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Biomedical subjects

L Sarna

Publications and source records attributed to L Sarna.

At least 19 recordsLinked to original sources
PubMed1999

Prevention: tobacco control and cancer nursing.

In the next century, tobacco will become the number-one cause of preventable death throughout the world, resulting in half a billion deaths. As global patterns of tobacco use change, tobacco-related morbidity and mortality will shift from developed countries to developing countries. Internationally, lung cancer will become the fifth leading cause of preventable death, affecting an increasing number of women. Tobacco cessation after a diagnosis of cancer may decrease treatment-related morbidity and increase survival. With the increasing number of cancer survivors, tobacco cessation becomes an important part of rehabilitation. This article aims to provide a foundation for developing strategies to involve cancer nurses throughout the world in an international campaign to prevent tobacco-related morbidity and mortality. The devastating health impacts of tobacco are reviewed, and highlights of new scientific findings about nicotine addiction are presented. New approaches to tobacco prevention, legislation, and regulatory policies are discussed. Tobacco assessment strategies and treatment interventions for use in cancer nursing clinical practice are reviewed, and global strategies for nursing action in tobacco control are offered.

Global Health↗
PubMed1998

Women with HIV: living with symptoms.

This exploratory study used a semistructured interview to describe women's experiences coping with HIV-symptoms, their descriptors of their worst and best days, and their attempts to control symptoms. A convenience sample of 44 women, largely women of color, of lower socioeconomic status, unemployed, seeking treatment in one of six outpatient clinics in Los Angeles, were interviewed. Fatigue, the most frequently reported worst symptom, was present in 98% of these women. Feeling physically sick and having negative mood were mentioned most often in descriptions of worst days; being active, feeling physically healthy, and having positive mood were descriptors of best days. Of the total, 59% used rest/sleep to control symptoms, and this often was used in conjunction with healthy diet. The results of this study reveal aspects of women's day-to-day experiences with HIV-related symptoms.

Adaptation, Psychological↗
PubMed1998

Smoking cessation interventions in nursing practice.

Smoking cessation treatment by nurses in clinical practice significantly increases the number of smokers who are able to successfully quit the behavior. Nurse-managed cessation interventions have been shown to be effective with smokers, yet many nurses lack the knowledge to identify smokers easily, to identify those treatments that are most efficacious, and to deliver appropriate interventions. This article highlights recent developments in smoking cessation treatment that can be integrated into nursing practice. Attention is given to cessation techniques in special populations, including youth.

Female↗
PubMed1998

Effectiveness of structured nursing assessment of symptom distress in advanced lung cancer.

PURPOSE/OBJECTIVES: To test the efficacy of structured symptom assessment on level and rate of change in symptom distress over time. DESIGN: Prospective six-month randomized control trial. SETTING: Outpatient oncology offices and clinics in California. SAMPLE: 48 subjects newly diagnosed with advanced lung cancer, predominantly non-small cell. Most subjects received chemotherapy, 50% were women, and their average age was 62 years. 190 observations were analyzed. METHODS: Subjects were assigned randomly to structured assessment or usual care. Both groups completed the Symptom Distress Scale (SDS) monthly. After bivariate screening of potential predictors, a multivariate regression model for level and rate of change in SDS scores was created. MAIN RESEARCH VARIABLES: Symptom distress, functional status, and emotional distress. FINDINGS: Fatigue was the most common severely distressing symptom. In a multivariate model, chemotherapy and systematic assessment were associated with less symptom distress over time. Higher scores in depression and more functional limitations were related to higher levels of overall distress. Weight loss had a small impact. CONCLUSIONS: Systematic use of structured symptom assessment forestalled increased symptom distress over time. Chemotherapy lessened symptom distress, but the impact diminished with time. Subjects with more depression and greater functional limitations had greater symptom distress. IMPLICATIONS FOR NURSING PRACTICE: During the course of advanced lung cancer, systematic ongoing nursing assessment of symptoms may be the first step in enhancing interventions to decrease distress. Patients at highest risk for symptom distress are those who experience emotional distress and functional limitations.

Adult↗
PubMed1998

Developing a team for multicultural, multi-institutional research on fatigue and quality of life.

