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Biomedical subjects

M L Vachon

Publications and source records attributed to M L Vachon.

At least 19 recordsLinked to original sources
PubMed2001

The meaning of illness to a long-term survivor.

OBJECTIVES: To review the ways in which cancer survivors find meaning in their illness experiences. DATA SOURCES: Research literature and professional and personal experiences. CONCLUSIONS: Survivors confront a number of issues as they try to find a place for their cancer experience in their lives and adopt different approaches to cope with their survivorship. IMPLICATIONS FOR NURSING PRACTICE: Nurses can assist cancer survivors to find meaning in their illness experience by understanding the symptoms and issues associated with survival.

Adult↗
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↗
PubMed1999

Reflections on the history of occupational stress in hospice/palliative care.

The concept of hospice and palliative care emerged a quarter of a century ago out of recognition of the unmet needs of dying persons and the social issues of the 1960s and 1970s. The issues of the day included the sexual revolution; a questioning of social values; an increased awareness of death resulting from the murder of the Kennedy brothers and Martin Luther King and daily television exposure to deaths in the Vietnam War, feminism, consumerism, reclaiming a more humanized role in the birth process, and hence in the process of death. The history of the hospice movement and the stress experienced by staff is traced from the early developmental days through to the present. Initially there was sometimes a struggle to integrate the concepts of relief of physical symptoms with meeting the psychosocial and emotional needs of patients and families, caregivers were expected to sacrifice much of their personal life for work, emotional intensity was high and supports were developed to ease some of the stress experienced by caregivers. From the early days team stress and burnout have been issues of concern. In the 1980s issues involved establishing funding sources, dealing with the new crisis of AIDS, and dealing with the gap between the ideal and the real. In the 1990s the economic climate has escalated some of the tensions that have always existed as hospice attempts to position itself within mainstream care with diminishing fiscal resources. These are issues that confront us as we move into the next century.

Attitude to Death↗
PubMed1998

Caring for the caregiver in oncology and palliative care.

OBJECTIVES: To review the stressors and manifestations of stress present in oncology and palliative care settings and elucidate successful coping strategies. DATA SOURCES: Review articles and research reports. CONCLUSIONS: Professional care of advanced cancer patients and their families confronts nurses with a variety of challenges and stressors. Multiple strategies have been described in the literature to assist professionals to cope with stressful aspects of clinical practice. Research is needed to test the efficacy of these strategies. IMPLICATIONS FOR NURSING PRACTICE: Personal coping strategies and the development of supportive collaborative relationships within the work environment are essential to the enhancement of self-esteem and professional effectiveness.

Adaptation, Psychological↗
PubMed1995

Psychosocial issues in palliative care: the patient, the family, and the process and outcome of care.

This article presents a synopsis of the psychosocial needs of patients and families in the terminal phase of malignant disease, as well as approaches to auditing the care of these clients. Recommendations for future research from the National Cancer Institute of Canada Workshop on Symptom Control and Supportive Care in Patients with Advanced Cancer are presented. These include recommendations on the need for more effective tools to measure the symptoms and burden of illness; an improved taxonomy to describe terminal illness; and studies to (1) measure the impact of interventions for improved symptom relief on the psychosocial distress of patients and families, (2) determine the impact of psychosocial interventions on the symptomatology associated with terminal illness, (3) operationalize "good palliative care" and the optimal delivery of palliative care, (4) assess the auditing of palliative care, (5) develop family typologies of adaptation to terminal illness, (6) describe high risk families, and (7) measure the impact of staff support programs on improving patient/family care.

Family↗
PubMed1995

Staff stress in hospice/palliative care: a review.

A review of the research in the area of staff stress in hospice/palliative care since the start of the modern hospice movement shows that, while high stress was identified as a problem in the early days of the movement, later studies have shown that stress and burnout in palliative care are by no means universal. Staff stress and burnout in hospice/palliative care has been demonstrated to be less than in professionals in many other settings. However, other studies have noted suicidal ideation, increased alcohol and drug usage, anxiety, depression, and difficulty in dealing with issues of death and dying. It is hypothesized that part of the reason that stress may be lower than expected in some settings was the early recognition of the potential stress inherent in this field and the development of appropriate organizational and personal coping strategies to deal with the identified stressors. Staff in hospice/palliative care have been found to have increased stress when mechanisms such as social support, involvement in work and decision-making, and a realistic work-load are not available. The stress that exists in palliative care is due in large measure to organizational and societal issues, although personal variables were also found to have an influence. Suggestions are given for the direction of future research in the field.

