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Biomedical subjects

Linda Sarna

Publications and source records attributed to Linda Sarna.

At least 19 recordsLinked to original sources
PubMed2006

Quality of life and health status of dyads of women with lung cancer and family members.

PURPOSE/OBJECTIVES: To describe and compare the quality of life (QOL) and health status of dyads of women with lung cancer and their family members and to explore the correlates of family members' QOL. RESEARCH APPROACH: Descriptive, cross-sectional. SETTING: Interview, self-report. PARTICIPANTS: 51 dyads consisting of women with lung cancer and their family members. METHODOLOGIC APPROACH: One-time assessment of family members' and patients' QOL, health status, and demographics and patients' clinical characteristics. MAIN RESEARCH VARIABLES: Family and patient QOL and health status. FINDINGS: QOL of the dyads was not significantly related. Poorer physical QOL of family members was associated with older age, comorbid conditions, less education, and alcohol use. Poorer emotional QOL of family members was associated with younger age, depressed mood, and not being a spouse. Fifty-nine percent of family members had comorbid conditions. Significantly more family members continued to smoke and use alcohol. CONCLUSIONS: The QOL of family members of patients with lung cancer is diminished when their own health status is compromised. Further study is needed. INTERPRETATION: Additional study is needed to identify family members at risk for diminished QOL and with compromised health status because these factors might affect ability to support patients with lung cancer.

Adult↗
PubMed2006

Cancer screening and risk-reducing behaviors of women seeking genetic cancer risk assessment for breast and ovarian cancers.

PURPOSE/OBJECTIVES: To examine breast and ovarian cancer screening and risk-reducing behaviors of women seeking genetic cancer risk assessment (GCRA). DESIGN: Descriptive, cross-sectional. SETTING: An insurance-based clinic that serves high-risk patients in a southern California cancer center. SAMPLE: 134 women with breast or ovarian cancer (affected group) and 80 women with a family history of breast or ovarian cancer (unaffected group). The mean age of the sample was 48 years (range = 21-86), 79% were Caucasian, 66% were married, 60% were college educated, and 78% had children. Most affected women had early-stage disease. Unaffected women had a family history of breast (86%) or ovarian (14%) cancer. METHODS: Mailed surveys assessed pre-GCRA health behaviors and health and family histories. MAIN RESEARCH VARIABLES: Breast cancer screening (mammograms, clinical breast examination [CBE], breast self-examination), ovarian cancer screening (CA-125, pelvic ultrasound), and breast and ovarian cancer risk-reducing strategies (tamoxifen, bilateral mastectomy, oral contraceptive pills, bilateral salpingo-oophorectomy). FINDINGS: Twenty-one percent of the women who should have been having a mammogram had not had an annual examination as recommended, and 30% of affected women had not had annual CBEs. Few women took tamoxifen or oral contraceptive pills or had a bilateral salpingo-oophorectomy or bilateral mastectomy for cancer risk reduction. Twelve percent likely had unnecessary ovarian cancer screening. About 35% used other means, including herbs and homeopathy, for cancer prevention. CONCLUSIONS: Nearly a third of the affected women had not had appropriate breast cancer screening. About 12% used unsubstantiated, potentially harmful cancer "prevention" measures (e.g., herbs). IMPLICATIONS FOR NURSING: Nurses should assess clients' personal and family breast and ovarian cancer histories and promote cancer screening and risk-reducing behaviors that are appropriate for age and risk level.

Adult↗
PubMed2006

Strategies to implement tobacco control policy and advocacy initiatives.

Critical care nursing organizations and individual critical care nurses can have an important impact on tobacco-related health policies. This article reviews the importance of critical care nursing involvement in policy efforts to achieve tobacco control goals, barriers to such involvement, and strategies to implement successful tobacco control policy initiatives. The involvement of the Association of Critical-Care Nurses and other nursing organizations in the Nursing Leadership in Tobacco Control Task Force is described.

Critical Care↗
PubMed2005

Randomized trial of amifostine in locally advanced non-small-cell lung cancer patients receiving chemotherapy and hyperfractionated radiation: radiation therapy oncology group trial 98-01.

