Biomedical subjects

J S Carpenter

Publications and source records attributed to J S Carpenter.

At least 19 recordsLinked to original sources

PubMed2001

The Hot Flash Related Daily Interference Scale: a tool for assessing the impact of hot flashes on quality of life following breast cancer.

To assess the psychometric properties of the Hot Flash Related Daily Interference Scale (HFRDIS), a sample of breast cancer survivors and an age-matched comparison group completed a questionnaire packet and 2-day prospective hot flash diary at an initial time point and again 6 months later. There were 71 breast cancer survivors and 63 comparators at Time 1, and 54 survivors and 46 comparators at Time 2. The HFRDIS was internally consistent, with alphas of 0.96 at times 1 and 2. Validity was supported through 1) correlations with other hot flash variables, 2) correlations with measures of affect and mood, 3) significant differences between women with hot flashes and those without, and 4) demonstrated sensitivity to change over time. The HFRDIS is a psychometrically sound measure for assessing the impact of hot flashes on daily activities and overall quality of life in clinical practice or research protocols.

Breast Neoplasms↗

PubMed2001

Adherence to recommendations for clinical follow-up after benign breast biopsy.

PURPOSE: Women who undergo a benign breast biopsy are at elevated risk for the subsequent development of breast cancer (BC). Therefore, appropriate clinical follow-up of a benign breast biopsy is important. The present study examines the extent and correlates of nonadherence with follow-up recommendations after a benign breast biopsy. METHODS: Women (n = 114) who had undergone a benign breast biopsy completed an initial telephone interview within 50 days of their biopsy (mean = 21 days). Additional telephone interviews were completed at 4 and 8 months post-biopsy. Measures of BC risk perception, general and BC-specific distress, BC-related attitudes and beliefs, social support, optimism, and informational coping style were completed. Specific recommendations for clinical follow-up and evidence of actual follow-up were obtained from medical records. RESULTS: Of 103 women given a specific recommendation for clinical follow-up, 34% were classified as nonadherent with follow-up recommendations. Logistic regression analyses indicated that nonadherent women were characterized by younger age, recommendations for follow-up by clinical breast examination alone, greater confidence in their ability to perform breast self-examination properly, higher perceived personal risk for BC, and greater BC-specific distress. CONCLUSION: Despite the importance of appropriate clinical follow-up of a benign breast biopsy, about one-third of women did not adhere to recommended follow-up. Risk factors for nonadherence suggest potential avenues for interventions to enhance participation in appropriate clinical follow-up.

Adaptation, Psychological↗

PubMed2001

Vascular compression by a ventricular shunt catheter: clinical value of volume-rendered CT angiography.

One of the strongest advantages of CT angiography (CTA) lies in its unique ability to display simultaneously the anatomy of the vascular system and the topographic relationships existing between the vessels and the neighboring structures. The case we report, a 76-year-old man who underwent an intraventricular shunt placement complicated by a stroke, shows how this topographic assessment also provides important diagnostic information when vascular lesions resulting from an extrinsic compression mechanism are suspected.

Aged↗

PubMed2000

Hot flashes and their management in breast cancer.

OBJECTIVES: To review literature relevant to defining and managing hot flashes in women with breast cancer. DATA SOURCES: Published literature on hot flashes in women with breast cancer and in healthy women. CONCLUSIONS: The etiology of hot flashes is influenced by several breast cancer treatment-related factors. Hot flashes are a prevalent, severe problem that can negatively impact quality of life. Certain women are at higher risk for hot flashes following breast cancer treatment. Little research supports the safety or effectiveness of treatments in women with breast cancer. IMPLICATIONS FOR NURSING PRACTICE: Implications include the need to improve patient education, perform comprehensive symptom assessments, and counsel women about various treatment alternatives.

Adult↗

PubMed1999

Rheumatoid symptoms following breast cancer treatment: a controlled comparison.

