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Biomedical subjects

Christine Toye

Publications and source records attributed to Christine Toye.

8 recordsLinked to original sources
PubMed2006

Would people with Parkinson's disease benefit from palliative care?

Parkinson's disease (PD) is a chronic, progressive, degenerative disorder of the nervous system, causing substantial morbidity and has the capacity to shorten life. People with PD and their families can find the disease devastating. Nevertheless, this population of patients is not usually considered a group to be supported by palliative care specialists. But the nature of the illness and the challenges of managing its many physical and psychological effects raises questions about the potential benefits of a palliative care approach. The purpose of this project was to describe the experience of PD and consider the relevance of palliative care for this population. Semi-structured interviews were conducted with eight people with PD, 21 family caregivers and six health professionals. Five themes were developed from the data analysis: (1) emotional impact of diagnosis; (2) staying connected; (3) enduring financial hardship; (4) managing physical challenges; and (5) finding help for advanced stages. These data revealed that people with PD and family caregivers are confronted with similar issues to people with typical palliative care diagnoses, such as advanced cancer, and that a palliative approach may be helpful in the care of people with PD and their families.

Adaptation, Psychological↗
PubMed2006

Fatigue in frail elderly people.

Many frail older people are likely to suffer from fatigue, but tools to measure fatigue in this population are lacking. Stage one of this study explored and described the experiences of fatigue of 12 older people from Australian residential aged care facilities. Themes identified were pacing yourself, battling on, hitting rock bottom, feeling safe, and moving on. Findings indicated that, with support, frail elders may be able to manage fatigue effects themselves. A measure of fatigue was developed from stage one findings, with reference to the literature. In stage two of the study, the Frail Elder Fatigue Assessment Tool was subjected to panel review, piloting, and refinement. The refined tool comprises 20 items in three subscales: fatigue effects; fatigue resources; and adaptation to fatigue. Further work is required to establish the tool's psychometric properties, but it should then be useful for both research and clinical assessment purposes.

Activities of Daily Living↗
PubMed2005

Measuring symptom distress among frail elders capable of providing self reports.

This study aimed to develop a valid and reliable method of measuring symptom distress in frail elderly people capable of providing self reports. We tested a tool used in palliative care settings with 46 elders in residential aged care, refined the tool, and tested the new version with 48 additional elders. Items assessed the prevalence and severity of distress attributed to nausea; pain; insomnia; fatigue; and breathing, bowel and appetite problems in the first phase, and pain; insomnia; fatigue; and breathing, bowel, and bladder problems in the second phase. Participants rated symptom distress on a 10-point scale over 5 days. Internal consistency reliability coefficients for the revised tool ranged from 0.50 to 0.64. Concurrent validity with an established measure of well-being was demonstrated. Further research will assess stability. The tool provides a valid overview of symptom distress in frail aged people able to provide self reports.

Aged↗
PubMed2004

Psychometric testing and refinement of the Support Needs Inventory for Parents of Asthmatic Children.

This study refined the Support Needs Inventory for Parents of Asthmatic Children (SNIPAC) (Coleman, Maltby, Kristjanson, & Robinson, 2001) to produce a more parsimonious tool to assess the importance and meet the support needs of parents of children with asthma. The original tool was completed by 145 parents of 199 children with asthma, and 74 of these also provided test-retest responses. Internal consistency reliability, construct validity, and stability over time were assessed and refinements were made. Internal consistency reliability of the revised 20-item tool ranged from .77 to .95 for the three subscales of the Parent's Priority Scale (PPS), and .92 for the full PPS. Cronbach's alphas ranged from .74 to .90 for the three subscales of the Parent's Fulfillment Scale (PFS) and was .91 for the full scale. Factor analysis results of the PPS were compatible with the tool's conceptual framework. The revised 20-item tool demonstrated adequate psychometric properties in most areas. This tool may be used for research or clinical screening without imposing undue burden on parents. Further work is required to establish the tool's stability over time.

Adolescent↗
PubMed2003

New dimensions in palliative care: a palliative approach to neurodegenerative diseases and final illness in older people.

A palliative care approach has much to offer people in the advanced stages of neurodegenerative diseases, as well as elderly people dying from diseases other than cancer. Palliative care can be part of the treatment repertoire of any health worker, supported by intermittent consultation or referral to specialist palliative care services (eg, for management of neuropathic pain). A palliative care approach encourages a focus on pain and symptom management, and prompts more open communication about end-of-life issues. This approach recruits as necessary the expertise of specialists and multidisciplinary teams to encourage a flexible, responsive service. Home carers and healthcare providers require education to ensure a palliative approach that meets the physical, psychological, spiritual and social challenges facing patients and their families, and enhances dignity and quality of life.

Aged↗
PubMed2003

Evaluating the Navigate Care Model: clinical palliative care pathways based on anticipated care outcomes.

The Navigate Care Model (NCM) specifies clinical pathway assignments for hospice patients based on the anticipated outcomes of death, discharge home, or discharge into residential care. This study, set in a freestanding, inpatient hospice, evaluated the effects of NCM implementation on 338 patients, 154 family members and the organization, including 49 staff. Accuracy of pathway assignment on admission was also assessed. The results indicate that patients' symptoms were managed as well or better than previously, as compared with 1998 data. Discharged patients reported being highly satisfied with care and there were fewer readmissions. Families reported greater satisfaction with care than those surveyed previously, as compared with 1999 data. Staff reported initial negative effects but elected to retain a refined version of the model after the study. Pathway assignments on admission were correct 64% of the time, 92% correct when assignment was for terminal care. Clinical pathways based upon the expected outcomes of death or discharge appear to offer benefits for patients and families.

Adult↗
PubMed2003

Ensuring content validity in instrument development: challenges and innovative approaches.

The challenges of developing new and valid instruments specific for use in nursing research and practice can be complex and varied. In this paper we identify a number of innovative approaches for achieving content validity based on our instrument development work. These approaches include ways of identifying the conceptual domain, the role of literature reviews and key experts, processes used to confirm content validity and clarity of content, feasibility of the validity process and exploration of pertinent ethical issues. The review of key issues covered here may provide guidance for nurses and researchers in developing sound and content valid instruments.

Ethics, Nursing↗