Adaptation, Psychological↗
PubMed1994

The impact of pain and impaired role performance on distress in persons with cancer.

The observed upward trend in the incidence of many cancers is expected to continue for the next 20 years despite monumental basic research efforts. There are interpersonal and intrapsychic complications associated with cancer and its treatment leading to considerable distress which, in extreme cases, becomes clinical depression and anxiety. Pain and impaired role performance have been cited as being important sources of distress in people with cancer. This paper presents data from a community sample of 1,309 people living with cancer in Prince Edward Island, Manitoba and Quebec and examines risk factors for cancer-related distress. In the model tested in this paper, pain and other symptoms and treatment side-effects as well as cancer-related fears were seen to have direct and indirect effects on psychological symptoms of distress. Impaired role performance was a central mediator for the indirect effects. The model explained 34% of the variance in distress scores (General Health Questionnaire) and was equally applicable to all three study sites, both male and female subjects, rural and urban settings, and to all stages of illness. Pain was the single most important explanatory variable. Impaired role performance had a negative effect on distress over and above the effect of pain. The results suggest that interventions directed at reducing distress in cancer should also address interpersonal issues such as the impact of the illness on family, social network a work.

Adaptation, Psychological↗
PubMed1993

Disordered communication and grieving in deaf member families.

When a deaf child is born to hearing parents, a grieving process is initiated in the parents. Unresolved grieving over their child's deafness often makes it difficult for hearing parents to accept the importance of signing, thus increasing the child's problems--a further source of grief for these parents. Clinical illustrations are provided of (1) the reciprocal relationship between disruption of the mourning process and disturbance of communication between family members, and (2) the transmission of the dysfunctional relationship between hearing parents and deaf children to the subsequent relationship between the deaf children, when they reach adulthood, and their hearing children.

Adolescent↗
PubMed1991

Cancer control and the older person. Psychosocial issues.

Three major areas related to psychosocial issues pertinent to the provision of cancer control services to older people have been delineated. These are values and medical decision making, psychosocial barriers to screening and access to care and services, and quality of life, including rehabilitation. These areas are explored, salient issues are defined, and specific questions and areas for consideration in future research are identified at the macro and micro levels.

Age Factors↗
PubMed1987

Unresolved grief in persons with cancer referred for psychotherapy.

Of 135 persons with cancer referred for psychotherapy, 76 per cent were found to have had a previous grief experience, and 60 per cent were suffering from unresolved grief for previous losses. This article discusses the identification of those most vulnerable to unresolved grief in later life and discusses the problems previous losses have on one's ability to deal with the current crisis of a diagnosis of cancer. The impact of early childhood loss, identification with the deceased, chronic grief, delayed grief, exaggerated or masked grief, and the death of a dream are discussed, and clinical examples are used to illustrate concepts of intervention.

Adolescent↗
PubMed1982

Predictors and correlates of adaptation to conjugal bereavement.

The authors interviewed 162 widows 1, 6, 12, and 24 months after bereavement to determine which sociodemographic, prebereavement, and response variables and circumstances of the husband's death were related to distress level, as measured by the General Health Questionnaire (GHQ). The most important variable associated with high distress at 1 month was the woman's perception that she was seeing old friends less than before her husband's death. At 2 years it was possible to predict distress levels with 86% accuracy by means of a multiple regression analysis using 10 variables, including 1-month GHQ score, short final illness of the husband, and satisfaction with available help.

Adaptation, Psychological↗
PubMed1981

A psychosocial analysis of risk of psychological impairment following bereavement.

A multiple regression analysis was used to investigate the explanatory potential of a multidimensional approach to risk of psychological impairment. Information from a study of bereavement in Canadian women included meaning of the event to the individual, personality attributes, social supports available following bereavement and sociodemographic data. Risk of psychological impairment was estimated by score on the General Health Questionnaire (GHQ). Sixty-four per cent of the variance in GHQ scores at one month postbereavement was accounted for. The authors hypothesize that the addition of a measure of coping styles and more comprehensive measures of the other dimensions studied would increase the power of the technique. It seems critical to take into account the possible large effects of sociodemographic factors.

Age Factors↗