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Raybin JL, Zhou W, Pan Z, Hendricks-Ferguson VL, Jankowski C. Creative Arts Therapy Among Children With Cancer: Symptom Assessment Reveals Reduced Anxiety. Cancer Nurs 2024; 47:12-19. [PMID: 36624566 DOI: 10.1097/ncc.0000000000001186] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Abstract
BACKGROUND Symptom distress is related to decreased quality of life (QOL) among children with cancer, with high levels of pain, nausea, and anxiety reported. Creative arts therapy (CAT) has been related to improved QOL and symptoms in pediatric oncology, but the quality of evidence is mixed. OBJECTIVE This article aims to examine the QOL symptom subscales in relation to CAT over time in children during the first year of cancer treatment. METHODS A secondary analysis of prospective data was performed with linear mixed modeling on 267 observations with predictors of 2 groups: No CAT (n = 18) vs CAT (n = 65). The covariate of time (6 months) was used to explore the CAT relationship with the Pediatric Quality of Life Inventory (PedsQL) symptom subscales (pain and hurt, nausea, procedural anxiety, treatment anxiety, worry, cognitive problems, perceived physical appearance, and communication). RESULTS Children (n = 83) were between 3 and 17 years old (M = 6), 51.2% female, and 32% minority. All tumor types were represented: liquid (37.3%), solid (24.1%), and central nervous system (38.6%). Reduced child report of procedural anxiety was significantly related to receiving CAT with a medium magnitude of association (adjusted effect size = 0.58, P = .01). CONCLUSION Creative arts interventions were associated with a longitudinal improvement in anxiety in children with cancer. Further work is needed to target interventions to the appropriate specific burdensome symptoms. IMPLICATION FOR PRACTICE Pediatric oncology nurses can advocate for CAT as an effective intervention to ameliorate the burdensome procedural anxiety experienced by patients.
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Affiliation(s)
- Jennifer L Raybin
- Author Affiliations: Oregon Health & Sciences University, Schools of Nursing and Medicine, Pediatric Hematology Oncology, Doernbecher Children's Hospital (Dr Raybin); College of Nursing and School of Medicine, University of Colorado Anschutz Medical Campus (Drs Raybin, Pan, and Jankowski); Colorado School of Public Health-Biostatistics and Informatics (Ms Zhou); and Trudy Busch Valentine School of Nursing, Saint Louis University (Dr Hendricks-Ferguson), Missouri
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2
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Bhimani R, Xiong J, Anderson L. Fatigue Experiences in People With Stroke. Rehabil Nurs 2023; 48:200-208. [PMID: 37733016 DOI: 10.1097/rnj.0000000000000431] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/22/2023]
Abstract
PURPOSE Fatigue is a major symptom in patients with stroke. Because fatigue is an overarching multidimensional phenomenon, it is important to understand how the characteristics of fatigue change over time. The purpose of this study was to explore how fatigue characteristics change over time in patients with stroke. DESIGN This study used a mixed-method observational design. METHODS This study is a secondary analysis of data from a previous study, the results of which indicated fatigue to be a prominent symptom. Participants in that study were patients with stroke who met eligibility criteria and provided informed consent. This secondary analysis used data from numeric rating scale scores for fatigue, Functional Assessment of Chronic Illness Therapy-Fatigue Scale scores, fatigue descriptors, and participant comments about fatigue gleaned from transcribed interviews. RESULTS Twenty-two patients participated in the study. Thirteen characteristics of fatigue were evaluated. Seven characteristics showed significant improvement ( p < .05) from admission to 1 month follow-up, and six characteristics did not change significantly. CONCLUSIONS Fatigue experiences vary over time and have both physical and mental aspects to them. CLINICAL RELEVANCE TO REHABILITATION NURSING Nurses may consider providing a quiet environment for physical rest, which may allow the brain to not be distracted by multiple stimuli.
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Affiliation(s)
- Rozina Bhimani
- University of Minnesota School of Nursing, Minneapolis, MN, USA
| | - Jiayue Xiong
- University of Minnesota School of Nursing, Minneapolis, MN, USA
| | - Lisa Anderson
- Department of Integrative Biology and Physiology, University of Minnesota, Minneapolis, MN, USA
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3
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Chen YJ, Petrinec A, Stephenson PS, Radziewicz RM, Sheehan D. Home-Based Reiki by Informal Caregivers: A Mixed-Methods Pilot Study. Holist Nurs Pract 2023; 37:285-297. [PMID: 34029232 DOI: 10.1097/hnp.0000000000000450] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
This pilot study explored whether Reiki delivered by family caregivers to cancer patients in a home setting was feasible in reducing cancer symptoms and enhancing health-related outcomes. An explanatory sequential mixed-methods study design was applied using pre-/post-Reiki questionnaires and post-Reiki interviews. Six patient-caregiver dyads from an outpatient clinic and cancer support facilities in northeast America performed daily Reiki at home for 3 weeks. Differences with symptoms, mental well-being, health-related quality of life, and satisfaction with at-home Reiki as well as qualitative content analyses were evaluated. Positive feedback was reported after at-home Reiki practice. Large statistical effects were identified for improving fatigue, memory, mood, nausea, and emotional well-being ( P < .10, r = 0.51-0.59). All participants were satisfied and 83.3% of them would recommend self-practice home Reiki. High involvement and adherence to the intervention protocol illustrated intervention fidelity. The qualitative data revealed 2 major categories, perceived benefits and barriers. Overall Reiki benefits outweighed barriers in relation to time commitment and place distractions/positioning. Our preliminary findings support that the at-home Reiki protocol had potential benefits and was feasible and acceptable by both community-dwelling patients and their family caregivers in promoting cancer-related outcomes. Further studies with larger samples are warranted to examine the effectiveness of home-based Reiki for a patient-centered cancer care modality.
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Affiliation(s)
- Yea-Jyh Chen
- School of Nursing, College of Health and Human Services, University of North Carolina Wilmington, Wilmington, North Carolina (Dr Chen); College of Nursing, Kent State University, Kent, Ohio (Drs Petrinec, Stephenson, and Sheehan); and MetroHealth Medical Center, Cleveland, Ohio (Ms Radziewicz)
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4
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Abduljawad SF, Beckstead JW, Dobbs D, Visovsky C, Rodriguez CS, McMillan SC, Wang HL. Fatigue-related symptom clusters and functional status of older adults in hospice. Palliat Support Care 2023; 21:57-64. [PMID: 35676795 PMCID: PMC11022836 DOI: 10.1017/s1478951522000207] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
BACKGROUND Fatigue is frequently co-existing with other symptoms and is highly prevalent among patients with cancer and geriatric population. There was a lack of knowledge that focus on fatigue clusters in older adults with cancer in hospice care. OBJECTIVES To identify fatigue-related symptom clusters in older adult hospice patients and discover to what extent fatigue-related symptom clusters predict functional status while controlling for depression. METHOD This was a cross-sectional study in a sample of 519 older adult hospice patients with cancer, who completed the Memorial Symptom Assessment Scale, the Center for Epidemiological Studies Depression, Boston Short Form Scale, and the Palliative Performance Scale. Data from a multi-center symptom trial were extracted for this secondary analysis using exploratory factor analysis and hierarchical multiple regression analysis. RESULTS Data from 519 patients (78 ± 7 years) with terminal cancer who received hospice care under home healthcare services revealed that 39% of the participants experienced fatigue-related symptom clusters (lack of energy, feeling drowsy, and lack of appetite). The fatigue cluster was significantly associated positively with depression (r = 0.253, p < 0.01), and negatively with functional status (r = -0.117, p < 0.01) and was a strong predictor of participants' low functional status. Furthermore, depression made a significant contribution to this predictive relationship. CONCLUSION Older adult hospice patients with cancer experienced various concurrent symptoms. The fatigue-specific symptom cluster was identified significantly associated with depression and predicted functional status. Fatigue should be routinely monitored in older adults, especially among hospice cancer patients, to help reduce psychological distress and prevent functional decline.
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Affiliation(s)
- Suzan F Abduljawad
- Lombardi Comprehensive Cancer Center, Georgetown University Medical Center, Washington, DC
| | | | - Debra Dobbs
- School of Aging Studies, University of South Florida, Tampa, FL
| | | | | | - Susan C McMillan
- Emeritus Distinguished Professor, University of South Florida, Tampa, FL
| | - Hsiao Lan Wang
- School of Nursing, The University of Alabama at Birmingham, Birmingham, AL
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5
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Im EO, Choi MY, Jin R, Kim G, Chee W. Cluster Analysis on Gastrointestinal Symptoms during Menopausal Transition. West J Nurs Res 2023; 45:133-143. [PMID: 35801285 DOI: 10.1177/01939459221109810] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
The purpose of this secondary analysis was to determine the clusters of midlife women by gastrointestinal (GI) symptoms and to explore differences in the clusters by race/ethnicity. This analysis used the data from two internet-based studies among 1,054 midlife women. The analysis was conducted with the data on background characteristics, health and menopausal status, and GI symptoms (collected using the GI Symptom Index for Midlife Women). The data were analyzed using factor analyses, hierarchical cluster analyses, chi-square tests, multinomial logistic regression analyses, and analyses of covariance. Three clusters were adopted: Cluster 1 (with low total numbers and severity scores of symptoms; 46.0%), Cluster 2 (with moderate total numbers and severity scores of symptoms; 44.0%), and Cluster 3 (with high total numbers and severity scores of symptoms; 10.0%). Only in Cluster 2, there were significant racial/ethnic differences in individual GI symptoms. These results provide directions for future GI symptom management among midlife women.
