PubMed Health⌕ Search

Biomedical subjects

R McCorkle

Publications and source records attributed to R McCorkle.

At least 19 recordsLinked to original sources
PubMed1992

Gaps and contract: evaluating the diffusion of new information. Part I. A description of the strategy.

Time and fiscal constraints on oncology nurses require that continuing education programs yield demonstrable benefit to the clinician, the institution, and patient outcomes. This article describes "gaps and contract," a strategy that provides nurses with a tool to transfer knowledge from theory to practice, in a measurable form. The framework for this strategy lies within the concept of innovation diffusion. This strategy was used by two universities collaborating to educate 912 oncology health professionals in 38 continuing education programs. Part II of this article will describe the measurement of this strategy.

Child↗
PubMed1992

Gaps and contract: evaluating the diffusion of new information. Part II. The measurement of the strategy.

This article is the second of a two-part series describing "gaps and contract," a strategy that provides nurses with a mechanism to transfer knowledge from theory into practice in a measurable format. Two universities under contract from the Pennsylvania state cancer plan used this strategy to evaluate the effectiveness of a cancer continuing education program. Two hundred seventy-four (274) contracts from one setting and 205 from a second setting are described. Recommendations for using this strategy to measure the efficacy of cancer continuing education programs are included.

Adult↗
PubMed1990

Quality of life issues in patients with disseminated breast cancer.

Over half the women treated for breast cancer will experience advanced disease, and issues related to quality of life are particularly important. This article has reviewed components of quality of life specific to women with advanced breast cancer following two clinical courses:those who develop a recurrence and those who present with advanced disease. It is clear that additional research is warranted on the quality of life in women with advanced breast cancer. Work to date has clearly indicated that the management of women with advanced disease requires the resources available from a multidisciplinary perspective. Efforts to manage advanced breast cancer must include both current medical therapies and attention to the critical factors associated with enhancing the quality of their lives. Of final concern is the relationship of social class to advanced disease. Following Freeman's recent outline of the agenda for the American Cancer Society, more attention must be given to people who are economically disadvantaged because cancer incidence and mortality are greater among poor people than among the affluent. It is possible that over 50% of women presenting with advanced cancer of the breast are economically disadvantaged. Validation of this problem through research should lead to prevention programs targeted to this population. Women with breast cancer who are economically disadvantaged may be particularly receptive to interventions that will enhance their quality of life.

Breast Neoplasms↗
PubMed1990

Continuing care in the community.

Early discharge from the hospital or home health agency necessitates effective continuity of care planning in order to assure that patients and families will have their health care needs met after discontinuance of formal health care services. In this article, we have defined continuity of care from several perspectives, presented two theoretical viewpoints on this concept, and, with four models of care that have actually been implemented, analyzed the commonalities and differences among models. In addition, recommendations for future research and care delivery for the purpose of enhancement of continuity of care have been made.

Community Health Services↗
PubMed1990

Measurement of stress in clinical nursing.

The Nurse Stress Checklist was developed to measure stress in clinical nursing as a multidimensional construct. The instrument was formulated within a transactional model of stress. The items were derived from five domains thought to contribute to nurse stress in clinical settings and were organized into a questionnaire. Holmes Schedule of Recent Events was included as a validity measure. The instrument was tested on 104 staff nurses working in three institutions in an urban community. Exploratory factor analysis was applied to the 74 items presented to subjects in Likert-type format. Five factors were derived and subjected to psychometric evaluation. Internal consistency reliability for the five factors was good, ranging from 0.80 to 0.91. Means and measures of dispersion supported the potential of the five subscales to discriminate among respondents on the attributes being measured. Intercorrelations of the factors provided evidence of the distinctiveness of the five components of stress, although factor loadings showed some overlap between Personal Reactions and Work Concerns and Work Concerns and Work Completion Concerns. Validity of the factors also was supported by correlations with Holmes' Schedule of Recent Events. Content validity was supported by comparison of these results with findings of other investigators. Limitations of the results are discussed, and recommendations for future work on the instrument are offered.

Adult↗
PubMed1990

Evidence against extended DR3-related haplotypes in Graves' disease.

Three HLA-DR3-linked polymorphisms of the DPA, DPB and DRB genes, previously associated with myasthenia gravis or coeliac disease, have been examined in Caucasian patients with Graves' disease. The patients did not differ from healthy DR3 subjects, indicating an absence of any association of Graves' disease with specific DR3 subtypes.

Graves Disease↗
PubMed1989

A randomized clinical trial of home nursing care for lung cancer patients.

