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Biomedical subjects

M E Haisfield-Wolfe

Publications and source records attributed to M E Haisfield-Wolfe.

11 recordsLinked to original sources
PubMed2001

SNAP-shots: scenes from nursing action plans--the cultivation of leadership in oncology nursing.

PURPOSE/OBJECTIVES: To describe the experiences of oncology nurses who participated in a national workshop to prepare nurses to lead the transformation of cancer care and to illustrate the range of possibilities available to nurses motivated to affect positive change. DATA SOURCES: Literature on leadership and negotiation are referenced and related to the personal experiences and the observations of participants in the workshop. DATA SYNTHESIS: Leadership is presented in historical context. A case study approach was used to organize the personal accounts of participants' plans to affect positive organizational change in oncology care settings. Scenes from action plans illustrate how the workshop's core curriculum, which focuses on leadership models, processes, and skills, was realized in practice. CONCLUSIONS: Leadership is a dynamic process that shapes and is shaped by all stakeholders during the process of planned change. Education, risk taking, and active participation are vital components of the process of leadership development. IMPLICATIONS FOR NURSING PRACTICE: The contributions of nurses may be simple of complex and affect single individuals, groups, or institutions. In all cases, oncology nursing practice and cancer care may be enhanced.

Breast Neoplasms↗
PubMed1999

Staging of malignant cutaneous wounds: a pilot study.

PURPOSE/OBJECTIVES: To determine the color, size, hydration, and general appearance of malignant cutaneous wounds (MCWs); the effectiveness of using digital imagery to quantify wound characteristics; and the feasibility of an MCW staging system. DESIGN: Descriptive pilot study. SETTING: A university-affiliated, comprehensive cancer center. METHODS: Assessment of each subject's wound (N = 13) using the Hopkins Wound Assessment Tool (HWAT) and digital analysis of photographs. Development of an MCW staging system from grouping and classifying the assessment data. A panel of experts used the assessment data and MCW staging system to determine each subject's wound stage and the feasibility of a staging system. Visual HWAT data and digital photographic assessment data were compared for consistency in size, color, and hydration status. MAIN RESEARCH VARIABLES: Characteristics and stages of MCW; digital imagery. FINDINGS: Investigators identified four stages of MCW using the wound characteristics. Digitally assessed wound measurements of size, color, and hydration status were consistent, reflecting the ability of this method to accurately capture malignant wound characteristics. CONCLUSIONS: An MCW staging system is feasible. Wound color, hydration status, the absence or presence of nodules, drainage, pain, odor, and tunneling indicate the stage of malignant wound progression. The two stages identified are distinctly different from pressure or diabetic wound progression. Stage 1N is characterized by fibrous desmoplasia (hard fibrous nodule) of cancer metastasis, and stage 4 is characterized by destruction of the basement membrane. Data comparisons indicate that digital assessment has potential for more accurately recording wound assessment indices. IMPLICATIONS FOR NURSING PRACTICE: Nurses can improve their assessment and management of a patient's MCW by understanding the wounds' stages and using a digital imaging protocol. Further research is needed to establish the reliability and validity of the MCW staging system and the digital assessment and quantification protocol.

Adult↗
PubMed1998

Establishing mechanisms to conduct multi-institutional research--fatigue in patients with cancer: an exercise intervention.

PURPOSES/OBJECTIVES: To describe the process of establishing a multi-institutional interdisciplinary team of oncology researchers and conducting a pilot study of an exercise intervention for fatigue. DATA SOURCES: Project meeting minutes and records, research team members' logs, subjects' research records, the research study proposal, and team members' individual and collective shared experiences. DATA SYNTHESIS: Site investigators established research teams at five academic medical centers. Fifty subjects were enrolled in the study and tested during their cancer treatment. Study methods, including instrumentation, were evaluated carefully and revised. CONCLUSIONS: The multi-institutional network of researchers is an effective and efficient model for testing an intervention to manage fatigue during cancer treatment. IMPLICATIONS FOR NURSING PRACTICE: Exercise is a feasible and potentially beneficial intervention to combat distressing cancer treatment-related fatigue. A pilot study is essential to determine the best methods for conducting a clinical trial and to develop the teams of researchers necessary for such a project.

Exercise Therapy↗
PubMed1997

Effects of exercise on fatigue, physical functioning, and emotional distress during radiation therapy for breast cancer.

