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Biomedical subjects

M Rhiner

Publications and source records attributed to M Rhiner.

At least 19 recordsLinked to original sources
PubMed1995

Survey of the provision of supportive care services at National Cancer Institute-designated cancer centers.

PURPOSE: The purpose of this survey was to determine the scope of supportive care services (SCS) designed to promote quality of life during cancer therapies at National Cancer Institute (NCI)-designated cancer centers. METHODS: A survey was mailed to the medical directors and nursing directors of 52 NCI-designated comprehensive (n = 26), clinical (n = 11), and planning cancer centers (n = 15) in the United States. Only one survey was completed from each institution. Survey questions identified services provided such as pain management, terminal care, psychosocial programs, and spiritual care. RESULTS: Thirty-nine questionnaires were received for a total response rate of 75%. Of the respondents, 45% were comprehensive cancer centers, 24% clinical cancer centers, and 29% planning centers. One center did not identify their NCI designation. Sixty-one percent of the centers reported research programs in supportive care. Outside funding was reported in 51% of the respondents, with 39% having American Cancer Society (ACS) or National Institutes of Health (NIH) funding and 28% having private industry funding. Overall SCS self-ratings improved from a 21% rating of excellent to very good 5 years ago to the current 54% rating. CONCLUSION: Survey results provide data on SCS across a representative sample of NCI cancer centers and can be used to develop standards for future cancer control programs.

Cancer Care Facilities↗
PubMed1994

The experience of pediatric cancer pain, Part I: Impact of pain on the family.

This two-part article reports on the results of qualitative data derived from the study on the impact of pediatric cancer pain on the family. Part I of this two-part article explores the family caregivers' description of a child with cancer, the helplessness experienced in the management of the child's pain, and the impact of pain on the entire family. Study findings support existing literature identifying inadequate assessment and management of pediatric cancer pain. Parents identified the benefits of pain management teams for the child and for themselves. Family caregivers also identified the stresses associated with managing pain at home. Part II will describe the role of the parents in managing their child's pain. This study provided valuable information that can enable health care professionals with an opportunity to intervene not only with the child but also with the family.

Adaptation, Psychological↗
PubMed1994

The experience of pediatric cancer pain, Part II: Management of pain.

This paper reports on the results of qualitative data derived from a study on the impact of pediatric cancer pain on the family. Part I of this two-part article reported on the family caregivers' description of a child with cancer, the helplessness experienced in the management of the child's pain, and the impact of pain on the entire family. This article will describe the role of the parents in managing their child's pain, including use of pharmacological and nondrug interventions, family caregivers' perspectives on what physicians and nurses could do to improve the care of patients in pain, and family caregivers' advice to other families when placed in a similar situation of trying to manage pediatric pain. Five major themes were identified related to the role of family caregivers in managing the child's pain. Parents also identified six major ways in which physicians and nurses could help to improve care related to pain management. Although some parents were unable to identify information that may be useful for other parents in similar situations, nine major themes were identified. Study data demonstrates the experience of family caregivers in caring for a child with cancer pain and provides health care professionals with information that can promote effective pain relief for the pediatric cancer patient with pain as well as address issues affecting the family.

Adolescent↗
PubMed1993

Development and implementation of a pain education program.

Pain is a significant problem for cancer patients and is of particular concern for the elderly. This article reports on the development and implementation of a pain management educational intervention for elderly cancer patients and their family caregivers. This patient education program was developed within a research study funded by the American Cancer Society. Subjects were stratified as either elderly (60-75 years) or oldest (greater than 75 years) and then were randomly assigned to an experimental group that received the three-part, structured pain education program or a control group that received usual care. Control group subjects were offered the intervention at the conclusion of data collection. The outcomes of the pain education were measured at two times after the intervention. Study variables included patient outcomes such as pain intensity, pain knowledge and attitudes, medication compliance, and quality of life as well as family caregiver outcomes. This pain education program was developed, implemented, and evaluated in 40 patients and family caregivers in the first year of a 2-year project. In this article, the investigators present the development and structure of the three-part education program, general principles of patient education regarding pain, methods of evaluating pain education, and initial results of the pain education. Pain education includes basic principles of pain relief, pharmacologic interventions, and nondrug interventions for relief of pain. This program has demonstrated that both cancer patients and their family caregivers benefit from a structured education program for relief of cancer pain.

