Your browser doesn't support javascript.
loading
Show: 20 | 50 | 100
Results 1 - 20 de 42
Filter
1.
Diversitas perspectiv. psicol ; 14(1): 83-96, ene.-jun. 2018. tab
Article in Spanish | LILACS | ID: biblio-975043

ABSTRACT

Resumen El presente estudio es un análisis bibliométrico de las publicaciones en intervenciones basadas en las terapias de tercera generación en niños y adolescentes durante los años 2011-2016. Para esto se realizó un estudio descriptivo dentro del cual se analizaron 60 artículos científicos de diversas bases de datos como Proquest, Redalyc, Sage, ScienceDirect y Springer Science, Dialnet, Ebsco Host. Se evidenció que entre los años 2012 y 2014 se presentó un incremento en las publicaciones de terapias de tercera generación en Iberoamérica y Europa. La revista International Journal of Behavioral Consultation & Therapy presenta la mayor cantidad de publicaciones en este ámbito. En relación con el autor que presenta más publicaciones, se referencia a Swart, J como el principal. La revisión teórica y el estudio cuasi experimental fueron la metodología más reportada y el Mindfulness la terapia más utilizada. En cuanto al país con Mayor número de investigaciones en esta temática es Estados Unidos. Este estudio permite concluir que las terapias de tercera generación han comenzado a tomar fuerza en varios de los problemas comportamentales y emocionales en niños y adolescentes. Sin embargo, es necesario ampliar las investigaciones en este ámbito dado que en la mayoría de los artículos no se cuantifica el grado de eficacia.


Abstract The present study is a bibliometric analysis of publications on interventions based on third generation therapies in children and adolescents during the years 2011-2016. For this, a descriptive study was carried out in which 60 scientific articles from diverse databases were analyzed, such as Proquest, Redalyc, Sage, ScienceDirect and Springer Science, Dialnet, Ebsco Host. It was evidenced that between the years 2012 and 2014 there was an increase in the publications of third generation therapies in Ibero-America and Europe. The International Journal of Behavioral Consultation & Therapy presents the largest number of publications in this field. In relation to the author who presents the most publications, reference is made to Swart, J as the principal. The theoretical review and the quasi-experimental study were the most reported methodology and Mindfulness the most used therapy. As for the country with the largest number of investigations in this area is the United States. This study allows us to conclude that third generation therapies have begun to gain strength in several behavioral and emotional problems in children and adolescents. However, it is necessary to expand the research in this field since in most articles the degree of efficacy is not quantified.

2.
Intensive Crit Care Nurs ; 29(1): 20-7, 2013 Feb.
Article in English | MEDLINE | ID: mdl-22705052

ABSTRACT

OBJECTIVES: To determine the feasibility of conducting a sedation wake-up trial (SWT) plus a spontaneous breathing trial (SBT) in critically ill trauma patients based on the ability to implement the combined intervention; to measure and describe patients' physiological responses; and to maintain patient safety. METHODS: A secondary analysis of the intervention group from a trial of 20 mechanically ventilated patients receiving SWT plus SBT in a trauma-intensive care unit. RESULTS: Patients passed 67% of the 39 SWTs performed; those who failed presented RASS scores of +1 and +2 (70%), tachycardia (15%) or ventilator asynchrony (15%). Eighteen patients tolerated their first SBT, and after the second SBT, more than half of the patients were discontinued from the mechanical ventilator. A significant increase from the beginning to the end of the SWT was found in heart rate (p=.021), respiratory rate (p=.043) and systolic blood pressure (p=.04). Although these measures increased significantly, their overall mean did not increase by 20%. CONCLUSION: SWT plus SBT was well tolerated and successfully implemented. Our data showed that it is not necessary to withhold continuous-infusion analgesia during the SWT.


Subject(s)
Critical Care/methods , Ventilator Weaning/methods , Wounds and Injuries/therapy , Blood Pressure , Critical Care Nursing , Delirium/prevention & control , Feasibility Studies , Heart Rate , Humans , Hypnotics and Sedatives/administration & dosage , Intensive Care Units , Length of Stay , Respiratory Rate , Wounds and Injuries/nursing
3.
Clin J Pain ; 27(7): 561-6, 2011 Sep.
Article in English | MEDLINE | ID: mdl-21436683

