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Biomedical subjects

E L Lev

Publications and source records attributed to E L Lev.

At least 19 recordsLinked to original sources
PubMed2001

An intervention to increase quality of life and self-care self-efficacy and decrease symptoms in breast cancer patients.

This study tested effects of a nurse-administered self-efficacy intervention given on five monthly occasions and designed to enhance patients' self-care self-efficacy. The hypotheses were that at four months and eight months after beginning chemotherapy the efficacy-enhancing experimental group would have significantly higher scores on quality of life and self-care self-efficacy than the control group and significantly less symptom distress. Fifty-six women receiving chemotherapy for breast cancer were randomized to the experimental and control groups. Outcome variables were quality of life, measured by the Functional Assessment of Cancer Treatment-Breast (FACT-B), symptom distress, measured by the Symptom Distress Scale (SDS), and factors of self-care self-efficacy, measured by Strategies Used by Patients to Promote Health (SUPPH). The interaction effects for the FACT-B ranged from small for functional concerns (eta square = .03) to large for social concerns (eta square = .110); effects for the SDS were large (eta square = .140), and for factors on the SUPPH effect sizes ranged from small (eta square = .01) for Enjoying Life and Stress Reduction to medium (eta square = .089) for Coping, and large (eta square = .141) for Making Decisions. Interventions to promote self-efficacy may increase quality of life and decrease symptom distress for women diagnosed with breast cancer.

Adaptation, Psychological↗
PubMed2000

Insomnia, fatigue, anxiety, depression, and quality of life of cancer patients undergoing chemotherapy.

The purposes of this study were to examine: (a) the relationships between the symptoms of insomnia and fatigue and the psychological factors of anxiety and depression, and; (b) the relationships between these psychological and symptom variables and quality of life in cancer patients who were receiving chemotherapy. The Theory of Unpleasant Symptoms was the framework for the study. A descriptive correlational design was used in a secondary analysis of data obtained from a sample of 263 cancer patients who were undergoing chemotherapy. Insomnia, fatigue, depression, and anxiety were positively correlated with one another (r = .26 to r = .69, p < .001) and negatively correlated with quality of life (r = -.28 to r = -.63, p < .001). Women had more anxiety and fatigue and poorer quality of life than did men. Older age was associated with better quality of life and less insomnia, fatigue, anxiety, and depression. Multiple regression analysis revealed that the symptoms and psychological variables explained 47% of the variance in quality of life, with the largest proportion of the variance explained by depression. Fatigue and insomnia explained only 4% of the variance in quality of life in excess of that contributed by the psychological factors. Although overall depression levels were low in this sample, these findings suggest that insomnia and fatigue are related to depression and that depression is more closely associated with quality of life than are insomnia and fatigue.

Adult↗
PubMed1998

Loss, grief, and bereavement in family members of cancer patients.

OBJECTIVES: To review loss, grief, and bereavement related to family caregivers of cancer patients during illness and after death, and to review interventions to enhance survivors' recovery after the patient's death. DATA SOURCES: Review articles, research studies, book chapters, and data from authors' research. CONCLUSIONS: Loss and grief can lead to positive outcomes in survivors of patients who have died of cancer. Conversely, negative bereavement outcomes may put survivors at risk for illness and even death. IMPLICATIONS FOR NURSING PRACTICE: Nurses can provide interventions for family members that may positively influence physical health as well as recovery from bereavement. Outcomes research is needed to expand our understanding about how interventions affect survivors' recovery from bereavement.

Bereavement↗
PubMed1998

A prospective study of adjustment to hemodialysis.

