Biomedical subjects

Lis Adamsen

Publications and source records attributed to Lis Adamsen.

11 recordsLinked to original sources

PubMed2006

The effect of a multidimensional exercise programme on symptoms and side-effects in cancer patients undergoing chemotherapy--the use of semi-structured diaries.

The aim of this study was to evaluate the effects of a 6-week intervention with structured physical activity, relaxation, body-awareness techniques and massage on the symptoms/side-effects of cancer patients undergoing chemotherapy. The study was prospective and exploratory, and 54 patients completed assessments for all 6 weeks of the intervention. In order to obtain a continuous record of side-effects, a diary was developed for the patients' use throughout the intervention. The patients scored their symptoms/side-effects on a scale from 0 to 4, using the Common Toxicity Criteria and reported these scores in questionnaires. Twelve possible symptoms/side-effects were registered daily: lack of appetite, nausea, vomiting, diarrhea, paraesthesia, constipation, physical fatigue, mental fatigue, treatment-related fatigue, muscle pain, arthralgia and other pain. During the intervention a decrease in the scoring for 10 out of the 12 side-effects was found. Statistical significance was observed in the pain score (P=0.046) and the arbitrary-derived sum of the scores for symptoms and side-effects (P=0.036) respectively. Patients with evidence of disease (n=26) had significantly higher levels of symptoms/side-effects than patients with no evidence of disease (n=28) (P=0.027). The results indicate that a six weeks multidimensional exercise intervention undertaken by cancer patients with or without residual disease while undergoing chemotherapy can lead to a reduction in treatment-related symptoms.

Adolescent↗

PubMed2006

The impact of supervised exercise intervention on short-term postprogram leisure time physical activity level in cancer patients undergoing chemotherapy: 1- and 3-month follow-up on the body & cancer project.

BACKGROUND: Exercise is becoming an important component of cancer rehabilitation programs. A consistent finding across studies is that patients experience improved physical fitness and reduced fatigue. However, sustained physical activity is essential if the benefits are to be preserved over the course of cancer survivorship. OBJECTIVE: This study examined self-reported short-term exercise adherence following a 6-week, supervised exercise program (muscle strength, cardiovascular fitness, relaxation, body awareness, and massage) in a heterogeneous group of 61 cancer patients (mean age 42.9 years, 82% oncological and 18% haematological) from the Body & Cancer Project. METHODS: Semistructured interviews were used to quantitatively assess leisure time physical activity level 1 and 3 months after completion of the program. The study furthermore included 3-month follow-up assessment of psychological distress (Hospital Anxiety and Depression Scale-HADS). Patient statements were selected that best illustrated trends found in the statistical material. RESULTS: There was a significant postprogram reduction in physical activity from 6 to 10 weeks and from 6 to 18 weeks. However, the patients (half of whom were still undergoing treatment at the time of follow-up) reported a higher physical activity level postprogram compared to their baseline levels. The analyses showed a positive association between the 3-month postprogram physical activity level and pre-illness physical activity level, treatment, and postprogram changes in depression. SIGNIFICANCE OF RESEARCH: Given the significant decrease in postprogram PA level, especially in subjects still undergoing cancer treatment, the study suggests that continuous supervised programs may be required in order to encourage and support exercise adherence in this population. However, randomized clinical controlled trials and more follow-up studies are needed to establish the optimal program length and content for sustained exercise adherence in cancer patients.

Adult↗

PubMed2005

The effect of a multidimensional exercise intervention on physical capacity, well-being and quality of life in cancer patients undergoing chemotherapy.

