The Impact of Nurses' Beliefs, Attitudes, and Cultural Sensitivity on the Management of Patient Pain.

INTRODUCTION: Nurses' attitudes and beliefs may impact pain management. This study investigated nurses' perceptions regarding their own and patients' pain experiences by examining relationships between pain cautiousness and stoicism, cultural sensitivity, and personal pain attitudes. METHODOLOGY: A correlational methodology examined nursing staff in a Midwestern private hospital. The sample included 102 primarily female (95.1%), Caucasian (97%), and married (66%) nursing staff. Measures included the Intercultural Sensitivity Scale, Pain Attitudes Questionnaire to Assess Stoicism and Cautiousness, and the Pain Management: Nurses' Knowledge and Attitude Survey. RESULTS: Cultural sensitivity was a significant predictor of pain knowledge and attitudes total score (R2 = .081, ß = .244, p = .040), while pain stoicism and pain cautiousness were not predictive. DISCUSSION: Findings highlight the importance of nurses being aware of personal attitudes, beliefs, and cultural sensitivity in pain management. Results also demonstrate a gap between the knowledge and utilization of nonpharmacologic pain management interventions among nursing staff.

Anticipating posttraumatic growth from cancer: patients' and collaterals' experiences.

Posttraumatic growth has been demonstrated to occur following the diagnosis and treatment of cancer. Still unknown is whether patients expect such growth, how growth is perceived at early points in time that follow the cancer experience, and whether patient reports of growth are corroborated by others. Participants were 87 patients and 55 collaterals who reported their anticipation of growth pretreatment and their perceived growth at a 9-month follow-up. Patients' expectations for their own growth were significantly higher than collaterals' expectations for theirs. When anticipated growth was compared to later reported growth, patients overanticipated growth across all domains and collaterals underanticipated growth.

Spiritual growth and decline among patients with cancer.

PURPOSE/OBJECTIVES: To investigate spiritual transformation among patients with cancer. DESIGN: Longitudinal. SETTING: A university medical center in the midwestern United States. SAMPLE: 47 adult cancer survivors. METHODS: Patients were asked about spirituality, religious and spiritual importance, religious coping, and spiritual gain and decline at baseline as well as nine months post-treatment. MAIN RESEARCH VARIABLES: Religious importance, religious coping, and spiritual gain or decline. FINDINGS: Positive religious coping at baseline predicted spiritual growth at the nine-month follow-up point. Spiritual decline was predicted by negative religious importance. A bivariate relationship existed between increased levels of negative religious coping and increased spiritual growth. CONCLUSIONS: Positive religious coping strategies may influence spiritual transformation. IMPLICATIONS FOR NURSING: Healthcare providers who support a strengths-based perspective on human functioning may be equipped to perform research on spiritual or religious interventions for patients with cancer. KNOWLEDGE TRANSLATION: Greater use of spiritual resources, even if conceptualized as negative religious coping mechanisms or initial spiritual decline, may contribute to increased levels of spiritual growth later. When acting as expert companions, healthcare providers may facilitate spiritual growth by addressing spiritual transformation, creating safe environments for exploring spirituality, becoming familiar with different religious faiths, and seeking appropriate consultation and referrals for patients.

Influence of coping style on symptom interference among adult recipients of hematopoietic stem cell transplantation.

PURPOSE/OBJECTIVES: To investigate the influence of coping style on interference caused by a variety of common post-treatment symptoms after hematopoietic stem cell transplantation. DESIGN: Longitudinal; secondary analysis of data from the original study that examined health-related quality-of-life variables (e.g., depression, well-being) in adult patients treated with conventional bone marrow transplantation or depleted T-cell bone marrow transplantation. SETTING: Fifteen university medical centers in the United States. SAMPLE: 105 adult recipients of hematopoietic stem cell transplantation. METHODS: Patients were assessed via telephone-based interviews for coping style at baseline and for symptom interference in daily living six months post-treatment. MAIN RESEARCH VARIABLES: Coping style and symptom interference. FINDINGS: Neither age nor gender predicted symptom interference, with the exception of chronic graft-versus-host disease, where older patients experienced more interference at six months, and breathing symptoms, for which women experienced more interference than men at six months. Avoidant coping style at baseline predicted increased interference from symptoms, but emotion-focused and instrumental coping styles did not predict decreased interference. CONCLUSIONS: A generalized avoidant coping style before treatment increased interference from common cancer symptoms six months after hematopoietic stem cell transplantation. IMPLICATIONS FOR NURSING: An intervention to teach alternate coping strategies should be implemented prior to treatment and tested for prevention of symptom-related life interference.

Well-being and posttraumatic growth in unrelated donor marrow transplant survivors: a nine-year longitudinal study.

OBJECTIVE: To study posttraumatic growth and psychological and physical well-being among 25 cancer survivors (12 men, 13 women) 9 years after receiving a hematopoietic stem cell transplant from an unrelated donor. MEASURES: Participants completed measures of well-being (e.g., depression, physical function) and posttraumatic growth at the 9-year follow-up. Prior to treatment, optimism, social support, and well-being had been assessed. RESULTS: Findings reveal high levels of physical and psychological well-being. Survivors reported posttraumatic growth in several domains, including increased personal strengths and enhanced interpersonal relationships. Higher levels of growth were significantly related to gender and age: Women reported more total posttraumatic growth, and older survivors reported more enhanced spirituality, one domain of growth. Posttraumatic growth and well-being after treatment were predicted by 2 psychosocial variables assessed prior to treatment: dispositional optimism and social support. IMPLICATIONS: Although long-term survivors report ongoing physical limitations, they also experience well-being in both physical and psychological domains. Posttraumatic growth is an area of well-being deserving of additional research and clinical attention. In particular, there may be reason to assist survivors to articulate growth as part of ongoing care.

College student suicide: a call to action.

This article examines current issues related to the topic of college student suicide and why it continues to be an issue of major concern. The nature/extent of the problem, risk and protective factors, responses to college student suicide, legal issues, and training issues are discussed. The importance of addressing the issue of college student suicide and its prevention on college campuses is emphasized as is the importance of protective factors. Although more is being done to address this issue than has been done in the past, it remains a major concern, and it is an issue that requires a strong national response.

Papiloma vesical invertido / Inverted bladder papilloma

Se presenta un caso de papiloma vesical invertido tratado por resección endoscópica, señalándose las características histológicas típicas y el comportamiento clínico benigno de este tipo de patología que mejor pudiera denominarse adeno urotelioma de Von Brunn