The primary purpose of this investigation was to construct a quantitative scale to measure the perception of severity of visible disfigurement and dysfunction following ablative head and neck cancer surgery. Facial disfigurement and disruption of physical function induced by head and neck surgery pose formidable obstacles to the medical and psychosocial adaptation of cancer patients. Although this problem is widely acknowledged, virtually no research has attempted reliable and valid measurement of such concepts. Consequently, the present study investigated the psychological perceptions of 100 registered nurses regarding 11 disfiguring surgical procedures and loss of associated functions. Results indicated that the nurses' judgments of disfigurement and dysfunction were highly consistent and not a function of patient gender. Judgments of the severity of disfigurement, moreover, were independent of the perceived severity of associated dysfunction. It was concluded that this is a reliable method for measuring the relative degree of disfigurement and dysfunction and represents a critical precursor to prediction of a patient's psychological rehabilitation and compliance with medical care after surgery.

Adaptation, Psychological↗

PubMedDate not supplied

Family caregiving in cases of hip fracture.

The growing incidence and cost and the serious nature of hip fracture in the elderly require a closer examination of the family's role in the rehabilitation process and how it can be assisted in that role. In this prospective study, 57 family caregivers provided information before the hospital discharge of the patient with hip fracture and at 2, 8, and 14 weeks postdischarge. They were asked about caregiving demands and problems, caregiver mood, expectations about recovery, and advice to future caregivers. A brief follow-up was conducted at 6 months. The care recipients were all women and had been living at home before injury. The postdischarge location of the patient (e.g., in a residence shared with the caregiver, in a different residence, or in a nursing home) was a major factor in the types of caregiving activities but not in total demand. Nonspouses cited the most problems. Mood distress did not change over time. Caregivers appeared to have unrealistic expectations about the length of the recovery period; by 14 weeks, 35% judged the care recipient's mobility to be worse than expected, and 20% felt that the patient had more pain than expected. The most frequent advice to future caregivers was to have patience and to give encouragement.

Adult↗

PubMedDate not supplied

Posthospital convalescence in older women with hip fracture.

Women who had lived at home before hip fracture repair (N = 120, M age = 79.9) were interviewed before hospital discharge and at 2, 8, and 14 weeks postdischarge to determine (a) early recovery patterns in function and mood, (b) factors predictive of assistance needed in mobility and perceived mobility compared to prefracture status, (c) problems faced, and (d) advice to others. The mobility pattern was that of a relatively rapid gain until 8 weeks, with a smaller gain from 8 to 14 weeks. Affective mood distress was low except in those going to nursing homes. Somatic mood distress was high, decreasing only gradually. Factors predictive of needed assistance in mobility and of perceived mobility included both those without potential for nursing intervention (age, prefracture mobility, how fell, and type of surgical procedure), and those with the potential for intervention (affective distress, fatigue, and urinary problems). Persistent problems related to limitations in mobility, especially in dressing. Overwhelmingly, subjects advised the need for maintaining a good mental attitude.

Activities of Daily Living↗

PubMedDate not supplied

Relocation appraisal, functional independence, morale, and health of nursing home residents.

Relocation to a nursing home can be stressful and may result in mental and physical illness. Appraisal, or the meaning assigned to relocation, can influence relocation outcome. This study examined the relationships between appraisal of relocation and 30 nursing home residents' psychological and physical health, morale, functional independence, and demographic and situational factors, including age, gender, income, education, prior residence, participation in the decision to relocate, and preparation for the move. Positive, benign, and challenge appraisals were related to higher morale and functional independence. Threat appraisal was related to poorer psychological health and lower morale. Harm-loss appraisal was associated with lower morale and lower functional independence. Preparation for the move was related to higher positive appraisal, higher morale, functional independence, and lower harm-loss scores. Implications include the need to assess people's appraisal of relocation so as to plan strategies that prevent relocation stress.

Activities of Daily Living↗

PubMedDate not supplied

Perception of control and appraisal of illness in chronic low back pain.

