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Piil K, Locatelli G, Skovhus SL, Tolver A, Jarden M. A Shifting Paradigm Toward Family-Centered Care in Neuro-Oncology: A Longitudinal Quasi-Experimental Mixed-Methods Feasibility Study. J Fam Nurs 2024; 30:127-144. [PMID: 38531858 DOI: 10.1177/10748407241236678] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 03/28/2024]
Abstract
Family-centered intervention can help families facing illness-related issues. We investigated the feasibility of Family and Network Conversations (FNCs) in high-grade glioma patients and their families. Quasi-experimental feasibility study with longitudinal mixed-methods design. Patients and families were invited to three FNCs over 1 year. They completed questionnaires at four time points and expressed their perspectives on the intervention through telephone interviews. Nurses' perspectives were collected in a focus group. Twenty-one patients and 47 family members were included. On average, patients were 66 years old, mainly male, married, living with caregivers, with unifocal cancer. On average, caregivers were 47 years old, mainly female, being spouses or children of the patient. Quantitative and qualitative data did not always match and expanded each other. Nurse-delivered FNCs holistically addressed families' needs while strengthening family's dialogue and union. Nurses felt empowered, underling that advanced competencies were required. Nurse-delivered FNCs are feasible to provide family-centered care, but they should be tailored to each family's needs.
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Affiliation(s)
- Karin Piil
- Copenhagen University Hospital, Rigshospitalet, Denmark
- Roskilde University, Denmark
| | | | | | | | - Mary Jarden
- Copenhagen University Hospital, Rigshospitalet, Denmark
- University of Copenhagen, Denmark
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Porebski V, Bara L, Maillet D, Belin C, Carpentier A. [Better assessment, better care: Quetci, a questionnaire for assessing cognitive disorders in nursing practice]. Rev Infirm 2024; 73:37-39. [PMID: 38644001 DOI: 10.1016/j.revinf.2024.03.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/23/2024]
Abstract
Cognitive disorders can have significant repercussions on the quality of care and daily life for patients. We have developed a new tool specifically designed for nursing practice to identify these problems in patients with brain tumors. The Cognitive Impairment Assessment Questionnaire for nursing practice is an objective, quick and easy-to-administer tool that is readily accepted by patients.
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Affiliation(s)
- Virginie Porebski
- Service de neurologie à orientation oncologique, Hôpital Saint-Louis (AP-HP), 1 avenue Claude-Vellefaux, 75010 Paris, France; Université Paris-Cité, 12 rue École de médecine, 75006 Paris, France.
| | - Liza Bara
- Service de neurologie à orientation oncologique, Hôpital Saint-Louis (AP-HP), 1 avenue Claude-Vellefaux, 75010 Paris, France; Université Paris-Cité, 12 rue École de médecine, 75006 Paris, France
| | - Didier Maillet
- Service de neurologie à orientation oncologique, Hôpital Saint-Louis (AP-HP), 1 avenue Claude-Vellefaux, 75010 Paris, France; Université Paris-Cité, 12 rue École de médecine, 75006 Paris, France
| | - Catherine Belin
- Service de neurologie à orientation oncologique, Hôpital Saint-Louis (AP-HP), 1 avenue Claude-Vellefaux, 75010 Paris, France; Université Paris-Cité, 12 rue École de médecine, 75006 Paris, France
| | - Antoine Carpentier
- Service de neurologie à orientation oncologique, Hôpital Saint-Louis (AP-HP), 1 avenue Claude-Vellefaux, 75010 Paris, France; Université Paris-Cité, 12 rue École de médecine, 75006 Paris, France
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Ramirez C, Christophe V, Dassonneville C, Grynberg D. Caregivers' quality of life and psychological health in response to functional, cognitive, neuropsychiatric and social deficits of patients with brain tumour: protocol for a cross-sectional study. BMJ Open 2017; 7:e016308. [PMID: 29061609 PMCID: PMC5665306 DOI: 10.1136/bmjopen-2017-016308] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/06/2023] Open
Abstract
INTRODUCTION Patients with gliomas generally present cognitive, neuropsychiatric and functional deficits. Although previous research has shown that their caregivers present a poor quality of life and poor mental health, only a few studies have tested in a comprehensive way which deficits/preserved abilities of patients predominantly impact their caregivers. Furthermore, only a few studies have focused on the social impact of gliomas, which may also damage the caregivers' quality of life. Therefore, this cross-sectional study aims to investigate which patients' impairments are particularly deleterious for the caregivers and whether the histological characteristics of the gliomas also affect their quality of life. METHODS AND ANALYSIS In order to examine these research questions, this study intends to include 180 patients (60 patients with grade II gliomas, 60 patients with grade III gliomas and 60 patients with grade IV gliomas), their caregivers and 60 healthy controls. While patients will complete a full battery of cognitive, neuropsychiatric, functional and social tests, caregivers will complete questionnaires about their quality of life, depression, anxiety and burden. Patients' performances and caregivers' reports of depression and anxiety will be compared with the scores of healthy controls. Eventually, our aim will be to provide specific care support both to reduce patients' deficits and alleviate caregivers' difficulties. ETHICS AND DISSEMINATION The study has obtained the approval of the local faculty ethics committee ('Comité d'éthique en sciences comportementales'; 2016-5 S41 and 2015-3 S37). On completion of the study, data will be kept by Lille University for 5 years before they are destroyed. Study findings will be disseminated through peer-reviewed journal publications and conference presentations with no reference to a specific individual.