The aim of the present study was to investigate the impact of a multidimensional exercise intervention focusing on physical capacity; one-repetition maximum (1RM) and maximum oxygen uptake (VO2Max), activity level, general well-being and quality of life in cancer patients undergoing chemotherapy. The intervention comprised resistance and fitness training, massage, relaxation and body-awareness training. Eighty-two cancer patients, with or without evidence of residual disease, were included: 66 patients with 13 different types of solid tumours and 16 patients with 6 types of haematological malignancies. The patients trained in mixed groups for 9 h weekly for 6 weeks. Physical capacity, physical activity level and psychosocial well-being as measured by the Medical Outcomes Study 36-item Short-Form Health Survey and the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire C30 were assessed pre- and post-intervention. Highly significant increases were achieved in muscular strength (p<0.001), physical fitness (p<0.001) and physical activity levels (p<0.001). The patients reported significant reduction in treatment-related symptoms, i.e., fatigue (p=0.006) and pain (p=0.03). Highly significant improvements were observed in physical functioning (p<0.001) and role functioning (p<0.001). Even patients with advanced disease were able to improve their results after 6 weeks. It is concluded that a multidimensional exercise intervention, including resistance training, may be beneficial for cancer patients undergoing chemotherapy. This study indicates significant clinical meaningful improvements. The exact role of the intervention has to be defined in a randomized controlled design. A clinically controlled trial including 250 patients is currently being carried out.

Adolescent↗

PubMed2005

The impact of a multidimensional exercise program on self-reported anxiety and depression in cancer patients undergoing chemotherapy: a phase II study.

Little is known about the role of exercise in improving cancer patients' mood while undergoing chemotherapy. In this phase II study changes in self-reported anxiety and depression and fitness (VO2max) are reported in relation to a 6-week, 9 h weekly, multidimensional exercise program. A total of 91 patients receiving chemotherapy, between 18 and 65 years old, completed a Hospital Anxiety and Depression Scale Questionnaire (HADS; response rate 91%, adherence rate 78%). Anxiety (p < 0.001) and depression (p = 0.042) was significantly reduced. The mean +/- SD of the change was -1.14 +/- 2.91 for anxiety and -0.44 +/- 2.77 for depression. Improvements in fitness were correlated with improvements in depression, chi2(1) = 3.966, p = 0.046, but not with improvements in anxiety, chi2(1) = 0.540, p = 0.462. The research suggests that exercise intervention may have a beneficial impact on psychological distress for cancer patients receiving chemotherapy with low to moderate levels of baseline psychomorbidity. The study furthermore indicates that changes in distress may be associated with disease status and levels of physical activity undertaken during disease. The study is followed up by an ongoing randomized clinical controlled trial to evaluate potential causal effects of exercise intervention on psychological distress and fitness in cancer patients undergoing chemotherapy.

Adult↗

PubMed2005

Malignant wounds in women with breast cancer: feminine and sexual perspectives.

AIMS AND OBJECTIVES: . The aim of this article is to investigate the way malignant fungating wounds affect femininity, sexuality and daily life in women with progressive breast cancer. Malignant wounds occur when the underlying localized tumour filtrates into the skin, blood capillaries and/or lymph vessels. DESIGN: The study was a prospective and exploratory intervention study. The intervention was tested on 12 consecutively selected women with progressive breast cancer and malignant fungating wounds. METHODS: The 12 women participated in a 4-week wound care intervention programme that comprised evidence-based wound care principles and psychosocial support. Data were generated by means of interviewing prior to and following the intervention period. RESULTS: The women described how malodorous and oozing wounds trigger anxiety about seepage, prevent them from wearing feminine attire and cause them to suppress the need for physical closeness and sexual activity. The results showed that by using modern wound care products, the patients could be secured against seepage and odour. The women experienced a sense of comfort, were able to dress again as they wished, no longer felt caged in and isolated and were given a sense of freedom which they had not felt for a long time. CONCLUSIONS: The intervention succeeded in increasing breast cancer patients' psychosocial well-being and reducing social isolation. RELEVANCE TO CLINICAL PRACTICE: There is a lack of standard methods of practice for care of malignant wounds in women with breast cancer. This article describes an intervention for wound care which could improve daily live in women with progressive breast cancer.

