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Biomedical subjects

F Gaston-Johansson

Publications and source records attributed to F Gaston-Johansson.

At least 19 recordsLinked to original sources
PubMed2000

The effectiveness of the comprehensive coping strategy program on clinical outcomes in breast cancer autologous bone marrow transplantation.

Patients with breast cancer who undergo autologous bone marrow/peripheral blood stem cell transplantation (ABMT) cope not only with a life-threatening medical treatment, but also with multiple, interrelated symptoms including pain, fatigue, psychological distress, and nausea. The purpose of this study was to determine, in a randomized controlled clinical trial, whether a comprehensive coping strategy program (CCSP) was effective in significantly reducing pain, fatigue, psychological distress, and nausea in patients with breast cancer who underwent ABMT. The CCSP was composed of preparatory information, cognitive restructuring, and relaxation with guided imagery. Randomization placed 52 patients in the CCSP treatment group and 58 patients in the control group. The CCSP was found to be effective in significantly reducing nausea as well as nausea combined with fatigue 7 days after the ABMT when the side effects of treatment were most severe. These results are important given the high incidence of nausea and fatigue in the ABMT population. The CCSP-treated group experienced mild anxiety as compared with the control group who reported moderate anxiety. The greatest effectiveness of CCSP may correspond to the time of the greatest morbidity for patients with breast cancer who have undergone ABM.

Adaptation, Psychological↗
PubMed1999

Pain, coping and analgesic medication usage in rheumatoid arthritis patients.

The major purposes of this study were to describe pain characteristics and coping strategies used in rheumatoid arthritis (RA) patients. Further purposes were to examine relationships among pain, coping and analgesic medication intake. Sixty-eight consecutively sampled subjects with RA participated in the study. The Pain-O-Meter was used to evaluate pain intensity and quality, and the Coping Strategies Questionnaire (CSQ) to determine coping strategies. The results showed that the patients with RA scored more intense sensory than affective pain although they used more affective pain descriptors. The sensory and total pain components were related to coping self-statements and increased pain activities. There were significant relationships between analgesic medication intake and all coping strategies used in the RA patients. The findings' implication for education and treatment are discussed.

Adaptation, Psychological↗
PubMed1999

Pain, psychological distress, health status, and coping in patients with breast cancer scheduled for autotransplantation.

PURPOSE/OBJECTIVES: To describe pain, psychological distress, health status, and coping that patients with breast cancer who were scheduled for autotransplantation experienced; the strength and direction of relationships among pain, psychological distress, health status, and coping; and the percentage of variance within the concept of health status that age, pain, psychological distress, and coping. DESIGN: Descriptive, correlational. SETTING: An urban, National Cancer Institute-designated comprehensive cancer center located in the eastern United States. SAMPLE: A convenience sample of 83 female patients with breast cancer scheduled for autotransplantation. The population age ranged from 22-59 years (X = 44.47 years) and was comprised of 72 (88%) Caucasians, 6 (7%) African Americans, and 4 (5%) from other minorities. METHODS: An oncology clinical nurse specialist in the outpatient medical oncology clinic collected the data during a regularly scheduled visit approximately 20 days prehospitalization for high-dose chemotherapy and autotransplantation. Data were collected using a demographic data from and self-report instruments (Gaston-Johansson Painometer, State-Trait Anxiety Inventory, Beck Depression Inventory, Medical Outcomes Study Short-Form General Health Survey, and Coping Strategies Questionnaire). MAIN RESEARCH VARIABLES: Pain, psychological distress, health status, and coping. FINDINGS: Although the subjects experienced low pain intensity, the range of reported pain intensity ratings was wide. Pain locations varied but were reported mainly in the vagina, chest, shoulder, and arm. Although subjects reported primarily mild depression and mild state anxiety, the range of depression and state anxiety scores was wide. Coping strategies used most frequently to deal with pain included positive coping statements, diverting attention, praying and hoping, increasing activity level, and ability to control and decrease pain. Subjects reported moderate total health status and low role functioning. Moderate, positive correlations were seen between state anxiety and depression and physical functioning and role functioning. Sixty-five percent of the variance in health status was explained by sensory pain depression, and catastrophizing. CONCLUSIONS: Patients with breast cancer who are scheduled for autotransplantation may experience pain, psychological distress, and alterations in coping and perceived health status. Total pain intensity, sensory pain, depression, and catastrophizing appear to be important variables related to the patient's perceived health status. IMPLICATIONS FOR NURSING PRACTICE: Oncology nurses need to include assessment of pain, psychological distress, health status, and coping in their routine patient assessment prior to autotransplantation to provide appropriate care and make necessary multidisciplinary referrals. Future nursing research should be directed toward the implementation and evaluation of interventions that promote the use of comprehensive coping strategies to decrease pain, anxiety, and depression.

