Biomedical subjects

M I Fitch

Publications and source records attributed to M I Fitch.

At least 19 recordsLinked to original sources

PubMed2001

Patient-health care provider communication during chemotherapy treatment: the perspectives of women with breast cancer.

Recognition that communication plays a central role in the provision of quality patient care has led to learning more about interactions between patients and their health care providers. The present study examined interactions between women with breast cancer and their cancer care specialists from the patients' perspective during the time the women underwent chemotherapy treatment. In total 40 women from two regional cancer centers were interviewed about their communication experiences. Prevalent themes identified from analysis of the interview transcripts could be classified into two main categories. One category focused on the nature of the information exchange and included the themes of interaction modes and the power of information. The second category reflected relationship issues and included the themes of roles and responsibilities and connectedness. From their narratives, several patient, professional, and contextual factors could be identified that influenced women's perceptions about the quality of their communication experience.

Adult↗

PubMed2001

Self-help groups: oncology nurses' perspectives.

During the past decade in North America, the number of self-help groups for cancer patients has grown dramatically. Nurses' knowledge and attitudes about self-help groups could influence their practice behaviours and the information they provide to cancer patients. However, little is known about oncology nurses' views regarding self-help groups. This study used a cross-sectional survey to gather information about knowledge, attitudes, and practice behaviours of Canadian oncology nurses regarding self-help groups. A total of 676 nurses completed the survey (response rate of 61.3%). The respondents had spent, on average, 21.6 years in nursing and 11.6 years in oncology nursing. Results indicated that a large majority of nurses knew about available self-help groups. Approximately one-fifth of the nurses are speaking frequently about self-help groups with patients (20.7%) and are initiating the conversation on a frequent basis (22.0%). Overall, oncology nurses rated self-help groups as helpful with regards to sharing common experiences (79.5%), sharing information (75.6%), bonding (74.0%), and feeling understood (72.0%). The most frequently identified concern regarding the groups was about misinformation being shared (37.9%), negative effects of associating with the very ill (22.1%), and promoting unconventional therapies (21.2%). Implications from the study suggest that oncology nurses would benefit from learning more about the nature of self-help groups and being able to talk with patients about the self-help experience.

Attitude of Health Personnel↗

PubMed2001

Evaluation of a breast self-examination (BSE) program in a breast diagnostic clinic.

The purpose of this study was to evaluate the short-term effectiveness of a breast self-examination (BSE) teaching program on women's knowledge about BSE, proficiency in performing BSE, and motivation to perform BSE. The program was developed for delivery by nurses in a breast diagnostic clinic, a clinic designed to meet the need for expeditious management of breast disease, current information about breast cancer risk, surveillance, and counselling. A convenience sample of 68 women attending the clinic in a regional cancer centre participated in a pre- and five month post-teaching program evaluation. The Toronto Breast Self Examination Instrument was used as the evaluation tool. There were statistically significant changes following the teaching program in the areas of knowledge about the correct technique for performing BSE, proficiency performing BSE, and confidence about finding changes when performing BSE. No significant changes were observed in motivation to practise BSE, although group scores did improve following the education. Participants found the video presentation and the review of BSE information pamphlets by the nurse to be the most helpful components of the BSE teaching program.

Adult↗

PubMed2001

Perspectives on living with ovarian cancer: older women's views.

PURPOSE/OBJECTIVES: To describe the perspectives of older women regarding their experiences living with ovarian cancer. DESIGN: Retrospective survey. SETTING: Canada. SAMPLE: 146 women, 61 years of age or older, diagnosed with ovarian cancer. METHODS: Questionnaire distributed by oncologists and nurses in 26 cancer clinics across Canada to eligible patients during a six-week period. MAIN RESEARCH VARIABLES: Patient problems experienced, help received for problems, impact of illness, quality of life, importance of and satisfaction with information received, and helpfulness of others. FINDINGS: Women experienced, on average, 5.2 problems since diagnosis. The most frequently identified problems were side effects (54%), fear of recurrence (45%), bowel difficulties (43%), and difficulty sleeping (36%). Of the women who experienced problems, the proportion who felt they received adequate help ranged from 36%-74%. Approximately half (57%) of these women reported a lifestyle change. A significant difference was observed in quality of life before and after the diagnosis of ovarian cancer (p = 0.0002). When asked about the desire to talk about their difficulties with cancer, only 54% indicated that they wanted to talk. Approximately one-quarter of the women were satisfied with the information they received regarding complementary (25%) and alternative (23%) therapies, and how to speak with other women living with ovarian cancer (28%). Thirty-five percent were satisfied with the information they received about self-help groups. CONCLUSION: Ovarian cancer has a significant impact on older women, and many perceive they are not receiving adequate assistance for problems they experience. IMPLICATIONS FOR NURSING PRACTICE: Oncology nurses should conduct comprehensive assessments of the needs of older women with ovarian cancer, refer those who require specialized counseling, and provide information desired by patients with ovarian cancer about available resources.

