PARADIGMS AND THEORIES IN NURSING

Paradigms and Theories in Nursing

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Abstract

This paper explores the contributions of empirical, interpretive, and critical paradigms to nursing practice, as well as discusses the implications for nursing practice of a pragmatic perspective of theories and paradigms.

Paradigms and Theories in Nursing

Introduction

Cancer refers to a disease that is heterogeneous, and patient can undergo several consequences subsequent diagnosis, plus primary care metastasis to a remote site. Metastatic cancer is mainly responsible for mortality and complications related to epithelial malignancies; for example, pancreatic, stomach, liver, breast, prostate, colon, and lung cancers. Moreover, metastasis is typically complex to treat radiation therapy, conventional surgery, and confer poor prognosis and chemotherapy for the suffering patient. Consequently, distant metastases and local invasion attribute to 90 percent of death due to cancer. Metastasis consideration is clinically appropriate in both treatment and evaluation of cancer patient. While, in diagnosis, patient is evaluated to assess clinical metastasis development, which is essential for determining and prognosis the probable systemic therapy benefit. Patients who are at high risk for metastasis would preferably be treated by therapist, which interrupt the disease spread or deter growth.

Discussion

Empirical Paradigms

Empirical paradigms emphasizes on surgery and chemotherapy. At times surgery is a choice for a patient whose is suffering from colorectal cancer has spread in a restricted way, like the liver. Approximately 30% of patients can be cured if liver is completely removed from its metastases (medically known as "resected"). Surgery is an option only if there is no evidence of cancer outside liver, as well as there should be enough liver left in the functioning stage to prolong life. There is variability and controversy regarding what is nonresectable and resectable disease of metastatic in the liver.

However, in some cases chemotherapy is recommended, even if the disease of metastatic seems limited to the liver. This method is helpful for a patient who is at a surgery edge as of location and size of the tumors to have successful surgery. Moreover, even after surgery of the liver/ lungs, chemotherapy is recommended for metastatic colorectal cancer (Bross, Viadana & Pickren, 1975).

Chemotherapy is of two types associated with lungs or liver cancer. First approach is known as hepatic intraarterial chemotherapy that is directly given into liver/ lungs. Second approach is a chemotherapy known as intravenous chemotherapy that is given into the veins. It is debatable that which of the approach is relatively effective; however, intravenous chemotherapy is commonly used. In addition, surgery is only recommended to the cancer patient who has a limited amount of metastatic disease present in the lung.

For the second-line treatment, combination of regimes is used. In case, the colorectal cancer is constantly expanding or starts to enlarge in spite of chemotherapy, a different combination of chemotherapy can be attempted based on the patients' tolerance level (Ewing, 1928).

Patient is usually switched solely to irinotecan alone or FOLFIRI, if XELOX or FOLFOX was given with or without bevacizumab. For succeeding therapy, if the cancer does not contain the ...