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Biomedical subjects

C Miaskowski

Publications and source records attributed to C Miaskowski.

At least 73 records · Page 4Linked to original sources
PubMed1995

Differences in pain knowledge and perception of the pain experience between outpatients with cancer and their family caregivers.

PURPOSE/OBJECTIVES: To determine if knowledge about pain and the perception of the pain experience differ when comparing outpatients experiencing cancer-related pain with their family caregivers. DESIGN: Quantitative, descriptive. SETTING: Sixteen oncology outpatient settings that are part of the Oncology Nursing Research Network. SAMPLE: Eighty-six outpatients with cancer-related pain and their family caregivers. METHODS: Patients and their family caregivers were recruited in the outpatient setting and asked to complete a demographic questionnaire and the Pain Experience Scale. The patients also were asked to complete the Karnofsky Performance Scale. MAIN RESEARCH VARIABLES: Patients' and their family caregivers' knowledge about pain and their perception of the pain experience. FINDINGS: No significant differences in knowledge scores were found between the patients and their family caregivers. A significant difference in the perception of the pain experience was found, with the family caregivers viewing the experience more negatively than the patients did. Family caregivers reported that (a) patients had significantly higher levels of pain compared to patient reports, (b) patients experienced significantly greater distress from their pain than the patients reported for themselves, and (c) family caregivers experienced significantly greater distress from the patients' pain than the patients reported for their caregiver. CONCLUSIONS: Outpatients with cancer and their family caregivers possess limited knowledge about pain and pain management and perceive the pain experience differently. IMPLICATIONS FOR NURSING PRACTICE: Outpatients and their family caregivers need to be better educated about how to manage cancer-related pain. In addition, to reduce patient and caregiver distress, oncology nurses need to facilitate communication between patients and family caregivers about the pain experience.

Caregivers↗
PubMed1994

Assessment of patient satisfaction utilizing the American Pain Society's Quality Assurance Standards on acute and cancer-related pain.

An evaluation of patient satisfaction with pain management is one component of a total quality assurance program on pain management recommended by the American Pain Society. This study utilized the patient satisfaction survey recommended by the Quality Assurance Committee of the American Pain Society and was conducted in an acute care, municipal hospital. Seventy-two medical-surgical patients were interviewed about their pain management. Data from the survey suggest that while patients experienced moderate-to-severe pain and had to wait relatively long periods of time for pain medications, in most cases they were satisfied with their overall pain management. Recommendations for conducting patient satisfaction surveys of pain management in acute care settings are reviewed, and methods for interpreting data from these types of surveys are discussed.

Acute Disease↗
PubMed1994

Breast cancer prevention: a summary of the chemoprevention trial with tamoxifen.

PURPOSE/OBJECTIVES: To review the Breast Cancer Prevention Trial, which is testing tamoxifen as a chemoprevention agent. DATA SOURCES: Published articles and books; National Surgical Adjuvant Breast Project protocols. DATA SYNTHESIS: Because tamoxifen has proven to be an effective hormonal agent in the treatment of all stages of breast cancer and because it has a low side effect rate, a national study is under way to determine its effects as a breast cancer preventive agent. CONCLUSIONS: Results of this double-blind, placebo-controlled study will be available at the study's completion in 1997. IMPLICATIONS FOR NURSING PRACTICE: Providing patients with education, informed consent assistance, and help in adjusting to the drug's side effects and influences on quality of life.

Breast Neoplasms↗
PubMed1994

Cancer pain guidelines: now that we have them, what do we do?

Addressing the what, who, when, where, and how of implementing the AHCPR guidelines is an attempt to simplify what may be an overwhelming process. Use the suggestions presented in Figure 1 to formulate an action plan, and remember to assign a time frame and individual accountability. The commitment to moving the guidelines from the bookshelf to the bedside begins now. Using a process such as this will assist efforts to improve care of patients in pain. It is our hope that a year from now the copy of the AHCPR cancer pain guidelines on your shelf will not be covered with dust but rather will be a well-worn text translated to practice.

Clinical Protocols↗
PubMed1994

Advances in understanding the mechanisms and management of acute myelogenous leukemia.

PURPOSE/OBJECTIVES: To review current knowledge about the causes, pathophysiology, treatment, and nursing care of patients with acute myelogenous leukemia (AML). DATA SOURCES: Articles, books, and proceedings of national meetings. DATA SYNTHESIS: AML, an an often fatal disease, is characterized by signs of anemia, thrombocytopenia, neutropenia, and leukemic cell infiltration throughout the body. Possible etiologies include genetic predisposition and exposure to radiation, chemicals, and viruses. Various types of chemotherapy and bone marrow transplantation are treatments of choice. Both result in significant side effects and complication rates. CONCLUSIONS: Throughout every stage, nursing care is of the utmost importance. Research continues to increase understanding of the disease process and the survival of patients. IMPLICATIONS FOR NURSING PRACTICE: Goals of care are directed at prevention of bleeding, infection, fluid and electrolyte imbalance, and chemotherapy-related side effects; assisting patients and families to cope with diagnoses, therapy, and prognoses; and helping the patient to achieve an acceptable quality of life regardless of the eventual outcome.

