Biomedical subjects

C J Meares

Publications and source records attributed to C J Meares.

5 recordsLinked to original sources

PubMed2000

Nutritional issues in palliative care.

OBJECTIVES: To present current information on nutritional problems and management during the palliative care period. DATA SOURCES: Research and review articles from three computerized databases, the table of contents of an on-line nursing journal, and pursuit of pertinent references in articles reviewed. CONCLUSIONS: Controversies continue on the most appropriate management of intake in the palliative care period from both physical and ethical perspectives. IMPLICATIONS FOR NURSING PRACTICE: Until the literature is conclusive on the amount and type of suffering incurred by patients who are ceasing intake, nurses will need to stay current with the research literature and approach each case individually in determining appropriate care.

Ethics, Medical↗

PubMed1997

A case study application of the Integrated Ethical/Clinical Judgment Model.

PURPOSE/OBJECTIVES: To discuss diagnostic, therapeutic and ethical reasoning, as linked in the Gordon Murphy Candee and Hiltunen Integrated Clinical Judgment Model in the context of a case study. DATA SOURCES: An interview conducted with a widow who had been her husband's primary hospice caregiver while he was dying at home of lung cancer as well as published books and articles. DATA SYNTHESIS: Elements of ethical reasoning parties claims and moral basis for claims are revealed in the experiences of one family receiving hospice care. CONCLUSIONS: The Integrated Clinical Judgment Model has applicability in ethical research and clinical nursing practice. IMPLICATIONS FOR NURSING PRACTICE: Nurses firm grounding in both diagnostic and ethical reasoning will facilitate the application of sound clinical judgment in the provision of optimal hospice nursing care.

Adaptation, Psychological↗

PubMed1997

Effects of exercise on fatigue, physical functioning, and emotional distress during radiation therapy for breast cancer.

PURPOSES/OBJECTIVES: To test the hypothesis that women participating in a walking exercise program during radiation therapy treatment for breast cancer would demonstrate more adaptive responses as evidenced by higher levels of physical functioning and lower levels of symptom intensity than women who did not participate. DESIGN: Experimental, two-group pretest, post-test. SETTING: Two university teaching hospital outpatient radiation therapy departments. SAMPLE: 46 women beginning a six-week program of radiation therapy for early stage breast cancer. METHODS: Following random assignment, subjects in the exercise group maintained an individualized, self-paced, home-based walking exercise program throughout treatment. The control group received usual care. Dependent variables were measured prior to and at the end of radiation therapy. In addition, symptoms were assessed at the end of three weeks of treatment. MAIN RESEARCH VARIABLES: Participation in the walking exercise program, physical functioning fatigue, emotional distress, and difficulty sleeping. FINDINGS: Hypothesis testing by multivariate analysis of covariance, with pretest scores as covariates, indicated significant differences between groups on outcome measures (p < 0.001). The exercise group scored significantly higher than the usual care group on physical functioning (p = 0.003) and symptom intensity, particularly fatigue, anxiety, and difficulty sleeping. Fatigue was the most frequent and intense subjective symptom reported. CONCLUSIONS: A self-paced, home-based walking exercise program can help manage symptoms and improve physical functioning during radiation therapy. IMPLICATIONS FOR NURSING PRACTICE: Nurse-prescribed and -monitored exercise is an effective, convenient, and low-cost self-care activity that reduces symptoms and facilitates adaptation to breast cancer diagnosis and treatment.

Adult↗

PubMedDate not supplied

Terminal dehydration: a review.

Terminal dehydration is a naturally occurring condition which hospice nurses encounter daily. Although much has been written on this topic in recent years, a review of the literature will provide a summary of research and opinion which can form the basis for future research. This article covers the physiology, patient symptoms, and a discussion of the benefits of terminal dehydration. Ethical and legal issues have been clarified by the President's Commission for the Study of Ethical Problems in Medicine and Biomedical and Behavioral Research. A comparison of nurse and physician perceptions concludes the article. In order for nurses to provide anticipatory guidance for family/caregivers of the imminently dying, more must be known about family/caregiver perceptions of terminal dehydration.

Attitude of Health Personnel↗

PubMedDate not supplied

Primary caregiver perceptions of intake cessation in patients who are terminally Ill.

PURPOSE/OBJECTIVES: To explore the meaning of nutrition cessation in adult in-home hospice patients with cancer as described by women primary caregivers during the first year of bereavement. SETTING: In-home hospice in the northeastern region of the United States. SAMPLE: Twelve English-speaking adult women who had cared for patients who were terminally III with cancer who ceased oral intake. DESIGN: Qualitative phenomenologic inquiry. METHOD: Verbatim written transcripts of semistructured interviews were studied line by line to identify themes. Shared themes emerged through ongoing comparison across cases. FINDINGS: Within the framework of transition, seven essential themes emerged: The Meaning of Food, Caregiver as Sustainer, Concurrent Losses, Personal Responses, Ceasing to Be--"Starved to Death," Being Bereaved--The Meaning Now, and Paradox. Patient changes in intake patterns and caregiver actions to encourage intake were described. Decreasing intake led to ongoing and spiraling losses. Caregiver intake patterns also changed. CONCLUSIONS: Caregivers believed that patient-nutrition cessation was naturally occurring and not physically painful. IMPLICATIONS FOR NURSING PRACTICE: Sensitized nurses can look for the presence of the phenomenon in cancer caregiving families and open dialogue. Anticipatory guidance can serve to normalize the situation and ease the transition. Future research should focus on what nurses know and what they share with families regarding intake cessation. Research with caregivers could address values clarification, decision making, knowledge needed for caregiving, the perceptions of caregiving men, and caregivers of diverse cultures. More research conducted with patients ceasing intake is needed to determine whether and to what degree patients suffer.

Adaptation, Psychological↗