ABSTRACT

OBJECTIVE: The purpose of this study was to evaluate differences in pain intensity, pain quality, physiological measures, and adverse effects when patients received morphine with saline (MS) compared with morphine and a small dose of ketamine (MK) before an open wound care procedure (WCP). METHODS: A randomized, cross-over design was used to determine whether the addition of a small dose of ketamine would potentiate morphine's analgesic effects and decrease WCP pain intensity. Patients were randomized to receive either 0.1 mg/kg of morphine (8 mg maximum) plus saline intravenously (IV) or 0.05 mg/kg of morphine (4 mg maximum) plus ketamine 0.25 mg/kg IV before the WCP. Patients were crossed-over to receive the alternate treatment during the next WCP. RESULTS: Eleven male patients participated in the study. Mean rank of pain intensity during WCP-MK was significantly less than during WCP-MS (P=0.005). Mean±standard error of mean pain intensity during the WCP-MK was 3.09±0.99, whereas it was 6.82±0.92 during the WCP-MS. However, 91% of the patients had adverse effects (eg, strange sensations, hallucinations, blurred vision) with MK versus 0% with MS. Diastolic blood pressure was significantly higher during the WCP-MK. DISCUSSION: Ketamine with morphine significantly reduced procedural wound pain intensity during WCP. Adverse effects and higher diastolic BP occurred with MK. Further research is warranted to determine the optimal analgesic dose of ketamine or if the addition of a benzodiazepine would mitigate the psychotomimetic effects of ketamine.


Subject(s)
Analgesics/therapeutic use , Ketamine/therapeutic use , Morphine/administration & dosage , Pain/drug therapy , Adult , Aged , Cross-Over Studies , Dose-Response Relationship, Drug , Double-Blind Method , Drug Administration Routes , Drug Synergism , Humans , Intraoperative Period , Male , Middle Aged , Pain/etiology , Pain Measurement , Polypharmacy , Trauma Centers , Wounds and Injuries/surgery , Young Adult
4.
Oncol Nurs Forum ; 37(2): 172-81, 2010 Mar.
Article in English | MEDLINE | ID: mdl-20189922

ABSTRACT

PURPOSE/OBJECTIVES: To describe the pain experience of Chinese American patients with cancer and to examine the relationships among pain characteristics, demographic characteristics, performance status, self-reported analgesic use, mood disturbances, and patients' acculturation levels. DESIGN: Descriptive, correlational, cross-sectional study. SETTING: Three community-based oncology facilities in the San Francisco, CA, Bay area. SAMPLE: 50 Chinese Americans who reported experiencing pain from cancer. METHODS: Participants completed in their preferred language a demographic questionnaire, the Karnofsky Performance Status Scale, the Brief Pain Inventory, the Hospital Anxiety and Depression Scale, the Suinn-Lew Asian Self-Identity Acculturation Scale, and information about analgesic use. Descriptive and correlational statistics were used to evaluate data. MAIN RESEARCH VARIABLES: Pain intensity, pain interference, performance status, anxiety, depression, analgesic use, and acculturation level. FINDINGS: Most of the patients reported moderate to severe pain and moderate levels of interference. Lower levels of acculturation were associated with higher least and worst pain intensity scores and higher pain interference scores. Anxiety and depression scores were in the moderate range. Higher depression scores were associated with higher pain interference scores. Self-reported analgesic use for 62% of the patients was classified as inadequate. CONCLUSIONS: A significant percentage of Chinese American patients experience moderate to severe cancer pain that affects their mood and their ability to function. IMPLICATIONS FOR NURSING: Nurses should assume a proactive role in assessing the physical, emotional, and cognitive dimensions of pain in Chinese American patients. Future research should evaluate the cancer pain experience of these vulnerable patients and develop and test culturally appropriate interventions.


Subject(s)
Acculturation , Asian/statistics & numerical data , Mood Disorders/ethnology , Neoplasms/ethnology , Pain/ethnology , Adult , Aged , Analgesics/therapeutic use , Cancer Care Facilities , Community Health Services , Complementary Therapies , Cross-Sectional Studies , Female , Humans , Male , Middle Aged , Mood Disorders/nursing , Neoplasms/nursing , Oncology Nursing , Pain/drug therapy , Pain/nursing , Pilot Projects , San Francisco/epidemiology , Surveys and Questionnaires , Transcultural Nursing
5.
Cancer Nurs ; 33(2): 85-92, 2010.
Article in English | MEDLINE | ID: mdl-20142740

