PubMed Health⌕ Search

Biomedical subjects

M Haberman

Publications and source records attributed to M Haberman.

10 recordsLinked to original sources
PubMed2005

Development, feasibility and compliance of a web-based system for very frequent QOL and symptom home self-assessment after hematopoietic stem cell transplantation.

We believe that many adverse events following hematopoietic stem cell transplantation (HSCT), particularly relapse and chronic graft-versus-host disease (CGVHD), are preceded by a subclinical period of development that is accessible by frequent psychometric assessment. Documenting these associations could improve future clinical care by extending the potential window for intervention. However, conventional methods of assessing quantity of lite (QOL) in patients in their homes, typically by mailed self-assessment questionnaires, are impractical for very frequent administration. We have developed and implemented a web-based system for measuring short-term (dynamic) changes in QOL by employing brief, online, daily QOL assessments and more extensive, monthly online assessments from patients' homes. Here we report the feasibility of collecting very frequent patient home self-assessments of QOL via the web for a 52 week participation period; we detail incidence of home web access, accrual, compliance, and satisfaction with the system in an HSCT patient sample. We also describe our integrated web-systems for administering patient recruitment, scheduling, monitoring, and analysis. Our results suggest that very frequent routine collection of QOL outcomes is entirely feasible using our web-based home assessment tool, with good patient compliance and high user satisfaction. We believe our methodology shows great promise for use with other cancer and health populations.

Adult↗
PubMed1996

Evaluation of burnout and job satisfaction in marrow transplant nurses.

The study examined incidence of burnout syndrome, psychopathology, and job satisfaction in bone marrow transplant nurses, in relation to existence of an informal psychosocial support programme for staff needs. Forty nurses participated in the study completing four standardised measures related to burnout, anxiety, depression, satisfaction with aspects of their job, and social support. Results indicated that burnout among these nurses was low, and high personal accomplishment from working with marrow transplant patients was the response of the majority. Job satisfaction was also found to be high, with outpatient nurses scoring significantly higher than inpatient nurses in most aspects of job satisfaction. One out of four subjects presented with the psychic manifestations of the anxiety neurosis, suggesting the stressfullness of the marrow transplant environment, which requires a high degree of responsibility and advanced nursing skills. Social support was not found to influence burnout, psychopathology, or job satisfaction. Presence of depression, low personal accomplishment, and dissatisfaction with pay were the variables predicting high emotional exhaustion, one of the main components of burnout. These results were suggestive of less burned out and more satisfied nurses compared to marrow transplant nurses working in environments with no formal or informal staff support programmes. This highlights the need for development of support services for the nursing staff, allowing them to ventilate their feelings, discuss issues of concern to them and seek professional support where necessary.

Adult↗
PubMed1995

Quality of life of 125 adults surviving 6-18 years after bone marrow transplantation.

BACKGROUND: Recent studies examining the medical and psychosocial sequelae of bone marrow transplantation have reported most survivors do relatively well while a smaller group continues to experience less than optimal quality of life (QOL). Many of these studies are limited by small sample sizes, limited scope, and focus on a narrow (1-4 year) window of survival. METHODS: The descriptive survey examined the QOL, late medical complications, psychological distress, demands of long-term recovery, and health perceptions of 125 adults surviving 6-18 (mean 10) years after marrow transplantation. Seven wide-ranging tests covering 271 items were completed on average in 90 min. Two tests were developed by the authors specifically for assessing QOL in this population. RESULTS: 74% of long-term survivors of bone marrow transplantation reported their current QOL was the same or better than before transplantation, 80% rated their current health status and QOL as good to excellent, and 88% said the benefits of transplantation outweighed the side effects. Ten years or more post-transplantation, long-term survivors continued to experience a moderate incidence of lingering complications and demands, including emotional and sexual dysfunction, fatigue, eye problems, sleep disturbance, general pain and cognitive dysfunction. However, the severity or degree of distress attributed to those complications was, for most survivors, consistently low. Nearly all were back to work or school. Only 5% rated both their QOL and health status as poor. Long-term survivors demonstrated good mood and low psychological distress compared to cancer and population norms, and had the same perceptions as the general population of their current health and expectation of future health. Demands attributed to long-term survival appeared to impose little hardship. The most frequently cited demand of recovery was the perceived lack of social support as time went on. CONCLUSIONS: Almost all long-term survivors were leading full and meaningful lives. Persistent complications were, on the whole, dismissed as relatively trivial and the overwhelming majority viewed themselves as cured and well.

Adult↗
PubMed1995

The meaning of cancer therapy: bone marrow transplantation as an exemplar of therapy.