PURPOSE/OBJECTIVES: To describe the process of establishing a multisite team to conduct research with a multicultural focus on fatigue. DATA SOURCES: Articles, book chapters, personal experience. DATA SYNTHESIS: Teamwork facilitated development of a productive professional working group, sharing of resources, and data collection culminating in a research proposal for studying cancer-related fatigue in a multicultural population. CONCLUSIONS: Establishing a common goal by investing time, committing to the process, and establishing trust was the secret to effective team functioning. IMPLICATIONS FOR NURSING PRACTICE: The prospect of multi-institutional collaboration has implications for oncology nurses in the areas of research and practice. Goals that could not be achieved easily in the setting of a single institution are reached more easily with multisite collaboration and teamwork.

Cooperative Behavior↗
PubMed1996

Emotional distress in men with life-threatening illness.

This descriptive survey explored the relationship of health status, functional status, stressful life events, stress resistance resources and emotional distress in 60 men with life-threatening illness (N = 30 with cancer and N = 30 with AIDS). Sixty-two percent met CES-D criteria for clinical depression. This study's results supported the hypotheses that poorer functional status and greater negative stressors are associated with both higher levels of hopelessness and depression. Twenty-four patients constituted a group with severe emotional distress. This group was significantly different from the less vulnerable group with poorer functional status (KPS), a greater number and severity of negative stressors, less satisfaction with social support, and less hopefulness.

Acquired Immunodeficiency Syndrome↗
PubMed1995

Smoking behaviors of women after diagnosis with lung cancer.

The purpose of this study was to describe the smoking behavior of women with a recent diagnosis or recurrence of lung cancer. A convenience sample of women (N = 65) participated in interviews about their smoking status, their perception of the effect of their diagnosis on the smoking behaviors of others, and self reports of symptom distress and functional status. Content analysis of the audiotapes was used to classify responses. Exemplars describe feelings related to smoking, smoking cessation, and responses of others. Current smokers were likely to be younger (F4.60 = 4.3, p < .05). In this small sample, symptom distress and functional status were not statistically differentiated by smoking status; current smokers had the greatest mean distress from cough. Diagnosis had a variable effect on the smoking behavior of family members with over 25% stopping smoking in response to the diagnosis; 31% of smoking spouses continued to smoke.

Aged↗
PubMed1995

A cancer nursing curriculum guide for baccalaureate nursing education.

Cancer is a leading cause of morbidity and mortality in the United States, affecting one of four Americans. Many nurses without specialized oncology preparation will provide counsel and care for people at risk for or with cancer. In recognition of the cancer-related educational needs for all nurses in the wide variety of health care settings, the American Cancer Society Professors of Oncology Nursing provide a curriculum guide for core cancer nursing content in undergraduate education for baccalaureate students. It is intended to assist educators to define expectations for clinical competencies in cancer care for preparing graduates at the baccalaureate level. A variety of educational strategies and resources for the educator are suggested to facilitate integration of cancer content within existing programs.

American Cancer Society↗
PubMed1994

Delirium in the older person with cancer.

Delirium occurs in 25-40% of patients with cancer and in as many as 85% of patients with advanced cancer. Delirium, or acute confusion, can be short term and reversible and differs from dementia, which is chronic and irreversible. Accurate assessment is critical for effective treatment and to reduce the increased mortality associated with delirium. Assessment for differentiating depression as well as dementia is needed, because mistaken diagnoses often prolong and exacerbate the symptoms of delirium. Different treatment strategies are appropriate depending on the cause(s) of confusion. In this article, risk factors and assessment tools are reviewed, and interventions for delirium in older persons with cancer are presented. Future areas for research are identified, because there is a paucity of research on delirium in older patients with cancer.

Aged↗
PubMed1994

Weight change and lung cancer: relationships with symptom distress, functional status, and smoking.

