摘要:

Phenomenologic inquiry was used to explore patients' experiences with autologous bone marrow transplantation (ABMT). Interviews were conducted before and after implementation of a clinical pathway that included a teaching protocol for ABMT. Texts were analyzed individually, compared for pre- and postpathway patients to determine if different themes emerged from these two groups, and then combined. Themes common to both groups included (a) a range of needs for information, (b) everybody's different: a fine balance (the challenge of finding a balance when giving information to patients who vary in the amount of information they desire), (c) someone who has been there (the value of talking to someone who has survived an ABMT), (d) and the burden of ABMT patients teaching family. One theme that reflected different experiences of pre- and postpathway patients was that ofthe need to knowdetailed information about the ABMT andthe fear of knowingtoo much. Whereas postpathway patients reflected more on the burden of knowing too much, prepathway patients expressed more dissatisfaction about not being told enough about procedures and symptoms to be expected. Suggestions for teaching patients about ABMT include being generally realistic while focusing on the positive, and viewing patient education as a process individualized according to each patient's needs.

ISSN:0162-220X    

出版商:OVID    

年代:1999

数据来源: OVID

摘要:

Soft-tissue sarcoma (STS) affects men and women with equal frequency and commonly presents as an asymptomatic mass in patients 40 to 50 years of age. Recent study has identified physical, emotional, and psychological factors associated with a diagnosis of malignancy, but the issues affecting the STS patient population may differ from those of more common cancers due to physical disability secondary to treatment. Research to date has not dealt specifically with gender differences in the reaction and adaptation to the cancer diagnosis. This pilot study was designed to evaluate the treatment experiences of five males and five females treated with surgery and radiation for STS of the thigh and followed posttreatment for at least 2 years. The open-ended interview was used to collect data, which was then subjected to a constant comparative analysis technique. The STS patients shared many concerns of cancer patients, with additional physical complaints. Physical symptoms were common to men and women, but women adapted more easily with explanation. Women feared losing life, family role, and relationships. Along with men, they also feared the losses of limb and career. For women, support included faith and sharing stories with others, whereas men preferred to deal with their illnesses individually and concealed emotions from loved ones. The perception of disease time frame was also distinct, with men adopting a fatalistic attitude and regarding their disease as an isolated episode. Women believed their condition was ongoing. Women need repeated information from several sources along with reassurance and increased social support, whereas men prefer the minimum of social support, requiring instead independence and extra attention to physical limitations. These results can improve STS patient treatment by increasing awareness in the patient, family, and medical team of the psychosocial issues that can be expected to arise.

ISSN:0162-220X    

出版商:OVID    

年代:1999

数据来源: OVID

摘要:

The present study was performed to gain insight into the decision-making process that patients go through when asked to participate in a cancer clinical trial. Fourteen cancer patients entered a pilot study concerning decision making. They were interviewed in a semistructured manner after consenting or refusing to participate in a randomized phase III clinical trial concerning chemotherapy or immunotherapy. Results from this study showed that patients, after receiving information from the medical oncologist, oncology nurse, or both, decide about participation instantaneously. This means that time for procedural soundness has not been used, which raises questions about the normative quality of the decision.

ISSN:0162-220X    

出版商:OVID    

年代:1999

数据来源: OVID

摘要:

Distress associated with attendance at a radiotherapy treatment center for cranial radiotherapy was assessed in 10 consecutive patients using a method first employed by Munro et al.(1). This involved using a series of cards, each with a potential side effect of radiotherapy printed on it. The subjects were asked to highlight which side effects were a problem to them. The same method was used to determine the perceptions of nurses caring for patients receiving cranial radiotherapy, and the results were compared. This preliminary study suggests that the patient group found the physical side effects of their treatment most distressing, with "tiredness" and "hair loss" predominating. The nurse group had a tendency to overestimate the amount of side effects experienced by patients. They were able to choose quite successfully many of the more distressing side effects mentioned by the patient group. The study indicates the need for further research into the specific problems of patients undergoing cranial radiotherapy.

ISSN:0162-220X    

出版商:OVID    

年代:1999

数据来源: OVID

摘要:

The purpose of this descriptive correlational study was to identify the relationship between subjects' spiritual well-being and the demands of illness (DOI) imposed by colorectal cancer. Potential subjects were notified about the study through computer networks. Those who met the criteria and wished to participate in the study used e-mail to request a study packet, which included an explanation of the study, the Demands of Illness Inventory (DOII), the Spiritual Well-Being Scale (SWBS), a demographic form, and a stamped return-reply envelope. Of the 170 packets requested, 121 (71%) were returned complete. More than half of the respondents were men and were of a Christian faith. Most respondents reported physical symptoms, but were able to carry on normal activity. Demands of illness were greater among men, the youngest subjects, those who received treatment in the previous 2 months, and those who reported decreased activity, metastatic disease, and/or terminal status. Women reported significantly greater spiritual well-being than men. Subjects who reported higher levels of spiritual well-being indicated significantly lower DOI related to physical symptoms, monitoring symptoms, and treatment issues. Findings indicate that a greater degree of spiritual well-being may help to mitigate the DOI imposed by colorectal cancer.