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Affiliation(s)
- Carole Ramirez
- Department of Neurosurgery, CHRU de Lille, Lille, France
| | - Véronique Christophe
- UMR 9193 - SCALab - Sciences Cognitives et Sciences Affectives, Univ. Lille, Lille, France
- SIRIC ONCOLille, Maison Régionale de la Recherche Clinique, Lille, France
| | - Charlotte Dassonneville
- UMR 9193 - SCALab - Sciences Cognitives et Sciences Affectives, Univ. Lille, Lille, France
- SIRIC ONCOLille, Maison Régionale de la Recherche Clinique, Lille, France
| | - Delphine Grynberg
- UMR 9193 - SCALab - Sciences Cognitives et Sciences Affectives, Univ. Lille, Lille, France
- SIRIC ONCOLille, Maison Régionale de la Recherche Clinique, Lille, France
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Hendricks-Ferguson VL, Pradhan K, Shih CS, Gauvain KM, Kane JR, Liu J, Haase JE. Pilot Evaluation of a Palliative and End-of-Life Communication Intervention for Parents of Children With a Brain Tumor. J Pediatr Oncol Nurs 2017; 34:203-213. [PMID: 27920233 PMCID: PMC6711580 DOI: 10.1177/1043454216676836] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Providing timely palliative and end-of-life care (PC/EOL) information to parents of children with a serious illness is a national health care priority. The goals of this study were to determine feasibility, acceptability, and parent responses related to a PC/EOL communication intervention, titled "Communication Plan: Early through End of Life (COMPLETE)" to parents of children with a brain tumor. The study was a 2-site prospective, single-group pilot study targeting parents' stress and coping outcomes. The sample included 13 parents of 11 children (ie, 11 families). During the first 6 months postdiagnosis, we evaluated parent outcomes at 4 time points (baseline and 3 post-sessions). Our findings included significant decline in decision regret ( P = .0089); strong, significantly increased hope ( P ≤ .0001); and significantly decreased uncertainty ( P = .04). Over time, more than half of the parents (61.5%) preferred to receive information about their child's current condition and PC/EOL options. Our findings provide evidence to suggest that the COMPLETE intervention is feasible and acceptable and produces promising effects on 3 parent outcomes (ie, decision regret, hope, and uncertainty) in parents of children with a brain tumor. Further research is indicated to evaluate COMPLETE with a larger sample of parents of children with cancer and with a control group.
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Pichaut M. [The nurse and management of glioblastoma]. Rev Infirm 2017; 66:19-21. [PMID: 28160826 DOI: 10.1016/j.revinf.2016.12.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
Lead nurses in neuro-oncology support patients with glioblastoma and their family from the time of diagnosis. They work closely with all health professionals practising in hospitals and in the home. They coordinate patients' care pathways, from the diagnosis consultation to their death.
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Affiliation(s)
- Marion Pichaut
- Département de neurochirurgie, pôle neurosciences Hôpital Gui de Chauliac, CHU de Montpellier, 80 avenue Augustin-Fliche, 34 000 Montpellier, France.
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Abstract
Glioblastomas are serious tumours of the central nervous system. Recurrence is systematic and prognosis poor. Radiotherapy and chemotherapy follow surgery, when surgery is possible, to lengthen survival, while preserving quality of life as much as possible. In this respect, symptomatic treatments and supportive care are necessary.
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Affiliation(s)
- Hugues Duffau
- Hôpital Gui de Chauliac, CHU de Montpellier, 80 avenue Augustin-Fliche, 34 000 Montpellier, France; INSERM U1051, Institut des neurosciences de Montpellier, Hôpital Saint Eloi, CHU de Montpellier, 80 avenue Augustin-Fliche, 34 000 Montpellier, France.
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Lefort M. [Glioblastoma and nursing care in neurosurgery]. Rev Infirm 2017; 66:26-28. [PMID: 28160829 DOI: 10.1016/j.revinf.2016.12.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
Nurses in neurosurgical departments play a critical role as they are involved in the first stages of the care pathway of patients with glioblastoma. Indeed, surgery enables a definitive histopathological diagnosis to be established and the size of the tumour to be significantly reduced, thereby improving the prognosis.
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Affiliation(s)
- Mathilde Lefort
- Hôpital d'instruction des armées Percy, 101 avenue Henri Barbusse, BP 406, 92141 Clamart Cedex, France.
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8
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Picart T, Guyotat J. [Glioblastoma, innovations in surgery]. Rev Infirm 2017; 66:31-32. [PMID: 28160831 DOI: 10.1016/j.revinf.2016.12.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
One of the innovative principles in glioblastoma surgery consists in making the tumour fluorescent in order for it to be more easily visualised during the procedure. 5-aminolevulinic acid (5-ALA) undergoes an enzyme transformation, turning into another molecule, protoporphyrine IX (PPIX) whose property is fluorescence. It emits red light when it is stimulated by blue light.
