Carmencita Abaquin- PREPARE ME

To everybody in response to carlo's posting. After you read and internalized the theory, as a nurse, how does it change you in your caring behaviors and perceptions on caring for terminally ill patients?So, how does it change you as a human being?

To carlo and everybody, given that kind of scenario, like for example in a hospital you are working at, you are caring for 60 patients in a shift taking care of terminally ill patient specifically cancer patients, Is it practical to use this theory? In your experiences in the field of nursing, are you utilizing the theory?How about your co-nurses in the hospital? We are not questioning here the understaffing issue given that a lot of nurses are unemployed. We are to see the practicality and usefulness of the theory in our nursing care. Please be guided by the questions.

In this theory, you cannot improve your life as a human being per se for the reason that this theory is intended to improve quality of care rendered by a health care provider to the patient. In short, it is intended for the patient to whom you are caring not for the user or the giver whose providing it.

I would to comment that nursing understaffing prevalence is not an issue here in terms of practicality of this system but it is a problem that need to be solve for the reason that when we said practicality itn is a choice of the user using it.

Carmencita Abaquin

“PREPARE ME” Interventions & the Quality of Life of Advance Progressive Cancer Patients

Carmencita M. Abaquin is a nurse with Master’s Degree in Nursing obtained from the University of the Philippines College of Nursing.
An expert in Medical Surgical Nursing with subspecialty in Oncologic Nursing, which made her known both here and abroad.
She had served the University of the Philippines College of Nursing, as faculty and held the position as Secretary of the College of Nursing.
appointment as Chairman of the Board of Nursing speaks of her competence and integrity in the field she has chos

Basic Assumptions and Concepts:
PREPARE ME (Holistic Nursing Interventions) are the nursing interventions provided to address the multi-dimensional problems of cancer patients that can be given in any setting where patients choose to be confined. This program emphasizes a holistic approach to nursing care. PREPARE ME has the following components:

Presence – being with another person during the times of need. This includes therapeutic communication, active listening, and touch.
Reminisce Therapy – recall of past experiences, feelings and thoughts to facilitate adaptation to present circumstances.
Prayer
Relaxation-Breathing – techniques to encourage and elicit relaxation for the purpose of decreasing undesirable signs and symptoms such as pain, muscle tension, and anxiety.
Meditation – encourages an elicit form of relaxation for the purpose of altering patient’s level of awareness by focusing on an image or thought to facilitate inner sight which helps establish connection and relationship with God. It may be done through the use of music and other relaxation techniques.
Values Clarification – assisting another individual to clarify his own values about health and illness in order to facilitate effective decision making skills. Through this, the patient develops an open mind that will facilitate acceptance of disease state or may help deepen or enhance values. The process of values clarification helps one become internally consistent by achieving closer between what we do and what we feel.

“To Nursing… may be able to provide the care that our clients need in maintaining their quality of life and being instrumental in “Birthing” them to External life”

Identify origins of the theory (what prompted)
the incidence of cancer has significantly increased not only in the Philippines but also worldwide

Examine the meaning of theory
1. Terminally-ill patients especially cancer patients require holistic approach of nursing in different aspects of man namely the emotional, psychological, social and spiritual. In this premise, patients with incurable disease require multidimensional nursing care to improve quality of life.
2. PREPARE ME nursing interventions are effective in improving quality of life in terminally-ill patients.
3. Utilization of intervention as a basic part of care given to cancer patients, likewise, incorporation in the basic nursing curriculum in the care of these patients. PREPARE ME must be introduced and focus during training of nurse both in academe and practice.
4. Development of training programs for care provider as well as health care profession where intervention is a part of treatment modalities.
5. The nurse must be honest about the feedback on his/her condition. Nurses must do this so that they would know what the expectations of the patient and the family so that they may render a holistic caring style for the patient together with his family in his dying days. This would help the patient and family address the needs of the patient in any manner possible. (physical, emotional and spiritual)
6. The nurse must help make a supportive environment for the patient and his family in his dying days. An environment like this would promote dignity in his days left thus helping the patient accept his fate and help him/her be ready for the afterlife. The family is also guided in this rough time addressing their grieving process by instilling in them that death is part of life.

Logical Adequacy
The conceptual framework is logical because it is parallel with her definition of nursing and it works for the goal which is QUALITY OF LIFE
She didn’t give emphasis on the extraneous variables affecting the variables involved.

Strength
 It provides us standardized and holistic approached in addressing the needs of terminally ill cancer patients.
 It can also be used for other terminal cases.

Weakness/Limitations
 Caring Ideals of nurse
 Severe depression of the patient.
► more time is needed to make the patient interested in PREPARE ME interventions because they are already experiencing loss of interest in things
► "Understaffing in Philippine hospitals is prevalent. (Inamarga, 2009)
► In the Philippine setting, due to understaffing and financial constrain, time for bed side care is limited

Usefulness (practicability)
 This theory is useful in addressing the needs of terminally-ill cancer patients. This encompassed different aspects including family relationship and self-actualization.
 Appreciating the impact of a relative's cancer and offering guidance and support via patient-centered counseling can enhance quality of care.(zapka, fisher, lemon, clemow & fletcher, 2006)

Generalizability & parsimony (thriftiness)
It can only be applicable to terminally ill patients and hospice facilities
Abaquin’s theory has a wide scope of application. She generated it primarily as a result of her experience with oncology patients. But it is not limited to use in the setting.
It is applicable whenever a nurse encounters terminally-ill patients.
It seems to be most useful when working with those patients with imminent death.

Simplicity
Abaquin’s theory does not possess simplicity because there are many variables. The theory is designed to facilitate nursing care holistically.

Testability of the theory (empirical properties)
Due to high mortality/morbidity rate of cancer patients, it can be applied in practice, education and research for enrichment of oncology care. According to DOH(2007), cancer is the top 3 highest mortality rate in the Philippines.
Can also be utilize in hospice care.

Empirical Precision
Abaquin’s theory appears to have a low degree of empirical validity primarily because variables are hardly measurable to the full extent even with the use of instruments.

GUIDE QUESTION:
1. Do u think with the nursing understaffing prevalence, PREPARE ME can still be a practical system to use?
2. How can you assess the need for PREPARE ME in clients?
3. What other nursing interventions can you think that is fitting to improve the concept of abaquins theory?
4. What subjective & objective cues can alert you that PREPARE ME is needed?
5. What are the moral and social implications of the theory?
6. How can the theory improve your life as a human being?
7. How did the theory improve your caring values as a nurse?