ABSTRACT
PURPOSE/OBJECTIVES: To provide an overview of cancer-related patient-education research to determine future research needs. DATA SOURCES: A literature search of peer-reviewed articles from 1989-1999. Databases that were searched included Medline, CINAHL, HealthStar, ERIC, CancerLit, and PubMed. DATA SYNTHESIS: 176 articles were analyzed and synthesized into narrative form. CONCLUSIONS: Patients with cancer want and benefit from information, especially when making treatment decisions. Education helps patients manage side effects and improves adherence. Literacy is an important factor in materials development. The efficacy of computer-assisted learning, audio and video programs, and telephone interventions is supported in a variety of patient groups. Pain education can improve pain control, but the impact on fatigue has not been well researched. IMPLICATIONS FOR NURSING PRACTICE: Patient education is an important component of nursing care. Research has confirmed its impact in many areas but questions still remain.
Subject(s)
Neoplasms/nursing , Nursing Research , Patient Education as Topic/methods , Communications Media , Computer-Assisted Instruction , Decision Making , Educational Status , Humans , Neoplasms/complications , Teaching MaterialsABSTRACT
A number of disorders may result in the complaint of dysphagia in HIV-infected patients. These include fungal, viral, bacterial, parasitic, medication-induced, and idiopathic lesions in the esophagus. In the current case, a 32-year-old man with advanced HIV infection had recurrent bouts of esophageal stricture. No ulcer was associated with this stricture. No infectious causes of the stricture could be determined. The patient required multiple upper endoscopies and dilatations for treatment of this stricture and subsequently had a food impaction. This is the first case in the medical literature of an idiopathic stricture in the middle portion of the esophagus in an HIV-infected patient. We postulate that this lesion may have been caused by the patient's medications. Esophageal strictures should be considered in HIV-infected patients with severe dysphagia or food-bolus impactions of the esophagus.
Subject(s)
Acquired Immunodeficiency Syndrome/complications , Deglutition Disorders/etiology , Esophageal Stenosis/etiology , Adult , Biopsy , Candidiasis/diagnosis , Esophagitis/diagnosis , Esophagoscopy , Fatal Outcome , Fluconazole/administration & dosage , Fluconazole/adverse effects , Humans , MaleABSTRACT
OBJECTIVE: To determine whether the prone sleep position was associated with an increased risk of the sudden infant death syndrome (SIDS). STUDY DESIGN: Population-based case-control study. PARTICIPANTS: Case subjects were infants who died of SIDS in King County, Washington. Control subjects were randomly selected infants born in King County. Up to four control subjects were matched on date of birth to each case subject. METHODS: During the study period, November 1992 through October 1994, sleep-position data were collected on infants who died of SIDS by the King Count Medical Examiner's Office during their investigation of the deaths. Parents of infants chosen as control subjects were contacted by telephone, and sleep position information was obtained. Infants who usually slept on their abdomen were classified as sleeping prone; those who usually slept on the side or back were categorized as sleeping nonprone. The adjusted odds ratio for prone sleep position as a risk factor for SIDS was calculated with conditional logistic regression after control for race, birth weight, maternal age, maternal marital status, household income, and maternal cigarette smoking during pregnancy. RESULTS: Sleep position data were collected on 47 infants with SIDS (77% of eligible infants) and 142 matched control subjects; 57.4% of infants who died of SIDS usually slept prone versus 24.6% of control subjects (p < 0.00001). The unadjusted odds ratio for prone sleep position as a risk factor for SIDS was 4.69 (95% confidence interval: 2.17, 10.17). After control for potentially confounding variables, the adjusted odds ratio for prone sleep position was 3.12 (95% confidence interval: 1.08, 9.03). CONCLUSION: Prone sleep position was significantly associated with an increased risk of SIDS among a group of American infants.
Subject(s)
Prone Position , Sleep , Sudden Infant Death/epidemiology , Adult , Birth Weight , Case-Control Studies , Humans , Infant , Infant, Newborn , Maternal Age , Odds Ratio , Risk Factors , Socioeconomic Factors , Sudden Infant Death/etiology , Washington/epidemiologyABSTRACT
Infection control in the nursing home or long-term care facility is an increasingly complex activity. The high rates (approximately 15%) and special risks (group activities, crowding) for nosocomial infection demand special attention by attending physicians. Some specific responsibilities include: recognition of infection; knowledge and use of basic infection control principles; appropriate antibiotic use; review of immunizations; facilitation of communications among office, hospital, and long-term care facility; and involvement with infection control program(s).