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Affiliation(s)
- Thiebaud Picart
- Service de neurochirurgie oncologique et vasculaire, hôpital neurologique Pierre Wertheimer, CHU de Lyon, 59 Boulevard Pinel, 69500 Bron, France
| | - Jacques Guyotat
- Service de neurochirurgie oncologique et vasculaire, hôpital neurologique Pierre Wertheimer, CHU de Lyon, 59 Boulevard Pinel, 69500 Bron, France.
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Affiliation(s)
- Alice de la Brière
- Service anesthésie réanimation-douleur, Institut Curie, 26 rue d'Ulm, 75005 Paris, France.
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Abstract
The objective of this study is to identify common problems and helpful resources important to parents of children with brain tumors by illness phase and to determine associations with stress. Parents with a child diagnosed within the past 10 years were surveyed regarding healthcare provider interactions, medical information/education, health care utilization and psychosocial concerns. Survey items were rated as problems or helpful, and for importance at each phase of illness. Stress was recorded from 0 to 10 for each phase; associations with demographic characteristics and items were tested statistically. A total of 139 parents from 87 families responded, with 45 mother-father pairs. Half reported unmet informational needs as most important during diagnosis (etiology), recurrence (complementary therapy), end of life (dying process), and remission (long-term effects). Mothers experienced greater stress than fathers during adjuvant treatment (p = .009). Stress increased (p < .05) during diagnosis and hospitalization/surgery with being married, at hospital discharge because of changes in child’s personality/moods, during adjuvant treatment with unmet informational needs regarding stopping treatment, during recurrence regarding employment concerns, and during remission with unmet informational needs regarding life-time expectations. Stressors changed across phases of illness. Married respondents appeared at increased risk for stress. Further work is needed to tailor and evaluate interventions to decrease stress during illness phases.
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Affiliation(s)
- Katherine Freeman
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, New York, USA.
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Deatrick JA, Thibodeaux AG, Mooney K, Schmus C, Pollack R, Davey BH. Family Management Style Framework: A New Tool With Potential to Assess Families Who Have Children With Brain Tumors. J Pediatr Oncol Nurs 2016; 23:19-27. [PMID: 16689400 DOI: 10.1177/1043454205283574] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Qualitative studies of families with children who have cancer or other serious illnesses have found that families often come to view their child and their lives as normal. They manage illness-related demands using family management styles that sustain usual patterns of family and child functioning. Few studies have addressed the family management styles of families who express less satisfaction with family and child functioning or who are identified by health care professionals as having difficulty with family functioning. Such families are likely to be overrepresented among those whose children are being treated for brain tumors that entail extremely burdensome treatments as well as a range of unfavorable prognoses and long-term sequelae. In fact, little is known about how these families manage on a day-to-day basis and how the interdisciplinary team can best provide supportive care to optimize their functioning. The purpose of this article is to present the Family Management Styles Framework as a tool that is useful in both clinical practice and research for assessing families who have children with cancer, including those with brain tumors.
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Affiliation(s)
- Janet A Deatrick
- Center for Health Disparities Research, University of Pennsylvania School of Nursing, 420 Guardian Drive, Philadelphia, PA 19104-6096, USA.
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Sabo B, Johnston G. Understanding the challenges to improve transition to palliative care: An issue for the primary malignant brain tumour population. Can J Neurosci Nurs 2016; 38:48-55. [PMID: 27468601] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
UNLABELLED Reports highlight the growing unmet need for palliative care as it applies to all cancers, yet the system and health care professionals (HCP) appear slow to respond. The following discussion paper highlights the current state of palliative care within the context of the primary malignant brain tumour (PMBT) population and argues for a shift in the current health care system's approach, which continues to place greater emphasis on cure over care. METHODS An exploration of extant literature over the past 10 years. RESULTS The current literature demonstrates that timely referrals to palliative care consult teams and access to community-based resources have been associated with fewer hospitalizations and visits to emergency departments and a decrease in the initiation of invasive, aggressive treatment at end of life. Timely referral to palliative care has also been shown to reduce distress, enhance quality of life and, in some cases, increase life expectancy. CONCLUSION Earlier referral to palliative care has yet to become a reality for many patients diagnosed with life-limiting illnesses and, in particular, those with a PMBT. More research is needed to uncover and challenge the barriers to early transition including communication issues among professionals, patients and families around palliative care.