Adaptation, Psychological↗

PubMed2000

Utilization of professional supportive care services by women with breast cancer.

This paper reports on the results of a survey of utilization of professional supportive care services by women with breast cancer, and on patterns of differential service utilization by sub-groups of patients. Study participants were women with invasive breast cancer diagnosed 23-36 months prior to contact about the study, and randomly selected from the Ontario Cancer Registry. From among 1,119 eligible women sent survey questionnaires, 731 returned completed questionnaires (65%). A total of 31% of respondents reported accessing one or more of the following professionals: social worker, psychologist, psychiatrist, dietitian, physiotherapist. Among those who responded to a question about whether they would have liked specific services, 34% reported that there was at least one professional supportive care service they would have liked to use, but were unable to access. Factors shown to be related to greater utilization of services included: younger age, higher household income, employed or student status, private health insurance coverage, and having received chemotherapy. Overall, there was a surprisingly low utilization of professional specialized supportive care services among women with breast cancer. Policy implications include finding strategies to better inform cancer patients about existing services, and ensuring that a core set of services are available to all patients.

Aged↗

PubMed2000

Women's perspectives regarding the impact of ovarian cancer: implications for nursing.

Ovarian cancer is the fourth leading cause of cancer-related death in women. Ovarian cancer and its treatment have a considerable effect on the quality of life of women diagnosed with the disease. Currently, little is known about the perspectives of women regarding their experiences of living with ovarian cancer or the impact of recurrent disease. This article presents data from a national study of Canadian women living with ovarian cancer and describes the impact of the disease and its treatment. In this study, 93 women had recurrent disease, and 170 had not experienced recurrent disease. Women in both groups were similar, ranging in age from 21 to 61 years. Two-thirds of the women were married, and all were white. A greater proportion of the women with recurrent disease reported bowel problems; fears of dying, pain, getting around; and feelings of self-blame. On the average, women with recurrent disease reported experiencing more problems since diagnosis than those without recurrent disease (p = 0.01). The proportion of women who perceived that they received adequate help for their problems ranged from 20% to 85%. Implications for oncology nurses regarding assessment, referral for assistance, and patient education are apparent from the study findings.

Adaptation, Psychological↗

PubMed2000

Measuring patient outcomes in palliative care: a reliability and validity study of the Support Team Assessment Schedule.

This study reports the process and results of a psychometric evaluation of a clinical audit tool, the Support Team Assessment Schedule (STAS), used to measure outcomes of palliative care. The STAS was developed in London, UK to audit community palliative care services provided by a support team. The purpose of this study was to evaluate the reliability and validity of the STAS when introduced in a different setting and with different populations from those for which it had been designed. Evaluation of the STAS was completed using multidisciplinary team members, patients and families from a palliative care unit and an oncology unit of a large urban Canadian teaching hospital. The results from the reliability tests revealed a lack of consistency in the use of the tool by team members with simulated patients in clinical scenarios. The validity analysis highlighted the differences between patients, families and health care professionals' perceptions of the same clinical situation. This study provided a valuable perspective on using a previously developed clinical audit tool in different patient populations and clinical settings. Recommendations for future use of the tool are offered.

Canada↗

PubMed2000

Cancer treatment-induced menopause: meaning for breast and gynecological cancer survivors.

Many cancer survivors are faced with irreversible changes resulting from cancer treatment. One such change some women face after cancer is treatment-induced menopause. Eight women (four with breast and four with gynecological cancers) were interviewed to explore the impact of treatment-induced menopause on their lives. Results indicated that participants' understanding and coping with menopause occurred within the larger context of the total cancer experience. For some of the women, menopause was not a significant problem; for others, the symptoms caused major distress and were a continuing reminder of the losses suffered due to cancer. Important concerns for all participants were: taking and keeping control, the desire to return to "normal" after cancer, and maintaining a coherent sense of self. Strong statements were also made about the power of knowing and the power of support in coping with treatment-induced menopause. Findings are discussed with implications for nursing practice.

