Biomedical subjects

Mary Cunningham

Publications and source records attributed to Mary Cunningham.

4 recordsLinked to original sources

PubMed2004

Sleep-wake disturbances in people with cancer part I: an overview of sleep, sleep regulation, and effects of disease and treatment.

PURPOSE/OBJECTIVES: To provide an overview of normal sleep, describe common sleep disorders, and discuss underlying sleep regulatory processes and how cancer, cancer treatment, and associated patient responses may adversely affect sleep. DATA SOURCES: Published peer-reviewed articles and textbooks. DATA SYNTHESIS: The duration, structure, and timing of sleep have a profound impact on health, well-being, and performance. Patients with cancer may be at risk for disturbances in sleeping and waking resulting from disease- and nondisease-related circumstances that interfere with normal sleep regulation, including demographic, lifestyle, psychological, and disease- and treatment-related factors. CONCLUSIONS: Patients with cancer are at high risk for sleep-wake disturbances. IMPLICATIONS FOR NURSING: An understanding of normal sleep, sleep pathology, and the factors that can precipitate sleep disturbance provides a context for nurses to interpret sleep complaints in their patients, evaluate responses to sleep-promoting interventions, and guide decision making regarding referrals.

Adult↗

PubMed2004

Sleep-wake disturbances in people with cancer part II: evaluating the evidence for clinical decision making.

PURPOSE/OBJECTIVES: To evaluate the quality of evidence on sleep-wake disturbances in people with cancer as a basis for clinical decision making and to discuss implications of the evidence for oncology clinicians, educators, and researchers. DATA SOURCES: Published, peer-reviewed articles. DATA SYNTHESIS: Members of the 2001 Oncology Nursing Society (ONS) Advanced Practice Nurse Retreat Evidence-Based Practice Sleep Working Group selected and evaluated data sources using criteria and processes outlined by ONS. CONCLUSIONS: The development of nursing science related to sleep-wake disturbances among people with cancer and the application of research findings to clinical decision making are limited by the quantity and quality of published evidence. IMPLICATIONS FOR NURSING: Clinicians are challenged to develop a plan of care that includes the assessment of sleep-wake disturbances and interventions to address them. Nurse educators are challenged to include sleep-wake content and skills to evaluate empirical data and interventions for sleep-wake disturbances in degree and continuing education curricula. Nurse researchers are challenged to specify consistent conceptual and operational definitions of key variables in sleep-wake models, use measurement instruments with evidence of reliability and validity, and design clinical trials to test interventions for sleep-wake disturbances among people with cancer.

Adult↗

PubMed2004

A process model for evidence-based literature syntheses.

PURPOSE/OBJECTIVES: To describe the development and implementation of the Triad Model of Research Synthesis, developed as a mechanism to produce systematic literature reviews that can serve as sources of evidence for decision making in health care. DATA SOURCES: Authors' recollections of the development and implementation process over a one-year period during 2002. Tracking forms were completed by members of three triad teams as they compiled research syntheses on clinical topics: pharmacologic treatment of dyspnea, assessment of sleep disturbances in patients with cancer, and exercise as an intervention for cancer-related fatigue. DATA SYNTHESIS: The systematic literature review process includes the following steps: (a) organize, search the literature, and focus the research synthesis question; (b) critique the selected literature; (c) synthesize the evidence; and (d) write. On average, triad members spent hours that were equivalent to full-time work during the year (excluding completion of manuscripts) on the synthesis projects. Hours spent varied by member role and with each phase of the process. CONCLUSIONS: Performing a research synthesis using the triad model was a productive and resource-intensive experience that points to the need for negotiating resources prior to embarking on such an exercise. IMPLICATIONS FOR NURSING: Given a group of highly motivated nurses and others with adequate time and resources, this model can be effective when developing systematic reviews about a variety of topics. Literature syntheses developed can be used as evidence for clinicians and others to develop practice protocols and other evidence-based care guidelines.

Evidence-Based Medicine↗

PubMed2003

Wandering spleen as an asymptomatic pelvic mass.

BACKGROUND: Wandering spleen is caused by laxity of the ligaments surrounding the spleen and may present as an asymptomatic pelvic mass. CASE: A 20-year-old woman with a neurogenic bladder was diagnosed with a pelvic mass on a routine screening ultrasound. The mass was described as solid and multilobulated, with the lobules measuring up to 5 cm in diameter. She was completely asymptomatic. Exploratory laparotomy revealed a wandering spleen. CONCLUSION: Wandering spleen, though unusual, should be included on the differential diagnosis of patients with an asymptomatic solid pelvic mass.

Adult↗