OBJECTIVE: To examine (a) changes in subjects' self-care self-efficacy over time and (b) the relationship of subjects' self-care self-efficacy with adjustment to hemodialysis. DESIGN: A longitudinal design was used to study changes in self-care self-efficacy and associations between self-care self-efficacy and measures of adjustment: health status, mood distress, symptom distress, dialysis stress, and perceived adherence to fluid restriction. SAMPLE/SETTING: Subjects were recruited from 8 settings in the Northeast where outpatient hemodialysis treatment was administered. Sixty-four subjects were recruited to the study. Twenty-eight subjects completed 3 occasions of data collection. METHODS: Data were collected on three occasions: (a) baseline-within 100 days of beginning treatment; (b) 4 months after beginning treatment; and (c) 8 months after beginning treatment. Eta-squared, a measure of practical significance, is reported for four factors of the self-care self-efficacy measure on each of the three occasions. Associations between self-care self-efficacy and measures of adjustment were examined by means of Pearson correlations. RESULTS: Eta-squared estimates showed generally positive changes occurring over time in subjects' self-care self-efficacy, health status, mood distress, symptom distress, dialysis stress, and perceived adherence to fluid restriction. Changes were more positive at 4-months than at 8-months after enrollment. Significant correlations (p < .05) occurred between self-care self-efficacy and mood states, health status, symptom distress, and perceived adherence to fluid restrictions. Correlations occurred more frequently between self-care self-efficacy and mood states than between self-care self-efficacy and other measures of adjustment. CONCLUSIONS: The study provided pilot data suggesting that hemodialysis patients' self-care self-efficacy and measures of adjustment change over time. Patients who had increased confidence in self-care strategies (self-efficacy) were associated with having more positive mood states, health status, and perceived adherence to fluid restrictions and less symptom distress. Interventions designed to increase patients' self-care self-efficacy may yield positive results. Nurses are in an excellent position to give efficacy enhancing feedback that may promote patients' adjustment.

Adaptation, Psychological↗
PubMed1997

Bandura's theory of self-efficacy: applications to oncology.

Self-efficacy (Bandura, 1986) has been shown to impact on health practices as well as adaptation to illness and treatment. The purposes of this paper are to describe self-efficacy theory and review literature using self-efficacy theory to investigate prevention of cancer and adaptation to cancer. Measurement of self-efficacy is also discussed. Evidence from research examining applications of Bandura's theory of self-efficacy in oncology suggests relationships between self-efficacy and cancer prevention and self-efficacy and adaptation to cancer. Strong percepts of self-efficacy predict intention to quit smoking, increased participation in screening programs, and adjustment to cancer diagnosis. Increased self-efficacy is associated with increased adherence to treatment, increased self-care behaviors, and decreased physical and psychological symptoms. The advanced practice nurse is in an excellent position to give feedback that may help support patients' self-efficacy.

Adaptation, Psychological↗
PubMed1996

A measure of self-care self-efficacy.

Strategies Used by People to Promote Health (SUPPH), a 29-item self-report, is a measure of self-care self-efficacy. Items for the SUPPH were empirically generated, validated by an expert panel, and tested (N = 275) for psychometric properties, factor composition, and convergent and discriminant evidence with existing scales. Good initial psychometric properties were found for the SUPPH and four factors emerged: coping, stress reduction, making decisions, and enjoying life. These factors are consistent with the underlying self-efficacy theory upon which the scale is based.

Adaptation, Psychological↗
PubMed1995

Triangulation reveals theoretical linkages and outcomes in a nursing intervention study.

CNSs ROUTINELY GIVE psychosocial support to patients dealing with life-threatening illnesses. Yet few studies discuss theoretical aspects of psychosocial support. The purpose of this paper is to report results of a study using an efficacy-enhancing intervention given to 49 patients receiving chemotherapy for cancer. Analysis of qualitative data revealed (1) linkages of a supportive psychosocial intervention with the theoretical basis of the study and (2) outcomes not apparent in statistical analysis of the hypothesis-testing study. Interventions were based on Orem's self-care framework and Bandura's description of sources of efficacy expectations. Data triangulation to identify areas where previous findings had not revealed interpretations provided a different perspective on the same phenomena and led to revisions in further study. Implications for CNS practice and research are discussed.

Adult↗
PubMed1991

Dealing with loss: concerns of patients and families in a hospice setting.

Although considerable attention has been given to describing and evaluating the hospice concept from the perspective of caregivers, little research has focused on the perspective of patients and families. The purpose of this study was to describe concerns defined by subjects experiencing loss. Thirty-four interviews were tape recorded, transcribed, and entered into the program Ethnograph for analysis. Concerns of subjects focused on health, communication, religious and existential beliefs, environmental, and psychosocial concerns. Principal meanings of support included providing comfort and maintaining individuals' coping strategies. Narrative examples of key concepts are included. Subjects' reaction to the taping is described. Knowledge of the range of subjects' reactions to loss will facilitate caregivers' assessment of natural and maladaptive reactions, and the development of a valid and reliable instrument to measure the grief experience.