ABSTRACT

BACKGROUND: Data about health-related quality of life (QOL) after surgical treatment for lung cancer are limited. Such information can be valuable in developing appropriate nursing interventions for follow-up care for survivors. OBJECTIVES: The purposes of this study were to describe physical and emotional QOL of disease-free female non-small cell lung cancer (NSCLC) survivors and to determine characteristics associated with greater risk for disruptions. METHODS: One-hundred-nineteen women surgically treated for NSCLC completed the Short-Form 36 (as a measure of physical and mental QOL) along with health status assessments (including comorbidity, depression, Center for Epidemiologic Studies-Depression Scale, smoking status, and body mass index), dyspnea (Dyspnea Index), meaning of illness, and demographic and clinical information at baseline and 3 and 6 months. RESULTS: On average, the women were 68 years of age, diagnosed 2 years previously, had adenocarcinoma, and were treated surgically with lobectomy. The majority (66%) had comorbid disease, 29% had depressed mood (Center for Epidemiologic Studies-Depression Scale score > or =16), 8% were current smokers, 62% were overweight, 22% had dyspnea (scores > or =2), and 24% had a negative meaning of illness. Physical and emotional QOL scores were comparable to Short-Form 36 norms for older adults and exhibited little change over time. Controlling for time since diagnosis, dyspnea, and depressed mood were strongly related to disruptions in physical and emotional QOL, respectively, across the 6-month study period, with comorbid disease contributing to both models. CONCLUSION: Depressed mood, comorbidities, and dyspnea were factors related to poorer physical and emotional QOL. Survivors with these characteristics might benefit from greater supportive care. IMPLICATIONS FOR PRACTICE: Screening for dyspnea, depressed mood, and comorbid illness can identify female survivors at-risk for poorer QOL after surgery.


Subject(s)
Attitude to Health , Carcinoma, Non-Small-Cell Lung/surgery , Lung Neoplasms/surgery , Quality of Life/psychology , Thoracotomy/psychology , Women/psychology , Adenocarcinoma/surgery , Adult , Aged , Aged, 80 and over , Carcinoma, Non-Small-Cell Lung/complications , Carcinoma, Non-Small-Cell Lung/psychology , Chi-Square Distribution , Comorbidity , Depression/etiology , Dyspnea/etiology , Female , Health Status , Health Surveys , Humans , Lung Neoplasms/complications , Lung Neoplasms/psychology , Middle Aged , Multivariate Analysis , Nursing Methodology Research , Prospective Studies , Regression Analysis , Statistics, Nonparametric , Surveys and Questionnaires , Survivors/psychology , United States
6.
Semin Oncol Nurs ; 26(1): 59-67, 2010 Feb.
Article in English | MEDLINE | ID: mdl-20152579

ABSTRACT

OBJECTIVE: To clarify the relationship between quality of life (QOL) and culture. DATA SOURCE: Journal articles, proceedings, and clinical experience. CONCLUSION: QOL is a subjective, multidimensional experience of well-being that is culturally constructed as individuals seek safety and security, a sense of integrity and meaning in life, and a sense of belonging in one's social network. IMPLICATIONS FOR NURSING PRACTICE: In a society where health disparities between diverse groups are known to exist, it is incumbent upon nurses to consider the impact of ethnicity/culture on the health care they deliver and on the QOL of their patients.


Subject(s)
Attitude to Health/ethnology , Cultural Diversity , Neoplasms , Nursing Research/trends , Oncology Nursing/trends , Quality of Life/psychology , Cross-Cultural Comparison , Evidence-Based Nursing , Existentialism/psychology , Health Status Disparities , Healthcare Disparities , Humans , Models, Nursing , Models, Psychological , Neoplasms/ethnology , Neoplasms/nursing , Social Identification , Spirituality , Stereotyping , Transcultural Nursing/trends , United States/epidemiology
7.
Adv Skin Wound Care ; 22(8): 373-80; quiz 381-2, 2009 Aug.
Article in English | MEDLINE | ID: mdl-19638801

ABSTRACT

PURPOSE: To provide the wound care practitioner with an overview of research and knowledge about the causes, mechanisms, contributing factors, and management of acute wound pain. TARGET AUDIENCE: This continuing education activity is intended for physicians and nurses with an interest in skin and wound care. OBJECTIVES: After reading this article and taking this test, the reader should be able to: 1. Describe the causes of acute wound pain. 2. Discuss research findings related to the physiology of wound pain. 3. Identify current concepts in the management of acute wound pain.


