ISSN:0162-220X    

出版商:OVID    

年代:2000

数据来源: OVID

摘要:

Patients with cancer experience high levels of symptom distress. Current measures of symptoms generally weight the importance of each symptom equally, and do not generally address the relative importance of different symptoms to patients. The purpose of this pilot study was to explore whether the assumption of equal weighting is warranted in measurements of symptom distress. Consecutive patients presenting with primary lung cancer at the Lung Medicine Unit of one Swedish hospital completed the Symptom Distress Scale and a Thurstone scale eliciting patients’ weightings of the symptoms’ relative importance three times: after first contact with the unit, then 1 and 2 months later. The results show that subjects weighted some symptoms as significantly more important than others, and the ordering of symptoms was found to differ by intensity and perceived importance in this group. Outlook was the symptom rated most important at T1. Fatigue received the highest intensity score, but ranked second lowest in importance. Kendall’s coefficient showed minimal agreement among these patients as to the specific order for the weighting of the importance of symptoms. In addition to theoretical relevance, this issue is clinically relevant in selecting symptoms that should be the focus of intervention and in determining how the success of interventions should be judged.

ISSN:0162-220X    

出版商:OVID    

年代:2000

数据来源: OVID

摘要:

Although the knowledge exists to relieve cancer pain, inadequate pain relief persists as an international health problem. The World Health Organization has recommended a threefold strategy to improve cancer pain management: health policy, drug availability, and education. Yet major barriers to effective cancer pain management exist in every country of the world. Effective strategies to improve pain management must be based on an understanding of the issues in individual countries. This report evaluates cultural and other factors influencing cancer pain management in the Republic of South Africa. This ethnographic field study included multiple methods of data collection: analysis of documents, participant observation, focused interviews, and in-depth interviews of informants (n= 33) who represented multiple stakeholders in a variety of settings. Cultural beliefs and practices form the context for understanding cancer pain and how it is managed. Cultural variability exists regarding cancer as a disease, pain expectations, pain tolerance, pain expression, and health care practices. Key factors that influence how pain is managed included standards, knowledge, resources, communication and the patient–provider relationship, and teamwork and professional relationships. The existence of these factors promotes effective pain management, whereas their absence creates a barrier to achieving this aim.

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:

Patients with cancer and bone metastases are vulnerable to severe pain, especially when changing their body position, and many such persons die with unrelieved pain. One step in obtaining acceptable pain control is communicating one’s pain to health care providers. This descriptive study aimed to depict possible gender differences in the meaning of pain in the context of pain self-report and self-management decision making for 10 men and 10 women with cancer and bone metastasis. No clear gender differences were found in the narrative data obtained during semistructured interviews. Both men and women equated pain with cancer recurrence. Pain interfered with work, social activities, and relationships. Most participants preferred not to tell others, even health care providers, about their pain. More than one half of the 20 participants did not take pain medications on schedules recommended by physicians. The study findings provide oncology nurses with direction for education related to pain management for persons with metastatic bone pain and their family members. Further research with a larger sample is needed to clarify how to overcome barriers to better pain management in this population.

ISSN:0162-220X    

出版商:OVID    

年代:2000

数据来源: OVID

摘要:

Colorectal cancers are common causes of morbidity and mortality among women in the United States. Many of these deaths are unnecessary because of the availability of effective early detection methods. The demands of caregiving may limit older women’s participation in screening. The purposes of this exploratory study were to describe the participation in colorectal cancer screening of older women (n = 52; mean age 65 years) who were the primary caregivers for an ill spouse or parent, and to investigate the relationship of the caregiving burden and perceptions of health to participation in recommended colorectal cancer screening tests. Results. Only 36% of the older women (n = 16) had been screened with both fecal occult blood testing (FOBT) and sigmoidoscopy. A number of women had never participated in colorectal cancer screening: 10 (21%) had never undergone FOBT and 22 (47%) had never undergone sigmoidoscopy. Only 20% (n = 9) had received all of the recommended cancer screening tests: mammogram, Papanicalaou smear, FOBT, and sigmoidoscopy. Those who did not participate in cancer screening with sigmoidoscopy had significantly worse health perceptions than those who did participate. Caregiver burden was not significantly associated with differences in cancer screening participation. Only 14 of these older women felt that they would have a good chance of survival if they received a diagnosis of colon cancer. Further research is needed to investigate strategies to increase participation of older women in colon cancer screening.