Family↗
PubMed1983

An activity therapy group with children in an in-patient psychiatric setting.

This article describes a short-term activity discussion therapy group for severely disturbed children in an inpatient psychiatric unit. Major themes of the sessions are reported as well as clinical vignettes that assist in clarifying techniques and demonstrating the efficacy of these techniques. Co-leaders include a resident psychiatrist, a nurse, and a mental health worker; supervision is provided by a social worker. The group described is on-going at the New York Hospital-Cornell Medical Center (Westchester Division) in the inpatient children's psychiatric unit. In summary, staff report that group members tolerate group activities better and exhibit more socially acceptable interactions.

Anger↗
PubMedDate not supplied

Age, self-efficacy, and change in patients' adjustment to cancer.

OBJECTIVES: The purpose of this secondary analysis was to investigate cancer patients' self-care self-efficacy and measures of adjustment over time, as well as the role of self-care self-efficacy with measures of adjustment. The primary study was a longitudinal study of cancer patients and family members' adjustments. MATERIALS AND METHODS: Three hundred seven cancer patients at all stages of cancer completed study instruments on one occasion; 181 completed the instruments 4 months later; and 124, 8 months later. Instruments included the Strategies Used by Patients to Promote Health (SUPPH) to measure self-care self-efficacy, the Functional Assessment of Cancer Treatment (FACT) to measure quality of life, the Profile of Mood States (POMS) to measure patients' mood disturbances, and the Symptom Distress Scale (SDS) to measure patients' concerns. RESULTS: Using analysis of variance, a series of one-way repeated measures used to investigate changes in cancer patients' self-care self-efficacy and measures of adjustment revealed significant decreases in patients' self-care self-efficacy (P = .01) and quality of life (P = .001) over time. Patients' symptoms and mood disturbances did not significantly change over time. The role of self-care self-efficacy with measures of adjustment was investigated using canonical correlations. For the predictor variables, subscores for coping and enjoying life on the SUPPH showed the strongest loadings, 0.83 and 0.94, respectively. On the dependent variables, the FACT was by far the most important variable, with a loading of 0.92. CONCLUSIONS: Results demonstrate that without intervention, cancer patients' measures of self-efficacy and adjustment decrease over time, and patients' self-efficacy influences their adjustment. Psychosocial interventions have been designed to increase self-efficacy and to enhance adjustment. Longitudinal study of efficacy-enhancing interventions is needed.

Adaptation, Psychological↗
PubMedDate not supplied

Psychoanalytic developmental ego psychology: a framework for advanced psychiatric nursing practice.

TOPIC: The use of psychoanalytic developmental ego psychology (PDEP) as a theoretical framework for understanding clinical material. METHODS: Thirty-four students in advanced practice psychiatric mental health nursing provided data for analysis. Interview data were organized into case studies and analyzed. FINDINGS: PDEP provides a framework that is suitable for education and practice of advanced psychiatric nurses. CONCLUSION: PDEP can provide a framework that is theory-derived, outcome oriented, and suitable for a variety of clients.

Adult↗
PubMedDate not supplied

Counseling women with breast cancer using principles developed by Albert Bandura.

PROBLEM: Although researchers suggest treatments that provide patients with an active coping strategy may increase patients' sense of self-efficacy, previous studies have not measured patients' self-efficacy. METHODS: Eighteen women receiving chemotherapy for breast cancer were randomized to efficacy-enhancing experimental (n = 10) and usual-care control (n = 8) groups. The experimental group received five interventions delivered monthly. Variables--quality of life, symptom distress, and self-care self-efficacy--were measured at baseline and at 4 and 8 months later. FINDINGS: At 4 and 8 months the interaction effects for the Functional Assessment of Cancer Treatment-Breast, used to measure quality of life, ranged from small for functional concerns to large for social concerns. Interaction effects for symptom distress, measured by the Symptom Distress Scale, were large. Interaction effects for self-care self-efficacy ranged from small for Enjoying Life and Stress Reduction, medium for Stress Reduction, and large for Making Decisions. CONCLUSIONS: Interventions to promote self-efficacy may increase quality of life and decrease distress for women diagnosed with breast cancer.

Adult↗