The prevalence of rheumatoid symptoms following breast cancer (BC) treatment was examined. Breast cancer patients (n = 111) who were a mean of 27.6 months postcompletion of BC treatment and 99 otherwise healthy women with benign breast problems (BBP) completed a self-report measure that assessed current joint pain, swelling, and stiffness, as well as measures of quality of life. Results supported a hypothesized link between BC and rheumatoid symptoms: (1) the BC group was more likely to report joint stiffness lasting more than 60 min following morning waking; (2) the prevalence of unilateral or bilateral joint point or swelling was greater (P < 0.10) in the BC group for four of 10 joint-symptom combinations examined, with differences between the BC and BBP groups in upper extremity joint swelling particularly pronounced; and (3) 41% of the BC group reported that current rheumatoid symptoms exceeded those experienced prior to diagnosis. Within the BC group, the data did not support postchemotherapy rheumatism as an explanation for rheumatoid symptoms. Rather, data suggested that symptoms were associated with surgical management of BC. Finally, among women in the BC group with the most severe joint pain, only a minority were receiving medication for these symptoms. Given the relationship between rheumatoid symptoms and quality of life, more systematic research examining potential contributing factors such as menopausal status, concurrent lymphedema, and weight gain is warranted.

Adult↗

PubMed1999

Self-transformation as a factor in the self-esteem and well-being of breast cancer survivors.

Diagnosis with a life-threatening illness can lead to many changes in one's self. These changes, called self-transformation, are not well understood. The present study used triangulation of methods and measures to (i) describe individual differences in self-transformation among breast cancer survivors, (ii) examine factors associated with self-transformation in breast cancer survivors, and (iii) examine the relationships between self-transformation and self-esteem and well-being in breast cancer survivors and age-matched comparison women without cancer. Cancer survivors (n = 60) participated in structured interviews and both survivors and comparison women (n = 60) completed a set of questionnaires. Narrative analysis revealed three categories of transformation among breast cancer survivors: positive transformation, minimal transformation and feeling stuck. These groups differed by age, marital status and income, but not by disease or treatment variables. Breast cancer survivors in the positive transformation group had significantly higher self-esteem and well-being in comparison with (i) survivors grouped as feeling stuck and (ii) age-matched counterparts without cancer. Cancer survivors who reported feeling stuck had significantly lower self-esteem and well-being than the other groups of survivors and lower well-being in comparison with healthy women of the same age. Findings provide support for the concept of self-transformation and a new understanding of disease, demographic and treatment factors associated with the concept. Findings also suggest that self-transformation may be a factor in the self-esteem and well-being of breast cancer survivors.

Adaptation, Psychological↗

PubMed1999

Feasibility and psychometrics of an ambulatory hot flash monitoring device.

OBJECTIVE: To assess the feasibility and psychometric properties of a lightweight, automated, ambulatory sternal skin conductance monitor to measure frequency of hot flashes (HFs) among breast cancer survivors (BCSs). DESIGN: A total of 19 postmenopausal BCSs and 5 premenopausal healthy comparison women participated by wearing the monitor for 24 h during their normal daily activities, including sleep. HFs were assessed using subjective (diaries, event markers) and objective (skin conductance) methods. RESULTS: Problems with subjective reporting of HFs were reported by 35% of BCSs. Technological problems and discomfort related to wearing the monitor were minimal. A total of 243 HFs were recorded using the skin conductance monitor by 17 BCSs and 5 premenopausal women (BCS group M = 13.4; range, 1-30). Subjective reporting of HFs was associated with a 31-33% false-positive rate. Skin conductance monitoring during waking hours was associated with a 30% false-negative rate. CONCLUSIONS: The monitor is a feasible method for objectively assessing HFs in BCSs. Data support continued use of sternal skin conductance as an objective measure of HF frequency. This technology should prove useful as an objective measure of HFs in future intervention research aimed at alleviating the symptom and improving quality of life among BCSs.

Adult↗

PubMed1999

Menopausal symptoms in breast cancer survivors.