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Storch J. Ethics in Practice: At End of Life--Part 3. Can Nurse 2015; 111:22-23. [PMID: 26753234] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
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Hendricks-Ferguson VL, Kane JR, Pradhan KR, Shih CS, Gauvain KM, Baker JN, Haase JE. Evaluation of Physician and Nurse Dyad Training Procedures to Deliver a Palliative and End-of-Life Communication Intervention to Parents of Children with a Brain Tumor. J Pediatr Oncol Nurs 2015; 32:337-47. [PMID: 25623029 PMCID: PMC5918283 DOI: 10.1177/1043454214563410] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
When a child's prognosis is poor, physicians and nurses (MDs/RNs) often struggle with initiating discussions about palliative and end-of-life care (PC/EOL) early in the course of illness trajectory. We describe evaluation of training procedures used to prepare MD/RN dyads to deliver an intervention entitled: Communication Plan: Early Through End of Life (COMPLETE) intervention. Our training was delivered to 5 pediatric neuro-oncologists and 8 pediatric nurses by a team of expert consultants (i.e., in medical ethics, communication, and PC/EOL) and parent advisors. Although half of the group received training in a 1-day program and half in a 2-day program, content for all participants included 4 modules: family assessment, goal-directed treatment planning, anticipatory guidance, and staff communication and follow-up. Evaluations included dichotomous ratings and qualitative comments on content, reflection, and skills practice for each module. Positive aspects of our training included parent advisers' insights, emphasis on hope and non-abandonment messages, written materials to facilitate PC/EOL communication, and an MD/RN dyad approach. Lessons learned and challenges related to our training procedures will be described. Overall, the MDs and RNs reported that our PC/EOL communication-training procedures were helpful and useful. Future investigators should carefully plan training procedures for PC/EOL communication interventions.
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Affiliation(s)
| | | | | | - Chie-Schin Shih
- Indiana University School of Medicine, Indianapolis, IN, USA
| | | | | | - Joan E Haase
- Indiana University School of Nursing, Indianapolis, IN, USA
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Mason MC. Raising the standard of brain cancer care. Nurs Stand 2015; 29:21. [PMID: 25872828 DOI: 10.7748/ns.29.33.21.s22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
Survival rates for people with brain cancer are poor, and some patients do not receive the specialist support they need. Nurse specialist Ingela Oberg calls for earlier diagnosis and improved access to nurse-led clinics and rehabilitation services.
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Miller CA. Pseudoprogression: Patient experience and nursing in uncertainty. Can J Neurosci Nurs 2015; 37:35-41. [PMID: 26647493] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
Glioblastoma Multiforme (GBM) is the most common primary brain malignancy in humans and has a limited survival (median of 14.6 months). The goal of treatment is supportive rather than curative. Patients with a GBM struggle with uncertainty related to the illness trajectory. This uncertainty is compounded when possible progression is noted on imaging. Pseudoprogression (PsP) is an early treatment-related effect where there are apparent imaging changes suggesting progression, which then improve or stabilize through time. This paper provides a review of the literature on PsP in patients with high-grade gliomas. Insights in the patient and family experience of PsP will be informed by Mishel's Uncertainty in Illness Theory, research on patients' and families' neuro-oncology experience, and the author's nursing practice. Nursing implications will be proposed.
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Abstract
Claire Marsden met midwife Ann Tasker, formerly employed at Airedale NHS Foundation Trust, when she supported her through labour when her son Harry was born at Airedale General Hospital in Keighley in 2009.
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Abstract
Introduction to qualitative research: the main approaches and designs. The main methods (phenomenology, ethnography, Grounded, narrative enquiry and case studies) and sampling technique of qualitative research are briefly outlined. A practical example is presented for each method.
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Longo L, Slater S. Challenges in providing culturally-competent care to patients with metastatic brain tumours and their families. Can J Neurosci Nurs 2014; 36:8-14. [PMID: 25265763] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
Being diagnosed with a metastatic brain tumour can be devastating as it is characterized by very low cure rates, as well as significant morbidity and mortality. Given the poor life expectancy and progressive disability that ensues, patients and family members experience much turmoil, which includes losses that bring about changes to family roles, routines and relationships. Crisis and conflict are common during such major disruptions to a family system, as individual members attempt to make sense of the illness experience based on cultural and spiritual beliefs, past experiences and personal philosophies. It is imperative health care providers strive towards increased awareness and knowledge of how culture affects the overall experience of illness and death in order to help create a mutually satisfactory care plan. Providing culturally-competent care entails the use of proper communication skills to facilitate the exploration of patient and family perspectives and allows for mutual decision making. A case study will illustrate the challenges encountered in providing culturally-competent care to a woman with brain cancer and her family. As the patient's health declined, the family entered into a state of crisis where communication between family members and health care professionals was strained; leading to conflict and sub-optimal outcomes. This paper will address the ethical dilemma of providing culturally-competent care when a patient's safety is at risk, and the nursing implications of upholding best practices in the context of differing beliefs and priorities.