Adaptation, Psychological↗

PubMed2000

Men's perspectives on the impact of prostate cancer: implications for oncology nurses.

PURPOSE/OBJECTIVES: To describe the perspectives of men with recurrent prostate cancer regarding their experiences with the disease, its impact, and the help they received and to compare these individuals to men without recurrent prostate cancer. DESIGN: Cross-sectional survey. SETTING: Physicians' offices and prostate cancer self-help groups in Canada. SAMPLE: A convenience sample of 120 men with recurrent prostate cancer and 845 men without recurrent disease. METHODS: A survey instrument was developed following in-depth interviews with men living with prostate cancer. The men received survey packages from their physicians or through a self-help group, completed the instrument at home, and returned it in a prestamped addressed envelope. MAIN RESEARCH VARIABLES: Impact on lifestyle, satisfaction with communication, importance of information, satisfaction with information received, problems experienced, and assistance received for problems. FINDINGS: Significant differences related to a number of factors were found between the men with recurrent prostate cancer and those without recurrent disease. A large number of those with recurrent disease experienced problems with side effects, anger, and pain and received help for their pain; experienced a negative impact on leisure time and on mental health; experienced difficulty talking with healthcare professionals; and felt the need to talk with someone about their cancer. Many of the men with recurrent disease were dissatisfied with the information they received about their medical condition and possible side effects. CONCLUSIONS: Men with prostate cancer experience both physical and psychosocial difficulties. Many perceive that they are not receiving adequate help for these difficulties. Future research is needed to increase understanding of how men are managing the impact of prostate cancer and what types of interventions would be most useful. IMPLICATIONS FOR NURSING PRACTICE: Findings emphasize the need for nurses to be certain that they are conducting broad-based assessments of patients with prostate cancer throughout the illness experience. Nurses need to inform patients about services available to assist them, help patients understand the emotional responses to illness, and provide opportunities for patients to talk about the illness and its impact.

Aged↗

PubMed1999

When mom's sick: changes in a mother's role and in the family after her diagnosis of cancer.

As social entities, individuals enact roles and carry out responsibilities. Roles are learned and influenced by many social forces. They give meaning and value to life and foster a sense of belonging and contribution. Roles can undergo profound transformation during and after a diagnosis of cancer. In most family situations, the role of mother is a significant caretaking role. However, little research has focused on understanding the alterations that can occur in the mother's role when a woman faces cancer. The purpose of this study was to explore, from a woman's perspective, the experience of being a mother living with life-threatening illness. In-depth interviews were held with 47 mothers diagnosed as having cancer. Their children ranged in age from 1 to 18 years. Content and theme analyses were performed on the transcribed texts. The findings describe the impact of the cancer on the women and their families and how they felt about any changes in their roles as mothers.

Adaptation, Psychological↗

PubMed1999

Oncology nurses' perspectives on unconventional therapies.

Unconventional therapies have become increasingly popular with health care consumers in recent years. As patients seek information and attempt to make decisions about unconventional therapies, they often turn to nurses, asking their opinion about certain therapies. The nurse's attitudes and beliefs about unconventional therapies very likely will influence the response to the patient's inquiries. This work represents the findings of interviews with 48 nurses regarding their perspectives on unconventional therapies. Without exception, all nurses interviewed emphasized the need for information regarding unconventional therapies to be readily available for patients and health care professionals. The other themes identified in the interviews included the following: various people use unconventional therapies; people seek unconventional therapies for a variety of reasons; communication about unconventional therapies needs to be open; and conventional and unconventional practitioners ought to work collaboratively. The participants interviewed saw a clearly defined role for nurses regarding unconventional therapies.

Attitude of Health Personnel↗

PubMed1999

Nurses' perspectives on unconventional therapies.

