The effects of informational audiotapes on knowledge and self-care behaviors of patients undergoing radiation therapy.

PURPOSE/OBJECTIVES: To develop and test the effects of informational audiotapes on knowledge and management of side effects in subjects undergoing radiation therapy. DESIGN: Post-test-only control group design. SETTING: A large urban radiation oncology department. SAMPLE: Seventy-five adult patients (with a mean age of 53 years) who were receiving radiation therapy. METHODS: Subjects were randomized into control and experimental groups. The control group received the facility's standard care, while the experimental group received the standard care and also listened to informational audiotapes. Patients completed a demographic data form, a knowledge test, and the Radiation Side Effects Profile (RSEP). MAIN RESEARCH VARIABLES: Number and severity of side effects, self-care measures used to manage the side effects, and helpfulness of these measures. FINDINGS: Patients in the experimental group were more knowledgeable about radiation therapy and its side effects, used more self-care measures, and practiced more helpful self-care behaviors than control group subjects. CONCLUSIONS: Audiotapes are an effective strategy for teaching self-care practices to patients undergoing radiation therapy. IMPLICATIONS FOR NURSING PRACTICE: An important role of the nurse is to assess clients for side effects of treatment and provide the knowledge necessary for patients to become active participants in their care. Use of audiotapes ensured that patients received the information they needed at times and places that were convenient to them.

Adjustment to breast cancer using downward comparison.

Downward comparison is a cognitive process that is used when events such as illness threaten a person's self-esteem. The afflicted person feels better about his/her situation when he/she compares himself/herself with another whose condition is worse. This study identified the presence of downward comparison in 195 women with recently diagnosed breast cancer and determined the impact of such comparison on adjustment. The results indicate evidence of downward comparison. In comparison to others with breast cancer, most patients indicated they thought that they were better in regard to physical condition, coping, medical condition, and life experience. Clinicians should assess for the presence of downward comparison at the time of diagnosis or when there is any change in the treatment plan that may be threatening to a patient. Future research of downward comparison and its relationship to self-esteem is indicated.

Evaluation of a PhD program: paving the way.

Quality assurance in doctoral education in nursing is a high priority as programs are developed and changed. The discipline and profession of nursing will not be well served if doctoral program quality is not monitored in a systematic way. Without the demands of a periodic, required evaluation by an external accrediting body, the motivation for quality assurance must be internally driven. One pragmatic motivating factor is that today's sophisticated doctoral applicant has resources available to assist with program choice by assessment of quality indicators. High-quality programs will attract the highly qualified students who will lead nursing in the next century. This article has presented a process leading to evaluation of quality and outcomes of one doctoral program. Some of our ideas and experiences may be helpful to those initiating an evaluation process in their own institutions.

Choosing a master's program in cancer nursing in the United States.

Returning to school to obtain a master's degree in cancer nursing in the United States is an undertaking that requires much thought. Going to school is an investment in oneself and, like any investment, many questions must be addressed before taking the step. Questions such as "Why go to school?" and "When to go?" need to be answered. The question "How will I pay for my education?" also needs to be answered. "Where to go to school?" often is the most difficult question. This article offers you some things to think about and some questions to ask when trying to choose a graduate program. In the final analysis, you will need to determine what is important to you and what school can best meet your personal needs to fulfill your professional goals.

Cognitive strategies used in adapting to a cancer diagnosis.

Adapting to a cancer diagnosis requires much time, energy, and effort. Patients, who often feel stressed and vulnerable, use several cognitive processes to help protect themselves and adapt to the illness. Denial, attributions, downward comparison, reappraisal of life, and developing a sense of mastery are some of the common emotion-focused strategies or cognitive processes used to allow patients to adapt to the disease and to a changed life. Before intervening, nurses must assess the presence of these processes and the intensity with which they are being used. Nursing interventions include cognitive restructuring, assisting with problem solving, giving information in small amounts, listening, and expressing care and concern.

Incorporating midmanagement skills in an oncology CNS program.

Today's health care system requires that CNSs be prepared to manage care within complex organizations as well as deliver expert care to individuals and their families. The integration of midmanagement preparation with clinical knowledge and skills is critical. In this paper, we (1) review the literature pertaining to the role of oncology CNS and management preparation, (2) describe the program at the University of Pennsylvania School of Nursing, and (3) identify the management content that was added to strengthen the theoretical and clinical components of the program and to prepare our graduates in assuming leadership positions.

Preparing clinical preceptors to teach master's-level students in oncology nursing.

This article reports the development of a structured program for clinical nurse specialists who served as clinical preceptors for graduate students in an oncology nursing program. A needs assessment of clinical preceptors was completed, and a program for the preceptors was developed based on the learning needs identified. In addition to the program, a Manual for Clinical Preceptors was developed. The benefits of this program include networking; positive working relationships among the preceptors, faculty, and students; potential job opportunities for students; potential applicants from the clinical agencies; and, ultimately, improved care for patients with cancer and their families. The authors conclude that administrators should support efforts to nurture and recognize the personnel in the clinical agencies.

The effects of a weekly radiation therapy newsletter on patients.

The purpose of this study was to investigate the effects that structured patient educational information in the form of a weekly newsletter has on the knowledge, side effects, and self-care behaviors of patients with cancer who are undergoing radiation therapy. It was hypothesized that subjects reading the newsletter would know more about radiation therapy and its side effects than subjects not reading the newsletter and, therefore, would employ more self-care behaviors, resulting in less severe side effects. A post-test-only control group design was used. Although the subjects who read the newsletter scored significantly higher on the knowledge test, there were no significant differences in the helpfulness or number of self-care behaviors or in the severity of side effects. Patient education in the form of a newsletter may provide benefits to patients other than knowledge (e.g., reduced anxiety) that may be just as important as side effects relief.

Effects of telephone call interventions on patients' well-being in a radiation therapy department.

This study examined the effects of telephone call interventions by a collaborative team on patients' well-being. Fifty-five subjects undergoing radiation therapy for cure and who were able to communicate by telephone comprised the sample. Subjects were randomly assigned to a control group, who received the usual care or to an experimental group, who received a weekly telephone call intervention in addition to the usual care. Speilberger's State Trait Inventory, the Side Effects Profile, and the Coping Strategies Profile were used along with a telephone survey to collect data. Analysis of the data showed no significant differences between groups in anxiety, severity of side effects, helpfulness of self-care strategies, and coping strategies. However, the survey indicated that the telephone calls were clinically significant and provided a mechanism for demonstrating that the health care professionals cared about their patients and provided an opportunity for patients to talk about their concerns. The investigators believe that collaboration, caring, and communication are the essence of exemplary health care.

Assessment preparation for nurse practitioners.

Faced with primary care graduate students who were not adequately prepared to meet the demands of their clinical courses, faculty at the University of Pennsylvania conducted a three-year study to determine the effectiveness of physical assessment prerequisites. They concluded that graduate level assessment preparation was well worth the time and effort such courses require.