Subject(s)
Pain/etiology , Wound Healing , Wounds and Injuries/complications , Acute Disease , Humans , Nociceptors , Pain Management , Pain Measurement , Pain, Postoperative/etiology , Risk Factors
8.
Intensive Care Med ; 35(5): 781-95, 2009 May.
Article in English | MEDLINE | ID: mdl-19165463

ABSTRACT

Sleep deprivation and delirium are conditions commonly encountered in intensive care unit patients. Sleep in these patients is characterized by sleep fragmentation, an increase in light sleep, and a decrease of both slow wave sleep and rapid eye movement sleep. The most common types of delirium in this population are hypoactive and mixed-type. Knowledge about the mechanisms of sleep and delirium has evolved over time, but these phenomena are not yet well understood. What is known, however, is that different areas in the brainstem transmit information to the thalamus and cortex necessary for sleep-wake regulation. Delirium is related to an imbalance in the synthesis, release, and inactivation of some neurotransmitters, particularly acetylcholine and dopamine. The relationship between sleep deprivation and delirium has been studied for many years and has been viewed as reciprocal. The link between them may be ascribed to shared mechanisms. An imbalance in neurotransmitters as well as alteration of melatonin production may contribute to the pathogenesis of both phenomena. A better understanding of the mechanisms and factors that contribute to sleep deprivation and delirium can guide the development of new methods and models for prevention and treatment of these problems and consequently improve patient outcomes.


Subject(s)
Delirium/epidemiology , Intensive Care Units/statistics & numerical data , Sleep Deprivation/epidemiology , Sleep Disorders, Circadian Rhythm/epidemiology , Brain Stem/physiopathology , Delirium/diagnosis , Delirium/physiopathology , Electroencephalography , Heart Rate/physiology , Humans , Nerve Net/physiopathology , Polysomnography , Severity of Illness Index , Sleep Deprivation/diagnosis , Sleep Disorders, Circadian Rhythm/diagnosis , Sleep Stages/physiology , Thalamus/physiopathology
9.
J Pain Symptom Manage ; 37(4): 665-75, 2009 Apr.
Article in English | MEDLINE | ID: mdl-19004613

ABSTRACT

Barriers to cancer pain management can contribute to the undertreatment of cancer pain. No studies have documented barriers to cancer pain management in Chinese American patients. The purposes of this study in a community sample of Chinese Americans were to: describe their perceived barriers to cancer pain management; examine the relationships between these barriers and patients' ratings of pain intensity, pain interference with function, mood disturbances, education, and acculturation level; and determine which factors predicted barriers to cancer pain management. Fifty Chinese Americans with cancer pain completed the following instruments: Brief Pain Inventory (BPI), Karnofsky Performance Status (KPS) Scale, Barriers Questionnaire (BQ), Hospital Anxiety and Depression Scale (HADS), Suinn-Lew Asian Self-Identity Acculturation Scale (SL-ASIA), and a demographic questionnaire. The mean total BQ score was in the moderate range. The individual barriers with the highest scores were: tolerance to pain medicine; time intervals used for dosage of pain medicine; disease progression; and addiction. Significant correlations were found between the tolerance subscale and least pain (r=0.380) and the religious fatalism subscale and average pain (r=0.282). These two subscales were positively correlated with anxiety and depression levels: (tolerance: r=0.282, r=0.284, respectively; religious fatalism: r=0.358, r=0.353, respectively). The tolerance subscale was positively correlated with pain interference (r=0.374). Approximately 21% of the variance in the total BQ score was explained by patients' education level, acculturation score, level of depression, and adequacy of pain treatment. Chinese American cancer patients need to be assessed for pain and perceived barriers to cancer pain management to optimize pain management.


Subject(s)
Asian/statistics & numerical data , Health Services Accessibility/statistics & numerical data , Neoplasms/complications , Pain Management , Acculturation , Aged , California , Female , Humans , Male , Mood Disorders/etiology , Mood Disorders/psychology , Pain/etiology , Pain Measurement , Surveys and Questionnaires
10.
Gynecol Oncol ; 112(2): 358-64, 2009 Feb.
Article in English | MEDLINE | ID: mdl-19059636

ABSTRACT

OBJECTIVE: Though cervical cancer is preventable, this cancer nonetheless poses serious mortality and morbidity threats to American women and women globally. The purpose of this study is to utilize a multidimensional framework to assess Health-related Quality of Life (HRQOL) and its salient predictors among a population based sample of cervical cancer survivors. METHODS: A cross-sectional design was used with a population-based sample ascertained from the California Cancer Surveillance Program. Descriptive, bivariate and multivariate regression analyses were conducted. RESULTS: Participants were 560 cervical cancer survivors: English-speaking Latina- (n=88), Spanish-speaking Latina- (n=199) and European- (n=273) Americans. The greatest concerns were documented for family/social and emotional well-being, and body image and sexual health. In general, Latina-Americans reported poorer overall HRQOL, functional, emotional, and social/family wellbeing compared to European-Americans. Differences in HRQOL persisted by ethnic/language group after controlling for covariates. Radiation, comorbidity, role limitations, perceived health status, psychological wellbeing, body image, sexual impact, doctor-patient relationship, and social support were significant predictors of overall HRQOL. The regression model explained 58% of the variance in predicting HRQOL. CONCLUSION: These cervical cancer survivors reported poor to moderate HRQOL with persistent psychosocial challenges. Our findings indicate that lower SES, monolingual Latinas are at greatest risk for poor HRQOL outcomes. Clinicians should pay attention to their patients' socio-ecological context as a risk factor for poorer outcomes; and provide early referrals to resources that are low cost and culturally and linguistically appropriate.


