摘要:

Unrelieved pain continues to be a problem among hospitalized patients with cancer. The purpose of this study was to evaluate pain management outcomes in a group of veterans with cancer receiving inpatient care. The sample consisted of 90 veterans with cancer hospitalized in one of two large veterans medical centers in the southeastern United States. Daily pain was assessed by administering the visual analog scale (VAS) for pain three times in a 24-hour period and averaging these three scores. The Brief Pain Inventory (BPI) and Constipation Assessment Scale (CAS) were administered once. The charts were audited using the Chart Audit for Pain (CAP). The sample was predominantly male (93.3%) and white (82.8%). The length of time since diagnosis ranged from newly diagnosed during this hospitalization to 16 years. Average daily pain was 32.9 on the VAS and 4 on the BPI. However, approximately one-fourth of the patients reported average daily pain above the midpoint (VAS > 50), and some patients reported average daily pain to be as high as 98. Fewer than half of charts (42%) showed evidence that a pain rating scale was used. Other assessment data also were very limited. Patients reported that pain interfered with all activities on the BPI, with highest interference scores for walking and sleep (mean, 5.5). Although 80% of the patients reported some problem with constipation, the chart audit indicated that this was recorded in only 11 patient records. No patient records indicated a problem with sedation. The findings indicate that limited attempts were made to manage pain using nonpharmacologic methods. In addition, only one of the nine charts reporting these attempts showed evidence that results from the attempt were evaluated. It may be concluded that pain management continues to be less than ideal in these veterans hospitals. Study results indicate that nurses are not documenting careful assessment of pain, not documenting evaluation of approaches to pain management, and not attending to the constipation that is inevitable when opioids are administered. Continued emphasis on nursing education related to pain management is needed. Future research should be undertaken to evaluate these outcomes.

ISSN:0162-220X    

出版商:OVID    

年代:2000

数据来源: OVID

摘要:

This is the second part of a two-part article describing a multifactorial model of clinical factors predicting decision-making quality, risk behaviors, clinical status, and health-related quality of life for cancer-surviving adolescents. To support the conceptualization of the model, findings from the literature and from the research program of the current author are presented. In part 1, support for the antecedent predictors, both primary and secondary factors, was presented. In part 2, the mediator of decision making, the moderator of risk motivation, and the expected outcomes related to risk behaviors, clinical status, and health-related quality of life are addressed. Besides a description supporting the second part of the clinical profile and its empirical underpinnings in part 2, methodologic challenges in future research and implications for clinical trials and clinical use specific to cancer-surviving adolescents also are discussed.

ISSN:0162-220X    

出版商:OVID    

年代:2000

数据来源: OVID

摘要:

The purposes of this article are to review literature on anger’s link to cancer, to analyze the state of the science in this area, and to propose some directions for future research. Extremely low anger scores have been noted in numerous studies of patients with cancer. Such low scores suggest suppression, repression, or restraint of anger. There is evidence to show that suppressed anger can be a precursor to the development of cancer, and also a factor in its progression after diagnosis. Some studies indicate that it may be beneficial for patients to mobilize anger to battle their cancer. However, there is a paucity of research on the outcomes of various anger interventions. Longitudinal studies that repeatedly measure anger and other moods over the disease trajectory are needed.

ISSN:0162-220X    

出版商:OVID    

年代:2000

数据来源: OVID

摘要:

The Papanicolaou (Pap) test is an effective screening mechanism for reducing morbidity and mortality from cervical cancer. Nevertheless, Pennsylvania ranks fifth in national cervical cancer incidence and fourth in national cervical cancer mortality, with a significant number of cases contributed by Philadelphia. Substantial subgroups of American women, specifically ethnic minorities, the elderly, the uninsured, and the poor, have not been screened or are not screened at regular intervals.A secondary data analysis was conducted to test whether age, income, insurance coverage, marital status, level of education, and number of persons living at home could predict whether a woman among convenience sample of 204 black and Hispanic women adhered to annual Pap testing. A woman was considered adherent to annual Pap testing if she reported undergoing a Pap smear in the 14 months preceding her enrollment in the study.African American woman who were high school graduates and had insurance coverage were more likely to be adherent to annual Pap testing. Hispanic women older than 50 years and born outside the mainland United States were less likely to be adherent to annual Pap testing. Findings suggest that cancer nurses working to promote cervical cancer screening in Philadelphia should continue to target at-risk populations, specifically uninsured and less-educated black and Hispanic women older than 50 years who were born outside the mainland United States.