Unconventional therapies have become increasingly popular with health care consumers in recent years. As patients seek information and attempt to make decisions about unconventional therapies, they often turn to nurses, asking the nurse's opinion about certain therapies. The nurse's attitudes and beliefs about unconventional therapies quite likely will influence the response to the patient's inquiries. This article represents the findings of interviews with 20 nurses regarding their perspectives on unconventional therapies. Without exception, all nurses who were interviewed emphasized that information regarding unconventional therapies needs to be available readily for both patients and health care professionals. Other themes identified in the interviews included the following: Various people use unconventional therapies; people seek unconventional therapies for a variety of reasons; communication about unconventional therapies needs to be open, and a place should be found for unconventional therapies. The interviewees saw a clearly defined role for nurses regarding unconventional therapies.

Attitude of Health Personnel↗

PubMed1999

Survivors' perspectives on the impact of prostate cancer: implications for oncology nurses.

Providing effective care for individuals with prostate cancer is an important issue for oncology nurses. However, the paucity of empirical work regarding the impact of prostate cancer presents a limitation in designing and implementing appropriate nursing interventions. This article presents the findings from a national survey of 621 Canadian men living with prostate cancer regarding the impact of their disease and the availability of support. The most frequently identified problems included sexual function, side effects, fear of dying, incontinence, anger and pain. Approximately one-third of the respondents experienced a lifestyle change, but relatively few indicated experiencing a negative impact from the changes they experienced. The majority of respondents indicated they had been informed accurately about their treatment, but dissatisfaction was expressed regarding lack of information about emotional reactions, alternative therapies, how to speak with other prostate cancer patients and the availability of counselling and self-help groups. Clearly these results have implications for oncology nurses.

Adaptation, Psychological↗

PubMed1999

Important issues in clinical practice: perspectives of oncology nurses.

As the 1990's draw to a close, the cancer care environment is undergoing rapid change. Many issues exist within the complex environment of cancer care that could create a challenge in providing quality nursing care to patients. This study examined the current challenges oncology nurses face in their daily practice. Surveys were mailed to members of the Canadian Association of Nurses in Oncology asking them to indicate on a list of 80 issues which were problems in their daily practice. From the responses of 249 oncology nurses, the following items were ranked as the top 10 problems: anxiety, coping/stress management, bereavement/death, fatigue, metastatic disease, comfort, pain control and management, quality of life, recurrence of primary cancer, and nurse burn-out. Principal component analysis was conducted to determine if patterns existed in the way problems had been rated. Five components explained 42% of the variance in the data set: comprehensive cancer care, communication, experience of loss, terminal illness, and signs and symptoms. Implications for nursing practice, education and research are highlighted.

Adaptation, Psychological↗

PubMed1999

Canadian women's perspectives on ovarian cancer.

OBJECTIVE: To describe the perspectives of Canadian women living with ovarian cancer regarding their experiences with the disease. DESIGN: A cross-sectional survey of a convenience sample of Canadian women with ovarian cancer. SETTING: Survey questionnaires were sent to physicians in 26 cancer programs that treat women with ovarian cancer and to ovarian cancer self-help groups for subsequent distribution to women. PARTICIPANTS: Women diagnosed with ovarian cancer and able to read English or French. MAIN OUTCOME MEASURES: A variety of individual items in the survey related to information received, communication, physical and psychosocial symptoms, impact of illness and quality of life. RESULTS: A total of 315 women returned the survey. The average age of the respondents is 59 years. Each province and territory is represented in the sample. Over one-half of the women received a diagnosis of ovarian cancer within a month of seeking help for a concern and 85% had multiple treatment modalities. The majority of the women felt adequately informed (80%) and were satisfied with communication with their physicians (mean of 4.1 to 4.5 on a 5-point scale). A majority (62%) said that their lifestyle had changed as a result of their disease. Problems were experienced most frequently regarding side effects (58%), fear of recurrence (54%), sleeping difficulties (46%), bowel difficulties (44%), fear of dying (36%) and difficulty concentrating (32%). Many who experienced problems reported receiving inadequate help for them (16% to 49%). Quality of life was reported as significantly lower following the diagnosis and treatment of ovarian cancer (p = 0.0001). CONCLUSION: This study provides an important foundation for further investigation. There is a pressing need for research regarding the early identification of ovarian cancer and issues of support and coping. Care for women with ovarian cancer requires the expertise of a range of disciplines and community-based agencies working collaboratively as a team.

Adaptation, Psychological↗

PubMed1999

Family physicians' perspectives on ovarian cancer.