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Affiliation(s)
- Eun-Ok Im
- School of Nursing, Emory University, Atlanta, GA, USA
| | - Mi-Young Choi
- School of Nursing, Emory University, Atlanta, GA, USA.,Department of Nursing Science, Chungbuk National University, Cheongju, South Korea
| | - Ruiqi Jin
- School of Nursing, Emory University, Atlanta, GA, USA
| | - Gayeong Kim
- School of Nursing, Emory University, Atlanta, GA, USA
| | - Wonshik Chee
- School of Nursing, Emory University, Atlanta, GA, USA
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6
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Lin R, Li H, Chen L, He J. Prevalence of and risk factors for thirst in the intensive care unit: An observational study. J Clin Nurs 2023; 32:465-476. [PMID: 35199411 PMCID: PMC10078651 DOI: 10.1111/jocn.16257] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2021] [Revised: 01/13/2022] [Accepted: 02/08/2022] [Indexed: 01/17/2023]
Abstract
AIM AND OBJECTIVES This study investigated the incidence of thirst and contributing factors in intensive care unit (ICU) patients by analysing differences in physiologic, psychological, and disease- and environment-related parameters in ICU patients with vs without thirst. BACKGROUND Little is known about the factors that influence thirst, and there are no standardised methods for identifying at-risk patients in the ICU. Previous studies generalised the risk of thirst in ICU patients because of a lack of data on relevant variables. Here, we examined the factors contributing to thirst based on symptom management theory. DESIGN Prospective descriptive design. METHODS Physiologic, psychological, disease-related and environment-related data were collected for 301 patients from 4 ICUs (medical, surgical, cardiac and emergency ICUs) of a hospital from 15 December 2017-10 July 2019 through a screening interview, questionnaires and from electronic medical records. The data were analysed with descriptive statistics, the t-test and chi-squared test, and by logistic regression. Binary stepwise logistic regression was used to identify thirst-associated factors. The findings are reported according to the STROBE checklist for cross-sectional studies. RESULTS In total, 210/301 (69.8%) ICU patients experienced thirst. Risk factors were nil per os order (odds ratio [OR] = 4.10, 95% confidence interval [CI]: 1.44-11.69), surgery (OR = 2.96, 95% CI: 1.11-7.93), high glucose (OR = 3.36, 95% CI: 1.01-11.17) and greater disease severity (OR = 1.13, 95% CI: 1.02-1.24). CONCLUSION Thirst is common in ICU patients. Timely detection of patients' thirst and identification of those at high risk by ICU nurses can ensure the implementation of effective and safe interventions. RELEVANCE TO CLINICAL PRACTICE The results of this study highlight the need to evaluate thirst symptoms in patients with severe disease and develop relief strategies for fasting, perioperative, and hyperglycaemic patients and others who are at high risk of thirst.
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Affiliation(s)
- Rong Lin
- Research Center for Nursing Theory and Practice, Fujian Provincial Hospital, Fuzhou, China.,The School of Nursing, Fujian Medical University, Fuzhou, China.,Department of Nursing, Fujian Provincial Hospital, Shengli Clinical Medical College of Fujian Medical University, Fuzhou, China
| | - Hong Li
- Research Center for Nursing Theory and Practice, Fujian Provincial Hospital, Fuzhou, China.,The School of Nursing, Fujian Medical University, Fuzhou, China.,Department of Nursing, Fujian Provincial Hospital, Shengli Clinical Medical College of Fujian Medical University, Fuzhou, China
| | - Lili Chen
- Research Center for Nursing Theory and Practice, Fujian Provincial Hospital, Fuzhou, China.,The School of Nursing, Fujian Medical University, Fuzhou, China
| | - Jinyi He
- Intensive Care Unit, Fujian Provincial Hospital, Fuzhou, China
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7
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Correlates of quality of life in South Korean patients undergoing hematopoietic stem cell transplantation based on the symptom management model. Sci Rep 2022; 12:19679. [PMID: 36385163 PMCID: PMC9668985 DOI: 10.1038/s41598-022-21994-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2022] [Accepted: 10/07/2022] [Indexed: 11/17/2022] Open
Abstract
While hematopoietic stem cell transplantation (HSCT) has led to higher survival rates, the number of patients experiencing adverse reactions is also increasing. Based on the symptom management model, we aimed to analyze the relationships between symptom experience, symptom management strategies, self-management behavior, and quality of life among patients undergoing HSCT in South Korea and to identify the factors affecting their quality of life. The data of 67 conveniently sampled patients undergoing HSCT at a university-affiliated hospital, for the period from March 23 to June 7, 2016, were collected using a self-reported structured questionnaire. Data were analyzed using Pearson's correlations and multiple regression analysis. Quality of life showed a significant negative correlation with symptom experience and significant positive correlations with symptom management strategies. Factors influencing quality of life included symptom distress, symptom management strategies, and self-management behavior; these explained 39.4% of the variance. To improve quality of life in patients undergoing HSCT, the efficient management of multiple co-existing symptoms is important. There is a need for tailored nursing interventions based on a patient-focused and person-centered approach for patients undergoing HSCT.
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8
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Liu Y, Danyu L, Haishan R, Huyun, Shen N. Development and usability test of a symptom management WeChat Mini Program for parents of children with Cancer. Asia Pac J Oncol Nurs 2022; 9:100166. [DOI: 10.1016/j.apjon.2022.100166] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2022] [Accepted: 11/08/2022] [Indexed: 11/16/2022] Open
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9
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Abstract
The purpose of this secondary analysis was to determine the clusters of Asian American breast cancer survivors by the severity scores of menopausal symptoms and to explore the characteristics associated with the identified clusters. The data from an ongoing study among 94 survivors were used. The instruments included the Perceived Isolation Scale, the Personal Resource Questionnaire, and the Memorial Symptom Assessment Scale-Short Form. The data analysis was conducted using hierarchical cluster analyses and multinomial logistic analyses. Three clusters were identified: "the cluster with high severity scores of total, psychological, physical, and psychosomatic symptoms (Cluster 1)," "the cluster with moderate severity scores of total, psychological, physical, and psychosomatic symptoms (Cluster 2)," and "the cluster with low severity scores of total, psychological, physical, and psychosomatic symptoms (Cluster 3)." The clusters had significant differences in the level of acculturation, perceived social isolation, and perceived social support (p < 0.05).
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Affiliation(s)
- Eun-Ok Im
- Nell Hodgson Woodruff School of Nursing, Emory University, Atlanta, GA, USA
| | - Wonshik Chee
- Nell Hodgson Woodruff School of Nursing, Emory University, Atlanta, GA, USA
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10
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Application of Nursing Intervention Plan Based on Symptom Management Theory among Breast Cancer Patients. CONTRAST MEDIA & MOLECULAR IMAGING 2022; 2022:3816768. [PMID: 36051927 PMCID: PMC9410828 DOI: 10.1155/2022/3816768] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/25/2022] [Revised: 07/15/2022] [Accepted: 07/20/2022] [Indexed: 11/17/2022]
Abstract
In order to explore the application effect of nursing intervention based on symptom management theory in breast cancer patients, a total of 120 breast cancer patients who were hospitalized in the Thyroid and Breast Surgery Department of Zhejiang Xiaoshan Hospital from July 2018 to July 2021 were selected as the research subjects. Patients from the control group received routine nursing, while patients from the intervention group underwent nursing interventions based on symptom management theory. Before and after the intervention, symptom distress, Herth Hope Index, quality of life, self-rating anxiety scale (SAS), self-rating depression scale (SDS), visual analogue score (VAS), and Pittsburgh sleep quality index (PSQI) were evaluated in two groups. The results showed that the symptom severity score and the symptom distress score, SAS scores, SDS scores, VAS scores, and PSQI scores in the intervention group were significantly lower than those in the control group, while the Herth Hope Index scores and FACT-B scores in the intervention group were obviously higher than those in the control group (all P < 0.05) after intervention. In conclusion, nursing interventions based on symptom management theory could decrease symptom distress among breast cancer patients, increase their hope levels, improve their life quality, relieve the negative emotions, enhance the sleep quality, and reduce their pain. It is worthy of clinical application.
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11
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Salvetti MDG, Sanches MB. Symptom cluster: management and advanced practices in oncology nursing. Rev Esc Enferm USP 2022; 56:e20210452. [PMID: 35766922 DOI: 10.1590/1980-220x-reeusp-2021-0452en] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2021] [Accepted: 01/12/2022] [Indexed: 11/21/2022] Open
Abstract
OBJECTIVE To present the definition of "symptom cluster" in cancer patients and to reflect on the theory, assessment, outcomes, and interventions for symptom management, based on the perspective of advanced practices in oncology nursing. METHOD Theoretical-reflective study that presents and discusses possibilities for managing "symptom clusters" through advanced practices in oncology nursing. RESULTS The term "symptom cluster" can be defined as a set of two or more related symptoms. The theoretical concepts and models that can help in its understanding are: Theory of Unpleasant Symptoms, Theory of Symptom Management, concept of self-efficacy and Theory of symptom self-management. Advanced practice nurses have the skills to manage "symptom clusters," optimizing outcomes and positively influencing the quality of life of cancer patients. CONCLUSION Advanced practice nurses have the essential characteristics to design, to implement and to evaluate intervention protocols aimed at the management of "symptom clusters" in cancer patients.
