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Biomedical subjects

J Corner

Publications and source records attributed to J Corner.

35 records · Page 2Linked to original sources
PubMed1997

Inaugural lecture. Nursing and the counter culture for cancer.

The discourse surrounding cancer is that of warfare and of a militaristic endeavour aimed at helping those with the disease survive. The consequences of such a discourse have not previously been explored in detail; in particular the culture of the 'cancer clinic' has not been examined for how a battle mentality might effect the nature of care and treatment. This paper explores how the biomedical response to cancer and its treatment has established approaches which neglect the more day to day experiences of people living with the disease, and the suffering, disability and distress that it causes. A radical reconstruction of the culture surrounding cancer is called for, so that a new environment of care might be offered. This should be more participatory, collaborative and empowering of people with cancer and their families. It should also shift the dominant theme in cancer management from 'survival' to the here and now, and to the needs and problems people have. An argument is made for the contribution that nursing might make to such a reconstruction through developing new approaches to symptom and problem management, reorganising cancer services so that they are more supportive and patient focused, and through nursing research studies aimed at radically changing the process of research itself.

Attitude to Health↗
PubMed1997

Beyond survival rates and side effects: cancer nursing as therapy. The Robert Tiffany Lecture. 9th International Conference on Cancer Nursing, Brighton, UK, August 1996.

Survival rates and side effects have become the dominant constructs of cancer treatment and care, to the detriment of more supportive and patient-focused approaches. The concept of quality of life introduced to address this has failed to temper the language of oncology. Here an argument is made for the place of cancer nursing as a therapeutic enterprise in its own right, which warrants much greater recognition. Clear evidence for the therapeutic effects of cancer nursing intervention from a series of meta-analyses of cancer nursing interventions exists. Cancer nursing as therapy has the potential to operate on four levels and can effect radical change by reconstructing care, cancer services, and wider health care environments so that they are much more patient focused and offer nursing therapy as an integral part of care. These include fundamental knowledge or theory generation for therapeutic practice, therapeutic interventions for individuals or problems, developing and changing health systems or environments, or critique and reconstruction of care from a societal perspective. The features of cancer nursing as therapy can be identified and are described. Cancer nurses are encouraged to take up the challenge offered by the concept of therapeutic cancer nursing so that its potential for nurses, patients, and cancer services can be realised.

Humans↗
PubMed1996

Reducing naltrexone-resistant hyperphagia using laser acupuncture to increase endogenous opiates.

A 28-year-old woman with acquired brain damage suffered subsequent profound mental disability and an intense hyperphagic syndrome complete with life-threatening pica. She was the single subject of two consecutive experiments. In the first, Naltrexone, an orally administered opiate blocker, was given to reduce hyperphagia and distress, but was associated with even greater urgency when eating meals and a manifest increase in distress. While distress reduced to premedication levels on withdrawal of treatment, urgency of eating did not reduce so quickly. In the second experiment a laser acupuncture procedure was used at 2.5 Hz and 10 Hz for 10 days each with an intervening 10-day placebo condition to increase the availability of the subject's endogenous opiates, and thus hopefully produce opposite effects to the first experiment and effect a positive treatment. The 10 Hz condition produced a significant but transient reduction in pica measured by attempts at pica on a supervised walk shortly after each treatment. The subject was also easier to manage on walks, and appeared happier. Further studies using physical exercise or acupressure to achieve similar or better results are discussed.

Acupuncture Therapy↗
PubMed1996

Postgraduate research training: the PhD and MD thesis.

Higher research degrees, such as the PhD, MPhil and MD, have existed within universities for 80 years or more, although the differences between the MD and PhD remain confused. A higher research degree training provides individuals with greater research knowledge and skills, and benefits the specialty. Concern exists about the levels of supervision sometimes provided, failure to complete degrees, and the variable levels of research knowledge and skills attained. We propose that higher research degrees in palliative care have four functions: extending personal scholarship, generating knowledge, training for the individual and contributing to the growth of the specialty. Such an approach may include: a formalised first year with taught components such as in research MSc programmes, formal supervision and progress assessment. In palliative care, clinical and academic approaches need greater integration. Multiprofessional learning is essential. To allow individuals to undertake higher research degree programmes, fellowships or specific funding are needed.

Academic Dissertations as Topic↗
PubMed1996

Is there a research paradigm for palliative care?

The question of whether a coherent tradition in research and research methods (or paradigm) exists in palliative care is explored in this paper through an examination of the discussion and debate surrounding palliative care; attempts at achieving consensus for research through priority setting exercises; and a critical review of published research in palliative care accessed through a systematic review of studies. The findings of this systematic review of 384 published studies are reported. It appeared from the review that both the subjects employed for study and methods used are disparate, and that research to date has been preoccupied with describing activities and problems in palliative care, reflecting an emergent and new field of work, rather than actively evaluating existing and new approaches to care. More creativity in palliative care research is needed, and the future of palliative care research needs to be determined strategically. A model on which such a strategy might be based is presented.

