摘要:

Persons undergoing genetic testing for an inherited predisposition to cancer often raise questions about recommendations for follow-up care. Missing from current guidelines is consideration of the role of estrogens for BRCA1/BRCA2 mutation carriers. Potential implications of hormones for risk of cancer and effectiveness of risk-reduction strategies need to be considered in the design of comprehensive guidelines for high-risk women. Patients who are mutation carriers may ask questions about the use of oral contraceptives, hormone replacement, and utility of current screening modalities. Controversy exists, even when considering these issues for the general population, but become more imperative when considering young, unaffected women who carry an inherited genetic mutation making decisions that may have long-term health consequences. Many patients have considered estrogen ablation via prophylactic surgeries as risk-reduction interventions. This article reviews data regarding these issues, makes recommendations based on available information, and offers future perspectives for those identified at high risk for cancer because of genetic predisposition. Although questions remain regarding the potential implications of hormones for risk of cancer and effectiveness of risk-reduction strategies, all information should be considered when educating and caring for such patients.

ISSN:0162-220X    

出版商:OVID    

年代:2003

数据来源: OVID

摘要:

This study investigated the relation among perceived social support, uncertainty, and quality of life in older survivors with breast cancer. Proposed hypotheses predicted a significant positive correlation between perceived social support and quality of life, and a significant negative correlation between uncertainty and quality of life. It also was hypothesized that perceived social support and uncertainty, considered together, could explain more quality-of-life variance than either variable considered independently. A sample of 103 breast cancer survivors older than 50 years completed the Social Support Questionnaire, the Mishel Uncertainty in Illness Scale – Community Form, and the Ferrans and Powers Quality-of-Life Index – Cancer Version. Data were analyzed using Pearson product-moment correlation,ttests, analysis of variance, and stepwise multiple regression. All the hypotheses were supported. Additional findings showed significant positive correlations between age and uncertainty, and between support network size and social support. Significant negative correlations were found between age and perceived social support, and between age and size of support network. Uncertainty increased in the presence of other diseases, which were associated with poorer quality of life. The study results underscore the importance of social support in reducing illness uncertainty and improving the quality of life for older survivors of breast cancer.

ISSN:0162-220X    

出版商:OVID    

年代:2003

数据来源: OVID

摘要:

A pilot study was conducted to test the efficacy of a therapeutic group by telephone conference call for women with breast cancer. Sixty-six women with stage I or stage II breast cancer consented to participate in the study. Participants were randomly assigned to a usual psychosocial care or intervention group, using a permuted block method. Only 2 of 68 patients dropped out of the study, which included 27% African Americans. Assessments at 3 time periods (pretest, immediately after the intervention, and 3 months after the group ended) included evaluation of quality of life (QOL), mood, and immune function.ttests were performed to determine if differences on important variables existed at pretest. The intervention group had worse QOL and mood scores than did the control group on the pretests. A mixed-model repeated-measures procedure controlling for pretest differences was used to analyze data. A significant Group by Time interaction was found for spiritual well-being and mood. These differences were not in the expected direction. The intervention group showed improvement in QOL and mood during the intervention, but showed decompensation following the intervention. Conversely, the control group demonstrated stable or declining scores. This intervention is feasible and practical for women with breast cancer, especially African American participants. The puzzling results suggest several areas for future research, including a better conceptual fit with outcome measures, increasing dosage, and exploration of the value of emotional expression.

ISSN:0162-220X    

出版商:OVID    

年代:2003

数据来源: OVID

摘要:

Caregivers have complex needs as they care for a loved one with cancer at the end of life. The objective of this pilot study was to determine the feasibility of conducting a brief telephone intervention, Tele-Care II, for caregivers of hospice patients. Guided by Hogan's Model of Bereavement, nurse interventionists implemented Tele-Care II via teleconference calls with caregivers. Although 14 caregivers were recruited for the study, only 5 were able to complete the intervention before the patient's death. Those completing the intervention experienced decreased depression, despair, and disorganization although the patient's condition became more serious. Late enrollment in hospice continues to be problematic for patients, family caregivers, and hospice staff because it allows little time for completion of interventions with family caregivers before the patient's death.

ISSN:0162-220X    

出版商:OVID    

年代:2003

数据来源: OVID

摘要:

Cancer fatalism—the belief that death is inevitable when cancer is present—has been identified as a barrier to participation in cancer screening, detection, and treatment. Yet this literature has not been reviewed in a comprehensive and systematic manner. Therefore, this literature review addressed (1) philosophical and theoretical underpinnings of cancer fatalism; (2) relationships among demographic factors, cancer fatalism, and cancer screening; (3) the role of cancer fatalism for patients diagnosed with cancer; and (4) intervention strategies. Most of the reviewed studies were descriptive or correlational, did not have an explicit theoretical framework, had varied definitions of fatalism, and reported screening as “intent to screen” or as “past screening behaviors.” Review of the studies suggests that cancer fatalism develops over time and is most frequently reported among medically underserved persons and those with limited knowledge of cancer. Cancer fatalism may be modified through culturally relevant interventions that incorporate spirituality. Emphasis must be placed on recognizing the role of cancer fatalism when planning health promotion activities. Future studies should focus on the consistent measurement of cancer fatalism and testing intervention strategies.