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Affiliation(s)
- Marina de Góes Salvetti
- Universidade de São Paulo, Escola de Enfermagem, Departamento de Enfermagem Médico-Cirúrgica, São Paulo, SP, Brazil
| | - Mariana Bucci Sanches
- Universidade de São Paulo, Escola de Enfermagem, Departamento de Enfermagem Médico-Cirúrgica, São Paulo, SP, Brazil.,Hospital Sírio Libanês, São Paulo, SP, Brazil
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12
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Raybin JL, Zhou W, Pan Z, Jankowski C. Quality of Life Outcomes With Creative Arts Therapy in Children With Cancer. JOURNAL OF PEDIATRIC HEMATOLOGY/ONCOLOGY NURSING 2022; 39:155-167. [PMID: 35467438 DOI: 10.1177/27527530211055988] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
Introduction: Children with cancer experience distress and decreased quality of life (QOL). Creative arts therapy (CAT) is a therapeutic modality which may improve QOL. This study examined the relationship between CAT and QOL in children and adolescents with cancer. Secondary aims explored relationships between CAT and emotional reactions, resilience, and posture (to investigate future potential as an objective biomarker of QOL). Methods: Children aged 3-18 years undergoing cancer treatments and a parent proxy completed the PedsQL3.0 Cancer Module, Faces Scale for emotional reactions, Resilience Scale in adolescents (>12 years), and an inclinometer to measure thoracic kyphosis before and after CAT. CAT exposure (number of sessions) was recorded. Results: Ninety-eight children with cancer (mean age 7.8 years, range 3-17) and parent proxy were enrolled. Of the 83 participants included in the final analysis, 18 received no CAT, 32 received low dose, and 33 received high dose CAT. A significant improvement in QOL was seen with high dose CAT in (slope change, p = .015), but the overall time by group interaction was not significant. Slope change response patterns suggested that CAT led to improved posture as compared to no CAT (time by group interaction, p = .044). Discussion: CAT may be an effective intervention to improve QOL in this population. Because initial evidence suggests that posture also improves with CAT, further investigation of posture as a potential objective biomarker of QOL is supported. Further study with a randomized controlled trial is warranted.
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Affiliation(s)
- Jennifer L Raybin
- Pediatric Palliative Care, Center for Cancer and Blood Disorders, Pediatrics, Children's Hospital Colorado, University of Colorado, Aurora, CO, USA
| | - Wenru Zhou
- Colorado School of Public Health-Biostatistics and Informatics, CO, USA
| | - Zhaoxing Pan
- Department of Pediatrics, Anschutz School of Medicine, 129263University of Colorado, CO, USA
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13
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Peng MM, Ma Z, Ran MS. Family caregiving and chronic illness management in schizophrenia: positive and negative aspects of caregiving. BMC Psychol 2022; 10:83. [PMID: 35361263 PMCID: PMC8973811 DOI: 10.1186/s40359-022-00794-9] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2021] [Accepted: 03/24/2022] [Indexed: 02/08/2023] Open
Abstract
Background We aimed to explore the long-term caregiving experiences of family caregivers of people with schizophrenia (PwS) in terms of both positive and negative aspects. Method Utilising a purposive sampling method, we conducted in-depth interviews with 20 family caregivers of persons who had suffered from schizophrenia for more than 20 years. We empirically investigated their retrospective experiences of caregiver-patient interactions during a long period of family caregiving. We audio-recorded and transcribed the interviews into text. We thematically coded and analysed the transcribed text using a four-phase method of theme development. Findings Schizophrenia might not only generate a caregiving burden, affect caregivers’ psychological status, and accordingly influence their coping strategies, but also have short- or long-term patient-related consequences. Discussion Family caregivers should develop their stress management skills to cope with relevant life changes and increase their knowledge of the potential psychological consequences for care recipients resulting from negative caregiving strategies during home-based practice. Care recipients with schizophrenia in a relatively stable status should be empowered to take care of themselves. More effective family-based interventions for psychiatric nursing or individualised training for symptom management should be tailored to serve families’ diverse needs.
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Affiliation(s)
- Man-Man Peng
- Institute of Advanced Studies in Humanities and Social Sciences, Beijing Normal University at Zhuhai, Zhuhai, 519087, China.
| | - Zhiying Ma
- Crown Family School of Social Work, Policy, and Practice, The University of Chicago, Chicago, IL, USA
| | - Mao-Sheng Ran
- Department of Social Work and Social Administration, University of Hong Kong, Hong Kong SAR, China. .,Mental Health Center, West China Hospital, Sichuan University, Chengdu, 610041, Sichuan, China.
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14
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Kalantar-Zadeh K, Lockwood MB, Rhee CM, Tantisattamo E, Andreoli S, Balducci A, Laffin P, Harris T, Knight R, Kumaraswami L, Liakopoulos V, Lui SF, Kumar S, Ng M, Saadi G, Ulasi I, Tong A, Li PKT. Patient-centred approaches for the management of unpleasant symptoms in kidney disease. Nat Rev Nephrol 2022; 18:185-198. [PMID: 34980890 DOI: 10.1038/s41581-021-00518-z] [Citation(s) in RCA: 44] [Impact Index Per Article: 22.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/23/2021] [Indexed: 12/22/2022]
Abstract
Patients with chronic kidney disease (CKD) frequently experience unpleasant symptoms. These can be gastrointestinal (constipation, nausea, vomiting and diarrhoea), psychological (anxiety and sadness), neurological (lightheadedness, headache and numbness), cardiopulmonary (shortness of breath and oedema), dermatological (pruritus and dry skin), painful (muscle cramps, chest pain and abdominal pain) or involve sexual dysfunction, sleep disorders and fatigue. These symptoms often occur in clusters, with one of them as the lead symptom and others as secondary symptoms. Uraemic toxins (also called uremic toxins) are often considered to be the main cause of CKD-associated symptom burden, but treatment of uraemia by dialysis often fails to resolve them and can engender additional symptoms. Indeed, symptoms can be exacerbated by comorbid conditions, pharmacotherapies, lifestyle and dietary regimens, kidney replacement therapy and ageing. Patients with kidney disease, including those who depend on dialysis or transplantation, should feel actively supported in their symptom management through the identification and targeting of unpleasant symptoms via a tailored palliative care approach. Such an approach may help minimize the burden and consequences of kidney disease, and lead to improved patient outcomes including health-related quality of life and better life participation.
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Affiliation(s)
- Kamyar Kalantar-Zadeh
- The International Federation of Kidney Foundation - World Kidney Alliance (IFKF-WKA), Mexico City, Mexico. .,Division of Nephrology and Hypertension and Kidney Transplantation, University of California, Irvine, Irvine, CA, USA.
| | - Mark B Lockwood
- Department of Behavioral Health Science, University of Illinois at Chicago, College of Nursing, Chicago, IL, USA
| | - Connie M Rhee
- Division of Nephrology and Hypertension and Kidney Transplantation, University of California, Irvine, Irvine, CA, USA
| | - Ekamol Tantisattamo
- Division of Nephrology and Hypertension and Kidney Transplantation, University of California, Irvine, Irvine, CA, USA
| | - Sharon Andreoli
- James Whitcomb Riley Hospital for Children, Indiana University School of Medicine, Indianapolis, IN, USA
| | | | | | - Tess Harris
- Polycystic Kidney Disease Charity, London, UK
| | | | | | - Vassilios Liakopoulos
- Division of Nephrology and Hypertension, 1st Department of Internal Medicine, AHEPA Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Siu-Fai Lui
- The International Federation of Kidney Foundation - World Kidney Alliance (IFKF-WKA), Mexico City, Mexico.,Hong Kong Kidney Foundation, Hong Kong, China
| | | | - Maggie Ng
- The International Federation of Kidney Foundation - World Kidney Alliance (IFKF-WKA), Mexico City, Mexico.,Hong Kong Kidney Foundation, Hong Kong, China
| | - Gamal Saadi
- Nephrology Unit, Department of Internal Medicine, Faculty of Medicine, Cairo University, Giza, Egypt
| | - Ifeoma Ulasi
- Renal Unit, Department of Medicine, College of Medicine, University of Nigeria, Ituku-Ozalla, Enugu, Nigeria
| | - Allison Tong
- Sydney School of Public Health, The University of Sydney, Sydney, New South Wales, Australia
| | - Philip Kam-Tao Li
- Department of Medicine and Therapeutics, Carol & Richard Yu PD Research Centre, Prince of Wales Hospital, Chinese University of Hong Kong, Hong Kong, China.
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15
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Raybin JL, Harnke B, Hendricks-Ferguson V. Does Creative Arts Therapy Improve Distressing Symptoms in Children with Cancer? A Synthesis of Extant Literature. JOURNAL OF PEDIATRIC HEMATOLOGY/ONCOLOGY NURSING 2022; 39:60-71. [PMID: 35722867 DOI: 10.1177/27527530211059432] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
Introduction: Children with cancer experience symptom distress which has been correlated with decreased quality of life (QOL). Creative arts therapy (CAT) encompasses the therapeutic use of creative arts which may improve QOL among children with cancer by affecting symptoms. Therefore, the research question was asked: Does CAT affect symptoms of pain, nausea, fatigue, anxiety, and mood in children with cancer? Methods: Based on the study question, a comprehensive literature search of PubMed, CINAHL, PsycINFO, and Embase was completed. Inclusion criteria limited articles to specific symptom outcomes in two-group intervention studies in the English language. Selected articles were confirmed for inclusion by the study team, followed by group discussion to develop matrices with levels of evidence based on the Grading of Recommendations Assessment, Development, and Evaluation (Grade) guidelines. Results: Initial searches revealed 1,391 articles, screened to 44 for systematic review. Based on the inclusion criteria, 11 articles remained. Four studies had evidence levels graded as low, three were low to moderate, and four were moderate. Outcomes of mood and anxiety were measured in five studies, pain in four, fatigue in two, and nausea in one study. Discussion: Psychological outcomes were measured more commonly than physical outcomes. Evidence reached a moderate grade in four studies. Summary: Through this synthesis of intervention studies with CAT in children with cancer, improvement in distressing symptoms has potential, but the state of the science for symptom management with CAT could be strengthened for nurses to promote CAT to improve QOL among children with cancer.