PURPOSES/OBJECTIVES: To test the hypothesis that women participating in a walking exercise program during radiation therapy treatment for breast cancer would demonstrate more adaptive responses as evidenced by higher levels of physical functioning and lower levels of symptom intensity than women who did not participate. DESIGN: Experimental, two-group pretest, post-test. SETTING: Two university teaching hospital outpatient radiation therapy departments. SAMPLE: 46 women beginning a six-week program of radiation therapy for early stage breast cancer. METHODS: Following random assignment, subjects in the exercise group maintained an individualized, self-paced, home-based walking exercise program throughout treatment. The control group received usual care. Dependent variables were measured prior to and at the end of radiation therapy. In addition, symptoms were assessed at the end of three weeks of treatment. MAIN RESEARCH VARIABLES: Participation in the walking exercise program, physical functioning fatigue, emotional distress, and difficulty sleeping. FINDINGS: Hypothesis testing by multivariate analysis of covariance, with pretest scores as covariates, indicated significant differences between groups on outcome measures (p < 0.001). The exercise group scored significantly higher than the usual care group on physical functioning (p = 0.003) and symptom intensity, particularly fatigue, anxiety, and difficulty sleeping. Fatigue was the most frequent and intense subjective symptom reported. CONCLUSIONS: A self-paced, home-based walking exercise program can help manage symptoms and improve physical functioning during radiation therapy. IMPLICATIONS FOR NURSING PRACTICE: Nurse-prescribed and -monitored exercise is an effective, convenient, and low-cost self-care activity that reduces symptoms and facilitates adaptation to breast cancer diagnosis and treatment.

Adult↗
PubMed1996

End-of-life care: evolution of the nurse's role.

PURPOSE/OBJECTIVES: To describe nurses' expanded roles during end-of-life patient care considering changing attitudes toward death and the use of increased technology in medical care. DATA SOURCES: Books, journals, and professional exchange. DATA SYNTHESIS: Historical and currently changing attitudes toward death and medical technology have led to nurses increased involvement in end-of-life patient care activities. CONCLUSIONS: Nurses assume important roles in the end-of-life care of patients. Their roles, which still are evolving, are influenced by individual patient wishes, attitudinal changes toward death, technologic advances in medical care, and changing laws. IMPLICATIONS FOR NURSING PRACTICE: Nurses today do more than merely provide comfort care to dying patients. They also assist patients in making difficult decisions regarding care and making choices regarding death. This expanded nursing role must continue to be recognized, developed, and evaluated in order to provide quality outcomes, even in situations where death is inevitable.

Attitude to Death↗
PubMedDate not supplied

A nursing protocol for the management of perineal-rectal skin alterations.

Perineal-rectal care is defined as skin care to the region between the vulva and anus in the female and scrotum and anus in the male (Costello, 1997). Perineal-rectal care is essential to prevent infection and promote comfort but is complicated by the anatomical location of the perineum and rectum. In addition, no standardized perineal-rectal care approach exists. Patients with cancer are at particular risk for developing perineal-rectal skin breakdown because of immunosuppression, side effects of radiation and chemotherapy, and compromised nutritional status. A perineal-rectal skin-care protocol is presented that incorporates recommendations for routine care as well as recommendations for managing common skin alterations, including erythema, dry and moist desquamation, and infection.

Dermatitis↗
PubMedDate not supplied

Malignant cutaneous wounds: a management protocol.

Malignant cutaneous wounds are emotionally traumatic and difficult to manage lesions which occur secondary to infiltration of cancer into the skin. They occur in patients with end-stage disease and are highly exudative, malodorous, and bleed easily. Quality of life is the goal for treatment, which includes radiation, chemotherapy, surgery, and local wound care. Odor is addressed with varying levels of success through wound cleansing, external deodorizers, charcoal-impregnated dressings, topical antimicrobial therapy, and metronidazole. Exudate is managed with highly absorbent dressing materials, topical steroids or hyoscine (a drying agent). Light bleeding is controlled with local pressure and hemostatic dressings; heavier bleeding may require ligation or cauterization. Cosmetic appearance and other psychosocial issues must be assessed on an ongoing basis. Creative dressing techniques can help restore the look of symmetry to the patient's body. Effective wound management, debridement, and antimicrobial therapy can reduce the risk of infection. Wound cleansing, through irrigation or flushing, should not cause pain, further trauma or bleeding. Dressings should maintain a moist wound environment and not traumatize the wound upon removal. A protocol is included which can be individualized to the needs of each patient and addresses assessment, interventions, patient teaching, documentation, and expected outcomes.

Bandages↗