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Biomedical subjects

Debra E Lyon

Publications and source records attributed to Debra E Lyon.

6 recordsLinked to original sources

Symptom clusters and quality of life in survivors of lung cancer.

PURPOSE/OBJECTIVES: To explore the prevalence and intensity of depression, fatigue, and pain in survivors of lung cancer; to examine the relationship of symptoms in a cluster; and to examine the relationship of the symptom cluster to quality of life (QOL). DESIGN: Secondary data analysis. SETTING: Online lung cancer support group. SAMPLE: 51 patients diagnosed with lung cancer. METHODS: Mailed survey with self-report of depression, fatigue, and pain measured by subscales of the Short-Form 36 Health Status Survey and QOL measured by the Fox Simple QOL Scale. Pearson's correlation and multiple regression analyses were used to examine the possible symptom cluster. MAIN RESEARCH VARIABLES: Depression, fatigue, pain, and QOL. FINDINGS: Depression, fatigue, and pain were found in a majority of survivors, with pain being the least common symptom. Fatigue was the most intense of the three symptoms. Two significantly correlated symptoms were depression and fatigue. The cluster explained 29% (p less than 0.01) of the variance in QOL in the lung cancer survivors. CONCLUSIONS: The data provided preliminary support for the presence of a symptom cluster in patients with lung cancer consisting of depression and fatigue. The cluster had a negative relationship with QOL. Survivors of lung cancer have depression and fatigue that affect QOL. IMPLICATIONS FOR NURSING: Healthcare providers must assess the potential for symptoms to cluster, adversely affecting key patient outcomes such as QOL. Through increased knowledge of symptom clusters, clinicians will be able to more effectively target the most distressing set of symptoms for intervention.

Adult↗

Hormonal breast cancer agents: implications for the primary care provider.

PURPOSE: Over 2 million breast cancer survivors are in the United States, making women with breast cancer the largest group of cancer survivors. The purpose of this article is to review the current knowledge regarding survivorship issues in women with early-stage, estrogen receptor-positive breast cancer, focusing on advances in hormonal therapies for reducing risk of recurrence. DATA SOURCES: Published research studies, clinical treatment guidelines, and ongoing clinical trials. CONCLUSIONS: Innovations in antiestrogenic and estrogen modulator therapies are an important aspect of ongoing care after primary breast cancer treatment. Primary care providers may play an important role in monitoring potential complications of antiestrogenic treatment. IMPLICATIONS FOR PRACTICE: This article reviews the current state of the science in hormonal breast cancer agents for breast cancer survivors. With the high incidence and prevalence of breast cancer, primary care providers need to be aware of the potential short- and long-term health risks and benefits of hormonal therapies for breast cancer survivors.

Antineoplastic Agents, Hormonal↗

Development and preliminary evaluation of the existential meaning scale.

PURPOSE: The aim of this study was to develop and examine the psychometric properties of the Existential Meaning Scale (EMS). FINDINGS: Construct validity of the EMS was examined through factor analysis and correlational analyses with theoretically related instruments. After several weak items were deleted, the 20-item scale had a Cronbach's alpha coefficient of > .80 in an overall sample of 418 individuals. Scores on the EMS were significantly lower in a sample of persons with HIV-1 infection than in the general population samples. CONCLUSION: Although its initial psychometric properties were satisfactory, additional validation of the EMS is necessary in other clinical populations to examine further the psychometric properties of the EMS. In addition, further examination of the responsiveness of the EMS over time is needed to evaluate its potential utility in longitudinal trials.

Adult↗

Incorporating patients' perspectives in complementary and alternative medicine clinical trial design.

OBJECTIVES: To describe the importance and process of gathering the perspectives of former patients when designing clinical studies for complementary and alternative medicine (CAM) therapies and to describe how this information was used to guide the planning of a clinical study using complementary modalities to reduce symptom distress and enhance quality of life during the autologous stem cell transplantation (ASCT) process. DESIGN: Structured interviews with former ASCT patients to identify preferences, opinions, and other issues that may affect a clinical study in this population. SETTING: University of Virginia Health System Stem Cell Transplant Clinic. SUBJECTS: Ten (10) patients who had undergone ASCT within the previous year. RESULTS: In general, the 10 study participants interviewed reported that they would have been more receptive to receiving gentle Swedish massage than using guided imagery tapes during the ASCT process, although neither modality would have been particularly welcome during those treatment phases with highest physical or emotional/mental stress. Personal experiences, treatment side-effects, "personality," and life situation all had an influence on not only what was considered most stressful for the patient but also why it was perceived as stressful. CONCLUSION: Eliciting the views of persons who have undergone significant medical events is a necessary step in rigorous clinical trial development aimed at testing the efficacy of CAM modalities for symptom management. Consideration of patient preferences and motivations may ensure the best fit between interventions and the desired outcomes.

Attitude to Health↗

Using an interview guide to assess suicidal ideation.

More than 50% of Americans who commit suicide have seen their primary care provider in the weeks before their suicide. As primary care providers, we may miss opportunities to assess for suicidal ideation. Here, we present an interview guide that helps assess suicidal ideation in primary care patients.

Major Depressive Disorder↗

Coronary heart disease risks and lifestyle behaviors in persons with HIV infection.

Metabolic complications such as HIV-associated lipodystrophy syndrome are common in patients with HIV-1 infection who are taking highly active antiretroviral therapy. HIV-associated lipodystrophy syndrome is characterized by dyslipidemia, fat redistribution, and altered glucose metabolism; however, there has been little study of relationships between these risk factors for coronary heart disease (CHD) and lifestyle risks. The aims of this study were to (a) describe the physical activity levels, nutrition habits, and smoking behaviors of persons with HIV-1 infection; (b) describe their CHD risks and estimate 10-year risk for CHD outcomes; and (c) examine the relationship between potentially modifiable lifestyle behaviors and risk factors for atherosclerotic cardiovascular disease in persons with HIV-1 infection receiving highly active antiretroviral therapy. Variables included lipid profile and other metabolic indices, body fat distribution, body mass index, blood pressure, and lifestyle behaviors (physical activity, dietary habits, smoking). A cross-sectional design and convenience sampling (n = 95) was used. Participants had multiple modifiable risk factors: 20% had a 10-year risk of 10% or higher of developing CHD. Results underscore the need for health promotion interventions to target lifestyle risks in persons with HIV-1 infection taking highly active retroviral therapy.

Adult↗