PURPOSE/OBJECTIVES: To examine the prevalence and severity of menopausal symptoms among breast cancer survivors and the relationship between menopausal symptoms and quality of life (QOL). DESIGN: Cross-sectional, descriptive. SETTING: Outpatient breast care center servicing a southeastern city and regional rural areas. SAMPLE: 114 postmenopausal breast cancer survivors with a mean age of 59 years (SD = 10; range = 36-83 years) who were a mean of 34.9 months postcompletion of surgery, radiotherapy, or chemotherapy (SD = 22; range = 4-116 months). METHODS: Telephone interviews were used to assess demographic variables, menopausal status (questions adapted from the Massachusetts Women's Health Study), menopausal symptoms (adapted from the Blatt Menopausal Index), and QOL (SF-12 Health Survey). Disease and treatment information was extracted from medical records and the state cancer registry. MAIN RESEARCH VARIABLES: Menopausal status, menopausal symptoms, and QOL. FINDINGS: The most commonly reported menopausal symptoms (joint pain (77%), feeling tired (75%), trouble sleeping (68%), and hot flashes (66%)) were also the most severe. More than 40% of breast cancer survivors who reported these symptoms rated them as "quite a bit" to "extremely" severe. The total number and severity of symptoms reported was significantly related to the number of years postmenopause but not to time postdiagnosis. Higher prevalence and severity of menopausal symptoms were related to lower physical and emotional QOL. CONCLUSIONS: Menopausal symptoms appear to be a significant problem for breast cancer survivors. IMPLICATIONS FOR NURSING PRACTICE: Nurses can inform women that menopausal symptoms may be experienced following breast cancer treatment and that these symptoms may be more severe than those experienced by healthy women without cancer.

Adult↗

PubMed1998

Hot flashes in postmenopausal women treated for breast carcinoma: prevalence, severity, correlates, management, and relation to quality of life.

BACKGROUND: Research on hot flashes (HFs) after the diagnosis and treatment of breast carcinoma (BC) is scarce. To our knowledge, this research represents the second study of HF prevalence and severity in women with BC and the first study of 1) correlates of HF prevalence and severity, 2) use of HF management strategies, and 3) the relation between HFs and quality of life (QOL) among women with BC. METHODS: Eligible women (n = 136) participated in structured telephone interviews. RESULTS: Of the 114 postmenopausal women interviewed, 65% reported HFs, with 59% of women with HFs (n = 74) rating the symptom as severe. Multivariate analysis revealed that 1) HFs were most common in women with a high school education or less and those who were younger at diagnosis and 2) HFs were most severe in women with a higher body mass index, those who were younger at diagnosis, and those receiving tamoxifen. Among women with HFs, 37% were not using any HF management strategies and 63% expressed interest in learning more regarding > or = 1 strategy. HFs marginally were related to decreased mental and physical QOL using the SF-12 Health Survey (P < 0.10). CONCLUSIONS: The results of the current study significantly contribute to knowledge regarding HFs in women with BC and support the need for carefully controlled clinical trials evaluating interventions for relieving HFs in this population.

Adult↗

PubMed1998

Barriers to change: a pain management project.

Although considerable effort has been directed toward improving the management of acute pain, ineffective pain management practices remain in many institutions across this country. While educational efforts have increased health care providers' knowledge regarding the management of pain, a concomitant change in practice has not occurred. This project was designed to examine barriers to the effective management of pain encountered in acute care settings. A repeated case study of attempts to change was conducted in six institutions located in the southeastern United States. Results identified seven major barriers to pain management: lack of knowledge, non-facilitative attitudes, inconsistent leadership, poor working relationships, cultural and religious biases, physicians' fears of legal repercussions and a lack of resources.

Acute Disease↗

PubMed1998

Psychometric evaluation of the Pittsburgh Sleep Quality Index.

