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Biomedical subjects

S L Dibble

Publications and source records attributed to S L Dibble.

At least 19 recordsLinked to original sources
PubMed1998

Gender differences in the dimensions of quality of life.

PURPOSE/OBJECTIVES: To explore gender differences and similarities in the dimensions of quality of life (QOL). DESIGN: Secondary analysis of the Multidimensional Quality of Life Scale--Cancer Version (MQOLS--CA) data from two different research studies. SETTINGS: Multiple outpatient oncology sites. SAMPLE: The typical female participant (n = 254) was 58 years old (SD +/- 11.3) with 14 years of education, married/partnered (64%), Caucasian (88%), and diagnosed with breast (47%) or colorectal (16%) cancer. The typical male participant (n = 222) was 60 years old (SD +/- 14) with 14.3 years of education, married/partnered (69%), Caucasian (85%), and diagnosed with colorectal (31%) or prostate (13%) cancer. METHODS: Factor analytic procedures and reliability testing. MAIN RESEARCH VARIABLES: QOL as measured by the MQOLS-CA, gender. FINDINGS: For women, two factors emerged from the analysis procedures-psychosocial well-being (7 items) and physical competence (6 items). For the men, two different factors emerged--vitality (8 items) and personal resources (4 items). None of the cancer-specific items from the MQOLS-CA loaded on any of the factors for either gender. CONCLUSIONS: Measurement of QOL requires gender-specific questions to accurately address the dimensions of the concept of QOL in females and males. IMPLICATIONS FOR NURSING PRACTICE: Additional research is warranted to replicate these findings. Gender-specific interventions could then be developed and tested to maximize the QOL of all patients.

Adaptation, Psychological↗
PubMed1998

The revised Piper Fatigue Scale: psychometric evaluation in women with breast cancer.

PURPOSE/OBJECTIVES: To confirm the multidimensionality of the Piper Fatigue Scale (PFS) and to reduce the total number of PFS items without compromising reliability and validity estimates. DESIGN: Methodologic, part of a larger, cross-sectional, mailed survey design study. SETTING: Urban and suburban area in the northeast United States. SAMPLE: As part of the larger study, 2,250 surveys were distributed to women survivors of breast cancer who were on a mailing list for the educational organization Living Beyond Breast Cancer, 715 surveys (32%) were returned. Of these, 382 women met this methodologic study's criteria for having completed each of the 40 items on the PFS. The average respondent was 50 years old, postmenopausal, and treated with combination cancer therapy. METHODS: Principal axes factor analysis with oblique rotation. MAIN RESEARCH VARIABLES: Fatigue factors/subscales. FINDINGS: Five factors/subscales were identified initially. Because the fifth factor contained only two items (ability to bathe/wash and ability to dress), these items and the associated factor/subscale were dropped from the final solution. An additional nine items, not loading on any factor (> 0.40), also were dropped. The remaining items and factors/subscales were reviewed to ensure that the criteria were met: a pattern of inter-item correlations between 0.30-0.70; a minimum number of five or more items/subscale; standardized alpha for the subscales and total scale of at least 0.89; and absence of gender-specific items. CONCLUSIONS: The revised version of the PFS consists of 22 items and four subscales: behavioral/severity (6 items), affective meaning (5 items), sensory (5 items) and cognitive/mood (6 items). Standardized alpha for the entire scale (n = 22 items) is 0.97, indicating that some redundancy still may exist among the items. Additional revisions await further testing. IMPLICATIONS FOR NURSING PRACTICE: As fatigue is acknowledged to be the most frequent symptom experienced by patients with cancer, accurate measurement and assessment is essential to advance not only the science of fatigue but, most importantly, to evaluate the efficacy of intervention strategies on patient and family outcomes.

Breast Neoplasms↗
PubMed1998

Differences in outcomes among patients experiencing different types of cancer-related pain.

PURPOSE/OBJECTIVES: To determine differences in pain characteristics, mood states, and quality of life (QOL) in outpatients with different types of cancer-related pain (i.e., somatic, visceral, or neuropathic) compared to outpatients who were pain-free. DESIGN: Descriptive, comparative. SETTING: Sixteen outpatient facilities that are part of the Oncology Nursing Research Network. SAMPLE: A convenience sample of 129 outpatients who experienced cancer-related pain and 169 pain-free patients, all of whom were actively being treated for cancer. METHODS: All patients completed a demographic questionnaire, the Multidimensional Quality of Life Scale-Cancer, and the Profile of Mood States, Patients with pain completed a Cancer Pain Questionnaire and the McGill Pain Questionnaire. Patients' medical records were reviewed. MAIN RESEARCH VARIABLES: Types of cancer-related pain (i.e., somatic visceral, or neuropathic), pain intensity, pain duration, quality of pain, QOL, and mood states. FINDINGS: No differences were found in any pain characteristics or any pain indices from the word descriptors of the McGill Pain Questionnaire. Patients with somatic and visceral pain had significantly higher fatigue scores than pain-free patients. In addition, patients with somatic and visceral pain had significantly lower physical well-being, nutrition, and total QOL scores and more symptom distress than pain-free patients. CONCLUSIONS: The type of cancer-related pain appears to influence the mood states and QOL of outpatients with cancer. IMPLICATIONS FOR NURSING PRACTICE: Oncology nurses need fo determine the type of pain the patient is experiencing and the impact of the pain on the patient's mood and QOL.

