PubMed Health⌕ Search

Biomedical subjects

J M Wainstock

Publications and source records attributed to J M Wainstock.

7 recordsLinked to original sources
PubMed2004

Lymphedema following breast cancer treatment, including sentinel lymph node biopsy.

To compare the occurrence, signs, and symptoms of lymphedema (LE) the arms of women after axillary lymph node dissection (ALND), sentinel lymph node biopsy (SLNB), combined SLNB and ALND (Both), or neither as part of breast cancer diagnosis and treatment, a concurrent descriptive-comparative cross-sectional four-group design with retrospective chart review was carried out. In a convenience sample of 102 women treated for breast cancer and receiving follow-up care at a midwestern United States cancer center, sequential circumferential measurements at five selected anatomical sites along both arms and hands were used to determine the presence of LE (> or = 2 cm differences between sites). Participants self-reported LE-related signs and symptoms by interview and completion of the Lymphedema and Breast Cancer Questionnaire (LBCQ). Retrospective chart review was carried out to verify lymph node-related diagnostic and treatment procedures. Based on node group, LE occurred as follows: 43.3% (29 of 67) of women who underwent ALND alone; 22.2% (2 of 9) of those who underwent SLNB alone; 25.0% (3 of 12) of those with combined SLNB and ALND; and 22.2% (2 of 9) with neither SLNB nor ALND. LE-related symptoms were reported by women who underwent ALND alone, SLND alone, combined SLNB and ALND, and neither. Among the node groups, three symptoms were more common: larger arm size, firmness/tightness in past year, and numbness in past year. We conclude that circumferential measurements of the upper arm and forearm may be critical for distinguishing LE from no LE. Overall, the proportion of women who experienced LE-related signs and symptoms was higher among women who underwent ALND versus SLNB. However, numbness and tenderness frequently were reported by those undergoing ALND, SLNB or both; and by women without LE. It is possible that some frequently occurring symptoms, such as numbness and tenderness, may be related to breast cancer surgery and not LE. Findings from this study can assist health professionals in educating women with breast cancer about LE risk factors, as well as early detection and management of LE by using the LBCQ and sequential circumferential arm measurements to evaluate limb changes subjectively and objectively concurrent with each breast cancer survivor's follow-up care.

Adult↗
PubMed1998

Distress, symptom distress, and immune function in women with suspected breast cancer.

PURPOSE/OBJECTIVES: To investigate distress and its association with immune function among women with suspected breast cancer. DESIGN: Prospective, descriptive, correlational study. SETTING: An outpatient breast clinic at a tertiary urban hospital. SAMPLE: A convenience sample of women who had either a fine needle aspiration or open breast biopsy for a suspicion of breast cancer. Thirty-five women comprised the study sample, 6 with malignant and 29 with benign tumors. METHODS: Data were collected at three points in time. The first time (T1) was after the physician visit when the need for breast biopsy was ascertained. The second time (T2) was 7-10 days postbiopsy, and the third time (T3) was 7-10 days after T2. At T1, T2, and T3, participants filled out the Brief Symptom Inventory (a measure of psychological distress) and the Adapted Symptom Distress Scale (a measure of symptom distress) and provided a blood sample. Demographic data also were collected at T1. Immune function was measured by serum cytokine levels of transforming growth factor beta (TGF beta) and tumor necrosis factor alpha (TNF alpha). MAIN RESEARCH VARIABLES: Psychological distress, symptom distress, and immune function. FINDINGS: Psychological distress scores were moderate to high. Symptom distress was either nonexistent or slight. Significant correlations between psychological distress and symptom distress were found at T2 and T3. At T2, significant relationships between psychological distress and TNF alpha and between symptom occurrence and TNF alpha were found. Psychological and symptom distress scores were significantly different between women with malignant versus benign tumors at all three times. No differences in cytokine levels were found between the groups. CONCLUSIONS: These results suggest the strong effect that the diagnostic process has on psychological distress and its potential effects on immune functioning. Distress was significantly greater for women with malignant disease; however, women with benign disease continued to have elevated levels of distress. IMPLICATIONS FOR NURSING PRACTICE: Nurses should be aware of the extremely stressful nature of the diagnostic phase and should continue to provide support, knowing that this distress continues throughout this phase, particularly for women diagnosed with malignancy.

