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A Molassiotis

Publications and source records attributed to A Molassiotis.

53 records · Page 3Linked to original sources
PubMed1997

Psychosocial transitions in the long-term survivors of bone marrow transplantation.

Psychosocial transitions were assessed in the long-term survivors of bone marrow transplantation (BMT). A combination of quantitative and qualitative data from 91 survivors led to the identification of several psychosocial phases and transit points after the transplant. Throughout the years post-BMT survivors were concerned with their sexual functioning. Adjustment with social environment was initiated during the first 2 years post-BMT and finalised in the fourth year post-BMT. The third year post-BMT was characterized by a grieving phase which was followed by a life re-evaluation phase. Loss of control and independence were the main problems reported during the third and fourth year post-BMT. Occupational adjustment was also of main concern in the fourth and subsequent years post-BMT. The fifth year post-BMT featured a phase characterized by despair for those survivors who still had physical problems, and thoughts of what the future held for them. Moving on with life was a feature of those who had survived over a long period of time (6 years plus post-BMT), although a fraction of patients still had difficulties adjusting in their psychosocial environment. The identification of psychosocial transitions could help in understanding the specific psychosocial needs of the patients over time, which, in turn, could improve psychosocial services, with provision of professional support in crucial periods post-BMT.

Adaptation, Psychological↗
PubMed1997

Nursing research within bone marrow transplantation in Europe: an evaluation.

The limited contribution of nursing research and the utilisation of research findings in the field of bone marrow transplantation (BMT) in Europe have been identified as issues needing further attention. Reasons behind these issues include the lack of nursing training in research techniques, problems with funding nursing research, staff shortages and language barriers. An overall research strategy for nurses has been suggested as well as academic research support for those nurses who do not feel confident carrying out research projects. A small scale study in four European BMT centres identified that the main nursing research priorities included isolation techniques, psychosocial and quality of life issues, staff issues, central line catheter care and mouth care/management of oral mucositis. The same study also showed that only 20% of the BMT units regularly use research and research findings in their day-to-day nursing practice.

Bone Marrow Transplantation↗
PubMed1997

A conceptual model of adaptation to illness and quality of life for cancer patients treated with bone marrow transplants.

A conceptual model of adaptation to illness/treatment and quality of life in cancer and especially bone marrow transplant patients is presented. The process from the diagnosis of a life-threatening disease to adaptation to it is divided into five stages. This process starts with the initial stimuli (stressor) and the appraisal/perception of that as a threat (stage I), and continues with the reaction to the stressors, if it is perceived as a threat (stage II). This is the time that, if manipulation of the stressor with appropriate interventions occurs, prevention of ineffective coping and/or maladjustment to illness is possible. The third stage refers to the coping with the illness (adaptive or maladaptive coping), followed by the degree of adaptation to illness and satisfaction with daily life (quality of life). Depending on interventions applied at this stage, the outcome can be either adjustment to illness or maladjustment and low quality of life (final stage). In every stage of the process, certain physiological, psychological, social and developmental variables are important, and these are described, based on research findings. Assessment of these variables is necessary for more effective planning of care and application of nursing interventions. Such a model can provide a conceptual framework for the assessment and evaluation of quality of life in cancer/bone marrow transplant patients and can help health professionals, and nurses in particular, to develop their own assessment tools and plan care and/or interventions based on such a holistic assessment.

Adaptation, Psychological↗
PubMed1996

Nurses' awareness of restraint use with elderly people in Greece and the U.K.: a cross-cultural pilot study.

The use of restraints in hospitalised elderly people is a contentious but poorly-documented issue and many gaps remain in the literature. Despite the growth of the elderly population, there has been little attempt to safeguard their rights in relation to appropriate care whilst in hospital. Furthermore, little is known about the attitudes of nurses in the U.K. towards the use of restraints in the older population, and there is an almost total absence of cross-cultural studies. The current study is a small pilot study of nurses' attitudes towards and knowledge of restraint use with older patients. A structured questionnaire was given to 39 U.K. and 11 Greek trained nurses who were working in acute care settings where elderly patients were cared for, with the aim of identifying their perceptions and experiences of the use of restraints in their clinical settings. Although numbers were small, a number of differences between the two groups were found, and there were indications of further differences. These issues are examined, with particular reference to the need for education, restraint policies and multidisciplinary decision-making about restraint use. Some major principles which should be included in cross-cultural studies are also discussed.