OBJECTIVE: To describe the knowledge, practices and perspectives of Canadian family physicians regarding ovarian cancer. DESIGN: A mailed survey questionnaire was followed by a reminder card, a second mailing of the questionnaire and a final reminder card. SETTING: A national sample of family physicians was drawn randomly from the membership database of the College of Family Physicians of Canada. MAIN OUTCOME MEASURES: Knowledge related to ovarian cancer. Practices related to the screening and detection of ovarian cancer. Attitudes towards screening for ovarian cancer. Perceived role in the care of women at risk of, or diagnosed with, ovarian cancer. Perceived educational needs of physicians. RESULTS: A total of 1079 completed questionnaires were returned, providing a response rate of 56.6%. Although most family physicians were aware of the basic facts about ovarian cancer, there were knowledge limitations related to risk factors, familial ovarian cancer syndromes and symptoms. Practices related to asymptomatic women were found to be mostly in accord with current guidelines and recognized the prevailing lack of evidence for the effectiveness of tests. Areas that were troublesome included the role of screening in high-risk women and knowledge about available tests. Most family physicians indicated that they have an important role to play in the care of women after they have been diagnosed with ovarian cancer. They also expressed a high level of interest in obtaining additional information related to ovarian cancer. CONCLUSIONS: This study clearly shows that there is a need for additional research to assist with the development of evidence-based guidelines for women at increased risk of ovarian cancer and for women at no known risk. Pending more definitive evidence, interim guidelines could provide assistance to physicians currently having to make decisions in a context of massive uncertainty. Canadian family physicians would be interested in and would benefit from continuing medical education (CME) initiatives concerning ovarian cancer.

Adult↗

PubMed1999

Gynecologists' perspectives regarding ovarian cancer.

OBJECTIVE: To document the perspectives, practices and knowledge of Canadian gynecologists regarding ovarian cancer. DESIGN: A mailed survey questionnaire was followed by a reminder card and a second mailing of the questionnaire. SETTING: A sample of all gynecologists practising in Canada. MAIN OUTCOME MEASURES: Knowledge related to ovarian cancer. Practices related to the screening and detection of ovarian cancer. Attitudes towards ovarian cancer. Perceived role in the care of women at risk of, or diagnosed with, ovarian cancer. Perceived educational needs of gynecologists regarding ovarian cancer. RESULTS: A total of 504 completed questionnaires were returned, providing a response rate of 46%. Most gynecologists indicated that they knew the basic facts about ovarian cancer and risk factors. Practices related to asymptomatic, low-risk women were found to be mostly in accord with current guidelines and the lack of evidence for the effectiveness of tests. Practices regarding women with suspected early or late-stage ovarian cancer varied, particularly with regard to referral to gynecologic oncologists. Many respondents indicated that they have an important role to play in the care of women after they have been diagnosed with ovarian cancer or referred to another specialist. Respondents also expressed interest in obtaining additional information about ovarian cancer. CONCLUSIONS: This study shows that there is a need for the development and dissemination of evidence-based guidelines regarding ovarian cancer. It also pinpoints areas where educational efforts could be directed.

Adult↗

PubMed1998

Oncology nursing research priorities: a Canadian perspective.

The purpose of the study was to determine oncology nursing research priorities among Canadian oncology nurses. The following two groups of nurses were mailed survey questionnaires: oncology nurse researchers and nurses working in oncology clinical settings who were members of the Canadian Association of Nurses in Oncology (CANO). The questionnaire was based on prior Oncology Nursing Society (ONS) research surveys and the oncology nursing literature. It instructed participants to rank from a list of topics, the five they perceived as research priorities. The response rate was 31% (249/810) for CANO members and 41% (32/78) for nurse researchers. The top five research priorities for CANO members were communication, symptom management, quality of life, pain control/management, and standards of practice. The top five research priorities for nurse researchers were pain control/management, family issues, patient participation in decision making, symptom management, and communication. Many of the same topics appeared in the priority lists of both the CANO members and the nurse researchers. However, the rank ordering of topics was not identical. The lists of CANO members contained both clinical and professional issues, whereas the researchers' lists focused primarily on clinical issues. The findings provide the basis for developing a Canadian national oncology nursing research agenda. In addition, the findings provide direction for practice and education strategic plans as well as information to guide decision making around research funding.

Adult↗