Activities of Daily Living↗

PubMed2003

Feasibility, physical capacity, and health benefits of a multidimensional exercise program for cancer patients undergoing chemotherapy.

Cancer patients frequently experience considerable loss of physical capacity and general wellbeing when diagnosed and treated for their disease. The aim of this study was to evaluate the feasibility, physical capacity, and health benefits of a multidimensional exercise program for cancer patients during advanced stages of disease who are undergoing adjuvant or high-dose chemotherapy. The supervised program included high- and low-intensity activities (physical exercise, relaxation, massage, and body-awareness training). A total of 23 patients between 18 and 65 years of age (median 40 years) participated in groups of seven to nine patients for 9 h weekly for 6 weeks. Physical capacity in terms of repetition maximum (RM) and maximal oxygen uptake (VO(2)max), physical activity level and psychosocial wellbeing (EORTC QLQ-C30, SF-36, HAD) were compared prior to and after completion of the program. The program was safe and well tolerated. The completion rate was 85.2%. Highly significant increases in physical capacity (1RM, VO(2)max) and an improved level of physical activity were achieved. Quality of life and general wellbeing assessments indicated improvements in several measures, but without reaching significance. It is concluded that an exercise program, which combines high- and low-intensity physical activities, may be used to prevent and/or minimize physical inactivity, fatigue, muscle wasting and energy loss in cancer patients undergoing chemotherapy.

Activities of Daily Living↗

PubMed2003

Moving forward in a role as a researcher: the effect of a research method course on nurses' research activity.

The aim of this study was to investigate whether a 1-year research course in basic research methodology, designed for clinical nurses, had a positive effect on the nurses' own research activity and their commitment to research in general. The research method applied was use of semistructured interviews. Seventy-nine clinical nurses participated in the study. Students of the research course (n = 37), i.e. the study group, were compared with a group of clinical nurses who did not participate in the course (n = 42), i.e. the reference group. A statistically significant difference was found in several variables between the two groups. Eighty-nine per cent of the study group members were active in planning their own research projects compared with 35.7% in the reference group. The study group also showed a higher level of interest and commitment to research results of others and read English language articles. A total of 13.9% of the study group experienced being unable to find time during working hours to participate in research projects, while this was true for 50% of nurses in the reference group. Experiences from the research course in basic methodology show that educational programmes designed for clinical nurses may facilitate and support their own research efforts as well as enhance their commitment to research in general. The course reinforced nurses' self-confidence in research-based practice. Clinical nurses require personal initiative, perseverance and competence in research methodology as well as sensitization towards a research culture in order to move away from the salaried work of a practitioner and into the role of a researcher.

Adult↗

PubMed2003

Danish research-active clinical nurses overcome barriers in research utilization.

AIM: The aim of this study was to examine whether there was a difference between clinical nurses who were research-active, and clinical nurses who were nonresearch-active in utilization of research. A further aim was to identify the most significant barriers faced by a group of Danish clinical nurses in their use of research. BACKGROUND: Discrepancy between the improved quality of research results and the lack of implementing them was the starting point for a series of studies which showed the types of barriers clinical nurses found especially cumbersome when applying the research results of other researchers. This study investigates whether the clinical nurses' own engagement in research had any impact on their perception of research utilization. METHODOLOGY: The study had an exploratory and descriptive design. Seventy-nine Danish clinical nurses participated and semi-structured interviewing was used as the research method. FINDINGS: There was a statistically significant difference between the research-active and nonresearch-active nurses on various variables. The study showed that, to a larger extent, research-active nurses used evidence-based knowledge and were generally more internationally orientated. Furthermore, two important barriers for research utilization were identified by all 79 clinical nurses included in the study, i.e. 90% of the nurses explained that the quantity of research results was overwhelming, and 75% of them found that they were unable to evaluate the quality of the research. CONCLUSIONS: Clinical nurses, who were research-active themselves, experienced more success in overcoming some of the barriers, which existed in applying research to practice. The research potential found amongst clinical nurses in Denmark needed to be further supported through training and guidance in research methodology, establishing introductory stipends and part-time research positions. By doing so, some of the barriers affecting research utilization and the so-called theory-practice gap might be reduced. Further empirical studies, based on Giddens theory of sociological reflectivity, might see clinical nurses in a more serious light and simultaneously perceive them as producers of knowledge.

