The nursing process in the care of a patient with non-Hodgkin lymphoma

Non-Hodgkinov limfom je vrsta raka koji se razvija u limfnom sustavu, dijelu našeg imunološkog sustava koji nas štiti od bolesti i infekcija. Limfni sustav se sastoji od limfnog tkiva i limfnih žila koje transportiraju i skupljaju limfu koja sadrži bijele krvne stanice zvane limfociti. U non-Hodgkinovim limfomima pogođeni limfociti se počinju množiti na nenormalan način i skupljati u određenim dijelovima limfnog sustava kao što su limfni čvorovi. Pogođeni limfociti gube svoju obrambenu svrhu što dovodi do oslabljenog imunološkog sustava. Najčešći simptom NHL je bezbolno naticanje limfnih čvorova, obično na vratu, pazuhu ili preponama. Kada se sumnja da pacijent ima limfom, uzima se kompletna anamneza i obavlja se fizički pregled, nakon čega slijedi niz dijagnostičkih testova. Biopsija povećanih limfnih čvorova ili organa potrebna je kako bi se utvrdilo postoji li limfom. Kod agresivnijih tipova NHL-a liječenje obično uključuje kombinaciju kemoterapije, terapije zračenjem i imunoterapije. Odluke o liječenju temelje se na vrsti NHL-a, stadiju i stupnju bolesti te popratnim bolestima povezanim s pacijentom. Značajni životni događaji pacijenta poput dijagnoze limfoma zadaju posebne izazove medicinskim sestrama koje skrbe o njima. Medicinske sestre imaju odgovornost prema pacijentima ne samo u zadovoljavanju njihovih osnovnih ljudskih potreba, već i u edukaciji koja nije tako jednostavna s obzirom na to da pacijenti dolaze iz različitih etničkih i socioekonomskih sredina, te imaju različite prioritete u samom procesu zdravstvene njege. Pacijentima je potrebno pružiti psihološku podršku te ih saslušati o njihovim strahovima vezanim uz bolest. Cilj ovog rada je pobliže opisati važnost kvalitetnog procesa zdravstvene njege, te važnost podrške obitelji i zdravstvenih djelatnika odnosno medicinskih sestara kod pacijenata oboljelih od non-Hodgkinovog limfoma.Non-Hodgkin lymphoma is a cancer that starts in the lymphatic system, the part of our immune system that protects us from diseases and infections. The lymphatic system consists of lymphatic tissue and lymphatic vessels that transport and collect the lymph that contains white blood cells called lymphocytes. In non-Hodgkin's lymphomas, the affected lymphocytes begin to multiply in an abnormal way and begin to collect in certain parts of the lymphatic system, such as the lymph nodes. The affected lymphocytes lose their infection-fighting properties making the immune system vulnerable. The most common symptom of non-Hodgkin lymphoma is a painless swelling in a lymph node, usually in the neck, armpit or groin. If the signs or symptoms suggest that the patient might have lymphoma, a complete medical history is made and physical examination is performed, followed by a series of diagnostic tests. A biopsy of enlarged lymph nodes or organs is needed to determine whether lymphoma exists. The treatment of the aggressive type of lymphoma usually includes a combination of chemotherapy, radiation or immunotherapy. Treatment decisions are based on the type of NHL, its staging and degree of the disease and comorbidities associated with the patient. Significant events in the life of a patient, such as lymphoma diagnosis is especially challenging for the nurses who take care for them. Nurses are responsible not only for meeting their basic human needs, but also for educating them, which is not that simple given that patients come from different ethnic and socio-economic backgrounds, and have different priorities in the healthcare process itself. Patients need psychological support and they need to be listened to regarding their disease-related fears. The aim of this paper is to describe in detail the importance of the quality health care, family support and medical staff support, especially nurses´ support in patients with non-Hodgkin lymphoma