People who experience chronic low back pain face significant changes in their lives, and it is unclear why some people adapt to the pain situation better than others. Using a cognitive appraisal model, outcomes of the pain situation were examined in 40 chronic low back pain patients using situational control and appraisal of illness as predicted mediating factors. This article presents background of the problem and the results of the study.

Adaptation, Psychological↗

PubMedDate not supplied

Appraisal and caregiving burden in family members caring for patients receiving chemotherapy.

The purposes of this exploratory study of 49 family caregivers of patients receiving chemotherapy were to describe the time and difficulty associated with caregiving tasks, examine caregivers' appraisals of their situations, and to explore what variables are predictive of caregiver mood. Measures used in this study included the Caregiving Burden Scale, Appraisal of Caregiving Scale, Family Hardiness Index, and an abbreviated form of the Profile of Mood States. Multiple regression was used to examine predictive relationships. The 25 women and 24 men reported spending the most time giving emotional support and assisting with household tasks, errands, and transportation. Giving emotional support was the most time-consuming and difficult task; therefore, it received the highest burden score. Burden was predicted by level of patient dependency. Caregiving burden, family hardiness, and caregiver health predicted 50% of the variance in negative appraisal of caregiving. Negative appraisal and age of the caregiver explained 49% of the variance in mood disturbance. Findings suggest that caregivers' appraisals of their situations may mediate the effects of illness and contextual factors on caregiver outcomes and that family hardiness is an important caregiver resource.

Adult↗

PubMedDate not supplied

Private sector support of nursing research.

Members of the American Nurses' Association Council of Nurse Researchers were surveyed for information about their nursing research funding activity within the private sector: their submission of proposals to private organizations, the outcomes, and effective funding strategies. Results indicated that 51% of applications submitted to private organizations and 78% of intramural applications were funded. However, 65% of proposals funded by private organizations and 59% of intramurally supported projects were for $3,000 or less. A variety of strategies led to private sector support of successful nursing research proposals. These included making direct, personal contact with funding agencies, matching proposals with the needs and interests of the funding agency, networking with other professionals to obtain funding information, and submitting well-written proposals consistent with agency guidelines.

Financing, Organized↗

PubMedDate not supplied

Another look at informed consent.

Explore the source record for details and available documents.

Aged↗

PubMedDate not supplied

Stress-coping response to genitourinary carcinoma in men.

In this descriptive study of 30 men with chronic genitourinary cancer, subjects were found to have minimal emotional distress in response to a periodic diagnostic procedure (cystoscopy). State anxiety levels and critical thinking ability measured preprocedure were not significantly different from levels obtained six to eight weeks postprocedure in subjects with negative biopsy results. Routine hospitalization for diagnostic monitoring was found, during COPE interview (Weisman & Worden, 1976), to be less stressful than regular work or financial and family concerns. Subjects with higher concurrent life stress had higher state anxiety and achieved less resolution of problems. Although anxiety levels for the group were within normal limits, 33% of the sample were categorized as having high anxiety on at least one testing occasion. This high-anxiety group had more severe behavioral responses, including feelings of depression, helplessness, and inability to set priorities.

Adaptation, Psychological↗

PubMedDate not supplied

Family caregiving in a pediatric renal transplant population.

Twenty parents (3 fathers and 17 mothers) engaged in caring for a child 2 to 14 months after renal transplant were studied to: (a) determine the kinds of caregiving tasks required and how difficult they are; and (b) explore the relationships among caregiver characteristics, caregiving burden, appraisal, and mood state. Increased housework, errands, providing emotional support, transportation, and monitoring/reporting symptoms were the most demanding tasks; housework, emotional support, and managing behavior problems were the most difficult. Overall, caregiving was perceived as moderately demanding and not particularly difficult, and the caregiving situation was not appraised as being very threatening. Mood dysfunction scores were quite low, but were associated with perceptions of caregiving difficulty. Caregiving demands and difficulty were greater with adolescent children, when the parent had other dependents to care for, and when the parent was working. This suggests the need for careful assessment of the family environment to identify parents at risk of caregiving burden.

Adaptation, Psychological↗