients role
to bring change to completion.
Caring theory by Jean Watson
As nurses, we must care for our patients holistically. The healing of the mind
soul and spirit will bring about complete healing to the patients. After attending to our
patients physical injuries and illnesses, we must also look after their emotional and
psychological wellbeing. We can heal our patients body but if the mind is not
changed, there will be no behavior modification and the body will still suffer.
Environmental theory by Florence Nightingale
Our physical environment greatly affects the progression and the regression of
our health. If the environment is unsanitary, it should be eradicated for it will place us
in great risk for diseases. Just like our physical environment, our social environment
works the same way. If our goal is to have behavioral change, people who are pulling
you back to your old habits should be avoided for you to be not affected and for you
to be able to meet your goal.
Self-care Deficit Dorothea Orem
Patients can recover more quickly and holistically if they are allowed to
perform their own self-cares to the best of their ability. Just like in implementing
behavioral change, we must give the patients the independence to choose what their
course to change will be. The nurses should only be the facilitator and not the
decision-maker towards change.