摘要:

After pain management, poor communication with health professionals creates the most distress for families of patients with cancer. Difficulties communicating with families also have been identified as potentially stressful for nurses. This is particularly the case for nurses working in acute care settings. However, little research has been undertaken to examine the specific problems and challenges confronting nurses who endeavor to communicate with families of patients with cancer in a hospital setting. The purpose of this study was to describe nurses' perceptions of communication issues, potential barriers, and strategies associated with nurse-family interactions in an acute cancer hospital setting. Focus groups were conducted with nurses from two cancer wards at an Australia hospital. Four distinct themes emerged. First, all nurses described communication difficulties they encountered when interacting with families. Second, team factors appeared to be a central determinant of the quality of nurse-family communication. Third, nurses described difficulties associated with the delivery of bad news and treatment plans that are not clearly defined for the patient. Finally, the effects of poor communication on nurses were notably and vividly described. In this report, recommendations for clinical practice and subsequent research are offered.

ISSN:0162-220X    

出版商:OVID    

年代:2003

数据来源: OVID

摘要:

Patients with head and neck cancer experience complex and frustrating communication problems after surgery, yet patient communication during the in hospital postoperative period has received relatively little attention in clinical and research literature. A computerized and hand search of the medical (MEDLINE, Cancerlit), psychological (health and psychosocial instruments), and nursing (CINAHL) literature (1968 to April 2002) produced 10 published studies and 1 clinical case report specifically addressing the communication needs, methods, or perceived voice quality of patients with head and neck cancer during the postoperative period ([.lessequal]12 months after surgery). This review presents a summary and critique of research and related literature on in-hospital postoperative communication with adult patients who have head and neck cancer. Three major themes are addressed: (1) information needs, (2) communication methods and perceived voice quality and (3) quality-of-life perceptions related to communication, disfigurement, and socialization. This review shows that the communication needs, communication methods, and perception of voice quality among patients with head and neck cancer have been ignored during the in-hospital period. Clinical issues and technological advancements in augmentative and alternative communication applicable to the in-hospital period are discussed, and research implications are presented.

ISSN:0162-220X    

出版商:OVID    

年代:2003

数据来源: OVID

摘要:

Little research has addressed how a parent's cancer affects young children. The purpose of this study was to explore the well-being and coping of young children during a period of cancer illness in the family. An explorative design was chosen, and data were collected through qualitative in-depth interviews with children (ages, 7-12 years) and their parents. Data were analyzed and interpreted within a phenomenologic-hermeneutic frame of understanding. Four major themes emerged in the findings: illness ruling in the family, reactions over and under the surface, many efforts to manage the situation, and feeling good most of the time. This report discusses how children's reactions and their management of such a difficult life event affect their quality of life. By going “in and out” of the situation, both literally and emotionally, the children cope with the situation and maintain a balance in life. In general, the children reported “feeling good,” but they put a lot of effort into it, and their quality of life appeared to be fragile. Their well-being was especially vulnerable at the time of the diagnosis and when the illness situation changed.

ISSN:0162-220X    

出版商:OVID    

年代:2003

数据来源: OVID

摘要:

Early detection of cancer can lower mortality rates. Detection tests are available for some cancers such as breast and cervical cancer. Unrealistic optimism can affect compliance with health recommendations. Factors such as past experience (personal or at workplace) and perceived control over the disease influence unrealistic optimism. The purpose of this study was to examine the influence of past experience and perceived control over disease on unrealistic optimism towards breast and cervical cancer, and to examine the effect of unrealistic optimism, perceived control over the disease, and past experience on intentions to undergo screening tests. The study design was quasi-experimental correlative. Past experience was measured among 3 groups of women living in Tel-Aviv ranging in age from 21 to 60 years: oncology nurses (n= 50), obstetric nurses (n= 50), and laywomen (n= 50). These groups were presumed to differ from each other in the extent to which they were aware of cancer. In addition, the 2 types of malignancy represented different levels of awareness. Questionnaires were used to measure the study variables. Experience had a strong impact on unrealistic optimism with both cancers. However, the cancers differed in the impact of unrealistic optimism on behavioral intentions. With breast cancer (the more frequent), there was only a main effect of unrealistic optimism. A 3-way interaction was found with cervical cancer. The results indicate that unrealistic optimism plays a role in predicting participation in early detection testing and should be considered as an influencing factor in health-promoting plans.

ISSN:0162-220X    

出版商:OVID    

年代:2003

数据来源: OVID

摘要:

Hereditary breast cancer and the BRCA1 and BRCA2 genes have received a great deal of publicity over the past few years. Patients and family members frequently ask if they can be tested to see whether they have the “breast cancer gene,” assuming that all breast cancers can be linked to one chromosomal site. Although the BRCA1 and BRCA2 genes are the most common sites for hereditary breast cancer mutations, there are other hereditary gene mutations associated with breast cancer. Nurses should be aware of the spectrum of hereditary cancer syndromes and their associated “red flags.” Important skills for the oncology nurse interested in genetic health include careful assessment of benign and malignant disease histories, alertness to physical findings, performance of risk assessments, and ability to access genetic health resources. The following case study describes the assessment process for a less common genetic disorder known as Cowden syndrome, or multiple hamartoma syndrome, a hereditary cancer syndrome associated with early-onset breast cancer, thyroid cancer, goiters, enlarged head size, and a variety of skin findings.

