Biomedical subjects

H Wagenaar

Publications and source records attributed to H Wagenaar.

5 recordsLinked to original sources

PubMed2001

The impact and management of cancer-related fatigue on patients and families.

Fatigue has been identified as both a chronic and recurrent problem for individuals diagnosed with and treated for cancer, yet there is little information on how to manage the impact of fatigue. Describing what happens to individuals and their families as a result of fatigue and identifying what individuals do to manage or reduce the impact of fatigue are essential elements in determining multidimensional nursing interventions. The purpose of this pilot study was to examine the impact of fatigue on individuals with cancer of the lung and their families, and explore how they managed as a result of the fatigue. A semi-structured interview guide was used with 22 lung cancer patients and 14 family members six weeks post completion of radiation therapy. Results indicated that fatigue was not reported as a major concern by many of the participants in this study. For those who did experience fatigue, it was considered an inconvenience and a frustration that had to be dealt with for a limited time period. Some patients appeared to gradually adjust and accommodate to the fatigue and were not really aware of the changes that took place over time. Over half of the family members felt more of the impact of fatigue than did their loved ones. Family subtly assumed or took over responsibilities and activities the patient could no longer perform. The symptom of fatigue has been well documented in the cancer experience as both a chronic and recurrent problem for individuals diagnosed with and treated for cancer. The emphasis of previous work has been on deriving a conceptual definition of fatigue, achieving consensus on a definition, and developing theoretical frameworks to guide further study of this complex construct. Fatigue has been conceptualized as a multidimensional phenomenon, attributable to multiple causes and having a negative effect on quality of life (Piper, 1993; Tiesinga, Dasson, & Halfens, 1996). Describing what happens to individuals and their families as a result of fatigue and identifying what individuals do to manage or reduce the effects caused by the fatigue are essential elements in determining multidimensional nursing interventions.

Adaptation, Psychological↗

PubMed1996

Using health status measures with the seriously mentally ill in health services research.

Changes in the delivery of mental health care have prompted interest in using generic health status measures to test the effect of system change on those receiving treatment. Of special concern are those with serious and persistent mental illness who may be neglected when cost containment efforts reduce the availability of treatment services. This population may be affected by these changes, which might go undetected if investigators use scales that measure only pathology and not the full spectrum of well-being. The purpose of this study was to test the feasibility of using self-report health status measures with this population, to describe the psychometric properties of the scales, and to report the health status scores of a random sample of the Medicaid psychiatrically disabled population. We found that the four health status scales had adequate psychometric properties, that score variability was high, the distributions normal, and that patterns of association with more traditional clinical measures were of the expected size and direction. One scale, General Health Perceptions, had reliability and item-to-score correlation below acceptable levels.

Adult↗

PubMed1994

Evaluating mental health care reform: including the clinician, client, and family perspective.

This article suggests one direction that theory building might take to develop a stronger conceptual foundation needed to test the effect on clients of reforms in the financing and organization of mental health care delivery systems. The authors recommend that health status outcomes be measured from three perspectives: the client, who can best report his or her own subjective experience of illness; the clinician, who is the best source of information about the client's disease; and the family, which is the best source of information about the effects on members' health status of caring for a mentally ill family member. The authors also recommend that measurement of health status should be multidimensional.

Attitude of Health Personnel↗

PubMed1991

Dutch library services to disadvantaged persons.

Hospital libraries in the Netherlands provide a variety of services. In this paper two well-equipped hospital libraries, staffed by professionally qualified librarians, are described. Some hospital libraries rely on volunteers, supervised by professional librarians, while in others volunteers work completely on their own. Special services for elderly people are focused on persons who cannot visit the library by themselves. These services vary from visiting house-bound people to placing a small library in residential homes. Of special interest is the library work for aphasics in the Netherlands. The Section of Library Work for the Elderly, Sick and Handicapped Persons, a section of the Dutch Centre for Public Libraries and Literature (NBLC) is described.

Aged↗

PubMed1989

Ironies of inclusion: social class and deinstitutionalization.

This paper discusses changes in the social organization of mental institutionalization as they relate to developments in the wider social and economic environment. Despite dramatic changes in the system of inpatient psychiatric care during the last three decades, the historic division of labor between the private and the public system (with the latter treating the poor, the unemployed, and the nonwhite) has not ceased to exist. At the same time, under the influence of the postwar trend towards greater political integration of disadvantaged and marginal groups into society's central value systems, treatment of the mentally ill has become less segregated and more voluntary. An important implication of these two interacting trends--the changed legal position of the patient vis-à-vis the provider and the deteriorating economic position of the user of public psychiatric facilities--has been the exceeding irrelevance of one of the basic tenets of psychiatric care: that clinical treatment precedes social functioning. With two vignettes of chronic patients the article illustrates how symptoms and survival are fused in the contemporary, inclusionary system of care.

Adult↗