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Biomedical subjects

B R Ferrell

Publications and source records attributed to B R Ferrell.

At least 19 recordsLinked to original sources
PubMed1992

Pain and addiction: an urgent need for change in nursing education.

Lack of education of health care professionals, including nurses, is frequently cited as a major reason for undertreatment of patients with pain. A reason for undertreatment of pain with opioid analgesics is the irrational fear of creating opioid addiction. To characterize the information nurses receive in their basic education that could contribute to misinformation about this issue, the authors reviewed 14 nursing textbooks, published since 1985, including 8 pharmacology texts and 6 medical surgical texts. An analysis of content revealed that only one textbook correctly stated the definition of opioid addiction and its likelihood following use of opioid analgesics for pain control. Almost all of the texts used confusing terminology, and some erroneously promoted the fear of addiction when opioids are used for pain relief. A simple solution to this problem is to encourage nursing educators to use the American Pain Society publication "Guidelines for Analgesic Use" until textbooks have the opportunity to incorporate correct information.

Attitude of Health Personnel↗
PubMed1992

Home care: maintaining quality of life for patient and family.

Cancer affects the family as well as the patient. The home is a primary site of care, which often must be intensive and complex. Attention to home care of the cancer patient is therefore a major concern in maintaining quality of life for both patient and family. The authors explore the major burdens of home care that affect both patient and family and describe four specific interventions that the health care team can initiate to optimize quality of life in these difficult situations.

Aged↗
PubMed1991

Cancer clinical trials. Companion studies.

Nursing companion studies may accompany research in a variety of disciplines but most often are associated with medical research. Companion studies include "collaborative-companion" studies and "parallel-companion" studies and rely on a variety of methods. The majority of nursing companion studies have focused on the areas of treatment effects or symptoms, cancer control, and rehabilitation, however, there are many other areas that provide opportunity for independent nursing research.

Clinical Protocols↗
PubMed1991

Principles of pain management in older people.

The management of chronic pain should be a priority in geriatric care. Pain is a common problem that has tremendous potential to influence the physical function and quality of life of elderly people during their remaining years. Much research and education is still needed to further our understanding of pain and its management among elderly people. Existing pain management strategies should be tailored for the special needs of the geriatric population. Applications of "high tech" pain management strategies, such as morphine pumps and chronic spinal infusions, need to be clarified for older people. Finally, family and caregiver considerations should be included in chronic pain management strategies.

Aged↗
PubMed1991

Family factors influencing cancer pain management.

The purpose of this study was to describe family factors which influence cancer pain. Previous research has focused on the patients' and professional caregivers' perspective of pain. Cancer pain is an intense burden on the entire family as well as on the patient. Findings of the study demonstrate family perceptions of pain, caregiver burden associated with pain, caregiver moods and differences in caregiver experiences of pain between three sites of care including a hospice, a community hospital and a cancer centre. Understanding the perspective of the family caregivers and their role in pain management can assist health care providers in management of the patient's pain.

Adult↗
PubMed1991

Pain management at home.

The management of chronic pain should be a priority in geriatric home care. Pain is a common problem that has tremendous potential to influence the physical function and quality of life of elderly people during their remaining years. The experience of pain and its management at home are not analogous to institutional settings. Family and caregivers have important influences on pain management and may require education and support for the long-term management of chronic pain patients. Existing pain management strategies should be tailored to meet the special needs of geriatric patients and be sensitive to caregiver concerns. Implications, indications, and applications for high-tech pain management strategies need to be clarified for the management of older people at home.

Acute Disease↗
PubMed1991

Clinical decision making and pain.

Pain management is intimately linked to decision making. Nurses play a key role in making decisions regarding pain and its management. This paper presents data from a preliminary study (N = 53) extending the investigators' pain research into the areas of clinical decision making and ethical dilemmas related to pain management. Nurses completed surveys focused on actual experiences of caring for patients in pain. The results identify common clinical decisions related to pain, barriers to providing optimum pain relief, and ethical/professional conflicts in pain management. Decisions related to the amount of pain intensity, when to give medications, and choice of analgesics. Nurses identified verbal and nonverbal cues central to their decisions regarding pain assessment. Barriers to effective pain management included physician knowledge and cooperation, patient/family knowledge and cooperation, as well as nursing knowledge and time. Respondents identified ethical dilemmas about overmedication or undermedication, conflicts with physicians or patients, and concern over opioid side effects. A tentative model of decision making related to pain is presented.

Adult↗
PubMed1990

Assessment of quality of life with a single instrument.

A number of single measures of quality of life have been developed over the last few years. Some of these instruments have been used more frequently than others. Psychometric properties are reported in many of these instruments, and continued psychometric development is needed. Instruments differ in the content tested, and users are encouraged to have specific objectives in mind when selecting an instrument. The continued research interest and activity in the field of single measures has provided beginning tools for both research and clinical evaluations. Quality of life measures add to the depth of evaluation of the impact on cancer and cancer treatment, and provide a measurement dimension that augments that of the historic evaluation via morbidity and mortality statistics. Continued work on single measures for quality of life will provide both researchers and clinicians with valuable tools.

Humans↗
PubMed1990

Pain in the nursing home.

Pain is an understudied problem in geriatric medicine and especially among nursing home residents. The focus of this study was to describe the scope of the problem of pain in a long-term care facility. Ninety-seven subjects from a 311-bed multilevel teaching nursing home were interviewed, and charts were reviewed for pain problems and management strategies. Functional status, depression, and cognitive impairment were also evaluated. Results indicate that 71% of residents had at least one pain complaint (range, 1-4). Of subjects with pain, 34% described constant (continuous) pain and 66% described intermittent pain. Of 43 subjects with intermittent pain, 51% described pain on a daily basis. Major sources of pain included low back pain (40%), arthritis of appendicular joints (24%), previous fracture sites (14%), and neuropathies (11%). Moderately strong correlations were found between pain and infrequent attendance at recreational and social activities (r = .50). However, little correlation was observed between pain and the Yesavage Depression Scale, the Folstein Mini-Mental State Scale, or basic ADLs measured by the Katz Scale. Pain-management strategies consisted of analgesic drugs, physical therapy, and heating pads. Only 15% of patients with pain had received medication within the previous 24 hours. The findings suggest that pain is a major problem in long-term care. Strategies for pain management appear to be limited in scope and application in this setting. Important barriers were identified that influence the reporting and management of pain in this setting.

Aged↗
PubMed1989

Quality of life as an outcome variable in the management of cancer pain.

Valid measurement tools are needed by oncology researchers to help in the evaluation of the effectiveness of pain relief methods used in the treatment of cancer patients. A study was conducted to assess the validity and reliability of a tool designed to evaluate quality of life as a measure of pain management outcome in the individual patient. Items in the tested quality of life survey represented the areas of psychologic well-being, physical well-being, general and specific symptom control, and degree of social support. Using the test instrument, two oncology nurses interviewed subjects in three groups, each consisting of 50 subjects: cancer patients with pain, cancer patients without pain, and subjects with no cancer. Statistical analysis of the interview results revealed that the instrument has test-retest reliability, internal consistency, and interrater reliability, as well as content and construct validity for the major factors, psychologic well-being, worry, and nutrition. Further revision of the instrument is needed to restructure its subscales. The quality of life tool will enable researchers to evaluate a treatment regarding not only its effect on pain intensity but also its impact on the total individual.

Adult↗