Aged↗
PubMed1992

Health quality of life and colorectal cancer.

BACKGROUND: Quality of life associated with cancer and radiation treatment includes the dimensions of psychologic and physical well-being, nutrition concerns/side effects, and radiation treatment-related anxiety/adjustment. An understanding of the impact of colorectal cancer and radiation treatment on these aspects of health quality of life can be reached by comparing this diagnostic group to others undergoing similar treatment. METHODS: Thirty-six patients with colorectal cancers, 41 with uterocervical cancers, 43 with genitourinary tumors, 13 with leukemia or bone metastasis, and 129 with head and neck cancers undergoing radiation therapy provided complete health quality of life index (QLI-RT) data during weeks 1 and 3 of treatment and at the first follow-up visit after treatment completion. The QLI-RT was found to be reliable and valid. RESULTS: Those with colorectal cancer had similar QLI-RT summary scores as the other groups at the beginning of treatment and during the follow-up period. QLI-RT scores tended to range from 62 to 84 for the summary score and individual-item scores; this was a narrow span considering the QLI-RT uses a 0-100-mm linear analog-response scale. The exceptions were strength, which elicited scores in the 46-68 range and a couple of responses to worrying about radiation therapy. The largest change in QLI-RT score in relation to the treatment trajectory was 11 mm. CONCLUSIONS: These findings tend to support the notion that patients with cancer try to maintain health quality of life at an acceptable level despite the occurrence of stressful negative events. Future research should explore the stable versus dynamic attributes of health quality of life to learn more about the factors that contribute to the adaptive process that maintains such quality of life at an acceptable level.

Colorectal Neoplasms↗
PubMed1992

Pain and addiction: an urgent need for change in nursing education.

Lack of education of health care professionals, including nurses, is frequently cited as a major reason for undertreatment of patients with pain. A reason for undertreatment of pain with opioid analgesics is the irrational fear of creating opioid addiction. To characterize the information nurses receive in their basic education that could contribute to misinformation about this issue, the authors reviewed 14 nursing textbooks, published since 1985, including 8 pharmacology texts and 6 medical surgical texts. An analysis of content revealed that only one textbook correctly stated the definition of opioid addiction and its likelihood following use of opioid analgesics for pain control. Almost all of the texts used confusing terminology, and some erroneously promoted the fear of addiction when opioids are used for pain relief. A simple solution to this problem is to encourage nursing educators to use the American Pain Society publication "Guidelines for Analgesic Use" until textbooks have the opportunity to incorporate correct information.

Attitude of Health Personnel↗
PubMed1992

The meaning of quality of life for bone marrow transplant survivors. Part 2. Improving quality of life for bone marrow transplant survivors.

Surviving bone marrow transplant (BMT) represents a major victory against malignant disease but also creates challenges of survivorship for patients and the professionals who care for them. Part 2 of this report presents the findings of a qualitative study (N = 119) related to improving quality of life (QOL) for BMT survivors. Results are shared based on BMT survivors' perceptions of (a) what makes QOL better, (b) what makes QOL worse, and (c) what doctors or nurses could do to enhance QOL. The findings of the study have been useful in constructing a quantitative instrument to measure QOL in BMT and in understanding the conceptual basis of QOL for the BMT population. Nursing interventions can improve the QOL for the BMT patient across all phases of the transplant process and long-term issues related to survival.

Bone Marrow Transplantation↗
PubMed1992

Home care: maintaining quality of life for patient and family.