A randomized clinical trial was conducted to assess the effects of home nursing care for patients with progressive lung cancer. One hundred sixty-six patients were assigned to either an oncology home care group (OHC) that received care from oncology home care nurses, a standard home care group (SHC) that received care from regular home care nurses, or an office care group (OC) that received whatever care they needed except for home care. Patients were entered into the study 2 months after diagnosis and followed for 6 months. Patients were interviewed at 6-week intervals across five occasions. At the end of the study, there were no differences in pain, mood disturbance, and concerns among the three groups. There were significant differences in symptom distress, enforced social dependency, and health perceptions. The two home nursing care groups had less distress and greater independence 6 weeks longer than the office care group. In addition, the two home nursing care groups steadily reported worse health perceptions over time. Thus, it was remarkable that the office care group, which indicated more symptom distress and social dependency with time, also indicated perceptions of improved health with time. These results suggest that home nursing care assists patients with forestalling distress from symptoms and maintaining their independence longer in comparison to no home nursing care. Home care may also include assisting patients in acknowledging the reality of their situation.

Adult↗
PubMed1989

Work disability among cancer patients.

To identify factors affecting the ability of persons with recent cancer diagnoses to remain in the labor force and retain premorbid levels of work performance, the investigators analyzed data on 247 individuals with lung, pancreatic, prostatic, or cervical cancer. Subjects were selected from a population-based tumor registry. According to Pearson correlations, ordinary least squares multiple regression, and logistic analysis, physical factors related to disease were the strongest predictors of work disability, defined as either leaving the labor force or functioning less fully at work than before becoming ill. The strongest predictors of work disability were physical dysfunction measured by the Sickness Impact Profile (SIP) and disease stage. Social background factors such as age, sex, income, and education were not statistically significant predictors. Two job characteristics, (1) physical demands of work and (2) discretion over hours worked and how much work would be done, predicted work disability, the latter appearing to help prevent this condition. Strictly disease-related factors appear more important here in predicting work disability than in studies of other diseases. Still, it appears that increasing flexibility of working hours and the pace of work could help some individuals with cancer histories remain in the labor force. Unwillingness of employers to facilitate such accommodation where technically feasible may constitute a form of discrimination against the cancer patient.

Activities of Daily Living↗
PubMed1988

Death education.

Explore the source record for details and available documents.

Curriculum↗
PubMed1987

A program model for nurses involved with cancer education of black Americans.

In the last 30 years, cancer incidence rates for black Americans have increased 27% in contrast to an increase of 12% for white cancer rates. In answer to this obvious need for intervention to lower the incidence and mortality rates, the Oncology Nursing Society held a one-day workshop which focused on the primary prevention of cancer in black Americans. For the 40 workshop openings, 540 black nurses from 40 states responded to a call for applicants. The impact of the workshop was measured by four pre- and post-tests which provided both qualitative and quantitative data and indicated that the experience made a significant impact on the participants. The workshop content focused on the epidemiology of the cancers which are most frequently found in blacks, cultural attitudes toward these cancers, and techniques for early detection. The success of the workshop was due to the active involvement of the participants in the learning process and serves as a model for training minority nurses for active, creative roles which can be instituted in the community to help lower the high cancer incidence rate among black Americans.

Black or African American↗
PubMed1985

Models of care for persons with progressive cancer.

A need exists for a living-dying model that encompasses hospice care and alternative programs of care for the terminally ill. The existing medical and rehabilitative models are focused in directions that do not allow implementation of continuity of care directed toward supporting patients during the plateaus of their illnesses. Today, society has evolved to value the patient as a consumer of health care who can participate through making informed choices among the rich alternatives of care available. Yet the knowledge and technology base of health care delivery today increases at such a rapid rate that it almost seems out of control. This paradox makes it difficult for the patient-consumer to have access to information necessary for involvement in informed decision making. Greater numbers of consumers of health care are active in assuming responsibility for maintaining wellness. At the same time, they are seeking health care programs outside the medical model, as well as within the medical model. The "high-tech" atmosphere has been tempered with an emphasis on humanism, perhaps as a response to the infusion of machinery into our lives. As health care costs have escalated, concern has mounted that health care costs be contained, and that the poor and the elderly not be further curtailed in access to health care resources. There is tremendous potential among nurses for leadership in the creation of services that support quality of life for cancer patients and families. Nurses, as a collective, must be willing to engage in the politics of negotiation for reallocation of health care resources toward person-centered services and to establish a power base for influencing these decisions at the local, state, and national level of government and within various organizations offering health care services. As person-centered services are established, nurses must also move toward formalizing emergent practices into standards of care. Consumers deserve the protection of practice standards that are developed and sanctioned by the profession. It is also critical to test practice, both as it emerges, and after it has been formalized into standards. Nurses must continue to question the tenets of their practice. For example, what are the outcome effects of monitoring and supporting patients during the chronic phase of the living-dying interval? Is either the severity or the number of problems in the terminal phase reduced by these interventions? Changes in the provision of health services in this past decade have been extensive and broadly based.(ABSTRACT TRUNCATED AT 400 WORDS)

Attitude to Death↗