Determinants of Quality of Life in Lung Cancer Patients.

PURPOSE: To examine the relationships of self-care, symptoms, and a variety of demographic factors to quality of life (QOL), and to identify determinants of QOL in lung cancer patients undergoing chemotherapy. DESIGN: A cross-sectional, correlational study. METHODS: 159 patients with lung cancer undergoing chemotherapy were recruited from three southern hospitals in Taiwan. Four instruments were used: the Quality of Life Questionnaire Core 30-item (QLQ-C30), M.D. Anderson Symptom Inventory (MDASI), Memorial Symptom Assessment Scale-Short Form (MSAS-SF), and Self-Care Behavior Scale (SCBS). FINDINGS: Lung cancer patients rated lower scores of self-care behaviors on food choice and nutrition maintenance, regular exercise and sleep, and medical compliance. Being younger, having spouses as main caregivers, having food choice and nutrition maintenance, and getting regular exercise and sleep were associated with better QOL. Degree of interference with life, age, food choice and nutrition maintenance, and psychological symptoms were found to predict functional QOL and accounted for 43% of total variance. CONCLUSIONS: The findings identified factors influencing QOL and provided evidence for designing an intervention to enhance QOL in lung cancer patients undergoing chemotherapy. CLINICAL RELEVANCE: The findings may be useful for guiding intervention development for early detection and management of symptom interference with daily living, and place greater focus on patient self-care to promote food choice and nutrition maintenance, especially in older patients and those whose caregivers are not their spouses.

Concerns about pain and prescribed opioids in Taiwanese oncology outpatients.

Pharmacologic agents are considered to be a cornerstone of cancer pain management. Patients' concerns about use of analgesics are likely to lead to poor pain management. The purpose of this study was to describe participants' responses to their beliefs regarding pain and prescribed opioids. Ninety-two outpatients age ≥18 years who had taken prescribed opioid analgesics for cancer-related pain in two teaching hospitals in the Taipei area completed the Pain Opioid Analgesics Beliefs Scale-Cancer. An important finding of this study is that large numbers of patients had misconceptions about using opioids for pain. Between 33.7% and 68.5% of the patients in this study held negative beliefs about opioids and beliefs about pain. Specifically, 68.5% of the patients agreed that "opioid medication is not good for a person's body." Many patients (62%) agreed that "the more opioid medicine a patient used, the greater the possibility that he/she might rely on the medicine forever," and 61.0% agreed that "if a patient starts to use opioid medicine at too early a stage, the medicine will have less of an effect later." Two-thirds (66.3%) of the sample agreed that adult patients should not use opioid medicine frequently. The findings provide empirical support for the need for better programmatic efforts to improve beliefs of pain and analgesics in Taiwanese oncology outpatients.

Relationship between belief about analgesics, analgesic adherence and pain experience in taiwanese cancer outpatients.

Social and behavioral scientists have proposed that a person's belief system crucially influences his or her behaviour, and therefore may affect outcomes of pain management. The purpose of this study was to explore the relationship between analgesic beliefs, analgesic adherence and pain experience amongst Taiwanese cancer outpatients. The cross-sectional study included 92 oncology outpatients in two teaching hospitals in the Taipei area of Taiwan. The research instruments included the Pain Opioid Analgesic Beliefs Scale-Cancer (POABS- CA), opioid adherence, and the Brief Pain Inventory-Chinese (BPI-Chinese). Beliefs about pain and opioids demonstrated a significant relationship with patients' opioid adherence (r = -0.30, p < 0.01). The more negative beliefs regarding opioids and pain the patient had, the worse their adherence to around the clock (ATC) analgesic regimen. However, there was no significant correlation between opioid belief and pain experience. As well, there were no significant relationships between adherence to opioid regimen and any of the measures of pain experience. The study highlights the potential importance of a patient's pain and opioid beliefs in adherence to pain medication.

Violence in the nursing workplace - a descriptive correlational study in a public hospital.

AIMS AND OBJECTIVES: To explore the prevalence, types and sources of violence in the nursing workplace and to assess the factors related to violence. BACKGROUND: Workplace violence in nursing is not a new phenomenon; in recent years, much more attention has been paid to the issue in Taiwan. Few studies, however, have investigated the overall distribution of violence and the reasons for not reporting these incidents in nursing workplaces. DESIGN: This descriptive, correlational study used structured questionnaires to collecting information about workplace violence experienced by nurses over the last year. METHODS: Nurses (n = 880) working in a public hospital in southern Taiwan were invited to complete the questionnaires, with a response rate of 89·9%. RESULTS: Nurses working in outpatient units and emergency rooms experienced more frequent violence than those on surgical wards and intensive care units. CONCLUSION: These findings provide evidence of workplace violence in hospitals and may aid hospital and nursing administration to reduce and control violence. RELEVANCE TO NURSING PRACTICE: These results provide evidence in relation to the importance of effective communication training to nurses and will assist hospital administrations in establishing higher-quality, healthy workplace environments.