The effects of effleurage hand massage on anxiety and pain in patients undergoing chemotherapy.

OBJECTIVE: To determine the effectiveness of effleurage hand massage performed by trained volunteers on reducing anxiety and pain in patients receiving treatment at a chemotherapy center in Fort Wayne, Ind., as measured by heart rate, respiratory rate, BP, visual analogue scale for anxiety (VAS-A), and visual analogue scale for pain (VAS-P). METHODS: Volunteers trained in effleurage massage gave 10-minute hand massages to 24 patients at the beginning of their chemotherapy session. Baseline and post-treatment vital signs were collected. Patients completed VAS-A and VAS-P scales before massage and after the chemotherapy session. Analysis of premassage and post-treatment data was performed using one-tailed Wilcoxon signed rank test. RESULTS: Significant reductions were noted in systolic BP (z=-1.66, P<0.05), heart rate (z=-3.902, P<0.001), VAS-A (z=-3.91, P<0.001), and VAS-P (z=-3.49, P<0.001); no significant difference was found for diastolic BP (P=0.47) or respiratory rate (P=0.06). CONCLUSION: In patients receiving chemotherapy, effleurage hand massages performed by trained volunteers effectively reduced anxiety and pain similar to previously reported results with massages administered by massage therapists. These findings could have important future implications, allowing for training of family members and caregivers in the technique of effleurage massage.

Patient and referring provider satisfaction with a gastrointestinal consultation clinic for pregnant patients.

BACKGROUND: To improve multi-disciplinary care in pregnancy, a gastrointesintal (GI) disorders in pregnancy clinic was created. Patient and referring provider satisfaction with this service was assessed. METHODS: The first 100 patients and their referring providers were surveyed. Survey scores >3 on a 5-point Likert scale were considered favorable. Descriptive statistics were calculated and open-ended items were analyzed. RESULTS: Fifty-four percent of patients and 32% of providers returned questionnaires. All satisfaction items received an average patient score of >3.6 and provider score of >4.1, demonstrating overall satisfaction with the clinic. Referring providers were particularly satisfied. CONCLUSION: Patients and providers, in particular, report a high level of satisfaction with a GI pregnancy clinic.

Gender differences in the vocational satisfaction of physician assistants.

OBJECTIVE: The purpose of this study is to analyze vocational satisfaction differences by gender as a follow-up of data gathered from a mailed survey study on American physician assistant vocational satisfaction. METHODS: This is an analysis of a database from an original piloted, validated survey with a response rate of 50% from 2,323 labels from the 2003 AAPA's mailing list (n = 1,137). The survey measured vocational satisfaction in terms of career, job, and specialty choice on a forced-choice 6-point Likert-type scale. A qualitative analysis of answers to open-ended questions addressing career satisfiers and dissatisfiers was also conducted. RESULTS: PAs were shown to be highly satisfied with their careers, specialty choices, and jobs. Trends for male PAs showed that they were more satisfied with their careers, specialty choices, and jobs (6-point Likert scale) but female PAs were more likely to refer others into the PA profession than their male counterparts (4-point Likert scale). Statistically significant differences via 2-tailed Mann-Whitney U tests were shown for job satisfaction (P = .02, male Likert mean 3.92 vs. female 3.78) and the likelihood to refer others into the profession (P = .04, female Likert mean 3.43 vs. male 3.33). Twenty-one factors for vocational satisfaction and 29 for dissatisfaction were qualitatively analyzed by gender. The top three satisfiers of helping others, patient interaction, and intellectual challenge were the same by rank regardless of gender. Similarly, the top three dissatisfiers were the same but in reverse order for female and male PAs: (lack of) respect, compensation, and other, for females; and other, compensation, and respect, for males. CONCLUSIONS: This study demonstrated very similar vocational satisfaction measures for female PAs and male PAs via quantitative and qualitative methods with the noteworthy exception that male PAs were statistically more satisfied with their jobs while female PAs were statistically more likely to refer others into the career. These differences, while statistically significant, may be of no practical significance and need to be further studied.

Physician assistant vocational satisfaction.

Physician assistants (PAs) are known to be highly satisfied with their vocational choices, but the reasons for this high degree of satisfaction are not known. The author mailed a survey to 2,323 PAs whose names were randomly chosen from the mailing list of the American Academy of Physician Assistants (AAPA) to examine the factors that PAs feel contribute to vocational satisfaction. The survey response rate was 50%. PAs were found to be highly satisfied with their careers, specialty choices, and jobs. From qualitative data, 21 factors for vocational satisfaction and 29 factors for dissatisfaction were identified. The identified variables could be used to guide PA professional policy development and aid PA employers in making organizational and management decisions.

Chronic fatigue syndrome versus neuroendocrineimmune dysfunction syndrome:differential attributions.

Since 1988, when the term chronic fatigue syndrome (CFS) was coined, considerable discussion has occurred about stigma associated with this diagnostic term. In particular, patients with CFS have felt that this term trivializes the serious nature of this disorder. A Name Change Work group, appointed by the CFS Coordinating Committee, developed an umbrella term: chronic neuroendocrineimmune dysfunction syndrome (CNDS), and proposed that there would be sub-types under this term, one being CFS. The present study examined attributions of this new umbrella term when compared with CFS. Nurses and physician assistants (PAs) were presented a case study of a patient with symptoms of CFS. They were told that the patient had either "chronic fatigue syndrome," "chronic neuroendocrineimmune dysfunction syndrome," or "chronic neuroendocrineimmune dysfunction syndrome, which had formerly been called chronic fatigue syndrome." The different terms led to different attributions, with PA respondents rating the "CNDS" label as more severe. Results suggest that a more medical sounding term (CNDS) may lead to attributions that this syndrome is a more serious, disabling illness. The policy implications of these findings are discussed.