Cancer affects the family as well as the patient. The home is a primary site of care, which often must be intensive and complex. Attention to home care of the cancer patient is therefore a major concern in maintaining quality of life for both patient and family. The authors explore the major burdens of home care that affect both patient and family and describe four specific interventions that the health care team can initiate to optimize quality of life in these difficult situations.

Aged↗
PubMed1992

The meaning of quality of life for bone marrow transplant survivors. Part 1. The impact of bone marrow transplant on quality of life.

Quality of life (QOL) is an important concept in cancer nursing and has particular significance for bone marrow transplant (BMT). BMT survivors are faced with the demands of acute transplant symptoms as well as chronic illness demands posttransplant. The purpose of this study was to explore the concept of QOL for BMT survivors and to gain understanding of nursing interventions that may improve QOL in this population. The conceptual framework for this study was derived from the model of QOL developed by Ferrell, Grant, and Padilla (1989) that depicts the QOL domains of physical well-being, psychological well-being, social concerns, and spiritual well-being. This qualitative study consisted of a one-time interview of 119 BMT survivors using six open-ended questions. The items were based on previous research of the authors and content validity was established by a panel of BMT experts. Content analysis was performed on verbatim written responses to six questions regarding BMT and QOL. Part one of this two-part report provides analysis based on the questions regarding the meaning of QOL to BMT survivors and the impact of BMT on QOL.

Adult↗
PubMed1991

The experience of pain and perceptions of quality of life: validation of a conceptual model.

Pain is a common symptom of terminally ill cancer patients and a major challenge for hospice care. This paper presents a conceptual model of the relationship between pain and quality of life that was derived from the authors' previous research. The model should prove useful to hospice clinicians and researchers in evaluating the impact of palliative care on the quality of life.

Evaluation Studies as Topic↗
PubMed1991

Family factors influencing cancer pain management.

The purpose of this study was to describe family factors which influence cancer pain. Previous research has focused on the patients' and professional caregivers' perspective of pain. Cancer pain is an intense burden on the entire family as well as on the patient. Findings of the study demonstrate family perceptions of pain, caregiver burden associated with pain, caregiver moods and differences in caregiver experiences of pain between three sites of care including a hospice, a community hospital and a cancer centre. Understanding the perspective of the family caregivers and their role in pain management can assist health care providers in management of the patient's pain.

Adult↗
PubMed1990

Assessment of quality of life with a single instrument.

A number of single measures of quality of life have been developed over the last few years. Some of these instruments have been used more frequently than others. Psychometric properties are reported in many of these instruments, and continued psychometric development is needed. Instruments differ in the content tested, and users are encouraged to have specific objectives in mind when selecting an instrument. The continued research interest and activity in the field of single measures has provided beginning tools for both research and clinical evaluations. Quality of life measures add to the depth of evaluation of the impact on cancer and cancer treatment, and provide a measurement dimension that augments that of the historic evaluation via morbidity and mortality statistics. Continued work on single measures for quality of life will provide both researchers and clinicians with valuable tools.

Humans↗
PubMed1990

Defining the content domain of quality of life for cancer patients with pain.

This study identified attributes that define the content domain of quality of life in a sample of 41 cancer patients with chronic pain. Patients were asked four open-ended questions about the meaning of quality of life, what contributes to a good or poor quality of life, and how pain influences quality of life. Content analysis of responses revealed three categories of attributes that embrace the quality-of-life content domain. The first category is physical well-being. It includes general functioning and disease/treatment-specific attributes. The second is psychological well-being. It includes affective-cognitive attributes, coping ability, meaning of pain and cancer, and accomplishment attributes of quality of life. The third is interpersonal well-being. It incorporates social support and social/role functioning attributes. Replications of the current study in other groups of patients may yield data to support a two-part, multidimensional quality-of-life instrument. A norm-referenced measure can be used to evaluate quality of life in terms of attributes that are salient regardless of the disease or treatment. A domain-referenced measure may be used to evaluate attributes whose salience is dependent on specific disease, treatment, or life events.

Adaptation, Psychological↗