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Wilson KB, Ardoin KB. When professional and personal worlds meet: nurse as daughter. Medsurg Nurs 2013; 22:192-196. [PMID: 23865281] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Affiliation(s)
- Kathleen B Wilson
- University of Louisiana at Lafayette College of Nursing and Allied Health Professions, Lafayette, LA, USA
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Bruhn L, Jung K. [Fewer tumors in children since folic acid supplementation: value of the B vitamin is possibly greater than expected]. Kinderkrankenschwester 2012; 31:393. [PMID: 23016232] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
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Newberry A, Kuo J, Donovan H, Given B, Given CW, Schulz R, Sherwood P. Identifying family members who are likely to perceive benefits from providing care to a person with a primary malignant brain tumor. Oncol Nurs Forum 2012; 39:E226-32. [PMID: 22543393 PMCID: PMC3384490 DOI: 10.1188/12.onf.e226-e232] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
PURPOSE/OBJECTIVES To identify changes in positive aspects of care (PAC) from the time of diagnosis to four months following the diagnosis in family caregivers of care recipients with primary malignant brain tumors. DESIGN Longitudinal. SETTING Dyads were recruited from neurosurgery clinics in Pittsburgh, PA, at the time of care recipients' diagnosis with a primary malignant brain tumor. A second data collection took place four months following the diagnosis. SAMPLE 89 caregiver and care recipient dyads. METHODS Paired t tests were used to examine change in PAC, univariate analyses were used to determine predictors of PAC at four months, Mann-Whitney U tests and t tests were used to examine associations between categorical predictor variables and PAC at four months, and univariate linear regressions were used to examine associations between continuous predictors and PAC at four months. MAIN RESEARCH VARIABLES The impact of sociodemographic factors, caregiver-perceived social support, mastery, neuroticism, and marital satisfaction on PAC. FINDINGS Caregivers' PAC scores during the first four months following diagnosis appeared to remain stable over time. Significant differences were found between the care recipient reasoning domain group at diagnosis and PAC score. Care recipients who scored below average were associated with caregivers with higher PAC scores. Caregiver PAC at four months following diagnosis was significantly predicted by care recipient reasoning and caregiver social support. CONCLUSIONS PAC scores appear to remain stable over time, although levels of PAC may be related to care recipients' level of functioning. Future research should focus on the development of interventions for caregivers who report low levels of PAC at the time of diagnosis in an attempt to help these individuals identify PAC in their caregiving situation. IMPLICATIONS FOR NURSING Findings have clinical and research implications. Clinicians may be able to better identify caregivers who are at risk for negative outcomes by understanding the risks faced by caregivers of patients with milder symptoms in addition to those caring for more profoundly affected care recipients.
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Affiliation(s)
- Alyssa Newberry
- School of Nursing, University of Pittsburgh, Pittsburgh, PA, USA.
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Schmidt J, Murek M, Jilch A, Widmer HR, Schucht P, Beck J, Raabe A. [Conscious operation: the patient perspective. Brain exposed patient during awareness]. Pflege Z 2012; 65:76-78. [PMID: 22397188] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Affiliation(s)
- Jorgen Schmidt
- Universitätsspital Bern, Neurochirurgische Universitätsklinik.
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Nicholas DB, Chahauver A, Brownstone D, Hetherington R, McNeill T, Bouffet E. Evaluation of an online peer support network for fathers of a child with a brain tumor. Soc Work Health Care 2012; 51:232-245. [PMID: 22443403 DOI: 10.1080/00981389.2011.631696] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
This study explored impacts of an online support network for fathers of a child with a brain tumor. Evaluation comprised pre/post-intervention questionnaires, content analysis of online network postings, and post-intervention qualitative interviews. Findings suggest that this intervention was beneficial to fathers. Positive effects on paternal coping were demonstrated, as were opportunities to grapple with difficult issues related to having a child with a brain tumor. Fathers recommended a combined resource of online and face-to-support, including the development of a support network with a larger participant base. Implications for practice are examined.
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Fights SD. Reflections. Medsurg Nurs 2011; 20:281-336. [PMID: 22409109] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
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Thiede W. [Mobile phones love children: against the repression of long-term mobile phone risks]. Kinderkrankenschwester 2011; 30:403-405. [PMID: 22029136] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
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Conning J. Feeling proud to be a nurse. Nurs N Z 2011; 17:3. [PMID: 21853787] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
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29
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Pillet S. What's new in neuro-oncology? ONS Connect 2011; 26:8-12. [PMID: 21675690] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Affiliation(s)
- Susan Pillet
- Cancer Institute of New Jersey, New Brunswick, USA
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30
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Van Horn A. What is the journey for patients with brain tumors? ONS Connect 2011; 26:13. [PMID: 21675691] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
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31
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Staller A. Healing can begin with laughter. Fla Nurse 2011; 59:10. [PMID: 21500743] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
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32
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Parvataneni R, Polley MY, Freeman T, Lamborn K, Prados M, Butowski N, Liu R, Clarke J, Page M, Rabbitt J, Fedoroff A, Clow E, Hsieh E, Kivett V, Deboer R, Chang S. Identifying the needs of brain tumor patients and their caregivers. J Neurooncol 2011; 104:737-44. [PMID: 21311950 PMCID: PMC3170122 DOI: 10.1007/s11060-011-0534-4] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2010] [Accepted: 01/31/2011] [Indexed: 11/24/2022]
Abstract
The purpose of this study is to identify the needs of brain tumor patients and their caregivers to provide improved health services to these populations. Two different questionnaires were designed for patients and caregivers. Both questionnaires contained questions pertaining to three realms: disease symptoms/treatment, health care provider, daily living/finances. The caregivers’ questionnaires contained an additional domain on emotional needs. Each question was evaluated for the degree of importance and satisfaction. Exploratory analyses determined whether baseline characteristics affect responder importance or satisfaction. Also, areas of high agreement/disagreement in satisfaction between the participating patient-caregiver pairs were identified. Questions for which >50% of the patients and caregivers thought were “very important” but >30% were dissatisfied include: understanding the cause of brain tumors, dealing with patients’ lower energy, identifying healthful foods and activities for patients, telephone access to health care providers, information on medical insurance coverage, and support from their employer. In the emotional realm, caregivers identified 9 out of 10 items as important but need further improvement. Areas of high disagreement in satisfaction between participating patient-caregiver pairs include: getting help with household chores (P value = 0.006) and finding time for personal needs (P value < 0.001). This study provides insights into areas to improve services for brain tumor patients and their caregivers. The caregivers’ highest amount of burden is placed on their emotional needs, emphasizing the importance of providing appropriate medical and psychosocial support for caregivers to cope with emotional difficulties they face during the patients’ treatment process.
