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Exploring the management of bone metastasis according to the Roy Adaptation Model
T Maxwell1, E Givant, M O Kowalski
1Center for Palliative Care, Department of Family Medicine, Thomas Jefferson University, Philadelphia, PA, USA. terri.maxwell@mail.tju.edu
Purpose/Objectives:
To explore bone metastasis using Roy's Adaptation Model as a conceptual framework.
Data Sources:
Published articles, conference abstracts, recent texts, and prescribing information.
Data Synthesis:
Bone metastasis has a significant impact on the patient's ability to maintain physical and psychosocial functions. Primary (self), secondary (family and occupation), and tertiary (community) roles, as identified by the Roy Adaptation Model, may be impaired as a result of bone metastasis. Patient education is a nursing intervention that frequently is used, as it allows an individual to interpret an aversive event and take action, thus promoting adaptation to illness. Medications for the underlying disease, bone metastasis, pain, and other symptoms warrant consideration. Active interventions, such as relaxation therapy, guided imagery, music, meditation, and therapeutic touch, also promote adaptation.
Conclusions:
Bone is a common and potentially debilitating site of metastasis. The presence of bone metastasis indicates progressive and, almost always, incurable disease. Patient adaptation can be enhanced through the proper use of palliative therapies and other nursing measures.
Implications For Nursing Practice:
Oncology nurses can assist in the physical and psychosocial adaptation of patients with bone metastasis through assessment, patient education, and symptom management.