Adult↗
PubMed1998

Differences in fatigue by treatment methods in women with breast cancer.

PURPOSE/OBJECTIVES: To investigate the differences between various cancer therapies (radiation, hormonal, chemotherapy, and their combinations) and the specific dimensions of fatigue (affective meaning, behavioral/severity, cognitive/mood, and sensory). DESIGN: Descriptive, cross-sectional, mailed survey design. SAMPLE AND SETTING: Data were collected from women who were breast cancer survivors and members of a nonprofit educational organization in the North-east. Criteria for this study included no self-reported disease recurrence, and treatment was within 18 months prior to the mailed survey (N = 322). The typical participant was middle-aged (mean = 52.2; SD = 10.3), Caucasian (93%), postmenopausal (55%), and diagnosed with cancer 2.42 (SD = 2.6) years prior to the study. METHODS: Secondary data analysis from a study using the Piper Fatigue Scale. VARIABLES: Level of fatigue. FINDINGS: Significant differences were found by treatment in total fatigue scores (p < 0.03) and cognitive/mood scores (p < 0.05). Women who received combination therapy had the highest fatigue scores (mean = 4.8; SD = 2.0); those who received only radiation therapy had the lowest fatigue scores (mean = 2.7; SD = 2.0). CONCLUSIONS: Fatigue in breast cancer survivors varies by type of cancer therapy. Future studies are needed to investigate the relationships between fatigue and hormonal therapy, and they need to be designed to examine changes over time. IMPLICATIONS FOR NURSING PRACTICE: Study findings advance knowledge about fatigue in women with breast cancer and aid nurses in providing anticipatory guidance for women undergoing different treatment regimens.

Adult↗
PubMed1997

Health-related fitness and quality of life in organ transplant recipients.

BACKGROUND: The purpose of this study was to describe the levels of health-related fitness and quality of life in a group of organ transplant recipients who participated in the 1996 U.S. Transplant Games. METHODS: A total of 128 transplant recipients were selected on a first reply basis for testing. Subjects with the following organ types were tested: kidney (n=76), liver (n=16), heart (n=19), lung (n=6), pancreas/kidney (n=7), and bone marrow (n=4). Cardiorespiratory fitness (peak oxygen uptake) was measured using symptom-limited treadmill exercise tests with expired gas analysis. The percentage of body fat was measured using skinfold measurements, and the Medical Outcomes Short Form questionnaire (SF-36) was used to evaluate health-related quality of life. RESULTS: Participants achieved near age-predicted cardiorespiratory fitness (94.7+/-32.5% of age-predicted levels). Scores on the SF-36 were near normal. The active subjects (76% of total sample) had significantly higher levels of peak VO2 and quality of life and a lower percentage of body fat compared with inactive subjects (P<0.01). CONCLUSIONS: Although this is a highly select group which is not representative of the general transplant population, the data suggest that near-normal levels of physical functioning and quality of life are possible after transplantation and that those who participate in regular physical activity may achieve even higher levels.

Adult↗
PubMed1997

Differences in patients' and family caregivers' perceptions of the pain experience influence patient and caregiver outcomes.

The purposes of this study were to determine if there were differences in pain intensity scores, pain duration scores, mood states, and quality of life of oncology outpatients whose pain intensity scores were congruent with their family caregivers compared to patients whose pain intensity scores were non-congruent and to determine if there were differences in mood states, health status, and caregiver strain between family caregivers whose pain intensity scores were congruent with their family members and those family caregivers whose pain intensity scores were non-congruent. A total of 78 patient-caregiver dyads participated in the study. Patients completed a Demographic Questionnaire, a Cancer Pain Questionnaire, the Profile of Mood States, and the Multidimensional Quality of Life Scale-Cancer 2. Family caregivers completed a demographic questionnaire, the Profile of Mood States, the Caregiver Strain Index, and the Medical Outcome Study Short-Form Health Survey. Both patients and family caregivers rated the patient's pain intensity using a visual analogue scale (VAS). Patients in the non-congruent dyads (i.e. difference of >10 on the VAS score) had significantly more mood disturbance and a poorer quality of life than patients in the congruent dyads. Family caregivers in the non-congruent dyads had significantly higher caregiver strain score than caregivers in the congruent dyads. These findings suggest that differences in the perception of the pain experience between patients and their family caregivers is associated with deleterious outcomes for the patient and their family caregivers.