Adult↗
PubMed1996

Evaluation of burnout and job satisfaction in marrow transplant nurses.

The study examined incidence of burnout syndrome, psychopathology, and job satisfaction in bone marrow transplant nurses, in relation to existence of an informal psychosocial support programme for staff needs. Forty nurses participated in the study completing four standardised measures related to burnout, anxiety, depression, satisfaction with aspects of their job, and social support. Results indicated that burnout among these nurses was low, and high personal accomplishment from working with marrow transplant patients was the response of the majority. Job satisfaction was also found to be high, with outpatient nurses scoring significantly higher than inpatient nurses in most aspects of job satisfaction. One out of four subjects presented with the psychic manifestations of the anxiety neurosis, suggesting the stressfullness of the marrow transplant environment, which requires a high degree of responsibility and advanced nursing skills. Social support was not found to influence burnout, psychopathology, or job satisfaction. Presence of depression, low personal accomplishment, and dissatisfaction with pay were the variables predicting high emotional exhaustion, one of the main components of burnout. These results were suggestive of less burned out and more satisfied nurses compared to marrow transplant nurses working in environments with no formal or informal staff support programmes. This highlights the need for development of support services for the nursing staff, allowing them to ventilate their feelings, discuss issues of concern to them and seek professional support where necessary.

Adult↗
PubMed1996

Quality of life in long-term survivors of marrow transplantation: comparison with a matched group receiving maintenance chemotherapy.

A retrospective descriptive study was designed to assess the quality of life (QoL) and psychosocial adjustment in long-term BMT survivors compared with a group of patients with haematological malignancies receiving maintenance chemotherapy (MC), matched for age, post-treatment time, sociodemographic and disease characteristics. The sample consisted of 91 long-term BMT survivors and 73 MC patients from three teaching hospitals in the UK. The results indicated that most of the BMT subjects had a good to excellent quality of life and, in some domains, even better adjustment than the MC patients. However, 20% of the BMT subjects had failed to return to full-time employment at a mean post-BMT time of almost 40 months. A significant number of BMT subjects were also identified with symptoms of anxiety and depression. The physical symptomatology had an association with psychological status. Impotence-related difficulties, decreased sexual satisfaction and altered body image were the main characteristics of psychosexual dysfunction in the BMT group. Poorer quality of life was predicted by the presence of depressive symptoms, low affirmation, and impoverished social adjustment.

Adolescent↗
PubMed1995

Comparison of the overall quality of life in 50 long-term survivors of autologous and allogeneic bone marrow transplantation.

Fifty long-term survivors of bone marrow transplant (mean post-transplant time = 42.4 months) participated in a study examining their psychosocial adjustment and quality of life. Differences between patients who received an autologous marrow transplant and those who received an allogeneic marrow transplant were identified. Patients with an autologous transplant had mainly psychological difficulties in their post-transplant adaptation, whereas patients with allogeneic transplant developed more physical problems. Overall, their psychosocial adjustment was similar and comparable with other medical groups of patients. A quarter of both groups had failed to return to work/education and up to 9.5% had difficulty in carrying out daily tasks. Twenty per cent of the patients with autologous transplant had clinical signs of anxiety and 10% clinical signs of depression, whereas there was an incidence of 10% of patients with allogeneic transplant with anxiety, but no cases with clinical depression. Family relationships were found to be more integrated and lower in conflict compared with normal families. Quality of life has been described as good to excellent in most of the patients. Multiple regression analysis showed that physical symptomatology, vocational adjustment and depression are predictors of the degree of the patients' quality of life.

Activities of Daily Living↗
PubMed1995

Gonadal function and psychosexual adjustment in male long-term survivors of bone marrow transplantation.