ISSN:0162-220X    

出版商:OVID    

年代:2003

数据来源: OVID

摘要:

This article reviews recruitment and retention issues in a multisite, multistate (California, New York, Connecticut, Georgia, Alabama) 6-month prospective cross-sectional study focused on quality of life among 230 women with lung cancer. Recruitment of women into clinical trials and their retention are important, yet understudied. To date, few articles have described the challenges associated with recruiting women with lung cancer to participate in clinical research. Data from this trial were used to investigate the most effective strategies for recruitment across sites, to identify the most common reasons for refusal and attrition, and to identify challenges and potential solutions to recruitment and retention issues associated with multisite clinical research studies. Strategies for recruitment included letters from physicians, posters, announcements in community support groups, and newspaper and radio advertisements. Three sites allowed the researchers to contact potential participants directly, whereas 2 sites required the potential participants to contact the researchers for further information. Enrollment included 63% of the women eligible for the study (n= 230). The most common reasons for refusal were health limitations (n= 60), lack of interest (n= 46), and inconvenience (n= 16). The most common reasons for attrition (24% of the sample) were death (n= 21) and severity of illness (n= 13). Challenges related to recruitment and retention varied by geographic location.

ISSN:0162-220X    

出版商:OVID    

年代:2003

数据来源: OVID

摘要:

Systematic nursing research activities in South Korea began in the 1970s, but research into oncology did not begin until the mid-1980s. Although the number of Korean oncology nursing studies has increased steadily since then, no national agenda exists for future research in oncology nursing. This study involved a descriptive survey of oncology nursing research priorities among Korean oncology nurses. The analysis included 59 members of the Korean Oncology Nursing Society. The questionnaire used by the Oncology Nursing Society in a US survey was revised and translated into Korean. The questionnaire contained 108 items. In addition, respondents were asked to rank 5 items in order of research priority. The Korean Oncology Nursing Society members ranked prevention of cancer and cancer risk reduction as the top research priority, followed by pain management, quality of life, hospice and end-of-life care, and standards of care. These findings provide the basis for developing a Korean oncology nursing research agenda, and for determining the direction of oncology research funding.

ISSN:0162-220X    

出版商:OVID    

年代:2003

数据来源: OVID

摘要:

This qualitative study aimed to describe symptom management strategies oncology nurses have used in responding to and preventing requests of terminally ill patients with cancer for assisted dying (AD). The study involved secondary analysis of written stories from 36 nurses who agreed to describe their experiences with a request for assisted dying. Of the 36 nurses, 12 refused to support patient requests for AD and described their attempts to control the circumstances of dying by controlling symptoms. The remaining 24 nurses denied ever receiving requests for AD and described symptom management practices believed to prevent such requests. Data were analyzed using Denzin's process of interpretive interactionism. Two themes emerged from the participant's stories: alternative strategies for AD and prevention of requests for AD. The participants shared many examples of clinical interventions and other features of nursing responses to relieve or prevent suffering including physical, emotional, and spiritual care practices; comfort and medication management; and service as teacher-advocate. Both the nurses who had received requests for AD and those who had not used a variety of similar symptom management approaches to alleviate suffering. In doing so, these nurses upheld current standards of both their professional and specialty organizations.

ISSN:0162-220X    

出版商:OVID    

年代:2003

数据来源: OVID

摘要:

Cancer nursing education in the United Kingdom currently is the subject of widespread debate. The imperative to improve cancer care is driven by professional and ethical obligations for clinical excellence and an aggressive political agenda seeking to demonstrate tangible improvements through centrally administered targets and benchmarks. Attempts to provide a holistic approach to care have engendered a range of alternative approaches underpinned by an appreciation of the “cancer journey.” Despite the laudable intent of national policy initiatives aimed at improving the experience of cancer treatment, they have evidenced an emerging polarization in the practice arena. Nursing interventions, priorities, and goals are at risk of becoming confused by the competing paradigms of an outcome-driven strategy and a less focused humanistic philosophy of care. This dilemma presents significant problems in the planning of appropriate and effective education preparation for cancer nurses. This article aims to address the tensions produced by a dichotomy between the pragmatics of clinical practice and a professional quest for holism. It focuses on a specialist practitioner cancer nursing program, using case examples to illustrate innovations in teaching and learning. Embracing a postmodern perspective, reflection, and critical thinking, the discussion offers a challenge to diagnostic clinical language through the discursive structures of metaphor, narrative, and story.

ISSN:0162-220X    

出版商:OVID    

年代:2003

数据来源: OVID

摘要:

This study aimed to assess baseline knowledge about mammograms and pap smears among Australian Deaf women, to investigate their participation in breast and cervical cancer screening services, and to explore, where relevant, their perceptions about their access to breast and cervical screening services. An interview schedule was developed, and a convenience sample of 13 Deaf women was interviewed face-to-face by the first researcher with an accredited Auslan interpreter. The Deaf women's knowledge about mammograms and Pap smears often was incomplete. However, most of the eligible women had undergone a mammogram and had been rescreened within the recommended time frame. Although most had received a Pap smear, some were not attending as recommended by the Cancer Council of Australia. This exploration into the experiences of Deaf women can prompt all nurses to consider the needs of particular minorities and the barriers they may face to participate fully in health services.

ISSN:0162-220X    

出版商:OVID    

年代:2003

数据来源: OVID