ISSN:0162-220X    

出版商:OVID    

年代:1995

数据来源: OVID

摘要:

Because clinicians often do not recognize that patients have pain and patients do not spontaneously communicate their pain, clinicians may fail to prescribe or administer adequate pain medications. One method of improving clinicians' assessments of pain is to coach patients to communicate their pain in ways that clinicians recognize. The aims of our pilot study were to (a) examine the feasibility of implementing a randomized clinical trial of a COACHING protocol in 18 outpatients with lung cancer pain and (b) estimate the effects of COACHING on nurses' knowledge of patients' pain location, intensity, quality, and pattern. The expectation was that COACHING would show a trend toward reducing the discrepancy between patient self-report of sensory pain and sensory pain data known to nurse clinicians. Patients were randomly assigned to be COACHED or NOT-COACHED (usual care) and pretest-posttest measures with the McGill Pain Questionnaire (MPQ) and Visual Analogue Scale (VAS) were taken from nurses and patients. Patient-and nurse-completed MPQs and VASs were compared for agreement. Improvement in percent agreement occurred consistently more often (pretest to posttest) between patient self-report of sensory pain and nurses' pain assessments in the COACHED group than in the NOT-COACHED group. Pilot study findings demonstrated feasibility of implementing the COACHING protocol and suggest that COACHING may be effective in reducing discrepancies between patients' self-reports and nurses' assessments of sensory pain. Design modifications are recommended for implementation of future studies.

ISSN:0162-220X    

出版商:OVID    

年代:1995

数据来源: OVID

摘要:

The reluctance of patients with cancer to report pain and to use analgesics hinders the management of their pain. In the United States, this reluctance is related to the patient's misconceptions regarding addiction and tolerance to analgesics and the desire to be a “good patient” who does not complain. Reports in the literature suggest that patients in Taiwan may have these same concerns and misconceptions. This study was designed to explore (a) the concerns of patients in Taiwan about reporting pain and using analgesics and (b) the relationship between these concerns and the adequacy of analgesics used by the patients. Sixty-three patients with cancer completed the Barriers Questionnaire-Taiwan (BTQ) form, a self-report instrument that measures the extent to which patients have eight specific concerns about reporting pain and using analgesics. The responses indicated that patients who were less educated were more likely to have concerns and that patients in general were most worried about tolerance. Patients who were inadequately medicated, as determined by an index of “adequate pain management” constructed for the study, had significantly higher levels of concerns. Open communication between health professionals and patients and educational programs about pain and about the concerns measured in this study could help overcome these concerns and misconceptions and improve pain management.

ISSN:0162-220X    

出版商:OVID    

年代:1995

数据来源: OVID

摘要:

In order to determine which strategies are most effective in relieving fatigue of women undergoing treatment for cancer, women receiving either chemotherapy (n - 45) or radiation therapy (n = 54) were interviewed twice to determine their level of fatigue and the effectiveness of the strategies they used to relieve their fatigue. The subjects were interviewed either at the start and mid-point of any cycle of chemotherapy, or at the beginning and end of a 5− or 6-week course of radiation therapy. At each interview, the subjects completed the Pearson Byars Fatigue Feeling Checklist and the Fatigue Relief Scale. At the second interview, the patients were significantly more fatigued than they had been at the first interview (p < 0.0001). The more effective the fatigue-relieving strategies at the second interview, the less fatigue experienced by the women (p < 0.0001). At both interviews, subjects used similar strategies to relieve their fatigue. Sleep and exercise were among the most effective strategies. However, there was a wide range of scores for each strategy used, indicating variability among subjects as to the effectiveness of the strategy. The results of the study provide nurses with some guidance as to strategies they might suggest to patients who experience fatigue.

ISSN:0162-220X    

出版商:OVID    

年代:1995

数据来源: OVID

摘要:

Asians are the fastest growing minorities in the U.S. To deliver culturally sensitive care is a significant challenge to the nursing profession. Research identifying variables associated with breast self-examination (BSE) in the U.S. has been conducted on Caucasian women, but little is known about Asian women. Based on the health belief model (HBM) and Bandura's social learning theory, the purpose of this study was to identify barriers to the practice of BSE among Chinese women. The Chinese women (n = 174; mean age, 31 years) were surveyed with a 38-item, five-point Likert scale developed by Champion, and Lauver and Angerame, as well as a six-step accuracy check. The factors included susceptibility; seriousness for breast cancer; general efficacy for BSE; specific efficacy of BSE for oneself; competence; comfort; and control. The results showed that only 15% of these Chinese women practiced BSE monthly, and 48% reported never having performed BSE. Approximately 50% had no opinion on perceived susceptibility to and seriousness of breast cancer; nevertheless, > 80% recognize the efficacy of BSE. Perceived competence significantly accounted for 10% of the variance on BSE frequency (p < 0.001). Implications for nursing interventions that foster competence in BSE for this population are suggested. The study also demonstrates culturally specific methodological considerations.