Acute Disease↗
PubMed1993

Antinociception produced by receptor selective opioids. Modulation of supraspinal antinociceptive effects by spinal opioids.

This study evaluated the antinociceptive effects produced when different combinations of supraspinal mu- and delta-opioid agonists were co-administered with spinal mu-, delta-, and kappa-opioid agonists. Using the Randall-Selitto paw-withdrawal test, in the rat, changes in nociceptive thresholds were measured following co-administration of sequentially increasing i.c.v. doses of either DAMGO or DPDPE with a low-antinociceptive dose of intrathecal DAMGO, DPDPE, or U50,488H. Antinociceptive synergy (i.e. a more than additive antinociceptive effect) was demonstrated with all of the combinations tested except for supraspinal DPDPE co-administered with spinal DAMGO. The results of this study provide support for the suggestion that supraspinal and spinal antinociceptive mechanisms share, in part, common neural circuits. Marked differences in the overall magnitude of the antinociceptive effects produced by the various combinations of opioid agonists were demonstrated through a secondary analysis of the data. When sequentially increasing i.c.v. doses of DAMGO were administered, significantly larger increases in nociceptive thresholds were observed with co-administration of intrathecal injections of low antinociceptive doses of either DAMGO or U50,488H compared to DPDPE. In contrast, when DPDPE was administered supraspinally, the largest increases in nociceptive thresholds were demonstrated with co-administration of DPDPE at the spinal site. The results of the secondary analysis provide support for the hypothesis that descending antinociceptive control systems activated by supraspinal administration of selective mu- and delta-opioid agonists interact, differently, with spinal mu-, delta-, and kappa-opioidergic mechanisms.

Analgesics↗
PubMed1993

Nursing salaries and practice patterns: a nationwide evaluation by the Oncology Nursing Society.

This article summarizes the results of a national survey of salary, staffing, and professional practice patterns in oncology nursing conducted by the Oncology Nursing Society. The respondents represent a wide geographic distribution, and data were analyzed in the aggregate, as well as by American Hospital Association (AHA) regions, to allow for predictions of regional as well as national trends. This article reports on national and regional trends in salaries for entry-level and experienced practitioners; salary patterns for agency and float pool nurses; and the methods for awarding salary increases to nursing personnel in the past year. National trends in a variety of personnel practices affecting oncology nursing (e.g., shifts, self-scheduling, tuition reimbursement, and certification) are also presented. The data in this study come from a broad-based and geographically well-distributed sample that allows for meaningful national comparisons.

Economics, Nursing↗
PubMed1993

Current concepts in the assessment and management of acute pain.

The assessment and management of acute pain is a major responsibility for the medical-surgical nurse. Recent data suggest that unrelieved pain can have deleterious consequences for the patient. Therefore, nurses must take an active role in informing patients that pain management is an important part of their care. In addition, nurses must assess and reassess the severity of a patient's pain to determine if the pain management plan is effective or requires modification.

Acute Disease↗
PubMed1993

Pain with mammography: fact or fiction?

This article presents an overview of current knowledge about mammography-related pain and discomfort. Possible causes of pain and discomfort are discussed along with the results of two pilot studies that investigated the prevalence and severity of pain and discomfort associated with film-screen mammograms in a mobile screening program. Based on these studies, the authors conclude that pain is a problem for a significant number of women from diverse ethnic and socioeconomic backgrounds. A nursing care plan is provided to assist nurses in reducing mammography-related pain and discomfort.

Female↗
PubMed1993

Current concepts in the assessment and management of cancer-related pain.

Patients with cancer can experience a variety of cancer and non-cancer-related pain problems. Medical-surgical nurses are in an ideal position to perform a comprehensive assessment of the cancer patient to determine if pain is a significant problem for the patient and what effect, if any, the pain is having on the patient's quality of life. The pain management plan is predicted on an accurate assessment and ongoing evaluation of the pain complaint as well as related symptoms.

Analgesics↗
PubMed1992

Inhibition of spinal opioid analgesia by supraspinal administration of selective opioid antagonists.

