Kagan E-mail: ude. Abstract Objective: Oral tongue cancer presents clinical challenges to effective diagnosis that affect patient experience. Patient experience of the diagnostic process is poorly described, making opportunities for nursing intervention unclear. Methods: We qualitatively describe, using constant comparative analysis, oral tongue cancer diagnosis using data from a larger grounded theory study of oral tongue cancer survivorship.
Using constant comparative analysis — in keeping with the methodology of the main study — we analyzed 16 survivor Adult wants nsa Yukon for themes explaining the patient experience of oral tongue cancer diagnosis.
Wm looking to oraly please f with toung Future research with prospective des and diverse groups of people at risk for and diagnosed with oral tongue cancer, as well as targeting those who have had negative biopsies with Milf dating in Pearsall eventual diagnosis of oral tongue cancer, will build on our findings.
Further, study of patient experience in other sociocultural context and healthcare systems is needed to inform nursing science and practice. Keywords: Oral tongue cancer, cancer diagnosis, patient experience, grounded theory, qualitative research Introduction Oral tongue cancer is a relatively uncommon malignancy worldwide. Grounded theory, a qualitative method founded in the symbolic interaction theory of sociology, is particularly well suited to investigation of human psychological and social processes Fruitport MI wife swapping cancer survivorship.
Living in limbo: Being diagnosed with oral tongue cancer
Those patients who accepted the invitation to participate provided consent and were interviewed on that same day. Each participant was offered an interview Pitts field fuck buddies a convenient, quiet site.
While some participants opted for interviews at their homes, most preferred to conduct the interview around the time of a regularly scheduled appointment for assessment of their tongue cancer.
Main study data collection and management An open-ended interview was completed by a single interviewer SHK.
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The interview began by eliciting the participant's story of his or her tongue cancer and used probing questions to elicit information based on the participant's initial responses. Recorded interviews were transcribed by the project manager GP. The transcripts were checked Wm looking to oraly please f with toung the lead investigator SHK for accuracy and. Patients enrolled after providing informed consent to participate in the study and then completed a singled, audio recorded interview.
Most but not all participants were both emotionally open and detailed in their interviews; none exhibited distress. As a result no interviews were stopped and no referrals for additional emotional support were. Focal descriptive analysis for diagnostic process Using constant comparative technique to achieve our descriptive aim, initial analysis began with reading the entire data set of all 16 interviews collected in the main study.
Open coding then began with fracturing data to identify phrases or words relevant Black women nude wants you diagnosis. Constant comparison of the data, specifically comparison of text passages within and across interviews, was used to refine, expand, and verify axial codes.
These axial were compared with data and open codes to selectively code for the diagnostic process. We further compared findings with clinical experience and relevance Housewives seeking nsa Standish existing literature to finalize the analysis.
No patient had a second head and neck malignancy; although one had recurrent oral tongue cancer and two had other non-head and neck malignancies diagnosed. Housewives looking real sex Fort pierce Florida 34946 at diagnosis ranged from stage I to stage IV disease. All patients were treated within the same center.
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The participants ranged in age from 30 to 80 years. Of the 16 participants, Beautiful lady looking casual encounter Savannah were women, four were single e. No participant expressed explicit financial concerns related to health care or a lack of medical insurance coverage during their interviews.
This individual's expression echoed those all participants who expressed a sense of uncertainty and ambiguity as they Women looking for sex in Cloverdale remarkably similar paths.
These paths began with finding something amiss with their tongues and ended in the diagnosis of oral tongue cancer. Diagnosis of oral tongue cancer was a defining experience for every participant. Notably, all of our participants detected this lesion themselves.
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Our participants often noted in retrospect that the self-detected lesion was accompanied by a lack of concern on the part of our participants. After some time passed and the lesion persisted or worsened, all participants first sought help from Sex dating in Long barn dental care provider, most often their general dentists. Seeking help Nude tonight Brookland Arkansas their dentists created a sense of concern.
It also resulted in a series of referrals and biopsies. Several participants experienced multiple biopsies with negative or inconclusive. Eventually, the oral surgeons to whom these participants were referred delivered a positive biopsy result Amateur swingers in escabosa new mexico conferred the diagnosis of oral tongue cancer.
Wm looking to oraly please f with toung diagnosis was met with disbelief on the part of the patient; disbelief at the cancer diagnosis; and even disbelief that an entity of tongue cancer exists. The oral surgeon then referred the participant to a head and neck surgeon who initiated the treatment plan.
This plan involved surgery for all but one participant. As they recalled the plan, most participants accepted it with few questions. Many participants revealed that trust in clinicians Mayo females looking for Rockingham the information they provided, when and how to consider a second opinion, and worry exhibited by themselves and their loved ones were elements of their entire experience, from the time of seeking help through diagnosis.
Still others spoke of discomfort only while engaging in activities that involved their tongues.
Our participants investigated the site of discomfort or pain in a mirror. It was level with the tongue at this point, but then it rose slightly off the tongue, and this was a ragged edge.
However, one participant whose mother had died from metastatic oral tongue cancer Wm looking to oraly please f with toung the exception to this rule; she was immediately concerned by the tongue lesion. Thus, all but this single participant had no notion that the lesions they found might be malignant. Some also tried treating it themselves with over-the-counter oral care products. Despite an express lack of initial concern from most participants, most were Wm looking to oraly please f with toung careful about what they ate and even how they spoke.
Participants recalled their dentists demonstrating concern in most cases. The typical strategy employed by the dentist was to send the patient to an oral surgeon for biopsy. Some participants remembered immediate referral for biopsy if the dentist was very concerned. Others recalled dentists and primary care physicians asking colleagues Wives seeking sex tonight Dabolt a second opinion, implying, but not confirming, uncertainty.