The Pittsburgh Sleep Quality Index (PSQI) measures sleep quality and disturbance retrospectively over a 1-month period using self-reports. Although the PSQI has been used in a variety of populations, published psychometric data are limited. The goal of this study was to examine psychometric properties of the PSQI among four populations: bone marrow transplant patients (n=155); renal transplant patients (n=56); women with breast cancer (n=102); and women with benign breast problems (n=159). Results supported PSQI internal consistency reliability and construct validity. Cronbach's alphas were 0.80 across groups and correlations between global and component scores were moderate to high. PSQI scores were moderately to highly correlated with measures of sleep quality and sleep problems, and poorly correlated with unrelated constructs. Individuals with sleep problems, poor sleep quality, and sleep restlessness had significantly higher PSQI scores in comparison to individuals without such problems.

Adult↗

PubMed1998

Postmastectomy/postlumpectomy pain in breast cancer survivors.

Few studies have focused on careful assessment of postmastectomy pain (PMP); a chronic neuropathic pain syndrome that can affect women postlumpectomy or postmastectomy for breast cancer (BC). Study aims were to determine the prevalence of PMP in an outpatient sample of breast cancer survivors (BCS), describe subjective and objective characteristics of PMP, and examine the relationship between PMP and quality of life. Breast cancer survivors (n = 134) participated in telephone interviews, and those reporting PMP (n = 36) were invited to a pain center for further evaluation and treatment. Results show PMP is a distinct, chronic, pain syndrome affecting 27% of BCS. Findings support the need for clinical trials evaluating the effectiveness of nonpharmacological or cognitive behavioral therapies in alleviating mild to moderate PMP.

Adult↗

PubMed1997

Energy level and sleep quality following bone marrow transplantation.

While problems with sleep and energy level (ie fatigue) are commonly reported during recovery from bone marrow transplantation (BMT), little in-depth information regarding these two problem areas in BMT patients is available. Using both questionnaire and telephone interview methods, information regarding current sleep and energy level problems was obtained from 172 adult BMT survivors drawn from five different BMT treatment centers. Respondents were a mean of 43.5 months post-BMT at the time of the initial assessment. Similar questionnaire data was obtained from 137 respondents (80%) at a follow-up assessment 18 months after the initial assessment. Results suggested that half to two-thirds of disease-free BMT recipients experience problems with regard to current energy level or sleep quality. While for the majority of patients these problems were rated as mild, 15-20% of BMT recipients showed moderate to severe problems in these areas with corresponding decrements in quality of life. Furthermore, both cross-sectional and longitudinal analyses suggested that problems in these areas did not simply abate with time. Only low to moderate correlations were obtained between indices of sleep and energy problems and measures of anxious and depressed mood. Finally, the presence of current sleep problems was associated with older age at BMT, receipt of TBI during pre-BMT conditioning, and female gender. Further research needs to address the specific etiology of chronic problems with sleep and energy level in BMT recipients as well as evaluate biobehavioral strategies for managing these problems.

Adult↗

PubMed1996

Psychosocial adjustment and quality of life in women with breast cancer and benign breast problems: a controlled comparison.

Comparison of psychosocial adjustment in women with breast cancer (BC) and women with benign breast problems (BBP) has been hampered by a failure to control for age differences between these groups, as well as a failure to assess positive psychosocial adaptation in addition to psychological distress. Age-matched women with breast cancer (n = 80) and benign breast problems (n = 80) completed measures of psychological distress, positive psychosocial adaptation, and general quality of life (QOL). Breast cancer patients had completed primary treatment for breast cancer a mean of 24.6 months prior to participation (range, 6-57 months). Comparison of the BC and BBP groups indicated that the BC group reported (1) poorer physical health and functioning, (2) no differences in psychological distress, and (3) greater positive psychosocial adaptation, such as improved life outlook, enhanced interpersonal relationships, and deeper spiritual and religious satisfaction. Results support the theoretical position that cancer is a transitional event, that is, a traumatic event that alters an individual's assumptive world with the potential to produce long-lasting changes of both a positive as well as negative nature. This underscores the importance of using measures of both psychological distress and positive psychosocial adaptation when assessing psychological adjustment following transitional events such as breast cancer.