Subject(s)
Uterine Cervical Neoplasms/ethnology , Uterine Cervical Neoplasms/psychology , California/epidemiology , Cross-Sectional Studies , Female , Health Status Disparities , Hispanic or Latino , Humans , Middle Aged , Quality of Life , Social Support , Socioeconomic Factors , Survivors , Uterine Cervical Neoplasms/mortality , White People
11.
Oncol Nurs Forum ; 34(6): 1162-7, 2007 Nov.
Article in English | MEDLINE | ID: mdl-18024342

ABSTRACT

PURPOSE/OBJECTIVES: To explore the cancer symptom experience, self-care strategies, and quality of life (QOL) among Chinese Americans during outpatient chemotherapy. DESIGN: Descriptive, exploratory cohort study. SETTING: An outpatient infusion unit at a public urban county medical center. SAMPLE: 25 Chinese-speaking patients with cancer completed the study. Participants were first-generation immigrants with low levels of acculturation; 88% could not read English; 64% had an annual household income of less than $20,000. METHODS: Participants completed a basic demographics data sheet, the Suinn-Lew Acculturation Scale, the Memorial Symptom Assessment Scale and Self-Care Diary weekly for three weeks, and the Multidimensional QOL Scale-Cancer and Short-Form 36 Health Survey at the start and end of one chemotherapy cycle. Study instruments were translated into Chinese. MAIN RESEARCH VARIABLES: Symptoms, self-care, QOL, and acculturation. FINDINGS: Participants reported experiencing about 14 symptoms weekly. Lack of energy, hair loss, dry mouth, sleep difficulty, and loss of appetite were reported most frequently. On average, about two self-care strategies per symptom were reported and were low to moderate in effectiveness. About 20% of the sample listed Chinese medicine as part of their self-care strategies. A moderate level of QOL was reported. CONCLUSIONS: Using translated standardized questionnaires can be a feasible method of data collection in studies with non-English-speaking patients. However, having well-trained, bilingual data collectors is important. More attention to long-term cancer self-management in minority patients with cancer is needed. IMPLICATIONS FOR NURSING: Further research is needed with larger samples, more efficient community-based recruitment strategies, and the development and testing of culturally sensitive interventions.


Subject(s)
Asian , Neoplasms/diagnosis , Neoplasms/therapy , Quality of Life , Self Care , Adult , Aged , Cohort Studies , Female , Humans , Male , Middle Aged , Neoplasms/drug therapy , Surveys and Questionnaires
12.
Cancer Nurs ; 30(5): 335-46, 2007.
Article in English | MEDLINE | ID: mdl-17876178

ABSTRACT

Over 2 million new cases of cancer are diagnosed annually in China. In addition, cancer is the leading cause of death in China. Because cancer is often diagnosed in more advanced stages in China, a higher percentage of patients will experience pain related to their disease or treatment. This article presents a review and critique of the studies that examined the experience of pain in Chinese cancer patients. Because pain is a subjective experience with multiple dimensions, this review used the multiple dimensions of cancer pain to describe the pain experience in adult Chinese patients with cancer. The results from 24 studies of cancer pain in Chinese patients are summarized. Most of these descriptive correlational studies evaluated the physiologic and sensory dimensions of the pain experience. Most of the patients reported moderate to severe pain and that pain interfered with their normal activities and mood. In contrast, little information is available about the impact of cancer pain on the cognitive and sociocultural dimensions of the pain experience for Chinese patients.


Subject(s)
Asian People , Neoplasms/ethnology , Pain/ethnology , Asian , China/ethnology , Emigration and Immigration , Humans , Neoplasms/physiopathology , Neoplasms/psychology , Pain/physiopathology , Pain/psychology , United States
13.
Ann Behav Med ; 33(3): 242-50, 2007 Jun.
Article in English | MEDLINE | ID: mdl-17600451