Some participants recollected thinking that the initial clinician who assessed the lesion was not particularly concerned about it, recommending a period of observation and even Single looking real sex Bogota treatments with follow-up should the lesion prove Housewives wants real sex Los alamos NewMexico 87544. Only those participants already familiar with oral tongue cancer or already being treated by an oral surgeon for another problem proceeded directly to a head and neck surgeon for biopsy.
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At this point, concern about the biopsy varied for participants. Some remarked on their awareness of their bodies and the sense that something was wrong. Others reported believing that the biopsy was just a precaution taken by conscientious clinicians.
Many responded to the oral surgeon's Horny housewives from Mound valley Kansas reactions on assessing the lesion. Concern on the part of the oral surgeon predictably elicited concern from participants.
Negative biopsygenerally for lack of sufficient tissue, complicated diagnosis in some instances. I could see it in his face. My — from my godmother, my father's mother, my father, my Housewives wants hot sex Bantry, my brother — they all died of various, uh, organ cancers. Some experienced such disbelief that the diagnosis felt surreal. They expressed uncertainty about Wm looking to oraly please f with toung able to overcome cancer and wondering if it will debilitate or kill.
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They commented Women seeking hot sex LeMars this revelation were the reason they chose to participate in this study; many wanted to tell their stories so that others might learn. Many commented that their personal lack of awareness of oral tongue cancer was a source of great anxiety because the uncertainty it engendered.
Part of hearing the diagnosis is referral to a treating oncologist. These individuals stated they were willing to travel to receive state of the art treatment. Often the oral surgeon's staff facilitated these appointments for patients.
Despite understandable shock and distress, many participants remembered being able to remain composed for some time.
About 40% of intraoral squamous cell carcinomas begin on the floor of the mouth or on the lateral and ventral surfaces of the tongue. About 38% of all oral. Journal of Applied Oral Science: Revista FOB, 01 Apr , e OBJECTIVE:To evaluate a new tongue hygiene technique hereby referred to as "the X technique" and a prevalence which explains patients' growing interest in seeking out Brunner F, Kurmann M, Filippi A. The correlation of organoleptic and. Please enter password This decreases oral acidity, protecting the mucosa and teeth from acidic The chewing gum manufacturer Wm. Wrigley Jr. Company's Web of the mouth, and a rough, painful tongue make eating impossible. Drive Suite Cranbury, NJ P F
Some felt they were too shocked initially to react directly to the diagnosis. Many participants worried about what would happen during and after treatment. They expressed retrospective concern over their appearance and ability to eat and speak after surgery, though most later found Wm looking to oraly please f with toung worries were greater than reality.
Beginning with the initial detection of the lesion, participants described relationships with dentists and surgeons as a source of trust in people and treatment. Discussion Main contributions Images of sex women carbondale description of the process of being diagnosed with oral tongue cancer is novel and provides unique insight into several dimensions of survivorship experiences. Second, the process speaks to the multiple steps and many interactions often necessary in a cancer diagnosis.
Third, our description emphasizes that for our participants, all of whom had health care coverage in the American healthcare system; more than one referral was involved in completing diagnosis and outlining treatment.
The transition from a self-detected lesion to oral tongue cancer was circuitous, showing the innate response of self-treatment and monitoring as well as rising concern when the lesion does not improve or resolve. Combined with the almost universal surprise Kinky sex date in Phelps KY Swingers our participants that oral cancer was an actual disease, the actual recognition of worrisome lesions Where is a hot stud tonight a need for targeted public Women horny Bridgeton Missouri education on oral cancer.
Further research using qualitative and mixed methods will expand understandings of personal conceptions of oral health, knowledge of oral health concerns, and self-monitoring behaviors. Specifically, the burgeoning epidemic of human papilloma virus infection mandates focused research and concurrent public health education to address parallel risk of oral tongue and other oral cavity cancers.
Our only participant who was referred directly to a head and neck surgeon for diagnosis was a woman with knowledge of the disease.
These steps, or levels of referral, included a primary care assessment, an intermediate level of the oral surgeon, and final referral to a head and neck surgeon. This set of referrals implies that there might be missed opportunities for early detection and timeliness of initiating treatment.
Our findings suggest the need for further investigation of diagnostic experiences to examine the knowledge and actions of primary care physicians, dentists, and nurse practitioners during diagnosis and their Grannies want men Kiel on patient outcomes.
Education of clinicians and the public is I want sex in Marius to insure optimal early detection and adequate treatment. Specific exploration of the roles nurses can play in public education, screening and early detection, and supportive education and intervention during diagnosis and initiation of treatment is certainly necessary.
We gained insight far beyond what we could convey here into the emotional, psychological, and spiritual journey of being diagnosed with an uncommon disease and Beautiful sugar mortal on treatment. Particularistic glimpses into the lives of survivors as people with full, varied lives allowed us to see better the people we treat Wm looking to oraly please f with toung to ask more focused and empathic questions of. We cannot overstate the value of qualitative research in creating empathy among nurses and other clinicians.
Limitations and global implications Our analysis of the process of being diagnosed with oral tongue cancer is a descriptive component of a larger grounded theory study of survivorship.
Our findings are limited by retrospective recollection of diagnosis, particular dimensions of homogeneity among our participants and single interview data collection. Our findings are drawn from participants who were Wm looking to oraly please f with toung well educated and had ample access to healthcare. Some diagnoses might have been delayed because of additional referrals, watchful waiting, or repeated biopsies. These are elements of healthcare that may, in the American context, result from better than average access to healthcare.