Cancer touches all dimensions of life and consequently all realms of personal meaning including people's beliefs in an orderly and controllable world. Regaining a belief in a comprehensible world often begins with the confirmation of a definitive diagnosis and the initiation of therapy. The meaning of therapy will vary depending on the availability of viable treatment options, the natural history of cancer, the daily challenges of living with cancer, and the outcome of treatment. This article reviews the literature on the meaning of cancer therapy, explanatory models of therapy, and the meaning of personal control during treatment. A qualitative study of 23 adults with leukemia who were waiting to undergo a bone marrow transplantation (BMT) was conducted to describe the personal meaning of leukemia and BMT. The findings indicate that seeking confirmation for the diagnosis of leukemia is often impersonal, fraught with uncertainty, and surrounded by an unexplained sense of urgency. When making the decision to undergo BMT, people transformed the biomedical estimates of survival into personal terms to humanize the odds and to inflate their perceived chances of survival. Before undergoing BMT, individuals recalled their previous experiences with cancer therapy in an effort to make the unknown future more predictable. Ways to self-monitor daily progress and suggestions for mitigating the devastating effects of bad news were identified. Physicians were identified as controlling the BMT treatment regimen, whereas nurses were perceived as controlling the daily care routines. Implications include the need to give patients preparatory information about what to expect in therapy as well as the need to help them identify how they can cope effectively.(ABSTRACT TRUNCATED AT 250 WORDS)

Adaptation, Psychological↗
PubMed1994

Dietitian practices for adult outpatients with hypercholesterolemia referred by physicians. The Minnesota Dietitian Survey.

OBJECTIVE: To characterize the physician-to-dietitian referral process and dietitian practice patterns and opinions related to adult outpatients with hypercholesterolemia. DESIGN: Cross-sectional mail survey. PARTICIPANTS: Minnesota dietitians who treat adult outpatients referred by physicians for hypercholesterolemia. MAIN OUTCOME MEASURES: Proportion of patients for whom background information or specific diet instructions were provided by referring physicians and for whom follow-up was recommended and dietary fat content calculated by the dietitians. RESULTS: Completed questionnaires were returned by 216 of 267 eligible dietitians (81% response rate). Respondents saw, on average, 31 referred patients per month, 31% of whom were referred for hypercholesterolemia, 31% for type II diabetes mellitus, and 24% for obesity. For patients referred for hypercholesterolemia, background information was provided by physicians 37% of the time, and specific diet instructions 15% of the time. One or more follow-up visits by the dietitians were recommended for 42% of patients referred for hypercholesterolemia, compared with 60% and 70% of patients referred for diabetes and obesity, respectively. The average number of additional visits within 6 months of the initial consultation recommended by dietitians was 2.0 for patients referred for hypercholesterolemia, 3.5 for patients referred for diabetes, and 6.7 for patients referred for obesity, and the number of visits that occurred was half or less than that recommended. Dietary fat content was calculated by the dietitians for only 25% of patients referred for hypercholesterolemia. CONCLUSIONS: For adult outpatients referred to dietitians for hypercholesterolemia, relevant patient information is usually not provided by referring physicians, the number of follow-up visits is well below what would reasonably be expected to produce significant and sustained eating behavior change, and calculation of dietary fat content is generally not done. More research is needed to determine appropriate nutrition intervention protocols for these patients.

Adult↗
PubMedDate not supplied

Quality of life of adult long-term survivors of bone marrow transplantation: a qualitative analysis of narrative data.

Recently, clinicians and researchers alike have challenged the long-standing impression that survivors of bone marrow transplantation (BMT) experience a less than optimal quality of life (QOL). Despite the accumulating evidence suggesting that most adult survivors adjust relatively well within two to five years after BMT, little is known about the growing population of recipients living well beyond five years. This paper reports the design and qualitative components of a large study that used a cross-sectional, descriptive, mailed survey design. The aim of the study was to document systematically how 125 adult survivors of BMT (6-18.4 years post-transplant) perceived the quality of their lives. An eight-item, open-ended questionnaire was used to gather information on the reestablishment of life after BMT, demands of recovery, coping strategies, limitations imposed by BMT, current health problems, QOL, and concerns for the future. Content analysis of the verbatim responses indicated that most long-term survivors, despite the persistence of lingering side effects, perceive themselves as cured and well, leading full and meaningful lives. Nursing therapeutics can focus on providing accurate and timely information about the known long-range complications of BMT. Further research is needed to examine the entire issue of social support following BMT and to identify the special care requirements of the recipients (5%) who reported poor physical and mental health.

Activities of Daily Living↗
PubMedDate not supplied

Quality of life and the cancer experience: the state-of-the-knowledge.

PURPOSE/OBJECTIVES: To address the state-of-the-knowledge concerning quality of life (QOL) issues and the cancer experience from theoretical, research, clinical, and educational perspectives. DATA SOURCES: Published books and articles and a panel of experienced QOL experts who convened at the Oncology Nursing Society's State-of-the-knowledge Conference on Quality of Life in February 1995. DATA SYNTHESIS: Despite the evolution and support of QOL in oncology nursing practice, education, and research, there remains gaps in theory, research, and practice related to QOL. This article explores these gaps in knowledge and recommends future directions for QOL theory, research, education, and practice. CONCLUSIONS: Further conceptual work and resolution of QOL methodologic issues to guide clinical practice and education are warranted. The impact of cultural variables and precancer life experiences on patients' perceptions of QOL also must be addressed. NURSING IMPLICATIONS: Oncology nurse clinicians, educators, and researchers must continue to work collaboratively to enhance the knowledge base regarding QOL and to improve the nursing care provided to individuals with cancer.

Adolescent↗