Adult↗

PubMed2003

Exploring and encouraging through social interaction: a qualitative study of nurses' participation in self-help groups for cancer patients.

Self-help groups are a growing phenomenon across national borders. Current sociologic empirical evidence shows that nurses and other healthcare professionals have become an integral part of self-help groups. The aim of the study is to describe and highlight the experiences of patients with cancer (n = 21) and oncology nurses (n = 12) with self-help groups. These experiences are drawn on to illustrate the characteristics of professional involvement in self-help groups for patients with cancer. Data were obtained by individual qualitative interviews. The results show that the nurse functions as a social networker and uses her contextual competence by consciously encouraging relationships between fellow patients. Furthermore, the study illustrates that the nurse's involvement with self-help groups for patients with cancer serves as a complementary dimension to the traditional nursing discourse. It is concluded that when individualized care is supported through social practice and when personal issues are exchanged and negotiated, the nurse facilitates a milieu of togetherness in self-help groups for patients with cancer. The concept of self-help groups is a valuable contribution to new theories and service development in psychosocial care and complies with the understanding of the postmodern individual, who viewed as primarily responsible for negotiating, socializing, and making his or her own decisions.

Adult↗

PubMed2002

'From victim to agent': the clinical and social significance of self-help group participation for people with life-threatening diseases.

AIM: The main objective of the paper is to discuss the ways in which self-help groups can be useful to persons with life-threatening diseases like cancer or human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS). The paper offers an outline of the central characteristics of self-help groups, highlighted by the participants themselves. BACKGROUND: Self-help groups are a growing phenomenon across national borders. New empirical sociological studies show that nurses have become important agents in self-help groups, both within and outside the public health-care system. However, research on self-help groups is a relatively new area within nursing studies yet it serves an important function in shedding light on a rather unique form of social practice organized and managed partly by the participants themselves. METHODS: Qualitative interviews designed to examine how participants evaluate their experiences with self-help groups. The study includes 53 self-help group participants suffering from cancer or HIV/AIDS. FINDINGS: Contact with other people, forming of friendships, new networks and increased self-confidence are some of the effects indicated by the participants. Participation in a self-help group has a positive impact on the patients' ability to cope with the psychological and social consequences of living with a life-threatening disease. CONCLUSIONS: It is evident that the positive effects of self-help groups are mainly because of their inherent capacity for universalizing personal problems, which, in itself, legitimizes the scientific relevance of self-help groups. There is no evidence to indicate that self-help groups have a positive influence on the life expectancy of participants who suffer from cancer or HIV/AIDS, but it should be noted that this is not the explicit concern when groups are formed. By their very existence self-help groups indicate the need for a reevaluation of the scope and focus of the individualized care and nursing. The clinical and social significance of self-help group participation has not been sufficiently accounted for.

Denmark↗

PubMedDate not supplied

There is no gap 'per se' between theory and practice: Research knowledge and clinical knowledge are developed in different contexts and follow their own logic.

The aim of this article is to highlight relations between theory and practice and the genesis of professional action in clinical nursing and among researchers. With use of a sociologically based empirical approach, focus is placed on the knowledge involved in the work of researchers and practitioners in terms of the source of their knowledge. Unlike a dominant barrier paradigm, theory and practice have different logics; they are not on a continuum nor are they hierarchically ordered. They exist in their own right as theoretical knowledge and practical knowledge. In daily practice, clinical nurses are inspired and learn from the context, including each other, and they are active producers of knowledge, not simply recipients of knowledge. This study, therefore, claims that there is no research-practice gap "in itself" (per se) as argued in the "barriers paradigm."

Ethics, Clinical↗