Gonadal function and psychosexual adjustment were evaluated in 29 male patients after autologous and allogeneic BMT (mean post-BMT time 35.6 months). Patients were divided into groups according to their interval from transplant in order to evaluate gonadal function throughout the post-BMT years. Thyroid-stimulating hormone (TSH) and free thyroxine (FT4) were normal throughout the post-BMT years. Follicle-stimulating hormone (FSH) and luteinising hormone (LH) were increased throughout the years after BMT, suggesting moderate compensated hypogonadism. Hyperprolactinaemia was observed only in the 2nd year post-BMT and testosterone levels were normal, suggesting that Leydig cells can withstand alkylating agents or TBI. Psychosexual functioning in BMT survivors was compared with that of a group of mixed-diagnosis cancer patients (n = 30) and a group of healthy young subjects (n = 119). Long-term BMT survivors had similar psychosexual adjustment to that of other cancer patients who had received less intensive chemotherapy. Half the patients were dissatisfied with their current sex life. Major problems included impotence/erectile difficulties (37.9%), low sexual desire (37.9%) and altered body image (20.7%). However, both BMT survivors and cancer patients had significantly higher psychosexual dysfunction compared with healthy subjects. The type of chemotherapy, TBI (either single-dose or fractionated), type of transplant and post-BMT time did not correlate with either gonadal or psychosexual functioning.

Adaptation, Psychological↗
PubMed1995

Psychological stress in nursing and medical staff on bone marrow transplant units.

There were 129 nurses and 26 doctors from 16 BMT centres in the UK who responded to a mailed survey of their job satisfaction, their psychological difficulties at work, the sources and effects of working stress, and any stress-reducing techniques they found useful. Half were emotionally exhausted, and 80% reported feelings of low personal accomplishment. A significant proportion, particularly medical staff, had marked feelings of depersonalisation. All aspects of job satisfaction were thought to be unsatisfactory (namely professional support or training). Signs of clinical anxiety were seen in > 10% of staff, and overt depression was present in 0.8% of nurses and 3.8% of doctors. Emotionally burnout developed because of work-related and personality factors. Sources of stress were found in regular work with dying patients excessive responsibility, rapid advances in transplant technology, and excessive personal demands of patient and families. The majority of staff had experienced difficulties in their personal lives which were directly linked to stress at work. The implications for both the patients and staff are discussed, and stress management techniques are suggested.

Adult↗
PubMedDate not supplied

Effects of music therapy on anxiety in ventilator-dependent patients.

OBJECTIVE: The purpose of this study was to assess the effectiveness of music therapy in decreasing anxiety in ventilator-dependent patients. DESIGN: A crossover repeated measures design with random assignment was used. SETTING: The intensive care unit of a university hospital in Hong Kong was used as the setting for this study. PATIENTS: Twenty patients who were ventilator-dependent were recruited for the study. They were all Chinese with a mean age of 58.25 years (range, 19-84 y). Most (75%) were men. OUTCOME MEASURES: Physiologic measures of anxiety assessed in this study were mean blood pressure and respiratory rate. An additional measure was the Chinese version of the Spielberger State-Trait Anxiety Inventory. INTERVENTION: Patients were randomized to receive either 30 minutes of uninterrupted rest and then 30 minutes of music therapy or the music therapy first and then the uninterrupted rest period. Patients listened to relaxing music by using audiocassette players and headphones. Subjects selected the music of their choice from a selection including both Chinese and Western music. Subjects had physiologic measures taken immediately before the intervention (or rest period) and at 5-minute intervals throughout the intervention. The Chinese version of Spielberger's State-Trait Anxiety Inventory was completed before the intervention and immediately after the intervention. RESULTS: Findings indicated that music therapy was more effective in decreasing state anxiety than was an uninterrupted rest period (P <.01). As measured by analysis of variance with repeated measures, blood pressure and respiratory rate showed no significant differences in the 2 conditions over time. However, significant differences were observed at the end of the intervention (after 30 minutes) between the 2 conditions, with music therapy being superior to the rest period. CONCLUSION: Music therapy is an effective nursing intervention in decreasing anxiety in ventilator-dependent patients and its use should be incorporated into the care of mechanically ventilated patients. For the Chinese patients, culture and language were the predominant factors in their choice of music.

Adult↗
PubMedDate not supplied

A comparison of wound treatments in nasopharyngeal cancer patients receiving radiation therapy.

The purpose of this study was to compare the effectiveness of gentian violet and nonadherent absorbent dressing in the healing of postirradiation wounds in nasopharyngeal carcinoma patients. This was a randomized controlled trial. A sample of 146 nasopharyngeal carcinoma patients who had developed postirradiation wounds was assessed. Comparisons were made regarding parameters related to wound healing, including healing time, presence of infection, and wound pain, and also regarding the impact of wound on the patient, including mood changes, restriction of neck movement, social isolation, sleep problem, and disturbance in body image. The results showed that patients in the 2 groups did not have any significant difference on wound-healing time, disturbance in mood, sleep, social interaction, appearance, and neck mobility. However, there was a trend of higher wound pain score, not reaching statistical significance, in the gentian violet group.