ISSN:0162-220X    

出版商:OVID    

年代:1999

数据来源: OVID

摘要:

This multi-institutional sleep study involved two phases aimed at investigating sleep alterations in patients with any stage of breast and lung cancer. The first phase of this study used an 82-item, 20-minute telephone survey to elicit information regarding the impact of sleep disturbances on a convenience sample of 150 patients. Of these patients, 44% reported a sleep problem during the month before the interview. Significant relations included these: report of sleep problems prediagnosis over the past month (x= 5.82;p= 0.02), duration of sleep medication use and frequency of sleep problem (r= 0.58;p= 0.05), age and severity of sleep problems (r= 0.38;p= 0.05), and frequency and severity of the sleep problem over the past month (r= 0.21;p< 0.10). Communication with health care providers occurred in 16.6% of patients reporting a sleep disturbance. The second phase of this study explored the type, frequency, and severity of sleep problems and perceptions of causation, support, and methods of coping with the sleep problem. A qualitative approach to the problem was used in this phase. A one-time telephone interview of 42 patients, derived from a convenience sample, revealed a 45% prevalence of sleep problems a month before the interview. A qualitative analysis of the responses suggested that sleep problems are related to experiences of other symptoms and perceptions of cancer and treatment. Content analysis of the responses identified the following categories: figuring out the reason, seeking help, seeking support and relation to the overall cancer experience.

ISSN:0162-220X    

出版商:OVID    

年代:1999

数据来源: OVID

摘要:

Research has shown that routine mammography screening can significantly reduce mortality from breast cancer. The use of mammography screening, however, remains well below national goals. In an effort to understand the factors that influence women's mammography behaviors, this study explored the relation between health beliefs, locus of control, and women's mammography practice. Survey instruments used were Champion's health belief scales and the Multidimensional Health Locus of Control (MHLC) scales. The study used a convenience sample of 25 African Americans and 72 white women ages 35 to 84. Findings showed that women who participated in mammography screening were significantly more likely to perceive greater benefits, greater health motivation, and fewer barriers to screening than those who did not participate. These same three variables were similarly associated with greater frequency of receiving mammograms. It also was found that perceived benefits and health motivation were significantly correlated with shorter duration of time since the last mammogram. No support was found for perceived susceptibility, perceived seriousness, and health locus of control as predictors of women's mammography behavior. Implications for nursing research in further examining the MHLC and the Health Belief Model construct of susceptibility as they relate to mammography behavior are identified. Practice implications for nurses are suggested.

ISSN:0162-220X    

出版商:OVID    

年代:1999

数据来源: OVID

摘要:

Between 1989 and 1991, 102 breast cancer patients completed a questionnaire survey on concerns and needs at their first visit to the University Clinic after they were diagnosed or treated for breast cancer at other clinics. Their major concerns and needs were health, family, finances, work, the future, self-esteem, counseling and support for themselves and their family. Married women and those younger than 50 years were more likely to have concerns about their family. Nonwhites had more concerns about finances and work than white women, with an odds ratio (OR) of 6.58. Older women and those married, however, had less concerns about finances and work than younger women and those not married, with ORs of 0.96 and 0.34, respectively. Fewer nonwhite than white patients expressed concerns about their future (OR = 0.31). Young women were more concerned about self-esteem than older women. More nonwhites than whites and more married than unmarried women expressed needs for family counseling and support (OR = 3.58 and 3.68, respectively). Help for interpreting information was required more frequently by nonwhites than whites (OR = 7.25, 95% confidence interval [CI] = 2.19-24.00). Nonwhite women also tended to require more referrals than whites. In summary, major concerns and needs varied among patients of different demographic characteristics, especially those of age, race, and marital status.

ISSN:0162-220X    

出版商:OVID    

年代:1999

数据来源: OVID

摘要:

Menopause is beginning to be recognized as a survivorship issue for women with a diagnosis of breast cancer. This article presents an outline of the literature relating to natural menopause and its symptoms, moves on to discuss general management of menopausal symptoms, then reflects on the particular implications of breast cancer diagnosis and treatment. Finally, the role of nursing in restoring a holistic perspective to the subject of menopause generally, and to women with breast cancer specifically, is considered.

ISSN:0162-220X    

出版商:OVID    

年代:1999

数据来源: OVID

摘要:

This study aimed to assess nurses' involvement in the supportive care of patients with recently diagnosed breast cancer in Dutch hospitals. A questionnaire used to evaluate various aspects of nursing care for breast cancer patients was sent to the surgical nursing teams in all 120 Dutch hospitals that provide surgical treatment for these patients. Nursing care was defined to be optimal if it met the following criteria: (a) Specialized nursing support is provided to all patients during admission and in the outpatient departments both before and after surgery. (b) A protocol is in place outlining standard nursing procedures for breast cancer patients. (c) Formal communication about each breast cancer patient exists between the nurses involved. On the basis of this definition, it was found that optimal nursing care was provided in only 6% of the hospitals. Nursing care fell short mainly in the outpatient setting. This shortcoming also was recognized by most respondents, and many were already planning improvements. Nurses had varying opinions about their responsibility to provide the patient with information about the disease and its treatment, and consensus was lacking. In summary, nursing care for newly diagnosed breast cancer patients in Dutch hospitals needs improvement, especially in the outpatient setting.

ISSN:0162-220X    

出版商:OVID    

年代:1999

数据来源: OVID