Adaptation, Psychological↗
PubMed1998

Adolescents' perceptions of pain during labor.

This descriptive study systematically described the quality and intensity of adolescents' pain during the progression of labor. The Gaston-Johansson Pain-o-Meter was administered to 33 adolescents during the three labor phases (2-4 cm, 5-7 cm, and 8-10 cm) following a contraction. The most frequently selected sensory words were cramping in Phase I and pressing in Phases II and III. Miserable and killing were the most commonly chosen affective words during the three labor phases. Using the Gaston-Johansson Pain-O-Meter and the Gaston-Johansson Pain-O-Meter Visual Analogue Scale, the total pain intensity scores were highest during phase III of labor and delivery. At-test of independent samples found that quality and intensity pain scores for primiparous and multiparous adolescent participants were not significantly different during the progression of labor. The findings of the study illustrate the value of using objective measures, such as the Gaston-Johansson Pain-O-Meter and the Gaston-Johansson Pain-O-Meter Visual Analogue Scale, to assess pain during labor. The study also demonstrated that nurses can use these tools with minimal training.

Adolescent↗
PubMed1996

An assessment of pain and return to normal activity. Laparoscopic herniorrhaphy vs open tension-free Lichtenstein repair.

BACKGROUND: Laparoscopic herniorrhaphy is controversial and deserves critical evaluation. METHODS: In a randomized prospective study transabdominal preperitoneal laparoscopic herniorrhaphy (n = 24) was compared in patients to the tension-free Lichtenstein repair (n = 29) utilizing validated and reliable pain and activity assessment tools. The Sickness Impact Profile (SIP) was used to compare preoperative normal activity to postoperative activity. A Pain-O-Meter (visual analogue scale plus affective and sensory pain descriptors) assessed intensity of pain. The total pain assessment score and SIP were compared across time (postoperative day 1-42). Analgesic medication was used as a covariate. RESULTS: The total pain score was less for laparoscopic herniorrhaphy but this did not reach statistical significance. Similarly, the SIP showed modest improvement for laparoscopic herniorrhaphy. No differences between groups were noted for morphine equivalents of administered analgesics or length of hospitalization. CONCLUSION: Further investigation of laparoscopic herniorrhaphy is warranted.

Adult↗
PubMed1996

Pain intensity and health locus of control: a comparison of patients with fibromyalgia syndrome and rheumatoid arthritis.

The major purpose of this study was to determine if 31 patients with fibromyalgia syndrome (FS) reported different pain intensity and Health Locus of Control (HLC) scores than 30 patients with rheumatoid arthritis (RA). Another purpose was to determine the relationship among experienced actual pain (present, usual, worse, least), recalled prior episodes of pain (worse toothache, headache, and stomach ache), HLC orientation, age and the duration of the actual pain. Visual Analogue Scales were used to measure pain intensity. The Health Locus of Control Scale was used to determine external/internal orientation. The results showed that the FS patients reported significantly more intense actual pain, recalled pain for worse toothache and headache, and were more externally oriented than the RA patients. Present pain intensity was significantly correlated to actual intensity ratings, but not to reported earlier experienced pain, except for worse stomach ache in the RA group. The findings' implications for treatment and education are discussed.

Adult↗
PubMed1996

Measurement of pain: the psychometric properties of the Pain-O-Meter, a simple, inexpensive pain assessment tool that could change health care practices.

A self-administered pain assessment tool called the Pain-O-Meter (POM) was developed for the purposes of improving assessment and management of pain in acute and chronic pain patients. The POM is a hard, white, plastic tool that measures 8-in. long by 2-in. wide and 1-in. thick. Two methods for assessing pain are located on the POM. The first is a 10-cm visual analogue scale (POM-VAS) with a moveable marker that patients use to rate their pain. The second is a list of 15 sensory and 11 affective word descriptors (WDS). Each WDS is assigned an intensity value that can be as low as 1 or as high as 5. A pain intensity score is provided for the sensory and the affective WDSs. This psychometric study, which employed correlational and comparative designs, investigated the test-retest reliability and the concurrent and construct validity of the POM-VAS and the POM-WDS in 279 patients with acute or chronic pain. High correlations were found between initial and repeat pain intensity ratings on the POM-VAS (r = 0.88, P < 0.001) and POM-WDS (r + 0.84, P < 0.001) (test-retest reliability). Correlations between the POM-WDS and the McGill Pain Questionnaire (MPQ) (r = 0.69, P < 0.001) and POM-VAS (r = 0.85, P < 0.001) supported the concurrent validity of the POM-WDS. Construct validity was also supported for the Pain-O-Meter by showing that pain scores decreased significantly for POM-WDS (t + 5.53, P < 0.001), and POM-VAS (t = 6.18, P < 0.001) after the patients were treated with pain medication. The use of a pain tool, such as the POM, could improve patient care by facilitating the documentation of pain and evaluation of pain relief measures.