The effect of intracerebroventricular administration of a selective mu- (CTOP) or delta- (ICI 174,864) opioid receptor antagonist on the antinociceptive effects produced by intrathecal administration of selective mu- (DAMGO), delta- (DPDPE) and kappa- (U50-488H) opioid receptor agonists was evaluated using the Randall-Selitto paw-withdrawal test, in the rat. While the intracerebroventricular administration of CTOP or ICI 174,864, alone, had no effect on nociceptive thresholds, intracerebroventricular administration of CTOP and ICI 174,864 produced marked antagonism of the antinociceptive effects of intrathecal DAMGO. The antinociceptive effects of intrathecal administration of DPDPE or U50,488H were not antagonized by intracerebroventricular administration of CTOP or ICI 174,864. These data suggest that, in the rat, along with the established descending antinociceptive pathways, there is an ascending antinociceptive control mechanism projecting from the spinal cord to the brainstem. The ascending antinociceptive control involves mu- and delta-opioid agonism at supraspinal sites and appears to be mediated selectively by mu-, but not by delta- or kappa-opioid agonism at the spinal level.

3,4-Dichloro-N-methyl-N-(2-(1-pyrrolidinyl)-cycloh↗
PubMed1992

Antinociception produced by receptor selective opioids: modulation of spinal antinociceptive effects by supraspinal opioids.

The effect of intracerebroventricular administration of low-antinociceptive doses of selective mu- (DAMGO) or delta- (DPDPE) opioid agonists on the dose-dependent antinociceptive effects produced by intrathecal administration of sequentially increasing doses of selective mu-, delta-, or kappa-(U50,488H) opioid agonists was evaluated, in the rat, using the Randall-Selitto paw-withdrawal test. When DPDPE or U50,488H was administered intrathecally, the low doses of both intracerebroventricular DAMGO and intracerebroventricular DPDPE markedly enhanced the antinociceptive effects of both intrathecal opioids. In contrast, when DAMGO was administered intrathecally, both intracerebroventricular DAMGO and intracerebroventricular DPDPE, administered in low doses, markedly antagonized the antinociceptive effects of the intrathecal opioid. In addition, the intracerebroventricular administration of a low-antinociceptive dose of a second mu-opioid agonist, morphiceptin, antagonized the antinociceptive effects of intrathecal morphiceptin. The antagonism of the antinociceptive effects observed with spinal administration of DAMGO is dose-dependent, with the effect observed only at low doses. Furthermore, the antagonism cannot be explained by a reduction in motor deficits produced by intrathecal administration of DAMGO, because there were no differences in motor deficits, measured with an accelerating Rotarod treadmill, between intrathecal DAMGO administered as a single agent or as part of a combination regimen. The differences in antinociceptive effects obtained with the various supraspinal and spinal combinations are discussed in terms of the interactions that may occur between brainstem and spinal opioid receptor sites.

3,4-Dichloro-N-methyl-N-(2-(1-pyrrolidinyl)-cycloh↗
PubMed1992

Hypnotizability and recovery from cardiac surgery.

We studied 32 coronary bypass patients to examine the effect of hypnosis on recovery from surgery. The patients were assessed for hypnotizability with the Hypnotic Induction Profile (HIP) and assigned to experimental groups with a random stratification procedure to equate for differences in hypnotizability, age, and severity of illness. We taught patients in groups one and two formal hypnosis with different treatment strategies; patients in group three were not taught formal hypnosis or a treatment strategy. Scores on the HIP were significant predictors of recovery, independent of experimental treatment with formal hypnosis. Patients who scored "Midrange" stabilized more quickly in the intensive care unit (ICU) than those who scored "High" or "Low" (p = < .05). Patients who scored "High" had more labile blood pressure in the ICU compared to the "Midrange" and "Lows" (p = < .05). Measured hypnotizability was associated with the recovery sequence from surgery.

Coronary Artery Bypass↗
PubMed1992

Implementation of the American Pain Society Quality Assurance Standards for Relief of Acute Pain and Cancer Pain in oncology nursing practice.

Cancer pain represents a high-incidence problem that requires ongoing monitoring and evaluation. The recently published American Pain Society Quality Assurance Standards for Relief of Acute Pain and Cancer Pain provides an excellent basis for developing a quality assurance (QA) program in cancer pain assessment and management. These standards contain five critical areas for monitoring and evaluation related to cancer pain. The purpose of this article is to provide a useful framework for oncology nurses to develop a QA program in cancer pain assessment and management. The Oncology Nursing Society Position Paper on Cancer Pain and the American Nurses Association/Oncology Nursing Society Standards of Oncology Nursing Practice are incorporated into the framework to develop specific monitoring criteria. Practical suggestions are provided for implementing a QA program on cancer pain in a variety of oncology practice settings, using the standards of the American Pain Society.

Analgesics↗