Adaptation, Psychological↗

PubMed1996

Applying the Cantril methodology to study self-esteem: psychometrics of the Self-Anchoring Self-Esteem Scale.

The importance of the construct of self-esteem is evidenced by its extensive inclusion in prior research as a measure of well-being or adaptation to illness. Despite the construct's importance, current measures of self-esteem are inadequate when used among populations experiencing illnesses, such as cancer. Use of an alternative measure of self-esteem is proposed which addresses limitations of existing measures. The Self-Anchoring Self-Esteem Scale (SASES) is an adaptation of Cantril's methodology used to study quality of life, which requires individuals to subjectively define high and low endpoints of a 10-point ladder prior to providing numerical ratings. Data collected from three cross-sectional studies involving four samples of healthy individuals and women with cancer supported psychometric properties of the scale.

Adult↗

PubMed1995

Comparison of patients' ratings and examination of nurses' responses to pain intensity rating scales.

Patients' ratings of pain intensity are an important component of a comprehensive assessment of pain. Although a 10-cm visual analog scale (VAS) is recommended for quantifying subjective pain intensity, a 0 to 5 point numerical rating scale (NRS) is commonly used. These two scales are often viewed as interchangeable or mathematically equivalent, with a 2 on a 0 to 5 point scale seen as equal to a 4 on a 10-cm VAS. The purposes of this study were to compare patients' pain ratings on each scale and to examine nurses' responses to mathematically equivalent pain ratings. Results indicated that patients do not rate their pain in a mathematically equivalent way. VAS ratings were lower than NRS ratings, and more than three quarters of patients provided ratings that were not mathematically equivalent. In addition, nurses provided with fictitious patient scenarios did not provide the same pain medication for equivalent ratings and chose smaller analgesic doses in comparison with experts.

Adult↗

PubMed1994

Evaluation of self-esteem of women with cancer receiving chemotherapy.

PURPOSE/OBJECTIVE: To examine the concept of self-esteem as it relates to female patients with cancer before diagnosis and while experiencing chemotherapy-induced alopecia. DESIGN: Descriptive-analytic. SETTING: Oncology unit of a community hospital and an outpatient oncology clinic in a southeastern city of the United States. SAMPLE: 30 women receiving chemotherapy and who have experienced some degree of alopecia. METHODS: Subjects answered demographic questions and were evaluated for degree of hair loss. Subjects completed the Cantril Self-Anchoring Scale (CSA) on the day of the interview and retrospectively prior to their diagnosis. In addition they completed the Rosenberg Self-Esteem Scale (RSE). MAIN RESEARCH VARIABLES: Self-esteem, change over time, degree of alopecia, length of time since diagnosis. FINDINGS: A significant decrease in self-esteem from before cancer diagnosis levels to time of experiencing chemotherapy-induced alopecia; modest correlation between the CSA and the RSE. Four categories of characteristics (physical, spiritual, psychological, social) influencing self-esteem emerged from analysis of the CSA responses. CONCLUSIONS: Self-esteem was not stable in this group of women. Postdiagnosis levels were lower than those before the diagnosis; however, lower levels did not necessarily translate into low self-esteem. The CSA may be a more comprehensive and sensitive measure of self-esteem in patients with cancer because it is based on individual definitions of high and low self-esteem. IMPLICATIONS FOR NURSING PRACTICE: Understanding what specifically may lower an individual's self-esteem can be useful in identifying patient-specific interventions. Future research must explore ways to determine self-esteem consistently and easily.

Adult↗

PubMed1984

Multiple personality and borderline personality disorder.

The authors offer their theory that multiple personality represents a "special instance" of borderline personality disorder, that the introjects are composed of a representation of the self, a representation of the object, and an affective bond.

Adult↗