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Affiliation(s)
- Jennifer L Raybin
- Children's Hospital Colorado, School of Medicine University of Colorado, Aurora, Colorado, United States
| | - Ben Harnke
- Children's Hospital Colorado, School of Medicine University of Colorado, Aurora, Colorado, United States
| | - Verna Hendricks-Ferguson
- Trudy Busch Valentine School of Nursing at Saint Louis University, St. Louis, Missouri, United States
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Salvetti MDG, Sanches MB. Cluster de sintomas: manejo e práticas avançadas em enfermagem oncológica. Rev Esc Enferm USP 2022. [DOI: 10.1590/1980-220x-reeusp-2021-0452pt] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
RESUMO Objetivo: Apresentar a definição de “cluster de sintomas” em pacientes com câncer e refletir sobre modelos teóricos, avaliação, desfechos e intervenções para manejo de sintomas, na perspectiva das práticas avançadas em enfermagem oncológica. Método: Estudo teórico-reflexivo que apresenta e discute possibilidades de manejo de “clusters de sintomas” por meio das práticas avançadas em enfermagem oncológica. Resultados: O termo “cluster de sintomas” pode ser definido como um conjunto de dois ou mais sintomas relacionados entre si. Os conceitos e modelos teóricos que podem ajudar na sua compreensão são: Teoria dos Sintomas Desagradáveis, Teoria do Manejo de Sintomas, conceito de autoeficácia e teoria do autocontrole dos sintomas. Os enfermeiros de prática avançada têm habilidades para realizar o manejo dos “clusters de sintomas”, otimizando os desfechos e influenciando positivamente a qualidade de vida de pacientes com câncer. Conclusão: Os enfermeiros de prática avançada reúnem as características essenciais para elaborar, implementar e avaliar protocolos de intervenções direcionadas ao manejo de “clusters de sintomas” em pacientes com câncer.
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Affiliation(s)
| | - Mariana Bucci Sanches
- Universidade de São Paulo, Escola de Enfermagem, Brazil; Hospital Sírio Libanês, Brazil
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Im EO, Kim G, Choi M, Chee W. Gastrointestinal symptoms in four major racial/ethnic groups of midlife women: race/ethnicity and menopausal status. Menopause 2021; 29:156-163. [PMID: 34873105 PMCID: PMC8795485 DOI: 10.1097/gme.0000000000001898] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
OBJECTIVE The purpose of this study was to explore the associations of race/ethnicity and menopausal status to gastrointestinal (GI) symptoms experienced during the menopausal transition while considering multiple factors that could influence the symptoms. METHODS This secondary analysis was conducted with the data from 1,051 women from 2 Internet-based studies on midlife women's health issues. In the original studies, the data were collected using a dozen questions on sociodemographic and health/menopausal factors and the GI Index for Midlife Women. The data were analyzed utilizing ANOVA, multiple logistic regression, and hierarchical linear regression analyses. RESULTS When covariates were controlled, being Non-Hispanic (N-H) Asian was a significant factor that influenced the total numbers of GI symptoms (β = -0.26) and total severity scores of GI symptoms (β = -0.26). When covariates were controlled, premenopausal status was the strongest factor that influenced the total numbers of GI symptoms in all participants, Hispanics, N-H Whites, N-H African Americans, and N-H Asians (β = 53, -0.40, -0.77, -0.76, -0.26, respectively) and the total severity scores of GI symptoms in all participants, Hispanics, N-H Whites, N-H African Americans, and N-H Asians (β = -0.50, -0.38, -0.72, -0.75, -0.25, respectively). CONCLUSIONS This study supports the association of race/ethnicity and menopausal status to GI symptoms experienced during the menopausal transition.
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Affiliation(s)
- Eun-Ok Im
- School of Nursing, Emory University, Atlanta, GA
| | - Gayeong Kim
- School of Nursing, Emory University, Atlanta, GA
| | - Miyoung Choi
- School of Nursing, Emory University, Atlanta, GA
- Department of Nursing, Chungbuk National University
| | - Wonshik Chee
- School of Nursing, Emory University, Atlanta, GA
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18
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Adam S, Thong MSY, Martin-Diener E, Camey B, Egger Hayoz C, Konzelmann I, Mousavi SM, Herrmann C, Rohrmann S, Wanner M, Staehelin K, Strebel RT, Randazzo M, John H, Schmid HP, Feller A, Arndt V. Identifying classes of the pain, fatigue, and depression symptom cluster in long-term prostate cancer survivors-results from the multi-regional Prostate Cancer Survivorship Study in Switzerland (PROCAS). Support Care Cancer 2021; 29:6259-6269. [PMID: 33847829 PMCID: PMC8464556 DOI: 10.1007/s00520-021-06132-w] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2020] [Accepted: 03/04/2021] [Indexed: 12/25/2022]
Abstract
PURPOSE Aside from urological and sexual problems, long-term (≥5 years after initial diagnosis) prostate cancer (PC) survivors might suffer from pain, fatigue, and depression. These concurrent symptoms can form a cluster. In this study, we aimed to investigate classes of this symptom cluster in long-term PC survivors, to classify PC survivors accordingly, and to explore associations between classes of this cluster and health-related quality of life (HRQoL). METHODS Six hundred fifty-three stage T1-T3N0M0 survivors were identified from the Prostate Cancer Survivorship in Switzerland (PROCAS) study. Fatigue was assessed with the EORTC QLQ-FA12, depressive symptoms with the MHI-5, and pain with the EORTC QLQ-C30 questionnaire. Latent class analysis was used to derive cluster classes. Factors associated with the derived classes were determined using multinomial logistic regression analysis. RESULTS Three classes were identified: class 1 (61.4%) - "low pain, low physical and emotional fatigue, moderate depressive symptoms"; class 2 (15.1%) - "low physical fatigue and pain, moderate emotional fatigue, high depressive symptoms"; class 3 (23.5%) - high scores for all symptoms. Survivors in classes 2 and 3 were more likely to be physically inactive, report a history of depression or some other specific comorbidity, be treated with radiation therapy, and have worse HRQoL outcomes compared to class 1. CONCLUSION Three distinct classes of the pain, fatigue, and depression cluster were identified, which are associated with treatment, comorbidities, lifestyle factors, and HRQoL outcomes. Improving classification of PC survivors according to severity of multiple symptoms could assist in developing interventions tailored to survivors' needs.
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Affiliation(s)
- Salome Adam
- National Institute for Cancer Epidemiology and Registration (NICER), c/o University of Zurich, Zurich, Switzerland
- Division of Chronic Disease Epidemiology, Epidemiology, Biostatistics and Prevention Institute, University of Zurich, Zurich, Switzerland
| | - Melissa S Y Thong
- Unit of Cancer Survivorship, German Cancer Research Center (DKFZ), Heidelberg, Germany.
| | - Eva Martin-Diener
- Division of Chronic Disease Epidemiology, Epidemiology, Biostatistics and Prevention Institute, University of Zurich, Zurich, Switzerland
| | | | | | | | - Seyed Mohsen Mousavi
- Cancer Registry East Switzerland, St. Gallen, Switzerland
- Cancer Registry Graubünden and Glarus, Chur, Switzerland
| | - Christian Herrmann
- Cancer Registry East Switzerland, St. Gallen, Switzerland
- Cancer Registry Graubünden and Glarus, Chur, Switzerland
| | - Sabine Rohrmann
- Division of Chronic Disease Epidemiology, Epidemiology, Biostatistics and Prevention Institute, University of Zurich, Zurich, Switzerland
- Cancer Registry Zurich, Zug, Schaffhausen and Schwyz, University Hospital Zurich, Zurich, Switzerland
| | - Miriam Wanner
- Division of Chronic Disease Epidemiology, Epidemiology, Biostatistics and Prevention Institute, University of Zurich, Zurich, Switzerland
- Cancer Registry Zurich, Zug, Schaffhausen and Schwyz, University Hospital Zurich, Zurich, Switzerland
| | | | - Räto T Strebel
- Department of Urology, Graubünden Cantonal Hospital, Chur, Switzerland
| | - Marco Randazzo
- Department of Urology, GZO Spital Wetzikon AG, Wetzikon, Switzerland
- Department of Urology, Winterthur Cantonal Hospital, Winterthur, Switzerland
| | - Hubert John
- Department of Urology, Winterthur Cantonal Hospital, Winterthur, Switzerland
| | - Hans-Peter Schmid
- Department of Urology, School of Medicine (Med-HSG), St. Gallen, Switzerland
| | - Anita Feller
- National Institute for Cancer Epidemiology and Registration (NICER), c/o University of Zurich, Zurich, Switzerland
| | - Volker Arndt
- National Institute for Cancer Epidemiology and Registration (NICER), c/o University of Zurich, Zurich, Switzerland
- Unit of Cancer Survivorship, German Cancer Research Center (DKFZ), Heidelberg, Germany
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Lopes-Júnior LC, Tuma MC, Amorim MHC. Psychoneuroimmunology and oncology nursing: a theoretical study. Rev Esc Enferm USP 2021; 55:e20210159. [PMID: 34516609 DOI: 10.1590/1980-220x-reeusp-2021-0159] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2021] [Accepted: 06/22/2021] [Indexed: 11/21/2022] Open
Abstract
OBJECTIVE To discuss the evolution of research in cancer psychoneuroimmunology, the advances in the management of neuropsychological symptom clusters and their interface with mid-range theories, and practical applications in Nursing. METHOD This is a theoretical-reflective study anchored in recent literature, as well as in the critical analysis of the authors. RESULTS This is a promising field of investigation, which emphasizes the complexity and interaction of symptoms, the interrelationships among them, the factors influencing them, and their consequences. Subsidized by mid-range theories in Nursing, such as the Theory of Unpleasant Symptoms and the Theory of Symptom Management, analyses of these interrelationships support Oncology Nursing diagnoses and interventions. CONCLUSION An innovative approach is proposed to qualify Oncology Nursing care based on the integration of recent advances in cancer psychoneuroimmunology, Nursing mid-range theories, and practical tools such as health coaching. The approach proposed may strengthen clinical nursing practice in the management of neuropsychological symptom clusters in oncology and shall be integrated into decision-making during cancer treatment, favoring person-centered care.