ISSN:0162-220X    

出版商:OVID    

年代:2003

数据来源: OVID

摘要:

The aim of this study was to investigate the feasibility and acceptability of a repeated measurement of 5 major side effects (pain, nausea, vomiting, anxiety, and fatigue) experienced by patients during an entire course of chemotherapy. Forty-nine inpatients receiving intravenous chemotherapy in the medical oncology department of the Institut Paoli-Calmettes (Marseilles, France) were included in the study. At the study entry and every 12 hours from beginning of chemotherapy course, nurses assessed symptoms using Visual Analogic Scales (except for vomiting measured in number of episodes). Patients' pretreatment characteristics and their degree of satisfaction with nursing assessment were also recorded. The mean number of symptom measures was 2.9 in courses of less than 3 days, 5.4 in courses of 3 days, and 7.5 in courses of more than 3 days. Symptom patterns varied according to length of course. Furthermore, patients' pretreatment characteristics (age, sex, marital status, education level, type of cancer) had an impact on symptom scores at baseline and during treatment. About 80% of patients judged the nursing assessment as not constraining and 55% considered that its impact on their care was positive. This study demonstrates that repeated measurement of chemotherapy side effects was feasible and provide useful information for symptom management that might increase patient treatment satisfaction.

ISSN:0162-220X    

出版商:OVID    

年代:2003

数据来源: OVID

摘要:

This prospective randomized 2-period crossover study aimed at comparing the efficacy of 2 oral care protocols differing in the type of mouthwashes: chlorhexidine versus benzydamine in alleviating oral mucositis symptoms for children undergoing chemotherapy. Forty subjects were randomly allocated to receive either chlorhexidine first then benzydamine protocols or benzydamine first then chlorhexidine protocols. Each protocol was started on the first day of chemotherapy and continued for 21 days. Subjects were evaluated in intervals of 3 to 4 days using the World Health Organization (WHO) grading for mucositis and 10-cm visual analogue scale for oral symptoms evaluations. Among 34 evaluable subjects, 26% and 48% of them using chlorhexidine and benzydamine had WHO grade II mucositis, respectively (P< .05). The results revealed a significant difference in mean area under the curve (AUC) of mouth pain (1.35 ± 2.26 versus 3.09 ± 3.21) (P= .05), and a trend of a lessening of mean AUC of difficulty in eating/chewing (2.49 ± 3.74 versus 2.71 ± 4.1) (P = .82) and swallowing (1.34 ± 3.31 versus 1.91 ± 4.03) (P= .53) for subjects receiving chlorhexidine compared to those receiving benzydamine. In conclusion, chlorhexidine may be helpful in palliating mucositis symptoms for children in chemotherapy. The beneficial effect, however, is small and needs to be confirmed in a larger trial.

ISSN:0162-220X    

出版商:OVID    

年代:2003

数据来源: OVID

摘要:

The purposes of this study were to explore symptom distress, catastrophic thinking (catastrophizing) and hope, and factors predicting hope in Taiwanese nasopharyngeal carcinoma (NPC) patients within 3 years of receiving radiation therapy (RT). Instruments used were the modified Symptom Distress Scale, disease catastrophizing scale (modified from Coping Strategies Questionnaire), and Herth's Hope Index. Adult NPC patients (N= 115; 33 undergoing RT, 44 who completed RT within 1 year, and 38 who completed RT more than 1 year but less than 3 years) were recruited from an outpatient RT center in Northern Taiwan. Although participants' overall symptom distress was mild to moderate, they scored moderate level for several distressful symptoms: dry mouth, fatigue, hearing difficulty, loss of appetite, insomnia, and pain. Patients undergoing RT had greater symptom distress than subjects in the other 2 groups. Regression analysis revealed that catastrophizing was the only predictor of hope. Patients who engaged in catastrophizing reported much lower levels of hope. Particular care and attention are recommended to help NPC patients deal with the top distressful symptoms listed. Nursing interventions to reduce catastrophic thinking and enhance hope are discussed.

ISSN:0162-220X    

出版商:OVID    

年代:2003

数据来源: OVID

ISSN:0162-220X    

出版商:OVID    

年代:2003

数据来源: OVID

摘要:

Our 21st century has moved us into a world of technology never imagined. The aim of our article is to move oncology nurses beyond the realm of external beam radiation therapy. We chose to present 3 modalities of high precision that are infiltrating the everyday world of radiation therapy. Stereotactic radiosurgery for intracranial brain tumors and brachytherapy for prostate cancer require an expanded knowledge base for nursing to deliver excellent patient care. Cardiac patients receiving radiation seeds is new in the world of oncology nursing. These patients are unique but they are now a part of our world. Expanding our knowledge base to include a radiation procedure in cardiac care does bring us beyond the world of external beam radiation. Patients often seek information from nurses. Having an understanding of the basic principles and techniques will enable oncology nurses to educate patients. The purpose of this article is to explain the procedure of stereotactic radiosurgery, brachytherapy for prostate cancer, and intravascular brachytherapy for cardiac restenosis. Our discussion will include selection criteria, potential sides effects and risks, and nursing care.

ISSN:0162-220X    

出版商:OVID    

年代:2003

数据来源: OVID