ABSTRACT

BACKGROUND: Smoking cessation after a cancer diagnosis is associated with improved clinical outcomes. PURPOSE: The aims of this study are to determine smoking prevalence, describe patterns of smoking, identify readiness to quit and cessation strategies, identify factors associated with continued smoking among women with lung cancer, and determine smoking prevalence among household members. METHODS: Data were collected through questionnaires and medical record review from 230 women. Smoking was determined through self-report and biochemical verification with urinary cotinine. RESULTS: Eighty-seven percent of women reported ever-smoking, and 37% reported smoking at the time of diagnosis. Ten percent of women were smoking at entry to the study, 13% were smoking at 3 months, and 11% at 6 months. Fifty-five percent of smokers planned a quit attempt within the next month. One third of smokers received cessation assistance at diagnosis, and pharmacotherapy was the most common strategy. Significant factors associated with continued smoking included younger age, depression, and household member smoking. Continued smoking among household members was 21%. Twelve percent of household members changed their smoking behavior; 77% quit smoking, but 12% started smoking. CONCLUSIONS: The diagnosis of cancer is a strong motivator for behavioral change, and some patients need additional support to quit smoking. Family members should also be targeted for cessation interventions.


Subject(s)
Lung Neoplasms/epidemiology , Tobacco Use Disorder/epidemiology , Adult , Female , Health Behavior , Health Promotion , Humans , Middle Aged , Prevalence , Prospective Studies , Smoking Cessation/methods , Smoking Cessation/statistics & numerical data , Surveys and Questionnaires , Tobacco Use Disorder/prevention & control
14.
J Cardiovasc Nurs ; 22(3): 159-65, 2007.
Article in English | MEDLINE | ID: mdl-17545818

ABSTRACT

BACKGROUND: Patients with heart failure have higher mortality rates than those with most malignant diseases. The heart failure illness trajectory is one of gradual decline characterized by unpredictable events such as acute decompensation of heart failure or a sudden cardiac death. Health professionals have an obligation to give patients and their families concise and honest information concerning their prognosis. The challenge exists to give what ostensibly may seem a bleak prognosis within a context of hope and optimism. AIM: To explore the role of hope in heart disease and the potential utility of this construct in the development of nursing interventions. METHODS: The electronic databases CINAHL, MEDLINE, EmBASE, and PSYCHlit were searched from 1982 to August 2004 using the key words "hope," "hopelessness," "heart disease," and "heart failure." Articles were subsequently sorted to meet the inclusion criteria of (1) a philosophical discussion of the construct of hope and/or (2) investigation of hope in heart disease. RESULTS: This search retrieved 768 articles, and 24 met the inclusion criteria. Key findings from the review indicate that "hope" and "hopelessness" are underdeveloped, yet important constructs and conceptually linked with depression and spirituality. Intriguing findings from descriptive, observational studies have demonstrated the positive impact of expression of hope on cardiovascular outcomes. These findings need to be validated in randomized controlled trials. CONCLUSIONS: This critical literature review has determined that "hope" is strongly associated with the individual's future orientation. Increased understanding of this concept may assist in refining patient-focused interventions and developing therapeutic strategies to enhance hope.


Subject(s)
Attitude to Health , Cardiac Output, Low/psychology , Family Health , Humans , Prognosis
15.
Oncol Nurs Forum ; 34(2): 403-9, 2007 Mar.
Article in English | MEDLINE | ID: mdl-17573304

ABSTRACT

PURPOSE/OBJECTIVES: To examine how neutropenia affects quality of life (QOL) and explore strategies to assess neutropenia-related QOL in clinical practice. DATA SOURCES: Published articles, abstracts, conference proceedings, and clinical practice guidelines. DATA SYNTHESIS: Neutropenia can have a detrimental effect on the QOL of patients receiving chemotherapy. A neutropenia-related QOL questionnaire can help nurses better identify patients at risk for developing neutropenia and monitor patients who already have it. In some cases, the questionnaire may be the first step in the initiation of interventions to improve patient care. Ideally, the QOL questionnaire should be easy to use, provide clinically meaningful information, and be easily adapted from existing QOL measurement tools. CONCLUSIONS: Effective implementation of QOL assessments into clinical practice can lead to the initiation of interventions that may improve neutropenia-related QOL in patients with cancer receiving chemotherapy. IMPLICATIONS FOR NURSING: Nurses can enhance their clinical judgment and affect patient treatment by implementing a questionnaire that assesses patients' neutropenia-related QOL.