PURPOSE: To test the ability of the cytoprotectant, amifostine, to reduce chemoradiotherapy-induced esophagitis and evaluate its influence on quality of life (QOL) and swallowing symptoms. PATIENTS AND METHODS: A total of 243 patients with stage II to IIIA/B non-small-cell lung cancer received induction paclitaxel 225 mg/m(2) intravenously (IV) days 1 and 22 and carboplatin area under the curve (AUC) days 1 and 22, followed by concurrent weekly paclitaxel (50 mg/m(2) IV) and carboplatin (AUC 2), and hyperfractionated radiation therapy (69.6 Gy at 1.2 Gy bid). Patients were randomly assigned at registration to amifostine (AM) 500 mg IV four times per week or no AM during chemoradiotherapy. Beyond standard toxicity end points, physician dysphagia logs (PDLs), daily patient swallowing diaries, and QOL (EORTC QLQ-C30/LC-13) were also collected. Swallowing AUC analyses were calculated from patient diaries and PDLs. RESULTS: A total of 120 patients were randomly assigned to receive AM, and 122, to receive no AM (one patient was ineligible); 72% received AM per protocol or with a minor deviation. AM was associated with higher rates of acute nausea (P = .03), vomiting (P = .007), cardiovascular toxicity (P = .0001), and infection or febrile neutropenia (P = .03). The rate of >/= grade 3 esophagitis was 30% with AM versus 34% without AM (P = .9). Patient diaries demonstrated lower swallowing dysfunction AUC with amifostine (z test P = .025). QOL was not significantly different between the two arms, except for pain, which showed more clinically meaningful improvement and less deterioration at 6 weeks follow-up (v pretreatment) in the AM arm (P = .003). The median survival rates for both arms were comparable (AM, 17.3 v no AM, 17.9 months; P = .87). CONCLUSION: AM did not significantly reduce esophagitis >/= grade 3 in patients receiving hyperfractionated radiation and chemotherapy. However, patient self-assessments suggested a possible advantage to AM that is being explored with modified dosing route strategies.

Aged↗
PubMed2005

Quality of life and meaning of illness of women with lung cancer.

PURPOSE/OBJECTIVES: To describe the quality of life (QOL) of women with non-small cell lung cancer (NSCLC) and examine relationships of demographic, clinical, health status, and meaning of illness (MOI) characteristics to QOL. DESIGN: Descriptive, cross-sectional survey. SETTING: In-person interviews in homes or research offices. SAMPLE: 217 women with NSCLC (greater than 6 months and less than 5 years since diagnosis, mean = 2 years); 19% of the women had advanced disease. The mean age was 65 years. METHODS: Assessments of QOL with cancer-specific (QOL Scale-Patient Version) and generic (Short Form-36) self-reports, health status (i.e., number and type of comorbid conditions, presence of depressed mood using the Center for Epidemiologic Studies Depression Scale, smoking status), and MOI (positive and negative perceptions). MAIN RESEARCH VARIABLES: QOL, health status, MOI, and demographic and clinical characteristics. FINDINGS: Serious disruptions in psychological and social aspects of QOL were common. Depressed mood, negative conceptualizations of MOI, and younger age explained 37% of the variance of global QOL and were correlated with poorer physical, psychological, and social dimensions of QOL. Thirty-six percent reported negative ascriptions of MOI; 35% experienced depressed mood; more than 75% reported distress with their diagnosis, family distress, and impact of sexual function as lowering their QOL; and 67% reported comorbid conditions, the most common being chronic obstructive pulmonary disease (31%). CONCLUSIONS: Women with lung cancer experience a range of disruptions in QOL, and more than a third associate lung cancer with negative meaning. Younger age, depressed mood, and number of comorbid diseases are risk factors for negative QOL. IMPLICATIONS FOR NURSING: These findings support the importance of assessing the QOL, MOI, and health status of women with lung cancer even after treatment is completed. Younger women may be at higher risk for disruptions.

Adult↗
PubMed2005

Nurses, smoking, and the workplace.