Forecasting↗
PubMed1996

Non-pharmacological intervention for breathlessness in lung cancer.

OBJECTIVE: To evaluate the effect of non-pharmacological intervention for breathlessness in lung cancer on breathlessness ratings and patient functioning. DESIGN: Randomised controlled pilot study. SETTING: A nurse led clinic in a specialist cancer centre. SUBJECTS: 20 patients with advanced small cell and non-small cell lung cancer. INTERVENTION: Weekly sessions with a nurse research practitioner over 3-6 weeks using counselling, breathing re-training, relaxation and teaching coping and adaptation strategies. MAIN OUTCOME MEASURES: Visual analogue scale ratings of breathlessness, distress caused by breathlessness, functional capacity, ability to perform activities of daily living and the Hospital Anxiety and Depression Scale. RESULTS: Improvements in median scores on all measures were observed in the intervention group with the exception of depression, compared with the control group where median scores were static or worsened. Distress from breathlessness was improved by a median of 53%, breathlessness at worst by 35% and functional capacity by 21%. In contrast, distress in the control group worsened by a median of 10%. Significant improvements compared with the control group were observed in breathlessness at best (p < 0.02), breathlessness at worst (p < 0.05), distress caused by breathlessness (p < 0.01), functional capacity (p < 0.02) and ability to perform activities of daily living (p < 0.03) but were not observed for anxiety or depression. CONCLUSION: Lung cancer patients suffering from breathlessness benefited from this rehabilitative approach to breathlessness management and strategies employed in this pilot study warrant further multicentre research. Macmillan nurses and palliative care teams are recommended to explore the potential of adopting similar approaches.

Aged↗
PubMed1993

Building a framework for nursing research in cancer care.

This paper describes a framework for nursing research in cancer care, developed by a group of British nurses who met under the auspices of the Cancer Research Campaign, a British charity, in May 1992. In developing the framework the great potential for nursing research to contribute to cancer care was recognized, but was felt to be under-exploited because of the constraints that exist for nurses wishing to undertake research. The framework identifies the characteristic features of nursing research; highlights key areas for focus for such research; suggests mechanisms for building programmes of research; and strategies for creating milieux conducive to the development of cancer nursing research and nurse researchers.

Health Priorities↗
PubMed1992

The newly registered nurse and the cancer patient: an educational evaluation.

This paper reports a study which aimed to develop an understanding of newly registered nurses' attitudes, knowledge, confidence and educational needs in relation to cancer care. An educational intervention designed to meet these nurses' needs was then developed and evaluated with 127 newly registered nurses from two general hospitals. Nurses attended two different educational interventions; one group of nurses completing a 3 day experiential workshop; and a second group attended a more formal seminar programme. A third group of nurses who were unable to obtain study leave were followed up as a control group. A triangulation strategy was used to collect data from different sources, and included a baseline study, and a study of nurses before, after and 3 months following the educational interventions. Data from the study revealed the perceived need and desire for more education on cancer care, and the strong association of cancer with death amongst newly registered nurses. Significant benefits to those nurses attending the workshop were demonstrated. These differences were however less obvious at 3 months follow-up.

Adult↗
PubMed1991

In search of more complete answers to research questions. Quantitative versus qualitative research methods: is there a way forward?

This paper presents an overview of research methods utilized in nursing to date and traces the origins of the schism in nursing research which has led to the development of the quantitative-qualitative research-methods dichotomy. The philosophical and technical characteristics which distinguish these apparently opposing methodologies are described and critically discussed. The use of triangulation of different methods and types of data is suggested as an alternative research strategy. A study which used triangulation as a research approach which examined newly registered nurses' attitudes and educational preparation to care for patients with cancer, and developed and evaluated an educational intervention for nurses on cancer care, is described. This illustrates how the use of different research methods within a single study can provide a richer and deeper understanding of the area under investigation than would otherwise be possible. This paper also discusses the notion that nursing research has arrived at a watershed in which competing methodologies serve to divide and separate nurse researchers on the grounds of philosophical approach, a division which a neophyte discipline such as nursing can ill afford. Nurse researchers need to gain skills and understanding of different approaches to capitalize on the strengths and benefits of each in order to develop a more complete understanding of nursing practice in all its complexity.

Data Collection↗
PubMed1990

Integrating nursing research and practice--the role of the researcher as teacher.

For the past two decades authors have discussed the lack of research-based nursing practice. Many explanations are afforded but few focus on the way in which the researcher plans to involve staff in each stage of the process. The desire by practitioners to become researchers has been confounded in the main by increasing pressures on staff and a failure to realise that special training and opportunities are necessary for the generation and fruition of research ideas. In this article two recent studies are briefly discussed to demonstrate how the researcher can work with nurses to identify relevant topics, provide support and specific education to improve care and subsequently to evaluate the effects. Final discussion reflects the importance of introducing a number of individuals with a researcher-teacher role amid the practitioners.

Clinical Nursing Research↗
PubMedDate not supplied

Clearing the air.

Explore the source record for details and available documents.

Clinical Nursing Research↗