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Affiliation(s)
- Rupa Parvataneni
- Division of Neuro-Oncology in the Department of Neurosurgery, University of California, San Francisco, CA 94143, USA.
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33
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Starkweather AR, Sherwood P, Lyon DE, McCain NL, Bovbjerg DH, Broaddus WC. A biobehavioral perspective on depressive symptoms in patients with cerebral astrocytoma. J Neurosci Nurs 2011; 43:17-28. [PMID: 21338041 PMCID: PMC3732744 DOI: 10.1097/jnn.0b013e3182029859] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
More than 51,000 individuals are diagnosed with a primary brain tumor in the United States each year, and for those with the most common type of malignant tumor, an astrocytoma, almost 75% will die within 5 years of diagnosis. Although surgery, radiation, and chemotherapy have improved length of survival, mortality remains high, which underscores the need to understand how other factors affect the disease trajectory. Several recent studies have shown that depressive symptoms are independently associated with reduced quality of life and survival time after controlling for other variables in patients with an astrocytoma. Thus, depressive symptoms represent a significant risk factor for adverse outcomes in this patient population. A growing body of evidence indicates that depressive symptoms are linked to underlying biological phenomena, particularly inflammatory activation modulated through increased peripheral levels of proinflammatory cytokines. Recent research has shown that neoplastic astrocytes respond to elevated proinflammatory cytokine levels by secreting immune mediators within the central nervous system, including cytokines and glial fibrillary acidic protein that promote astrogliosis and angiogenesis and may increase tumor growth and metastasis. However, because these biological factors have not as yet been measured in conjunction with depressive symptoms in these patients, little is known about the interactions that potentially influence the treatment trajectory. To guide future research and to provide a deeper understanding of the factors that may influence depressive symptoms and length of survival in patients with an astrocytoma, a review of the literature was undertaken. Publications over the past 10 years were analyzed to examine the theoretical models and measures of depressive symptoms used in previous research. Although numerous studies have documented the relationship between depression and reduced length of survival, there were several methodological concerns identified, and there were no studies that included biological variables. Yet, research in the basic sciences provides compelling evidence of specific neuroendocrine-immune interactions orchestrated by astrocytes that can cause depressive symptoms and alter the tumor microenvironment so that standard treatments are not as effective. These findings support the need for clinically based research so that we can begin to understand the potentially modifiable biobehavioral mechanisms underlying depressive symptoms in patients with an astrocytoma. Grounded in the biobehavioral research paradigm of psychoneuroimmunology, a novel research program is presented that may provide a new level of understanding regarding the high prevalence of depressive symptoms in patients with an astrocytoma and lead to new treatment strategies, with possible implications for improved symptom management and quality of life in patients with brain tumors.
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34
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McBride D. Patients are more likely to choose comfort care after watching video on end-of-life options. ONS Connect 2010; 25:15. [PMID: 20486617] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/29/2023]
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35
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Descôteaux J. [Dr. Richard Béliveau: an author, science and a goal: preventing cancer]. Perspect Infirm 2010; 7:13-14. [PMID: 21744575] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
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36
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Matis GK, Birbilis TA, Chrysou OI, Zissimopoulos A. Satisfaction survey of Greek inpatients with brain cancer. J BUON 2010; 15:157-163. [PMID: 20414945] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/29/2023]
Abstract
PURPOSE To investigate brain cancer patients' satisfaction hospitalised in a tertiary care university public hospital in Alexandroupolis, Greece, in order to improve medical, nursing, and organizational-administrative services. METHODS This cross-sectional study involved 163 patients having been hospitalised for at least 24 hours. The patients were asked to fill in a satisfaction questionnaire previously approved by the Greek Ministry of Health. Four aspects of satisfaction were investigated (medical, hotel accommodation/ organisational facilities, nursing, global). Using Principal Component Analysis, summated scales were formed and tested for internal consistency using Cronbach's alpha coefficient. The non parametric Spearman's rank correlation coefficient was also used and the threshold p-value for statistical significance (2-sided) was set at 0.05. RESULTS The results revealed a high degree of global satisfaction (73.31%), yet satisfaction was higher for the medical (88.88%) and nursing (84.26%) services. Moreover, satisfaction derived from the accommodation facilities and the general organisation was found to be more limited (74.17%). Statistically significant differences (based on various demographic variables) in the participants' global satisfaction were not observed. On the contrary, self-assessment of health status at admission was negatively correlated with medical (r(s)=-0.157, p=0.045) and nursing (r(s)=-0.168, p=0.032) satisfaction. Greek citizenship contributed to bigger satisfaction scores in the accommodation/organisational facilities dimension (r(s)=0.158, p=0.044). Finally, age was positively linked to nursing satisfaction (r(s)=0.181, p=0.02). CONCLUSION The present study confirmed in part the results of previously published Greek surveys assessing general patient populations. However, more studies are urgently needed to confirm these findings in a much bigger brain cancer population.