The purpose of this study was to examine attitudes and experiences of nurses regarding smoking and smoking cessation in the workplace. Eight focus groups were conducted with current or former smokers (n = 60). A questionnaire provided information about smoking history. Content analysis revealed six themes: taking breaks, stress and smoking, social support from colleagues, hiding smoking from patients and their families, impact of workplace smoking restrictions, and challenges to smoking cessation in the workplace. Nurses who smoke were perceived as taking more breaks and spending less time with patients than those who do not smoke. These findings document the impact of smoking among nurses in the workplace. Strategies are needed to support smoking cessation efforts of nurses as an important occupational health issue.

Adult↗
PubMed2005

Smoking, the missing drug interaction in clinical trials: ignoring the obvious.

Tobacco use is universally recognized as the foremost preventable cause of cancer in the United States and globally and is responsible for 30% of all cancer-related deaths in the United States. Tobacco use, including exposure to secondhand smoke has been implicated as a causal or contributory agent in an ever-expanding list of cancers, including lung, oral cavity and pharynx, pancreas, liver, kidney, ureter, urinary bladder, uterine cervix, and myeloid leukemia. In addition to and independent of the etiologic effects of tobacco carcinogens in numerous cancers, there is a growing literature on the direct and indirect effects of smoking on treatment efficacy (short-term and long-term outcomes), toxicity and morbidity, quality of life (QOL), recurrence, second primary tumors (SPT), and survival time as summarized below. Oncology health professionals have called for increased advocacy for tobacco control. Despite the critical relevance of smoking to cancer outcomes, most oncology clinical trials do not collect data on smoking history and status unless the malignancy is widely acknowledged as smoking related (e.g., lung or head and neck cancer). Usually, these data are collected only at trial registration. Changes in smoking status during treatment or follow-up are monitored in very few trials and are infrequently reported in sample descriptions or included in analysis plans as a potential moderator of outcomes. Based on mounting evidence that tobacco use affects cancer treatment outcomes and survival, we recommend that smoking history and status be systematically collected as core data in all oncology clinical trials: at diagnosis, at trial registration, and throughout treatment and follow-up to long-term survival or death. We feel that the inclusion and analysis of such data in clinical trials will add important information to the interpretation of outcomes and the development of scientific knowledge in this area. Smoking status has been called another "vital sign" because of its relevance to a patient's immediate medical condition. We explain the critical value of knowing the smoking status of every patient with cancer at every visit by providing a brief overview of the following research findings: (a) the effects of tobacco use on cancer treatment and outcome; (b) recent findings on the role of nicotine in malignant processes; (c) some unexpected results concerning tobacco status, treatment, and disease outcome; and (d) identifying key questions that remain to be addressed. We provide a suggested set of items for inclusion in clinical trial data sets that also are useful in clinical practice.

Clinical Trials as Topic↗
PubMed2005

Tobacco control in the 21st century: a critical issue for the nursing profession.

Tobacco control is central to reducing death and disability and improving quality of life worldwide and nursing action is imperative. This article addresses tobacco as a global health issue with implications for nursing practice, education, research, and policy development. The lack of knowledge and skills, lack of expectation for clinical intervention, limited research, an absence of professional policies, and minimal nursing leadership have diminished the critical role that nurses can play in confronting this epidemic. Swift action is needed to ensure that all nurses are prepared to effectively engage in activities to prevent tobacco use, provide evidence-based cessation interventions, and support efforts to prevent exposure to secondhand smoke. Increased opportunities are needed to support creative nursing research efforts that test interventions and strategies to reduce barriers to tobacco control within different cultures, subcultures, and countries.

Clinical Competence↗
PubMed2004

Assessing coughing and wheezing in lung cancer: a pilot study.