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Affiliation(s)
- Luís Carlos Lopes-Júnior
- Universidade de Federal do Espírito Santo, Centro de Ciências da Saúde, Departamento de Enfermagem, Vitória, ES, Brazil
| | - Maria Carolina Tuma
- Universidade Federal de São Paulo, Escola Paulista de Enfermagem, São Paulo, SP, Brazil
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Hughes JA, Alexander KE, Spencer L, Yates P. Factors associated with the experience of patients presenting in pain to the emergency department. J Clin Nurs 2021; 31:1273-1284. [PMID: 34374159 DOI: 10.1111/jocn.15983] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2021] [Revised: 06/22/2021] [Accepted: 07/15/2021] [Indexed: 12/30/2022]
Abstract
AIMS AND OBJECTIVES This study aims to examine the association between person, environment, health and illness factors, pain care and the patient experience in the emergency department, guided by symptom management theory. BACKGROUND Current outcome measures of pain care in the emergency department focus on process measures such as the time taken to deliver analgesic medication. Patient-reported outcomes of pain care are rare in emergency department literature and predominantly focus on patient satisfaction. Measuring overall patient experience is common, with extensive surveys undertaken in the United Kingdom, United States of America and Australia; however, these are not used as an outcome of pain care. DESIGN Prospective cohort study. METHODS One hundred and ninety patients arriving at a large, inner-city adults-only emergency department in moderate to severe pain were recruited to answer a modified version of the emergency department patient experience of care survey. RESULTS Fifteen factors were identified as influencing the patient experience of care when presenting in pain. These influences of patient experience included the emergency department environment, time to first analgesic medication and the provision of analgesic medication. CONCLUSIONS In addition to pain care factors, there is a significant association between the emergency department environment-especially workload, throughput and patient placement-and the experience of patients who present in pain to the emergency department. RELEVANCE TO CLINICAL PRACTICE This study demonstrated an association between time to first analgesic medication and the patient experience of care. Providing timely care, including pain care, in emergency departments is difficult, but necessary to improve the patient experience of care.
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Affiliation(s)
- James A Hughes
- School of Nursing, Centre for Healthcare Transformation, Faculty of Health, Queensland University of Technology, Kelvin Grove, Qld, Australia.,Emergency and Trauma Centre, Royal Brisbane and Women's Hospital, Herston, Qld, Australia
| | - Kimberley E Alexander
- School of Nursing, Centre for Healthcare Transformation, Faculty of Health, Queensland University of Technology, Kelvin Grove, Qld, Australia
| | - Lyndall Spencer
- Emergency Department, Princess Alexandra Hospital, Woolloongabba, Qld, Australia
| | - Patsy Yates
- Faculty of Health, Queensland University of Technology, Kelvin Grove, Qld, Australia
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21
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Silva LAGPD, Lopes VJ, Mercês NNAD. Symptom management theory applied to nursing care: scoping review. Rev Bras Enferm 2021; 74:e20201004. [PMID: 34287492 DOI: 10.1590/0034-7167-2020-1004] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2020] [Accepted: 12/11/2020] [Indexed: 11/21/2022] Open
Abstract
OBJECTIVES to identify publications about the applicability of the Symptom Management Theory in nursing care to pediatric, adolescent, adult and elderly patients. METHODS scoping review following the steps: definition of the objective, research question and inclusion criteria; search, selection and analysis of publications; synthesis of results. The search occurred in the VHL, SciELO, CAPES and PubMed Journals Portal bases, contemplating publications between 1994 and July 2020. RESULTS out of 3,286 studies, ten were selected, published between 2008 and 2019. They described the relationships between the participants and the domains (person, environment, health and disease), components (symptom experience, management strategies, results) and presented strategies for symptom management. CONCLUSIONS the Symptom Management Theory was considered applicable to the participants of the studies and to nursing care. It was concluded that understanding the interaction of these elements is essential to plan actions aimed at controlling symptoms effectively.
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Mathew A, Doorenbos AZ, Vincent C. Symptom Management Theory: Analysis, Evaluation, and Implications for Caring for Adults With Cancer. ANS Adv Nurs Sci 2021; 44:E93-E112. [PMID: 33394585 PMCID: PMC10960233 DOI: 10.1097/ans.0000000000000347] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
A detailed analysis of Symptom Management Theory (SMT) along with its extent of use and implications for adults with cancer as demonstrated in 20 oncology research studies is reported. SMT provides useful guidance for adult oncology research and nursing practice. Theory dimension most researched in cancer was symptom experience. Although theory assertions were demonstrated in 80% of the studies, it was used to an adequate extent only in 35% of them. Comparisons between cancer-related clinical outcomes with and without use of SMT, certain theory modifications, and future SMT-based studies involving longitudinal designs in this population are warranted.
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Affiliation(s)
- Asha Mathew
- College of Nursing, University of Illinois, Chicago (Ms Mathew and Drs Doorenbos and Vincent); College of Nursing, Christian Medical College, Vellore, Tamil Nadu, India (Ms Mathew); and University of Illinois Cancer Center, Chicago (Dr Doorenbos)
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Abstract
BACKGROUND Children with advanced cancer experience symptoms despite access to quality care. Symptom research has previously relied upon retrospective designs and parent proxy rather than prospective measurement with self-report. OBJECTIVE This study evaluated the feasibility of electronic data collection in children with advanced cancer using self-report of symptom frequency, severity, and distress. METHODS A multisite prospective cohort design was used for this study. Children who were 7 to 18 years of age and English-speaking and had a diagnosis of advanced cancer were included. Symptom frequency, severity, and level of distress were measured every 2 weeks. RESULTS Forty-six children completed 563 of 622 (91%) administered electronic symptom assessments. Pain, fatigue, nausea, and sleeping difficulties were the most reported symptoms across all assessments and during the last 12 weeks of life. Symptoms with the highest composite scores included pain, fatigue, nausea, and sleeping difficulties. During the last 12 weeks of life, pain, fatigue, diarrhea, and sleeping difficulties had the highest composite scores. When the domains of frequency, severity, and distress were compared between groups, children reported significantly higher frequency of pain and eating difficulty during the last 12 weeks of life. CONCLUSIONS Electronic data collection is a feasible way to evaluate the constellation of symptoms. Children with advanced cancer continue to experience physical and psychological symptoms, especially during the last 12 weeks of life despite quality care. IMPLICATIONS FOR PRACTICE Assessment of symptom domains, including frequency, severity, and distress when symptoms are present may allow clinicians to better understand and manage symptoms of most concern to the patient.
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Hughes JA, Alexander KE, Spencer L, Yates P. Factors associated with time to first analgesic medication in the emergency department. J Clin Nurs 2021; 30:1973-1989. [PMID: 33829583 DOI: 10.1111/jocn.15750] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2020] [Revised: 02/08/2021] [Accepted: 02/25/2021] [Indexed: 11/30/2022]
Abstract
AIM AND OBJECTIVE To examine the factors associated with time to first analgesic medication in the emergency department. BACKGROUND Pain is the most common symptom presenting to the emergency department, and the time taken to deliver analgesic medication is a common outcome measure. Factors associated with time to first analgesic medication are likely to be multifaceted, but currently poorly described. DESIGN Retrospective cohort study. METHODS Cox proportional hazards regression modelling was undertaken to evaluate the associations between person, environment, health and illness variables within Symptom Management Theory and time to first analgesic medication in a sample of adult patients presenting with moderate-to-severe pain to an emergency department over twelve months. This study was completed in line with the STROBE statement. RESULTS 383 patients were included in the study, 290 (75.92%) of these patients received an analgesic medication in a median time of 45 minutes (interquartile range, 70 minutes). A model containing nine explanatory variables associated with time to first analgesic medication was identified. These nine variables (employment status, discharge location, triage score, Charlson score, arrival pain score, socio-economic status, first location, daily total treatment time and patient time to be seen) represent all of the domains of the Symptom Management Theory. CONCLUSIONS Person, environment, health and illness factors are associated with the time taken to deliver analgesic medication to those in pain in the emergency department. This study demonstrates the complexity of factors associated with pain care and the applicability of Symptom Management Theory to pain care in the emergency department. RELEVANCE TO CLINICAL PRACTICE Identifying a model of factors that are associated with the time in which the most common symptom presenting to the emergency department is treated allows for targeted interventions to groups likely to receive poor care and a framework for its evaluation.