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Affiliation(s)
- G K Matis
- Department of Neurosurgery, Democritus University of Thrace Medical School, University Hospital, Alexandroupolis, Greece.
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37
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Manicat-Emo A, Bankas D, Bradbury L, Espedido B. Truth-telling and an adolescent diagnosed with a malignant brain tumour: who are we protecting? Can J Neurosci Nurs 2010; 32:36-40. [PMID: 20865833] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/29/2023]
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38
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Abstract
Family management of childhood chronic conditions consists of 6 family factors: (1) the family's view of the child's daily life, (2) the impact of the condition on family life, (3) the difficulty of family life, (4) the family's effort managing the child's condition, (5) the family's ability managing the child's condition, and (6) parental mutuality. Recently, the Family Management Measure (FaMM), which measures family management of children with chronic conditions (excluding cancer), was validated. The purpose of this descriptive study was to examine the comparability of these 6 factors in families with childhood brain tumor survivors. First, 14 advanced practice nurses who are experts in neuro-oncology and survivorship rated items on the FaMM as relevant and clear to families of brain tumor survivors. Second, 22 cognitive interviews with parents of brain tumor survivors described family management as comparable with families of children with other chronic illness. In this report, 2 hypothetical, contrasting case studies of family management are used to illustrate family management within the context of brain tumor survivors.
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Affiliation(s)
- Janet A Deatrick
- Center for Health Disparities Research, University of Pennsylvania School of Nursing, Philadelphia, PA 19104-4217, USA.
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39
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Le Rhun E, Ramirez C. [Complications of gliomas, symptomatic treatments]. Soins 2009:40-42. [PMID: 19366002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
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40
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Taillibert S. [Chemotherapy of glioblastomas]. Soins 2009:38-39. [PMID: 19366001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
Affiliation(s)
- Sophie Taillibert
- Département de Neuro-oncologie, Centre Hospitalo- Universitaire Pitié-Salpétrière, Paris.
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41
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Froger O. [Haute couture and fashion shows]. Krankenpfl Soins Infirm 2009; 102:55. [PMID: 19348370] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
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42
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Charette S, Daoust L. [The story of Antoine]. Perspect Infirm 2009; 6:36-44. [PMID: 19341054] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
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43
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Honea N. How did you begin studying caregivers of patients with cancer? Caregivers of patients with brain tumors face special challenges. ONS Connect 2008; 23:15. [PMID: 19051771] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
Affiliation(s)
- Norissa Honea
- Arizona Oncology Services Foundation, Phoenix, AZ, USA
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44
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Sherwood PR, Given BA, Given CW, Schiffman RF, Murman DL, von Eye A, Lovely M, Rogers LR, Remer S. The influence of caregiver mastery on depressive symptoms. J Nurs Scholarsh 2007; 39:249-55. [PMID: 17760798 DOI: 10.1111/j.1547-5069.2007.00176.x] [Citation(s) in RCA: 49] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
PURPOSE The purpose of this study was to explore how the relationship between care recipients' problem behaviors and caregivers' depressive symptoms varies as a function of caregiver mastery, controlling for the effects of caregiver age, gender, and relationship to the care recipient in caregivers of people with primary malignant brain tumor (PMBT). DESIGN A cross-sectional design was used to gather data via telephone interviews from 95 caregivers of people with primary malignant brain tumor, recruited from 2003 to 2004 from a brain tumor treatment center, two national support groups, and a statewide cancer registry. METHODS Measures for the study included the Neuropsychiatric Inventory-Questionnaire, Caregiver Mastery, and the Center for Epidemiologic Studies-Depression. A stepwise regression procedure was used to evaluate potential moderating and mediating relationships. FINDINGS Data did not indicate that caregiver mastery was a moderating variable. The analysis showed caregiver mastery as a partial mediator, with both a direct effect of care recipients' problem behaviors on caregivers' depressive symptoms and an indirect effect through caregiver mastery. Concerning the indirect effect, care recipients' problem behaviors were related to lower levels of caregiver mastery, which in turn were related to more depressive symptoms in caregivers. CONCLUSIONS Findings showed a link between care recipients' problem behaviors and caregivers' depressive symptoms, a relationship that has not been well established in oncology. This association indicates one mechanism through which problem behaviors in the care recipient might lead to caregiver depressive symptoms.