Administration, Cutaneous↗
PubMedDate not supplied

A systematic review of worldwide cancer nursing research: 1994 to 2003.

The aim of this study was to assess the cancer nursing research papers published in the past decade; identify their characteristics in terms of country of origin, participants, settings, diagnostic foci, and methodologic choices; and evaluate their quality. A systematic review was carried out of all published papers in the Cumulative Index of Nursing and Allied Health Literature between the years 1994 and 2003, using the keywords "cancer," "nursing," and "research." A total of 619 papers met inclusion criteria and were evaluated by 5 researchers. Almost half the papers were derived from the United States (49.1%), followed by the UK, Sweden, Canada, and Australia. In more than half of the published papers (52.2%), health professionals (mostly nurses) were the studies' participants. Also, much of the published research used patients with mixed diagnosis, or patients with breast or hematologic cancers. Two-thirds of the studies were quantitative, whereas most studies were descriptive in nature. The quality of both quantitative and qualitative studies was low, with only a small percentage meeting the highest quality criteria. Studies reporting funding and those published in journals with an impact factor showed a higher quality score than those not reporting funding or not published in journals with an impact factor. Cancer nursing research is still in a developmental stage, although it has made a considerable contribution to the evidence base of the discipline. A number of issues need to be tackled before we improve our output, such as organizational or workforce issues, infrastructure support, funding, and methodologic challenges.

Humans↗
PubMedDate not supplied

Complementary and alternative medicine use in patients with gynecological cancers in Europe.

The aim of the present study was to assess the use of complementary and alternative medicine (CAM) specifically in women with gynecological cancer. The design of the study was of a descriptive cross-sectional survey using a 27-item questionnaire. The study was conducted in 11 countries in Europe as part of a larger project. Data were available from 72 gynecological cancer patients. Among the participants, 40.3% used CAM after the diagnosis with cancer. The most popular CAM modalities used were herbal medicine (34.5%), relaxation techniques (21.4%), and vitamins/minerals (20.7%). A very high level of satisfaction with CAM use was reported. Patients used CAM to increase the body's ability to fight the cancer or to improve physical and emotional well-being. The main sources of information about CAM were informal (friends/family or the media). It is important to discuss CAM use with gynecological cancer patients, as they frequently use it and such use may have implications for clinical practice.

Adult↗
PubMedDate not supplied

Late psychosocial effects of conditioning for BMT.

This study was designed to assess psychosocial difficulties in long-term survivors of bone marrow transplantation (BMT) as a possible result of the type of pre-BMT conditioning. Eighty-three patients replied to questionnaires concerning several dimensions of quality of life. These subjects were assigned to one of three treatment groups: subjects who had received cyclophosphamide (CY) and total body irradiation (TBI) (n = 43): subjects who had received the BEAM protocol consisting of busulphan, etoposide, cytarabine, and melphalan (n = 31); and subjects who had received the University College Hospital (UCH) protocol consisting of cyclophosphamide, doxorubicin, carmustine and thioguanine (n = 9). The results indicated that, although overall psychosocial adjustment seemed to be similar in all three groups of patients, daily activities were more impaired and psychological/psychosomatic symptoms were more prevalent in the combination chemotherapy groups. Distressing physical and psychosocial symptoms usually affect quality of life and the incorporation of quality of life measures in clinical trials of cancer treatments is of great importance.

Activities of Daily Living↗
PubMedDate not supplied

Quality of life following bone marrow transplant.

Continuing our series on haematological malignancies, this second paper on bone marrow transplantation looks at the psychological impact and quality of life of survivors. It also looks at the effect on patient's sexuality, the psychiatric aspects of BMT and the stress on nursing staff.

Bone Marrow Transplantation↗
PubMedDate not supplied

Psychological care in bone marrow transplantation.

This paper continues the series on haematological malignancies which began in the issue of August 2, and is the first of two papers looking at the psychological impact of bone marrow transplantation. It describes the psychological stages of bone marrow transplantation, the stresses and responses, as well as the patient's psychological reaction to isolation therapy.

Adaptation, Psychological↗