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Affiliation(s)
- James A Hughes
- School of Nursing, Queensland University of Technology, Victoria Park Rd, Kelvin Grove, Brisbane, Qld., Australia.,Emergency and Trauma Centre, Royal Brisbane and Women's Hospital, Butterfield Street Herston, Herston, Qld., Australia
| | - Kimberly E Alexander
- School of Nursing, Queensland University of Technology, Victoria Park Rd, Kelvin Grove, Brisbane, Qld., Australia.,St Vincent's Private Hospital Northside, Chermside, Qld., Australia
| | - Lyndall Spencer
- Emergency Department, Princess Alexandra Hospital, Ipswich Road Woolloongabba, Woolloongabba, Qld., Australia
| | - Patsy Yates
- School of Nursing, Queensland University of Technology, Victoria Park Rd, Kelvin Grove, Brisbane, Qld., Australia
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Bhimani R, Punjani B, Peden-McAlpine C. Understanding Clinical Characteristics of Muscle Weakness. J Neurosci Nurs 2021; 53:69-74. [PMID: 33538459 DOI: 10.1097/jnn.0000000000000574] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
ABSTRACT BACKGROUND: Muscle weakness is a debilitating condition that can lead to frailty, falls, and functional decline. Muscle weakness is found across many diseases; therefore, understanding what constitutes this condition is paramount. The National Library of Medicine provides 2 definitions of muscle weakness, both from a disease perspective. These definitions are narrow and do not account for overlapping causes of muscle weakness. Nurses are holistic practitioners, so they need to understand the clinical characteristics of muscle weakness, regardless of underlying disease processes. METHODS: Secondary analysis of data from an earlier qualitative study. Using content analysis of transcripts of semistructured interviews with a multidisciplinary group of 12 experts in the management of muscle disorders, we identified characteristics of muscle weakness from the clinicians' perspectives. RESULTS: Muscle weakness has characteristics of debility, loss of function, and asymmetry. The characteristics of debility include lack of strength, atrophy, and fatigue. Muscle weakness does coexist with muscle tightness. CONCLUSIONS: The characteristics of muscle weakness identified in our study are markedly different from those included in National Library of Medicine definitions. As a condition, muscle weakness has both subjective and objective traits. Therefore, clinician assessment and patient input combined capture the comprehensive nature of muscle weakness. Nurses' awareness of what constitutes muscle weakness, regardless of diagnosis, is the first step in optimal management of this condition.
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Salvetti MDG, Donato SCT, Machado CSP, de Almeida NG, Santos DVD, Kurita GP. Psychoeducational Nursing Intervention for Symptom Management in Cancer Patients: A Randomized Clinical Trial. Asia Pac J Oncol Nurs 2021; 8:156-163. [PMID: 33688564 PMCID: PMC7934602 DOI: 10.4103/apjon.apjon_56_20] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2020] [Accepted: 08/20/2020] [Indexed: 11/04/2022] Open
Abstract
Objective The objective of this study was to assess the effects of a psychoeducational intervention upon symptom control and quality of life (QoL) among cancer patients. Methods This was an open randomized clinical trial (RCT) conducted at the Cancer Institute of the State of São Paulo. The RCT comprised 107 outpatients in chemotherapy or radiation for malignant neoplasms. Participants were randomized to control group (usual treatment) or intervention group (IG) (psychoeducational intervention) with assessments at baseline and upon completion of the intervention. Sociodemographic information, clinical data, QoL, functionality, and symptoms were assessed. This trial is registered with the Brazilian Clinical Trials Registry number RBR-9337nv. A mixed-effects model was applied to compare the effects of the intervention between the groups. Results The most frequent symptoms were fatigue (76.6%), insomnia (47.7%), pain (42.1%), and loss of appetite (37.4%). The symptom intensity analysis suggests that insomnia was the strongest symptom, followed by fatigue, loss of appetite, and pain. The IG experienced a significant improvement in terms of loss of appetite (P = 0.002) and a tendency toward less insomnia (P = 0.053). Conclusions The intervention significantly reduced appetite loss in cancer patients. Despite no effects observed in global QoL or functionality, the intervention yielded a tendency to improve insomnia, and this outcome should be investigated in future studies.
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Affiliation(s)
- Marina de Góes Salvetti
- Department of Medical-Surgical Nursing, School of Nursing, University of São Paulo, São Paulo, Brazil
| | | | | | - Natalia Gondim de Almeida
- Department of Medical-Surgical Nursing, School of Nursing, University of São Paulo, São Paulo, Brazil
| | | | - Geana Paula Kurita
- Department of Neuroanaesthesiology, Multidisciplinary Pain Centre, Neuroscience Centre and Palliative Research Group, Rigshospitalet Copenhagen University Hospital, São Paulo, Brazil
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Pujasari H, Levy J, Culbert G, Steffen A, Carley D, Kapella M. Sleep disturbance, associated symptoms, and quality of life in adults living with HIV in Jakarta, Indonesia. AIDS Care 2020; 33:39-46. [PMID: 32266830 DOI: 10.1080/09540121.2020.1748868] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
Adverse symptom experiences, including sleep disturbances, are important negative predictors of quality of life (QoL), but few studies conducted in low-income countries have examined the impact of poor sleep and its associated symptoms on QoL among people living with HIV (PLWH). To this end, 200 PLWH who were receiving treatment with antiretroviral therapy (ART) were recruited through a community nongovernment organization in Jakarta, Indonesia. Validated instruments measured QoL, sleep disturbance, fatigue, pain, ART adherence, substance use, drug use severity, and methadone treatment. Descriptive statistics, bivariate correlations, and multivariate linear regression were conducted to identify independent correlates of QoL. Overall, participants perceived their QoL as being good to very good (mean = 105.70, standard deviation = 14.7) and higher among women than men (p < 0.05). After adjusting for sex, education, drug-use severity, and ART adherence, QoL was negatively associated with fatigue, insomnia, and pharmacological treatment with methadone. Along with other known symptoms of HIV, sleep problems and their complications are important to clinically address and research more fully to assure satisfying QoL among PLWH.
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Affiliation(s)
- Hening Pujasari
- Faculty of Nursing, Universitas Indonesia, Depok, Jawa Barat, Indonesia
| | - Judith Levy
- School of Public Health, University of Illinois at Chicago, Chicago, IL, USA
| | - Gabriel Culbert
- College of Nursing, University of Illinois at Chicago, Chicago, IL, USA
| | - Alana Steffen
- College of Nursing, University of Illinois at Chicago, Chicago, IL, USA
| | - David Carley
- College of Nursing, University of Illinois at Chicago, Chicago, IL, USA
| | - Mary Kapella
- College of Nursing, University of Illinois at Chicago, Chicago, IL, USA
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28
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Climent‐Sanz C, Gea‐Sánchez M, Moreno‐Casbas MT, Blanco‐Blanco J, García‐Martínez E, Valenzuela‐Pascual F. A web‐based therapeutic patient education intervention for pain and sleep for women with fibromyalgia: A sequential exploratory mixed‐methods research protocol. J Adv Nurs 2020; 76:1425-1435. [DOI: 10.1111/jan.14333] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2019] [Revised: 01/29/2020] [Accepted: 02/05/2020] [Indexed: 12/30/2022]
Affiliation(s)
- Carolina Climent‐Sanz
- Faculty of Nursing and Physiotherapy University of Lleida Lleida Spain
- Grup d'Estudis Societat, Salut, Educació i Cultura GESEC Department of Nursing and Physiotherapy University of Lleida Lleida Spain
- Grup de Recerca de Cures en Salut GRECS Institut de Recerca Biomèdica Lleida Spain
| | - Montserrat Gea‐Sánchez
- Faculty of Nursing and Physiotherapy University of Lleida Lleida Spain
- Grup d'Estudis Societat, Salut, Educació i Cultura GESEC Department of Nursing and Physiotherapy University of Lleida Lleida Spain
- Grup de Recerca de Cures en Salut GRECS Institut de Recerca Biomèdica Lleida Spain
| | - María T. Moreno‐Casbas
- Instituto de Salud Carlos III Nursing and Healthcare Research Unit (Investen‐isciii) Madrid Spain
- Ciber Fragilidad y Envejecimiento Saludable (CIBERFES) Madrid Spain
| | - Joan Blanco‐Blanco
- Faculty of Nursing and Physiotherapy University of Lleida Lleida Spain
- Grup d'Estudis Societat, Salut, Educació i Cultura GESEC Department of Nursing and Physiotherapy University of Lleida Lleida Spain
- Grup de Recerca de Cures en Salut GRECS Institut de Recerca Biomèdica Lleida Spain
| | - Ester García‐Martínez
- Faculty of Nursing and Physiotherapy University of Lleida Lleida Spain
- Grup de Recerca de Cures en Salut GRECS Institut de Recerca Biomèdica Lleida Spain
| | - Fran Valenzuela‐Pascual
- Faculty of Nursing and Physiotherapy University of Lleida Lleida Spain
- Grup d'Estudis Societat, Salut, Educació i Cultura GESEC Department of Nursing and Physiotherapy University of Lleida Lleida Spain
- Grup de Recerca de Cures en Salut GRECS Institut de Recerca Biomèdica Lleida Spain
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Raybin JL, Krajicek M. Creative Arts Therapy in the Context of Children With Cancer: A Concept Analysis. J Pediatr Oncol Nurs 2019; 37:82-90. [PMID: 31592707 DOI: 10.1177/1043454219878397] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Aim: To report an analysis of the concept of creative arts therapy (CAT) in the context of pediatric cancer. Background: Literature supports the intuitive conclusion that creative interventions improve a patient's journey through the cancer trajectory. However, a new definition is needed to encompass CAT and creative expression interventions in order to better understand the concept of creativity in health care, specifically in pediatric oncology. Design: Concept analysis. Data Sources: The scientific databases CINAHL, PsycInfo (Ovid), AMED (Allied and Complementary Medicine), and PubMed were queried for English language research articles published between 2008 and 2018 using the search terms: creative arts therapy and cancer. Method: The Walker and Avant method of concept analysis was implemented. Results: CAT is a broad concept bringing creative arts in a therapeutic manner to children with cancer. Attributes include expression of feelings; creating art, music, or movement; and improvement of symptoms. CAT is frequently measured using quality of life and symptom assessment scales. Antecedents include the diagnosis of cancer, the distress caused by cancer, and a child's willingness to participate in creative activity. Consequences include improved quality of life, improved sense of well-being, decreased psychosocial symptoms, and less cancer pain. Conclusion: The literature supports CAT as a concept that may decrease distress for children with cancer.