ISSN:0162-220X    

出版商:OVID    

年代:1995

数据来源: OVID

摘要:

With 5-year cancer survival rates increasing and breast cancer appearing in one of eight women in the United States, health-care providers need to become aware of issues common to this population. Knowledge of coping strategies can be used to improve the lives of survivors. This descriptive study used a semistructured interview to delineate concerns and coping as perceived by 14 women who had lived at least 5 years after a diagnosis of breast cancer. Informants gave evidence of a survivor personality as they described the use of multiple coping strategies, with information-seeking, work, spirituality, and family being predominant. The majority indicated that awareness of vulnerability had effected changes in how they viewed life. Their major concern was fear of recurrence. These women made adjustments to living with cancer and were able to describe positive aspects of their cancer experiences.

ISSN:0162-220X    

出版商:OVID    

年代:1995

数据来源: OVID

摘要:

The 1993 projections for breast cancer indicate a morbidity of 183,000 women with a mortality rate of 18%. Mammography is one of three approaches available for the early detection of breast cancer. However, underutilization has been reported and attributed to pain associated with the procedure, the expense to the consumer, and lack of referral by physicians. Other reasons for the low utilization rates include fears on the part of the woman of a positive diagnosis, radiation, and a possible mastectomy. This study provides an analysis of the responses of a convenience sample of 272 women, aged 30–90 years, to two open-ended questions about the mammography experience. The words and phrases women used to describe the mammography experience and the sensations experienced in their breasts during mammography were subjected to content analysis. The results of this study suggest that the word descriptors women use to describe their experience during mammography are highly individualistic and may not be totally captured by numeric or descriptive rating scales of pain intensity.

ISSN:0162-220X    

出版商:OVID    

年代:1995

数据来源: OVID

摘要:

The purpose of this study was to refine scales to measure Health Belief Model concepts of benefits and barriers using the context of mammography screening. Both scales used a summated Likert format with five response options. Items were first subjected to content analysis by national experts. Data were then collected from a random sample of 581 women who were 35 years or over. Retest data were gathered on a subset of women ∼ 4–6 weeks later. Construct validity was established using confirmatory factor analysis and exploratory factor analysis with results confirming independence of constructs. Construct validity was also tested by developing hypotheses based on theoretical relationships. Cronbach alpha reliability coefficients for the benefits scale was 0.79 and for the barriers scale was 0.73. Suggestions for further revisions are offered.

ISSN:0162-220X    

出版商:OVID    

年代:1995

数据来源: OVID

摘要:

Nausea and vomiting have been recognized as the most distressing side effects of chemotherapy, and are experienced by 66–91% of chemotherapy patients in Japan. Relaxation measures have been used for patients with various other diagnoses, but this technique has never been applied to patients receiving cancer chemotherapy. This pilot study examined the effects of progressive muscle relaxation (PMR) to reduce nausea, vomiting, and anxiety associated with chemotherapy in Japanese patients. Data for eight subjects who were randomly assigned to a treatment group or a control group were analyzed. Both treatment and control groups showed decrease in nausea and vomiting; therefore, the effect of PMR was not verified. However, there was an average decrease of 2.5 points in state-anxiety scores in the treatment group. In addition, some positive effects of PMR were shown by the subjects in the treatment group.

ISSN:0162-220X    

出版商:OVID    

年代:1995

数据来源: OVID

摘要:

This is the sixth of seven self-learning modules that will review radiation therapy. The focus of this module is potential long term and late effects related t o radiation therapy. The module will provide useful information to nurses and other health care professionals who care for cancer patients or which to have a better understanding of radiation therapy This module will focus on lymphedema, myelopathy brachial plexopathy, osteoradionecrios and other site specific effects the potential long-term and late effects are rare but it is important for nurses to be aware of them.

ISSN:0162-220X    

出版商:OVID    

年代:1995

数据来源: OVID