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Affiliation(s)
- Paula R Sherwood
- University of Pittsburgh School of Nursing, Pittsburgh, PA 15261, USA.
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Abstract
Current nursing literature recognizes the need to honor the concept of ambiguity. Nurses experience uncertainty with handling or honoring complexity and ambiguity when confronted with times of struggle. Traditional models of care fall short as patients and families define their expectations of the healthcare system. Nurses bear witness to the discomfort caused by the unknown in their daily practice. They are challenged to address their feelings, unsure of what to anticipate, what to say, or how to respond to their patients. Uncertainty diminishes the opportunity for meaningful dialogue between nurses and other people. Nurses attempting to ease the discomfort of ambiguity by providing patients or families with reassurance, offering advice on how to fix problems, or avoiding talking about situations often express dissatisfaction. Nurses should be invited to explore ambiguity and seek understanding through dialogue and nursing knowledge. Encouraging nurses to define the meaningfulness in nursing practice that embraces human science theory will help relieve some of the ambiguity that exists in current practice. This article will explore the concept of ambiguity, highlight how nursing theory based on human science can support practice, and propose recommendations for practice.
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Affiliation(s)
- Kalli Stilos
- Sunnybrook Health Sciences Centre, Toronto, Canada.
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Souza RG, Cunha ICKO, Reichert MCF, Diccini S. [Neurological disorders and dependence of nursing care in patients with brain tumor]. Rev Gaucha Enferm 2007; 28:180-6. [PMID: 17907638] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/17/2023] Open
Abstract
The aim of this study was to identify neurological disorders in 32 patients with diagnosis of brain tumor, and to evaluate the dependency of nursing care before and after the surgery. This study was carried out at the Neurosurgery Unit of São Paulo Hospital, Brazil, from June to December, 2004. One instrument was used to collect physical and neurological data, and another to evaluate the dependence degree. An increase of the dependence degree was observed after surgical intervention, which therefore needs to be correlated with nursing team size in order to optimize care.
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Affiliation(s)
- Renata Guzzo Souza
- Extraido do Trabalho de Conclusão do Curso de Especialização em Enfermagem em Neurocirurgia, Modalidade Residência em Enfermagem, Hospital São Paulo, Departamento de Enfermagem da Universidade Federal de St Paulo (UNIFESP).
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Abstract
Glioblastoma multiforme (GBM) is the most common primary malignant brain tumor. Spinal metastasis is rare. However, as local control of the primary tumor improves, metastatic disease is increasingly possible. The neuroscience nurse plays an instrumental role in caring for patients with GBM, developing a plan of care based on each patient's needs and outcomes.
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Affiliation(s)
- Jean Arzbaecher
- Brain Tumor Center, The University of Chicago Hospitals, USA.
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48
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Abstract
The blood-brain barrier (BBB) is a physiologic barrier that protects the brain from toxic substances, including most of the chemotherapeutic agents used today. The BBB may be partly responsible for the poor efficacy of chemotherapy for malignant primary or metastatic brain tumors. A technique of osmotic modification of the BBB, known as BBB disruption (BBBD), is used to increase the delivery of chemotherapy to the brain. This article discusses the technique of osmotic opening of the BBB, the national BBBD program, the role of nurses in the care and management of patients undergoing BBBD treatment, outcomes of this technique with a variety of brain tumors, and the future directions of the BBBD program.
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49
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50
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Cashman R, Bernstein LJ, Bilodeau D, Bovett G, Jackson B, Yousefi M, Prica A, Perry J. Evaluation of an educational program for the caregivers of persons diagnosed with a malignant glioma. Can Oncol Nurs J 2007; 17:6-15. [PMID: 17847985 DOI: 10.5737/1181912x171610] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
BACKGROUND Caring for a loved one with a malignant glioma can be a formidable responsibility. The guarded prognosis, side effects of treatments, and changes in brain function, personality and behaviour pose unique challenges in care provision by family members. It is rare that institutions provide educational programs for caregivers. PURPOSE To evaluate the impact of providing information in an educational program to caregivers of patients diagnosed with a malignant glioma. METHODS A structured educational program for caregivers of brain tumour patients was developed based upon multidisciplinary expert opinion and caregiver feedback. Twenty-four caregiver participants were enrolled in the program. Knowledge was assessed before, immediately following, and four to six weeks following the program. Open-ended questions were used to explore the caregivers' experiences, as well as additional benefits derived from the program. RESULTS Knowledge scores on testing immediately after the program and four to six weeks following the program were statistically significantly improved from baseline testing, although there was a decline in scores four to six weeks after the program. These findings demonstrate effective knowledge transfer (recall of the information) immediately after the education program and four to six weeks later. Specific qualitative and quantitative data serve as a basis for understanding caregivers' needs and experiences.
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Affiliation(s)
- Rosemary Cashman
- Crolla Family Brain Tumour Research Unit, Sunnybrook Health Sciences Centre, Toronto, ON
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