Biopsy, Needle↗
PubMed1991

Breast cancer: psychosocial consequences for the patient.

Women with breast cancer experience various psychosocial problems throughout the continuum of the disease. The psychosocial impact and adjustment of women with breast cancer during the phases of pretreatment, primary treatment, adjuvant therapy, recurrence, and advanced disease have numerous implications for nursing practice and research.

Adaptation, Psychological↗
PubMed1989

Perceptions of postmastectomy patients. Part I. The relationships between social support and network providers.

With the increased incidence of breast cancer in the United States, emotional adjustment of postmastectomy patients is a growing concern. This study was designed to examine demographic and social network variables that relate to social support. Breast cancer patients (N = 613) who had a mastectomy within the past 24 months (means = 12 months) responded to the Norbeck Social Support Questionnaire (NSSQ). To supplement the quantitative data, interviews were conducted with 27 women. Results from the NSSQ indicated that women perceived greater emotional support (means = 4.25) than aid (means = 3.97) from their network providers. The average number of persons (both professional and lay) in the women's total network was 8.1, comprising 57% family members and 27% friends. Relationships with network providers were characterized as stable (5-year) and frequent (weekly). Social support increased with age, but the size of the network decreased. No significant difference existed between marital categories in emotional support or frequency of contact. Married or widowed women perceived similar amounts of aid, whereas single and divorced women indicated less. Divorced women reported significantly larger networks than the other three marital status categories. Persons with less education perceived greater emotional support than those with more education. Being married had a significant positive relationship to emotional support (p less than .001).

Adult↗
PubMed1989

Perceptions of postmastectomy patients. Part II. Social support and attitudes towards mastectomy.

To measure the relationships among social support, attitudes toward mastectomy, and self-esteem in women postmastectomy, the Mastectomy Attitude Scale (MAS), the Norbeck Social Support Questionnaire (NSSQ), and Rosenberg's Self-Esteem Scale (RSE) were used. A factor analysis of the MAS yielded six factors that were used in regression analyses. Stepwise regression was used to identify variables that significantly contributed to women's self-esteem. Covariates in the analyses were age, years of education, marital status, and adjuvant chemotherapy. The women (n = 456) averaged 54 years in age, had slightly more than a high school education (mean = 13.0 years), and were predominately married (80%); almost half had adjuvant chemotherapy (45.6%). The overall regression model was significantly (df = 16,440; F = 15.12, p less than 0.0001) and accounted for 35.5% of the variance. Seven of the 16 variables were significant accounting for the following percentages of variance: sexuality, 21.1%; outlook, 5.8%, appearance satisfaction, 3.1%; emotions, 1.3%; college education, 1.2%; adjuvant chemotherapy, 0.6%; and age (60-69), 0.6%. Thus, women's attitudes toward mastectomy accounted for a greater proportion of the variance in their self-esteem than did social support and other demographic variables.

Aged↗
PubMed1988

Postmastectomy educational needs and social support.

Due to shorter hospitalization periods and changes in surgical procedures, breast cancer patients have less inpatient contact with rehabilitation resources. A questionnaire related to educational needs and social support was mailed statewide to 2,000 postmastectomy women who had received a Reach to Recovery visit. The findings are based on quantitative data reported by 933 women and from 27 women in follow-up interviews. Respondents ranked their educational needs in six categories from greatest to least importance as follows: (1) information about breast cancer, (2/3) personal hygiene/exercise and nutrition/weight control (both ranked of equal importance), (4) prosthesis/clothing information, (5) social support, and (6) sexual issues. Performance on the knowledge assessment correlated directly with the amount of educational experience and inversely with age. Respondents who lived in communities of less than 2,500 were less informed than those from other locations. Participation in formalized support groups was infrequent (11%). The major source of information was the media, with 88% indicating they would watch television programs about breast cancer. Thirty-three percent of the respondents indicated they owned a video cassette recorder (VCR); about 93% said VCRs were available for rent in their community. Work associates were identified as a group that encouraged information seeking; health care professionals were the most successful in motivating women to participate in support groups.

Adaptation, Psychological↗