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Affiliation(s)
- Jennifer L Raybin
- Children's Hospital Colorado, Aurora, CO, USA.,School of Medicine, University of Colorado, Aurora, CO, USA
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Silva-Rodrigues FM, Hinds PS, Nascimento LC. The Theory of Unpleasant Symptoms in Pediatric Oncology Nursing: A Conceptual and Empirical Fit? J Pediatr Oncol Nurs 2019; 36:436-447. [PMID: 31027449 DOI: 10.1177/1043454219844225] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Symptom management knowledge is a priority for pediatric oncology nursing research. Theories and models can frame the studies of symptoms experienced during childhood cancer. This article describes and analyzes the middle-range theory, theory of unpleasant symptoms (TOUS), for its conceptual and empirical fit with pediatric oncology nursing based on its current use in adult oncology research and its limited use to date in pediatric oncology. Searches in PubMed and CINAHL databases using the keywords theory of unpleasant symptoms and cancer and covering the time period 2000 to 2017 yielded 103 abstracts for review. Twenty published reports met eligibility criteria for review; only one included pediatric oncology patients. No study to date has tested all the components of the TOUS in pediatrics. The TOUS component of performance appears to be underaddressed across completed studies that instead include a focus on patient-reported quality of life rather than on perceived behavioral or performance indicators concurrent with the subjective symptom reports. Additionally, the influence of family, essential in pediatric oncology, is absent in the majority of studies guided by the TOUS. The TOUS is a structurally complicated framework that would be a conceptual fit for pediatric oncology if family influence and perceived function were included. Studies across this population and guided by the TOUS are needed, although testing all the theorized linkages in the TOUS would likely require a large sample size of patients and, thereby, multisite approaches given that cancer is a rare disease in childhood.
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Affiliation(s)
| | - Pamela S Hinds
- Children's National Health System, Washington, DC, USA.,George Washington University, Washington, DC, USA
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Im EO, Hu Y, Cheng CY, Ko Y, Chee E, Chee W. Racial/Ethnic Differences in Cognitive Symptoms During the Menopausal Transition. West J Nurs Res 2019; 41:217-237. [PMID: 29606085 PMCID: PMC6119544 DOI: 10.1177/0193945918767660] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
The purpose of this study was to explore racial/ethnic differences in midlife women's cognitive symptoms among four major racial/ethnic groups in the United States and to determine multiple factors that influenced the women's cognitive symptoms. This was a secondary analysis of the data from two larger studies among 1,054 midlife women. The instruments included multiple questions on background characteristics and health and menopausal status, and the Cognitive Symptom Index for Midlife Women. The data were analyzed using multiple logistic and Poisson regression analyses. There existed significant racial/ethnic differences in the total numbers and total severity scores of cognitive symptoms ( p < .01); non-Hispanic Asians had significantly lower total numbers and total severity scores compared with other racial/ethnic groups. Socioeconomic status and health and menopausal status were significant factors that influenced cognitive symptoms across racial/ethnic groups ( p < .05). Further studies on racial/ethnic differences in cognitive symptoms are needed with diverse groups of midlife women.
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Affiliation(s)
- Eun-Ok Im
- Duke University, School of Nursing, Durham, NC
| | - Yun Hu
- Duke University, School of Nursing, Durham, NC
- Shanghai Jiao Tong University, China
| | - Ching-Yu Cheng
- Duke University, School of Nursing, Durham, NC
- Chang Gung University of Science and Technology, Taiwan
| | - Young Ko
- Gachon University, Incheon, South Korea
| | - Eunice Chee
- North Caroline State University, Raleigh, NC
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Jaramillo García DM, Muñoz Olivar C, Nuvan Sastoque AN, Benavides Acosta FP. Revisión sistemática para el abordaje de síntomas desagradables gastrointestinales en cuidados paliativos. REVISTA CUIDARTE 2018. [DOI: 10.15649/cuidarte.v10i1.615] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
Introducción: Este artículo de revisión sistemática pretende examinar en detalle la evidencia cientifica para el abordaje desde la enfermería, en el manejo de síntomas desagradables, gastrointestinales tales como: síndrome anorexia caquexia, disfagia, náuseas y vómito enfocado al cuidado paliativo, basados en el referente teórico del modelo revisado del manejo de síntomas de Marylin J. Dodd. Materiales y Métodos: La estrategia que se realizó fue la del sistema PICO, metodológicamente se estableció una pregunta la cual se contesta con la selección de los artículos que se realizó, continuando con la revisión sistemática se aplica la declaración (PRISMA), la investigación de los artículos fue realizada en las bases de datos Medline, Cochrane Library, Scopus, Pubmed, Dialnet, Ebscohost, ProQuest y Elsevier. Dentro de los criterios de inclusión, se tuvo en cuenta principalmente los artículos que fomentan el manejo de los síntomas gastrointestinales en cuidado paliativo. Resultados: A pesar de que se evidencia los avances en conocimiento, se identifica que son insuficientes los estudios en este campo, mostrando la necesidad y la obligación de desarrollar el manejo y control de los síntomas desagradables gastrointestinales, el manejo del síntoma debe ser basado en: la experiencia del síntoma desde la percepción, evaluación y respuesta. Discusión: La evidencia muestra las diferentes maneras de abordar los síntomas desagradables gastrointestinales, con una mirada holística, en constante movimiento, resaltando que se debe intervenir, desde la dimensión espiritual, física y social. Conclusiones: La intención es contribuir con evidencia científica para abordar los síntomas desagradables gastrointestinales.Como citar este artículo: Jaramillo DMG, Muñoz CO, Nuvan ANS, Benavides FPA. Revisión sistemática para el abordaje de síntomas desagradables gastrointestinales en cuidados paliativos. Rev Cuid. 2019; 10(1): e615. http://dx.doi.org/10.15649/cuidarte.v10i1.615
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Abstract
Survival alone is no longer an adequate outcome for persons with brain tumors; the quality of the survivorship experience should be viewed with equal importance. Symptom management is a significant component of quality survivorship care. Regardless of their histology, brain tumors and therapies used to treat them produce symptoms that affect an individual's ability to function in everyday life. Common symptoms include fatigue, cognitive impairment, distress, and sleep disturbance. Symptom-based interventions for persons with brain tumors focus on prevention, self-management, and prescriptive interventions targeted to these problems. Unfortunately, little evidence exists to support many interventions, making it challenging for clinicians to provide concrete recommendations. Research is needed to provide evidence in support of symptom-based interventions while novel approaches to these challenging problems are developed.
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Affiliation(s)
- Christina Amidei
- Northwestern Medicine, Neurological Surgery, Feinberg School of Medicine, Northwestern University, Chicago, Illinois
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do Nascimento LA, Fonseca LF, dos Santos CB. Inter-rater Reliability Testing of the Safety Protocol for Thirst Management. J Perianesth Nurs 2018; 33:527-536. [DOI: 10.1016/j.jopan.2016.07.008] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2015] [Revised: 07/07/2016] [Accepted: 07/25/2016] [Indexed: 10/19/2022]
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Loades ME, Kagee A. Exploring our understanding of fatigue among adolescents living with HIV: Highlighting the unknown. J Health Psychol 2017; 24:125-136. [PMID: 28810460 DOI: 10.1177/1359105317710320] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Due to antiretroviral therapies, HIV is now a chronic illness rather than a terminal disease. Chronic symptoms, including fatigue, should be identified and managed to prevent or minimise their potential negative consequences. We apply a Symptom Management Model to conceptualise fatigue among adolescents with HIV. In the context of minimal research, we seek to identify a research agenda for resource-constrained contexts, where HIV prevalence remains high and treatment adherence is a significant problem. By better understanding and addressing the symptom of fatigue, treatment adherence, occupational, social and emotional functioning could be improved. We highlight conceptual, methodological and measurement-related caveats.