Subject(s)
Neutropenia/nursing , Nursing Assessment/methods , Oncology Nursing/methods , Quality of Life , Humans , Oncology Nursing/instrumentation , Surveys and Questionnaires
16.
J Pain Symptom Manage ; 34(1 Suppl): S20-7, 2007 Jul.
Article in English | MEDLINE | ID: mdl-17532176

ABSTRACT

Research to improve the care of patients with malignant bowel obstruction (MBO) is urgently needed. In particular, there is an urgent need for high-quality descriptive research, including prospective cohort studies, as well as randomized controlled trials to define optimal management strategies. However, investigators and clinicians face numerous barriers in conducting high-quality research in this patient population. These barriers include lack of funding, difficulties in identifying eligible patients, and a variety of practical and methodological challenges of designing these studies. In addition, there are a variety of ethical challenges that arise in the design and conduct of studies of MBO and particularly in the conduct of clinical trials. In this article, we address four categories of ethical issues: study design, recruitment, informed consent, and Institutional Review Board review. For each, we outline salient issues and suggest recommendations for enhancing the ethics of MBO studies, including interventional trials.


Subject(s)
Intestinal Neoplasms/therapy , Intestinal Obstruction/therapy , Palliative Care/ethics , Humans , Informed Consent , Intestinal Neoplasms/complications , Intestinal Obstruction/etiology , Palliative Care/methods , Practice Guidelines as Topic
17.
Cancer Nurs ; 30(2): 125-38, 2007.
Article in English | MEDLINE | ID: mdl-17413778

ABSTRACT

Quality of life (QOL) has become an important outcome measure for evaluating the impact of cancer therapy, especially aggressive cancer therapies such as hematopoietic cell transplantation (HCT). Despite the intense interest in examining the phenomenon of QOL, fundamental concerns remain. Most published QOL studies of HCT recipients do not state the theoretical model on which the investigation was designed. The absence of a theoretical foundation results in difficulties for healthcare professions to interpret the study's outcomes, generalize the findings and design and test theory-based interventions. Most HCT recipients report good to excellent QOL despite ongoing treatment-related sequela. This article explores the theoretical model of response shift as a means of understanding how HCT recipients maintain or improve their QOL after the treatment of life-threatening illness. Finally, a proposal for studying the QOL of HCT recipients based on the response shift model is offered, which includes a discussion of theory-based interventions.


Subject(s)
Hematologic Neoplasms/prevention & control , Hematologic Neoplasms/therapy , Hematopoietic Stem Cell Transplantation/adverse effects , Models, Psychological , Quality of Life , Adaptation, Psychological , Female , Hematologic Neoplasms/diagnosis , Hematologic Neoplasms/nursing , Hematopoietic Stem Cell Transplantation/methods , Humans , Male , Oncology Nursing/methods , Pain Measurement , Sensitivity and Specificity , Sickness Impact Profile
18.
Qual Life Res ; 16(3): 413-28, 2007 Apr.
Article in English | MEDLINE | ID: mdl-17279444

ABSTRACT

BACKGROUND: This study examined health related quality of life (HRQOL) and its predictors among African-, Asian-, Latina-, and European American breast cancer survivors (BCS) using a socio-ecologically and culturally contextual theoretical model of HRQOL. METHODS: We employed a case-control, cross sectional design with a population-based sample from the California Cancer Registry. Descriptive, bivariate, and multivariate regression analyses were conducted. RESULTS: The sample included 703 BCS: 135 (19%) African-, 206 (29%) Asian-, 183 (26%) Latina-, and 179 (26%) European Americans. Latinas reported the lowest HRQOL (p < 0.0001). The final regression model explained 70% of variance in HRQOL. Years since diagnosis, number of comorbidities, role limitation, emotional wellbeing, quality of doctor-patient relationship, social support, and life stress are significant HRQOL determinants. Exploratory regression analyses indicate ethnic differences in significant predictors for HRQOL. CONCLUSIONS: HRQOL among this multiethnic sample ranged from fair to good. Bivariate analysis suggests that ethnic differences in HRQOL exist. However, regression analyses demonstrated that socio-ecological factors in conjunction with medical characteristics are more salient to HRQOL outcomes, and that ethnic group membership may be a proxy for socio-ecological context. Furthermore, the influence of ethnicity, culture, and social-ecology are complex; research with large, population-based samples are necessary to disentangle the impact of contextual factors on HRQOL.


Subject(s)
Breast Neoplasms/ethnology , Breast Neoplasms/psychology , Carcinoma/ethnology , Carcinoma/psychology , Quality of Life , Sickness Impact Profile , Survivors/psychology , Treatment Outcome , Black or African American/psychology , Asian/psychology , Breast Neoplasms/mortality , Breast Neoplasms/therapy , California , Carcinoma/mortality , Carcinoma/therapy , Case-Control Studies , Cross-Sectional Studies , Female , Health Services Accessibility , Hispanic or Latino/psychology , Humans , Middle Aged , Models, Econometric , Registries , Socioeconomic Factors , Surveys and Questionnaires , White People/psychology
19.
Eur J Oncol Nurs ; 11(4): 298-308, 2007 Sep.
Article in English | MEDLINE | ID: mdl-17196431