PURPOSE/OBJECTIVES: To establish reliability and validity of two self-report questionnaires, the Lung Cancer Cough Questionnaire and the Lung Cancer Wheezing Questionnaire. DESIGN: Prospective, exploratory pilot study. SETTING: Clinical oncology settings in the southern United States. SAMPLE: 31 adult women with lung cancer. METHODS: Content validity of both questionnaires was assessed through a comprehensive literature review and an expert judge panel. Concurrent validity was established by Spearman rank correlation coefficients and Wil-coxon Rank Sum tests with items from other valid tools. Test-retest reliability was assessed by percent agreement, kappa, paired t tests, and correlations. Internal consistency was determined by Cronbach's alpha. MAIN RESEARCH VARIABLES: Cough, wheeze. FINDINGS: Cronbach's alpha showed excellent internal consistency and percent agreement, and kappa showed similarity of item responses across test-retest administrations. Nonsignificant paired t tests indicated similar mean scores, and significant test-retest correlations supported test-retest reliability. CONCLUSIONS: Preliminary testing indicates good reliability and validity for both questionnaires. Both instruments can identify people with problems of coughing and wheezing and have the potential for monitoring these symptoms over time and determining effectiveness of interventions. IMPLICATIONS FOR NURSING: Assessment of coughing and wheezing is an important component of monitoring respiratory symptoms of lung cancer. Both of these symptoms can be amenable to interventions. Further research is needed to confirm psychometrics and sensitivity of these tools.

Cough↗
PubMed2004

Why tobacco is a women's health issue.

Tobacco use is the leading cause of preventable death amongwomen but is under-recognized as a critical women's health issue. This article provides an overview of the current data about womenand tobacco use, tobacco industry tactics that have resulted in theincreased smoking among women, and gender differences inhealth effects of tobacco use and exposure to secondhand smoke,and in cessation interventions. Resources for clinicians are pro-vided that specifically focus on women and tobacco.

Advertising↗
PubMed2004

Age, body mass index, and serum prostate-specific antigen correlate with bone loss in men with prostate cancer not receiving androgen deprivation therapy.

OBJECTIVES: Preexisting osteopenia and osteoporosis in men with prostate cancer are of concern due to accelerated bone loss during androgen deprivation therapy (ADT). We sought to identify risk factors for osteoporosis in men with prostate cancer who have not received ADT to help determine which patients may need bone mineral density (BMD) testing prior to ADT. METHODS: Lumbar spine and hip BMD testing were performed using dual-energy x-ray absorptiometry in 34 men with nonmetastatic prostate cancer who were not receiving ADT. The demographic, health status, lifestyle, and disease variables (Gleason score, clinical stage, and prostate-specific antigen level) were obtained and analyzed using univariate and multivariate methods for their role in spine and hip BMD levels. RESULTS: Of the 34 men, 73.5% had osteopenia (55.9%) or osteoporosis (17.6%) of the spine and/or hip. On univariate analysis, aging, lower body mass index, and elevated prostate-specific antigen level correlated significantly with bone loss in the spine and hip. Regression models showed age independently predicted bone loss in the spine (R2 = 0.14). Prostate-specific antigen was an independent predictor of low BMD in the trochanter (R2 = 0.18), and body mass index independently predicted low BMD in the femoral neck (R2 = 0.19). Compared with men younger than 70 years old, men 70 years old or older had less BMD in the spine (P = 0.017), femoral neck (P = 0.047), and trochanter (P = 0.030). CONCLUSIONS: A high prevalence of osteopenia or osteoporosis was found in men with prostate cancer not receiving ADT. Consideration should be given to performing BMD studies in men older than 70 years and with slender stature before initiating ADT.

Absorptiometry, Photon↗
PubMed2004

Assessment of quality of life and symptom improvement in lung cancer clinical trials.

The majority of lung cancers are diagnosed at advanced stages when treatment options are limited and mainly palliative. In advanced lung cancer, quality-of-life (QOL) issues have become an integral part of making decisions about various treatment options. Recent clinical trials in patients with lung cancer have assessed symptom improvement and QOL as important endpoints. There are several valid and reliable QOL assessment instruments that specifically evaluate symptoms of lung cancer. These questionnaires evaluate a variety of factors related to emotional, physical, and social well-being. Several key factors, including age, gender, comorbidities, and quality of supportive care may affect symptoms and QOL in patients with lung cancer. Overall, QOL is important for patients with advanced lung cancer; therefore, symptom and QOL assessments are becoming vital in evaluating the efficacy of emerging cancer treatments.