ISSN:0162-220X    

出版商:OVID    

年代:2000

数据来源: OVID

ISSN:0162-220X    

出版商:OVID    

年代:2000

数据来源: OVID

摘要:

Ovarian cancer is the fourth leading cause of cancer-related death in women. Ovarian cancer and its treatment have a considerable effect on the quality of life of women diagnosed with the disease. Currently, little is known about the perspectives of women regarding their experiences of living with ovarian cancer or the impact of recurrent disease. This article presents data from a national study of Canadian women living with ovarian cancer and describes the impact of the disease and its treatment. In this study, 93 women had recurrent disease, and 170 had not experienced recurrent disease. Women in both groups were similar, ranging in age from 21 to 61 years. Two-thirds of the women were married, and all were white. A greater proportion of the women with recurrent disease reported bowel problems; fears of dying, pain, getting around; and feelings of self-blame. On the average, women with recurrent disease reported experiencing more problems since diagnosis than those without recurrent disease (p= 0.01). The proportion of women who perceived that they received adequate help for their problems ranged from 20% to 85%. Implications for oncology nurses regarding assessment, referral for assistance, and patient education are apparent from the study findings.

ISSN:0162-220X    

出版商:OVID    

年代:2000

数据来源: OVID

摘要:

To maintain dignity, patients with terminal cancer must be able to do things in their own way, to make their own decisions, and to preside over their own dying. Among the tasks considered essential for patients with terminal cancer is deciding where they prefer to die. The actual place of death has been recognized in hospice care as indicating quality of care. Approximately two-thirds of patients with cancer, when asked about the preferred place of death, say they wish to die in their own homes. Patients with terminal cancer dying at home may find physical and emotional comfort there. Home is a place where people may feel safety and a sense of belonging. In dying at home, patients with terminal cancer also may have a greater chance to control their environment, more autonomy and privacy, and a sense of normality. In this article, special cultural meaning of dying at home for the Chinese patient and the family is reviewed. It is essential for health care professionals to understand Chinese cultural beliefs and values related to dying at home in order to provide culturally sensitive care for Chinese dying patients and their families and to enhance their sense of control over the unknown process of dying.

ISSN:0162-220X    

出版商:OVID    

年代:2000

数据来源: OVID

摘要:

To assess how closely nurses and patients considered various situations as causing stress in chemotherapy treatment, this study was designed to compare nurse and patient perceptions of chemotherapy treatment stressors for patients in an oncology hospital. This descriptive study was conducted in the summer of 1997. Fifty patients receiving cytotoxic treatment were chosen by random sample. All 21 registered nurses of the Tabriz University of Medical Sciences who worked in the oncology department were contacted. A Likert-type questionnaire was designed to measure the stressfulness of commonly occurring items in chemotherapy treatment. The intensity of each item was measured by a scale with response choices ranging from the most to the least important. The patients were asked to indicate their perceptions of the seriousness of stress by sorting items. The nurses were asked to complete the same questionnaire as the patients completed. The greatest physical stressor mentioned by the patients was fatigue (66%), and by nurses, alopecia (62%). The nurses’ perceptions of psychosocial items causing the greatest stress included fear of disease recurrence (90.5%), fear of death (90.5%), economic problems (90.5%), and appearance changes (90.5%), whereas the patients perceived dependency (80%), economic problems (70%), and loss of social activity (66%), as the greatest stressors (p< 0.05). The findings showed disagreement between the two groups on intensity of physical and psychosocial stressors (p< 0.05). The results from this study increased nurses’ awareness of important stress factors in chemotherapy treatment. Identification of the situations perceived to be more stressful than others helped clinical nurses to modify their care and provide for their patients in a way that removes or reduces the stressors.

ISSN:0162-220X    

出版商:OVID    

年代:2000

数据来源: OVID

摘要:

The purpose of the study was to determine research priorities among Norwegian nurses in cancer care, and to investigate implications that these priorities might have for future planning of nursing research. Differences between specialists in cancer nursing and other nurses working in cancer care, and between the current results and earlier findings in this area also were evaluated. Half the members of The Norwegian Society of Nurses in Cancer Care (n= 197) were mailed a questionnaire used in a similar Canadian study. The nurses were asked to select the five topics they perceived as most important from a list of 80 items, and to rank them in order of research priority. The response rate was 43% (197/464), and 75 respondents were specialists in cancer nursing. Quality of life was given the highest research priority in the total sample. Psychosocial support/counseling, communication between patient and nurse, patient participation in decision making, nurse burnout, and ethics also were ranked highly. In contrast to the others, cancer nursing specialists ranked ethics as their number one priority. Except for symptom management, the priorities given in Norway and other Western countries were found to be similar. These results might suggest topics for future research tailored to the needs of cancer nursing.

ISSN:0162-220X    

出版商:OVID    

年代:2000

数据来源: OVID

摘要:

Based on two qualitative studies, this article describes the significance of fellow patients in cancer wards, and the relevance for health personnel involved in patient–patient relationships is discussed. Using grounded theory, in-depth interviews were conducted in the first study with 21 adult cancer patients and in a follow-up study with 8 patients and 27 health care providers. The findings indicate that the significance of fellow patients for the patient with cancer can be described in terms of three different dimensions: attitudes toward own illness, interpersonal relationships, and environmental factors. Although contact with fellow patients most often seems to engender positive experiences, some negative experiences are reported also. The suggestions in this article for practical implications are meant to help nurses and other health care providers to promote positive and prevent negative consequences in patient–patient relationships in hospitals.

ISSN:0162-220X    

出版商:OVID    

年代:2000

数据来源: OVID