Cost Control↗
PubMed1996

Psychological variables and cancer pain.

Pain can cause both physical and psychological distress that has a negative impact on a patient's quality of life. The purpose of this descriptive study was to determine whether cancer patients (N = 60) with pain (n = 30) had higher scores of depression, anxiety, somatization, and hostility than did cancer patients without pain (n = 30). The study was conducted in a midwestern medical center hospital during a 9-month period. Psychological variables were measured using subscales of the Brief Symptom Inventory (BSI). Patients who reported pain completed the McGill Pain Questionnaire (MPQ) and Visual Analogue Scale. Significant positive correlations were found between total MPQ scores and all four subscales of the BSI (r = 0.60-0.78, p < 0.05). Patients with pain scored higher on all four subscales of the BSI, with significant differences occurring in somatization (t = 2.05, p < 0.05) and hostility (t = 1.93, p < 0.05). The findings suggest a relationship between pain intensity and psychological status. Nursing interventions aimed at reducing these factors may help to decrease the pain, in addition to then decreasing the psychological distress experienced by patients with cancer.

Adult↗
PubMed1996

Psychological correlates of quality of life across the autologous bone marrow transplant experience.

A convenient sample of 24 patients was used to examine psychological response and quality of life (QOL) of patients undergoing autologous bone marrow transplantation (ABMT). The relationships among anxiety, depression, and quality also were examined. The study had a descriptive, correlational design. Instruments used to collect data were the Quality of Life Index (QLI), the Becks Depression Inventory, and the Spielberger State-Trait Anxiety Inventory. Data were collected 2 weeks before the patient's hospitalization for ABMT (baseline), 2 days before ABMT, and 5 and 20 days after ABMT. QOL and anxiety improved slightly after ABMT. Patients were significantly more depressed before ABMT (p < 0.05) than afterward. Analysis of QOL showed that health and functioning had the most negative impact on QOL, whereas family had the most positive impact on QOL. A strong negative relationship was found between depression and QOL (r = 0.79).

Adult↗
PubMed1996

Burden and health outcomes of family caregivers of hospitalized bone marrow transplant patients.

Twenty-four family caregivers of bone marrow transplant (BMT) patients were interviewed to describe the burden of care and health outcomes (anxiety, depression, symptom distress and fatigue). A descriptive correlational research design with repeated measures was used. Data were collected in a conference room in the oncology unit of a midwestern university hospital using a battery of questionnaires. Questionnaires were administered pre-BMT (prior to the patient's hospitalization) and 5 and 20 days post-BMT. Objective burden remained at a similar level throughout the study (mean range 31.4 to 32.9), whereas subjective burden was highest pre-BMT (mean range 25.3-21.7). Significant correlations were found between objective burden and all health outcomes (P < 0.01 to P < 0.001) on day 5. Symptom distress was significantly correlated to subjective burden pre-BMT and to both types of burden on days 5 and 20. Results of this study suggest that family caregivers of BMT patients may experience more objective burden than subjective burden, and that burden of care may contribute to negative health outcomes, especially on day 5 post-BMT. Interventions designed to reduce sources of caregiver burden and negative health outcomes should be planned according to critical time periods of the BMT patient's hospitalization.

Adult↗
PubMed1995

The importance of nursing research design and methods in cancer pain management. Enhancing care.

Cancer is diagnosed currently in more than 1 million Americans every year and cancer pain is experienced by patients in all stages of the disease. Even though research indicates that optimal pharmacologic management alone can provide adequate relief for 70% to 90% of these patients, and additional relief can be obtained from nonpharmacologic interventions, the problem of pain continues to exist. This article focuses on the contributions of nurse scientists to the study of cancer pain during the last 5 years. Selected contributions of nursing research designs and methods to the understanding of pain caused by cancer and cancer treatment modalities are reviewed. Limitations of present methodologic approaches to the study of cancer pain and gaps in nursing knowledge are examined. Recommendations for future nursing research designs and methods used to study nursing management of cancer pain and the implications of projected future treatment modalities also are discussed.

Humans↗
PubMed1991

Myocardial infarction pain: systematic description and analysis.