Clinical Trials as Topic↗
PubMed2004

Tobacco control policies of oncology nursing organizations.

Nurses, the largest group of health care professionals, and the policies of nursing organizations, have tremendous potential to promote health and tobacco control. Policies addressing tobacco use have been implemented by a variety of national and international nursing organizations. This article reviews existing tobacco control policies in oncology nursing organizations.

Global Health↗
PubMed2004

Impact of respiratory symptoms and pulmonary function on quality of life of long-term survivors of non-small cell lung cancer.

PURPOSE: To describe respiratory symptoms and pulmonary function among long-term survivors of non-small cell lung cancer (NSCLC), and their relationship to quality of life (QOL). METHODS: Cross-sectional survey of disease-free, 5-year minimum survivors of NSCLC (n = 142; 54% women; average age, 71 years); the majority (74%) had received a lobectomy. Analysis included frequency of self-reported respiratory symptoms (cough, phlegm, wheezing, breathlessness) as measured by the American Thoracic Society questionnaire, pulmonary function findings from hand-held spirometry, and QOL (Short Form-36). RESULTS: Two thirds of survivors reported at least one respiratory symptom (mean, 1.3; SD, 1.2): 25% cough, 28% phlegm, 31% wheezing, and 39% dyspnea. Twenty-one percent reported that they spent most of the day in bed in the past 12 months because of respiratory symptoms. Average FEV(1) percentage predicted was 68% (SD, 23); 21% had < 50% predicted FEV(1). Based on spirometry results, 36% had a moderate/severe obstructive and/or restrictive ventilatory disorder. Survivors exposed to second-hand smoke (28%) were more than three times as likely to report respiratory symptoms. Respiratory symptom burden contributed to diminished QOL in several domains. CONCLUSIONS: The majority of these survivors experienced respiratory symptoms, and more than one third reported dyspnea, including one of five patients with seriously diminished pulmonary function. Symptom burden, rather than ventilatory impairment, contributed to diminished QOL. Further study is needed to determine the patterns and effective management of posttreatment respiratory symptoms on survivors of lung cancer.

Aged↗
PubMed2003

Tobacco control policies.

OBJECTIVES: To review and summarize tobacco control policies, their impact in curbing the tobacco epidemic, and to describe a role for nursing advocacy. DATA SOURCES: Published articles and research studies. CONCLUSION: Comprehensive tobacco control policy is one of the most effective mechanisms to prevent tobacco-related cancers and other illnesses. The World Health Organization's Framework Convention on Tobacco Control, and the Master Settlement Agreement in the United States have provided new opportunities for tobacco control. Nursing participation in the policy process can expand and strengthen these policies' activities. IMPLICATIONS FOR NURSING PRACTICE: Involvement in tobacco control should be integral to oncology nursing efforts to prevent cancer, promote health, and quality of life.

Humans↗
PubMed2003

International efforts in tobacco control.

OBJECTIVES: To review international nursing involvement in tobacco control and discuss opportunities and challenges to enhance nurses' participation in decreasing tobacco-related morbidity and mortality. DATA SOURCES: Published literature and published and unpublished material developed by nurses in their tobacco control initiatives. CONCLUSION: Worldwide, nurses have been involved in tobacco control. However, many opportunities remain for involvement in the areas of education, research, and practice. IMPLICATIONS FOR NURSING PRACTICE: There are numerous opportunities for nurses throughout the world to enhance their involvement in tobacco control.

Africa↗
PubMed2003

The global epidemic of tobacco and cancer.

OBJECTIVES: To provide a global context for understanding the epidemic of tobacco-induced disease, and the need for nursing action. DATA SOURCES: International cancer and tobacco statistics; published articles. CONCLUSION: Tobacco use is a global problem and a significant issue for cancer control. The efforts of health professionals, especially those concerned about cancer, are needed to confront this epidemic. IMPLICATIONS FOR NURSING PRACTICE: Worldwide action of nurses, the largest group of health professionals, is critical in preventing tobacco use, helping with tobacco cessation, and decreasing exposure to second-hand smoke.

Global Health↗