ABSTRACT

The purpose of this cross-sectional descriptive study is to define sexual dysfunction and menopausal symptoms in women following cytotoxic or immunosuppressive medication for the treatment of malignant or life-threatening hematolymphoid diseases. These women were preparing to undergo hematopoietic cell transplantation (HCT) as the next step in their treatment plan. It is assumed that sexual dysfunction and symptoms of premature menopause are more pronounced post-HCT due to the intensity of the preparative regimen on the hypothalamic-pituitary-gonadal axis. This study included 48 pre-menopausal women and 28 spouses/partners. Data were collected using five self-report instruments (demographic and medical, the Female Sexual Function Index, the Menopause-specific Quality of Life, the Psychosocial Adaptation to Illness Scale, and a global quality of life score). The main research variables were female sexual functioning, symptoms of menopause, and quality of life. The findings indicate that 73% of women report decreased libido and 48% report dissatisfaction with their overall sex life. Hot flashes, the most common symptom of menopause are reported by 46% and 27% report the hot flashes moderate to severe in intensity. Vaginal dryness was reported by 35% with 23% reporting the vaginal dryness to be moderate to severe. The mean quality of life (QOL) score in women was 69+/-25 with a range of 2-100 (on a scale of 0-100 with 100 being an excellent QOL). The findings indicate that women treated with standard dose chemotherapy and immunosuppressive therapy for malignant and life-threatening hematolymphoid diseases experience alterations in sexual health and symptoms of premature menopause. The results show that the desire, arousal, and orgasm phase of the sexual response cycle are altered. Additionally, nearly half of the women are experiencing hot flashes, the most common symptom of menopause and over a third report vaginal dryness. There are statistically significant correlations between altered sexual health, menopausal symptoms, and QOL scores.


Subject(s)
Attitude to Health , Hematopoietic Stem Cell Transplantation , Quality of Life/psychology , Sexual Behavior/psychology , Women's Health , Adaptation, Psychological , Adult , Antineoplastic Agents/adverse effects , Cross-Sectional Studies , Female , Hematologic Neoplasms/psychology , Hematologic Neoplasms/therapy , Hematopoietic Stem Cell Transplantation/adverse effects , Hematopoietic Stem Cell Transplantation/psychology , Humans , Immunosuppressive Agents/adverse effects , Menopause, Premature/drug effects , Menopause, Premature/psychology , Middle Aged , Nursing Methodology Research , Personal Satisfaction , Sexual Behavior/drug effects , Sexual Dysfunction, Physiological/etiology , Sexual Dysfunctions, Psychological/etiology , Spouses/psychology , Surveys and Questionnaires , Transplantation Conditioning/adverse effects , Transplantation Conditioning/psychology
20.
Cancer Nurs ; 30(1): 45-55; quiz 56-7, 2007.
Article in English | MEDLINE | ID: mdl-17235219

ABSTRACT

Complementary and alternative medicine (CAM) use by cancer patients, especially women, is increasing. However, CAM use among patients with lung cancer, who have been reported to have the highest symptom burden, is poorly documented. This study describes types and frequencies of specific CAM therapies used by women with lung cancer to manage symptoms, and examines differences in demographic and clinical characteristics between CAM users and non-CAM users. Participants included 189 women with non-small cell lung cancer and > or =1 of 8 symptoms. Six CAM therapies, used to control symptoms, were assessed, including herbs, tea, acupuncture, massage, meditation, and prayer. Forty-four percent (84 women) used CAM therapies, including prayer (34.9%), meditation (11.6%), tea (11.6%), herbs (9.0%), massage (6.9%), and acupuncture (2.6%). Complementary and alternative medicine use was greatest for difficulty breathing and pain (54.8% each), with prayer the most commonly used CAM for all symptoms. Significant differences (P < .05) were found for age (t = 2.24), symptom frequency (t = -3.02), and geographic location (chi = 7.51). Women who were younger, experienced more symptoms, and lived on the West Coast or South (vs Northeast) were more likely to use CAM. We found that CAM use is variable by symptom and may be an indicator of symptom burden. Our results provide important initial data regarding CAM use for managing symptoms by women with lung cancer.


Subject(s)
Carcinoma, Non-Small-Cell Lung/therapy , Complementary Therapies/statistics & numerical data , Lung Neoplasms/therapy , Aged , Carcinoma, Non-Small-Cell Lung/complications , Cross-Sectional Studies , Female , Health Care Surveys , Health Status , Humans , Lung Neoplasms/complications , Middle Aged , Women's Health
SELECTION OF CITATIONS
SEARCH DETAIL
...