The pattern of weight change (at five 6-week intervals beginning 2 months after diagnosis of advanced disease) is described in adults with progressive lung cancer (N = 60). Weight loss of 10% or more at study entry occurred in 35% of subjects; 37% lost weight at three or more intervals; and 25% lost weight at only one interval. Pre-illness weight loss was moderately correlated with subsequent decreased functional status (Enforced Social Dependency Scale) at Times 1, 2, and 3 (r = -.49, r = -.43, r = -.48, p < .001). Weight loss correlated with subsequent increased symptom distress (Symptom Distress Scale, SDS) at three times (Times 2, 4, and 5: r = -.34, r = -.30, r = -.43, p < .05). Chemotherapy (50% of subjects) and smoking (25% at study entry) predicted weight loss from Time 1 to 5, explaining 28% of the variance.

Adenocarcinoma↗
PubMed1994

Functional status in women with lung cancer.

Lung cancer remains the number one cause of cancer-related death and the third most common cancer for women in the United States. The major purpose of this study was to describe physical functional status in a sample of women with lung cancer. Functional status was objectively measured by the Karnofsky Performance Status Scale, and subjectively by the Rand Physical Function Scale, and the Physical Function Subscale of the CARES-Short Form. A convenience sample of 69 women participated in a one-time data collection. The typical subject was < 65 years of age, had lived with primary or recurrent lung cancer for > 12 months, had non-small cell limited disease, and was not currently receiving treatment. The most prevalent disruptions in physical function were reduced energy (59%), difficulty with household chores (33%), and interference with work (28%). A third of the sample had serious limitations in three or more activities. Approximately 26% of the sample had severe limitations in moderate activities, 20% in walking short distances, and 16% in walking one flight of stairs. Only a quarter were satisfied with their level of activity. Physical function was different by income category (one-way analysis of variance), with those with the lowest income having the poorest function.

Activities of Daily Living↗
PubMed1993

Women with lung cancer: impact on quality of life.

The purpose of this study was to describe disruptions in quality of life (QOL) in women suffering from lung cancer, the leading cause of cancer-related death in the United States. QOL was measured with the CARES-SF. Symptom distress was measured with the modified Symptom Distress Scale, and functional status was measured with the Karnofsky Performance Status Scale. Sixty-nine women with lung cancer participated in a one-time data collection. The typical subject was under 65 years of age, married, has had primary or recurrent non-small cell lung cancer for over 12 months, had limited disease, and was not currently receiving treatment. Subjects had greater disruptions in global QOL and its dimensions compared to a normative heterogeneous female cancer sample. The most prevalent serious disruptions were fatigue, difficulty with household chores, worry about ability to care for self, and worry about cancer progression. The global CARES-SF score was moderately correlated to functional status (r = 0.69, p = < 0.001), and to symptom distress (r = 0.72, p = < 0.001). Symptom distress was associated strongly with the physical subscale of QOL (r = 0.80, p = 0.001) and significantly but less strongly with all other dimensions of QOL. Significantly greater differences in disruptions of quality of life occurred in women younger than 65 years (p = 0.04), women with recurrent disease (p = 0.003), and women with low income (p = 0.008). In stepwise regression, symptom distress predicted 53% of the variance followed by functional status (59%) and recurrence (63%) when QOL was the outcome variable.

Activities of Daily Living↗
PubMed1993

Fluctuations in physical function: adults with non-small cell lung cancer.

Disruptions in physical activities (functional status) were measured over a 1-month period in 24 patients with non-small cell lung cancer with the Karnofsky Performance Status Index and two patient self-report measures. Changes over time were noted for the whole group, and mean scores of the treated subgroup were compared with an untreated cohort. Prior weight loss was significantly associated with baseline functional status. Age was not significantly associated with degree of functional disruption, though 42% of the sample was aged 65 years or older. The greatest disruptions in physical activity were noted in ambulation. A third of the sample had difficulty walking one block or more. Serious fatigue was experienced by 79% of the subjects and 44% had difficulty with household chores. Only 21% were completely satisfied with their level of activity. Pain improved in the treated subjects over time. Despite no significant differences at baseline, untreated subjects had more limitations in physical activities than treated subjects over time. All three instruments were significantly correlated. Careful monitoring of physical difficulties may help nurses focus interventions and decrease the physical distress associated with illness and treatment. In this study, those receiving chemotherapy did not experience significantly greater physical dysfunction. In fact, the untreated patients, who might not receive vigilant nursing assessment, demonstrated greater physical decline.

Activities of Daily Living↗