ISSN:0162-220X    

出版商:OVID    

年代:2000

数据来源: OVID

摘要:

The revised prostate cancer screening guidelines of the American Cancer Society recommend that men be informed of the risks associated with prostate cancer screening. However, there are no published studies on men’s fear of impotence and its impact on prostate cancer screening. In addition, little is known about barriers to prostate cancer screening when the two main barriers of cost and lack of knowledge are eliminated. This study reports the association between barriers and free prostate cancer screening after a prostate cancer education program. All men were called 1 month after a prostate cancer education program and asked: “What would (or did) make it hard for you to get your prostate checkup done?” A total postbarrier score was created to measure how many barriers each man indicated. The following barriers were significant in predicting participation in prostate cancer screening: “put it off,” “doctor hours not convenient,” “didn’t know kind of doctor,” “didn’t know where to go,” and “refuse to go.” Fear of impotence was not a significant barrier. Suggestions for reducing barriers to prostate cancer screening are given.

ISSN:0162-220X    

出版商:OVID    

年代:2000

数据来源: OVID

摘要:

It is well documented that educated breast care nurses can provide essential support and information to empower a woman with breast cancer to participate in treatment decisions and take more control over her health and life. An evaluation of Breast Cancer Support Services, a dynamic unit within the Anti-Cancer Council of Victoria, Australia, conducted in 1994, recommended that breast cancer support service nurses should increase their knowledge of breast cancer treatment and management throughout the whole continuum from diagnosis to death. Greater knowledge would enhance the nurse’s role as a vital member of a multidisciplinary team and a resource to women experiencing breast cancer at any stage in their journey. Acting on these recommendations, the Anti-Cancer Council of Victoria, in conjunction with La Trobe University, designed and developed the first national, tertiary-level training program for breast care nurses. The Breast Cancer Distance Education program, which has graduates from all states in Australia, has been accredited by the Royal College of Nursing and positively evaluated by the Centre for Behavioural Research in Cancer. The evaluation found that students rated the course highly, and many planned to change their nursing practice as a result of taking the course. Accredited breast care nurses are taught to use accurate and up-to-date information in combination with advanced communication skills. They do not hesitate to confer with other members of the multidisciplinary team to ensure that women with breast cancer receive the individualized support and continuity of care they deserve.

ISSN:0162-220X    

出版商:OVID    

年代:2000

数据来源: OVID

摘要:

Most patients with obstructive jaundice caused by primary pancreaticobiliary malignancies and metastatic disease cannot be cured by surgical resection when diagnosed. Biliary drainage in the management of obstructive jaundice therefore represents one of the most important issues in the palliative treatment of these patients. For more than 20 years, percutaneous transhepatic biliary drainage procedures have allowed a nonsurgical approach to the management of malignant biliary obstruction. Improvements in radiologic access systems have extended the use of the percutaneous biliary approach, especially since the advent of metallic stents. Nursing care of these patients before, during, and after the percutaneous biliary intervention is challenging. Patient and family need to be educated about the aim and consequences of the procedure as well as its complications. To care for these patients, the nurse must understand the techniques of percutaneous transhepatic biliary drainage. The purpose of this article is briefly to review the etiology of biliary obstruction, the current treatments to relieve obstructive jaundice, and the basic steps of biliary intervention techniques. The nursing management throughout the procedure, the patient preparation before the procedure, and most importantly, the postprocedural nursing care are discussed.

ISSN:0162-220X    

出版商:OVID    

年代:2000

数据来源: OVID

摘要:

This article presents findings of an exploratory descriptive study on the effects of dimethyl sulfoxide (DMSO) odor in an oncology unit. The nursing staff, who had reported their concerns about the unpleasant odor emitted from patients undergoing peripheral stem cell transplantation, initiated the study. A literature review revealed some evidence of the possible ill effects on staff caring for patients having DMSO treatment, but many questions remain unanswered such as what staff experience in dealing with DMSO odor and whether nursing care is affected in any way? Data were collected through interviews with 22 oncology nurses who all had experienced direct and indirect exposure to DMSO odor. Of the 22 nurses interviewed, 20 reported that they found DMSO odor unpleasant and reported experiencing physical symptoms such as headaches and gastrointestinal reactions. The study also revealed a situation in which nurses described odor avoidance and distancing strategies that potentially compromised the nurse–patient relationship.

ISSN:0162-220X    

出版商:OVID    

年代:2000

数据来源: OVID