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Paroxysmal Sympathetic Hyperactivity in Children: An Exploratory Evaluation of Nursing Interventions. J Pediatr Nurs 2017; 34:e17-e21. [PMID: 28283208 DOI: 10.1016/j.pedn.2017.02.034] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/18/2016] [Revised: 02/27/2017] [Accepted: 02/28/2017] [Indexed: 11/23/2022]
Abstract
BACKGROUND Paroxysmal sympathetic hyperactivity (PSH) produces symptoms of autonomic instability and muscle over-activity; however, the majority of nursing interventions used in clinical practice are anecdotal and not evidenced based. OBJECTIVE The primary objective was to report nursing documentation of PSH events, and to describe the clinical nursing interventions and care provided to children who have suffered a severe brain injury and are exhibiting PSH. The secondary objective was to demonstrate how the Symptom Management Theory (SMT) can serve as a framework for research related to brain injury and PSH. METHODOLOGY The study consisted of a retrospective chart review of nursing progress notes using direct content analysis. The nested sample of ten randomly selected charts was chosen from a larger quantitative study of 83 children who had suffered severe brain injuries with and without PSH. Textual analysis of verbatim nursing progress notes was used to describe nursing interventions that were used and documented for this patient population. RESULTS The priority nursing interventions to manage these symptoms included medication administration, facilitation of family presence, and strategies to target auditory, tactile, and visual stimuli. The sample received different individual interventions for PSH. Additionally, individual subjects demonstrated different patterns of interventions. IMPLICATIONS While tactile interventions were documented most frequently, there was not a uniform approach to interventions. The SMT can be useful to provide a framework that organizes and tests clinical care and management of PSH strategies.
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Mororó DDDS, Enders BC, Lira ALBDC, Silva CMBD, Menezes RMPD. Análise conceitual da gestão do cuidado em enfermagem no âmbito hospitalar. ACTA PAUL ENFERM 2017. [DOI: 10.1590/1982-0194201700043] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Resumo Objetivo Analisar o conceito gestão do cuidado em enfermagem no âmbito hospitalar, com base no referencial teórico-metodológico de Walker e Avant. Métodos Realizou-se uma revisão integrativa, para operacionalizar a análise, nas bases de dados Literatura Latino-americana e do Caribe em Ciências da Saúde, Scientific Eletronic Library Online e a Base de dados de Enfermagem, utilizando palavra chave e descritores: Gestão do Cuidado, Enfermagem e Hospital. Resultados Evidenciou-se uma prática gerencial do enfermeiro com enfoque para as atividades burocráticas e pouco articulada ao cuidado. Entretanto, identificaram-se a articulação e integração entre o gerenciamento e o cuidar, liderança, comunicação, interação, tomada de decisão e cooperação como atributos essenciais da gestão do cuidado em enfermagem. Conclusão A aplicação desse conceito na prática gerencial do enfermeiro apresenta-se como uma necessidade emergente para o desenvolvimento de um modelo de gestão vinculada ao cuidar.
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Abstract
OBJECTIVE The purpose of this study was to identify clusters of midlife women by sleep-related symptoms in multiethnic groups and to examine racial/ethnic differences in the clusters. METHODS This secondary analysis was conducted on data from 1,054 midlife women who participated in two cross-sectional descriptive national Internet surveys. The instruments included questions on background characteristics, health, and menopause status, and the Sleep Index for Midlife Women. The data were analyzed using hierarchical clustering methods, χ2 test, analysis of variance, and multinomial logistic regression analyses. RESULTS A four-cluster solution was adopted: cluster 1 (low total symptoms group), cluster 2 (moderate physical and psychosomatic symptoms group), cluster 3 (moderate psychological symptoms group), and cluster 4 (high total symptoms group). There were significant differences in education, employment status, family income, social support, country of birth, race/ethnicity, body mass index, perceived general health, diagnosed disease, access to health care, and menopause status among clusters (P < 0.05). In cluster 1 only, there were significant racial/ethnic differences in the total number of total severity scores for physical symptoms (P < 0.01). When racial/ethnic differences in individual symptoms in each cluster were determined, there were no consistent racial/ethnic differences. CONCLUSIONS Researchers need to consider that racial/ethnic differences could be prominent in midlife women with low sleep-related symptoms.
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The relationships between psychological symptoms and cardiovascular symptoms experienced during the menopausal transition: racial/ethnic differences. Menopause 2015; 23:396-402. [PMID: 26645821 DOI: 10.1097/gme.0000000000000545] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
OBJECTIVE The purpose of the study was to examine the relationships between psychological and cardiovascular symptoms in a multiethnic group of midlife women while controlling for other influencing factors, and to determine the association of race/ethnicity to the relationships between psychological and cardiovascular symptoms. METHODS This was a secondary analysis of the data among 1,054 midlife women from two Internet surveys. The instruments included the questions on background characteristics, health, and menopause status and the Midlife Women's Symptom Index. The data were analyzed using correlation analyses, chi-squared tests, analysis of variance, and multivariate linear and logistic regression analyses. RESULTS The total numbers and total severity scores of psychological symptoms were significantly related to those of cardiovascular symptoms as a whole and in each racial/ethnic group (P < 0.01). In total participants, both the total numbers and total severity scores of psychological symptoms were significantly associated with increased risk for cardiovascular symptoms after adjusting for race/ethnicity (P < 0.01), and there were no interactions between race/ethnicity and psychological symptoms. The existence of diagnosed cardiovascular diseases was significantly associated with the total numbers of and total severity scores of psychological symptoms only in Asian women. CONCLUSIONS Further studies on the mechanisms through which psychological symptoms are related to cardiovascular symptoms are needed while controlling for race/ethnicity.
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Abstract
AIMS To identify the current status of theory evaluation in nursing and provide directions for theory evaluation for future development of theoretical bases of nursing discipline. BACKGROUND Theory evaluation is an essential component in development of nursing knowledge, which is a critical element in development of nursing discipline. Despite earlier significant efforts for theory evaluation in nursing, a recent decline in the number of theory evaluation articles was noted and there have been few updates on theory evaluation in nursing. DESIGN Discussion paper. DATA SOURCES A total of 58 articles published from 2003-2014 were retrieved through searches using the PUBMED, PsyInfo and CINAHL. The articles were sorted by the area of evaluation and analysed to identify themes reflecting the theory evaluation process. IMPLICATIONS FOR NURSING Diverse ways of theory evaluation need to be continuously used in future theory evaluation efforts. CONCLUSION Six themes reflecting the theory evaluation process were identified: (a) rarely using existing theory evaluation criteria; (b) evaluating specifics; (c) using various statistical analysis methods; (d) developing instruments; (e) adopting in practice and education; and (f) evaluating mainly middle-range theories and situation-specific theories.
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Affiliation(s)
- Eun-Ok Im
- School of Nursing, University of Pennsylvania, Philadelphia, Pennsylvania, USA
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Rosén HI, Bergh IHE, Schwartz-Barcott D, Mårtensson LB. The recovery process after day surgery within the symptom management theory. Nurs Forum 2014; 49:100-109. [PMID: 24404843 DOI: 10.1111/nuf.12062] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
PURPOSE The aim was to illustrate two cases in a postoperative situation following day surgery within the framework of the symptom management theory. METHOD Template analysis using the symptom management theory. RESULT Neither the woman nor the man was able to return to their normal activities, health status or functional status, within a week. CONCLUSION The results illustrate how a postoperative situation may involve personal suffering up to 3 months. PRACTICAL IMPLICATION To obtain an outcome following day surgery, as optimal as possible, improving clinical practices and routines, such as discharge criteria, guidelines, and care pathways, is necessary.
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Chang SJ, Chee W, Im EO. Menopausal symptoms and physical activity in multiethnic groups of midlife women: a secondary analysis. J Adv Nurs 2013; 69:1953-65. [PMID: 23171423 PMCID: PMC3646080 DOI: 10.1111/jan.12056] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/20/2012] [Indexed: 11/30/2022]
Abstract
AIMS To explore the effect of diverse types of women's physical activity on menopausal symptoms among multiethnic groups of midlife women in the USA. BACKGROUND Although physical activity is one of the most widely used non-pharmacological methods for managing menopausal symptoms, there is a paucity of clinical guidelines for women and healthcare providers because the relationship between physical activity and menopausal symptoms has been found inconsistent in previous studies. DESIGN A secondary analysis of the data from a lager Internet survey study conducted in 2008-2010. METHODS A total of 481 midlife women among four ethnic groups were selected from the original study. The data were collected using the Kaiser Physical Activity Survey and the Midlife Women's Symptom Index. Bivariate correlation analyses and hierarchical multiple regression analyses were used to analyse the data. RESULTS/FINDINGS The household/caregiving activity index was positively associated with the prevalence scores of the psychological symptoms in both non-Hispanic Asians and non-Hispanic African Americans. The increased sports/exercise activity index was negatively associated with the severity scores of the physical symptoms in both Hispanics and non-Hispanic Whites. The occupational activity index and the active living activity index significantly predicted the severity scores of the psychosomatic symptoms in Hispanics and non-Hispanic African Americans, respectively. CONCLUSION Nurses who take care of multiethnic groups of midlife women who experience menopausal symptoms should be aware of diverse types of women's physical activities within the cultural context.
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Affiliation(s)
- Sun Ju Chang
- School of Nursing, University of Pennsylvania, Philadelphia, PA, USA.
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Nausea and Vomiting Perspectives Among Children Receiving Moderate to Highly Emetogenic Chemotherapy Treatment. Cancer Nurs 2012; 35:203-10. [DOI: 10.1097/ncc.0b013e3182281493] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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