The aim of the study was to describe various components of pain in suspected acute myocardial infarction (MI). Ninety-four patients admitted to a Coronary Care Unit (CCU) complaining of chest pain with the preliminary diagnosis suspect MI were included in the study. Thirty-eight subjects were eventually diagnosed as having MI and 56 subjects as non-MI. A comparison of chest pain description was performed between MI and non-MI subjects. The Pain-o-meter (POM) and the Visual Analogue Scale (VAS) were used to assess pain intensity. MI patients reported more intense sensory and affective pain than non-MI patients. MI patients also reported more intense affective pain than sensory pain, whereas non-MI patients reported just the opposite. The number of affective words chosen by MI patients differentiated them more clearly from non-MI patients than any other factor in the pain description. Pain intensity was significantly correlated to the estimated size of the infarct.

Angina Pectoris↗
PubMed1990

A comparative study of feelings, attitudes and behaviors of patients with fibromyalgia and rheumatoid arthritis.

The purpose of this explorative study was to administer a battery of questionnaires related to a broad number of psychosocial factors in patients with fibromyalgia syndrome (FS). By doing this, psychological factors associated with the consequences of chronic pain in patients with FS could be identified and studied in more depth. Thirty-one patients with FS were compared to 30 patients with rheumatoid arthritis (RA) with regard to feelings about self, pain/ache preoccupation, support from significant others, psychosomatic symptoms, activities of daily living, job satisfaction, and future expectations. The results of the study showed that patients with FS had significantly more negative feelings toward themselves, were more preoccupied with thinking about their pain/ache, received more practical help from significant others, experienced more limitations with regard to activities of daily living, and experienced more negative feelings about employment than patients with RA. Patients with FS were also more pessimistic about future employment than RA patients.

Activities of Daily Living↗
PubMed1990

Pain description by nurses and physicians.

The purpose of this study was to determine if nurses and physicians selected similar words to describe painlike experiences and to determine how they rated terms commonly used to describe pain. Thirty-seven registered nurses and 21 physicians comprised the sample. The Visual Analogue Scale (VAS) was used to measure the terms ache, hurt, and pain. The McGill Pain Questionnaire (MPQ) provided a list of word descriptors from which the subjects selected words that best represented the terms ache, hurt, and pain. There was no significant differences between the nurses and physicians in the mean rating of any of the pain terms on the VAS. The nurses and physicians chose very similar word descriptors from the MPQ to discriminate one pain term from another. These findings suggest that nurses and physicians may have a common understanding of the language used to describe painlike experiences.

Adult↗
PubMed1990

Similarities in pain descriptions of four different ethnic-culture groups.

The purpose of this study was to identify pain terms commonly used by Hispanics, American Indians, blacks, and whites to describe painlike experiences. Subjects were asked to rate the intensity of the terms pain, ache, and hurt on a Visual Analogue Scale. Following this procedure, they were given three separate copies of the McGill Pain Questionnaire and asked to choose the words that represented pain, ache, and hurt, respectively. The results showed that all cultural groups rated pain as the most intense terms, followed by hurt; ache was rated least intense. There was a significant difference between the intensity level of the three terms (p less than 0.001). Word descriptors that distinguished pain from ache and hurt are presented. The importance of these findings for clinical practice is discussed.

Black or African American↗
PubMed1990

Do primiparas and multiparas have realistic expectations of labor.

Expectations of labor and childbirth can affect the degree of in-labor pain or discomfort experienced by the mother. By ascertaining whether expectations of labor experience are realistic or not, women can be prepared during the antenatal period to cope better with labor pain. The purposes of this prospective study were to 1) determine if pregnant women had realistic expectations of the labor experience, 2) determine if women who expected to have more pain during labor actually experienced more pain, than those not expecting to experience so much pain, and 3) determine if attending midwives assessed in-labor pain as intense as the mothers did. Fifty primiparas, 88 multiparas, and 12 full-time employed midwives participated in the study. The Visual Analogue Scale (VAS) was used to rate the expected and actual in-labor experience. A 3-point rating scale was used by the midwives to rate in-labor pain. Neither primiparas nor multiparas were found to have realistic expectations of the labor experience. Mothers experienced more pain and discomfort than expected, and the multiparas anticipated their need for medication to be greater than what was actually needed. The mothers reported that they felt less lonely and received more support from personnel during labor than they had expected. Multiparas who expected to experience more pain reported more pain than those expecting to experience less pain in stages I and III of labor. There was no significant correlation between midwives' and mothers' rating of the intensity of in-labor pain during stage III of labor.

Adult↗