Adult↗
PubMed1996

Clinical nurse specialists in California: who claims the title?

State nursing practice acts granting legal authority to advanced practice nurses vary widely, with many states not recognizing clinical nurse specialists (CNSs). This survey identified characteristics of registered nurses claiming the CNS title in California. A literature-based survey tool was designed, piloted, and distributed to 209,846 nurses in California, with instructions to return the survey if the recipient self-identified as a CNS. Among the 1061 respondents, 65% were prepared with a Master's in Nursing. Most CNSs practiced in hospitals, and patients were the most frequently listed clients. CNSs overwhelmingly identified their primary role as clinical expert. Major barriers to practice included lack of public recognition and legal recognition in nursing practice acts. Significant differences were found in most characteristics between graduate-prepared and nongraduate-prepared CNSs. Variability in practice and educational preparation is not only potentially confusing to other healthcare providers and the public, but it may not serve the best interests of CNS clients.

Adult↗
PubMed1996

Differences in nausea, vomiting, and retching between younger and older outpatients receiving cancer chemotherapy.

The purpose of this study was to determine whether there were differences in the side effects of nausea, vomiting, and retching (N, V, and R) between younger ( < 65 years, n = 102) and older ( > or = 65 years, n = 25) persons receiving outpatient chemotherapy. A longitudinal 4-month study was used for the 127 participants recruited from 18 settings. Participants completed two questionnaires (Inventory of N, V, and R and Behavior Checklist) over the course of the study. The pattern between the younger and older patients' N, V, and R subscale scores was consistent in that the younger patients' scores were consistently (except on one occasion) higher than the older patients' scores, but this difference was statistically insignificant. This study furthers our understanding of N, V, and R and has several clinical implications.

Adult↗
PubMed1996

Randomized clinical trial of chlorhexidine versus placebo for prevention of oral mucositis in patients receiving chemotherapy.

PURPOSE/OBJECTIVES: To test the effectiveness of a nurse-initiated systematic oral hygiene teaching program-PRO-SELF: Mouth Aware (PSMA)-in conjunction with two mouthwashes (0.12% chlorhexidine or sterile water) in preventing chemotherapy-induced oral mucositis. DESIGN: Randomized, double-blind, placebo-controlled, clinical trial. SETTINGS: 23 outpatient clinics and office practices in California. SAMPLE: 222 patients who were starting a cycle of mucositis-inducing chemotherapy. METHOD: Participants were followed over three chemotherapy cycles. All patients were provided the PSMA program. Random assignment to a mouthwash occurred prior to the development of oral mucositis. Researchers used the Oral Assessment Guide to assess the patients oral cavities monthly (with the patients cycles of chemotherapy) and when patients reported any oral changes between cycles. MAIN RESEARCH VARIABLES: Type of mouthwash, incidence, days to onset, and severity of chemotherapy-induced oral mucositis. FINDINGS: No significant differences existed between the two mouthwashes in regard to incidence, days to onset, and severity of mucositis. CONCLUSIONS: Because chlorhexidine (S20 per pint) was no more effective than water, a substantial cost savings can be realized by rinsing with water. Interestingly, the PSMA program appeared to reduce the incidence of mucositis from on a prior estimate of 44% to less than 26%. IMPLICATIONS FOR NURSING PRACTICE: A nursing prescription of a systematic oral hygiene program using water as a mouth rinse is cost efficient and may be effective in preventing oral mucositis.

Adult↗
PubMed1996

Cardiovascular clinical nurse specialists: demographic, practice and educational characteristics.

In 1993, California mandated a study of the practice characteristics of Clinical Nurse Specialists (CNSs) in the state. This report describes, compares and contrasts the demographic, practice and educational characteristics of a subsample of cardiovascular CNSs with the rest of the CNS sample. Cardiovascular CNSs tended to have characteristics more indicative of a hospital-based specialty and the role appeared to be more consistently established than the general CNS sample. In addition, cardiovascular CNSs had a significantly higher percentage of graduate-prepared nurses. They had significantly fewer interactions in outpatient, community, and home settings than the rest of the CNS group. While cardiovascular CNSs play a vital role in the high technology-based hospital setting, they do not appear to be moving out of that setting as are other CNSs. This is an interesting finding since cardiovascular disease is chronic and well suited to outpatient management within the CNS charter. These findings may aid in establishing future opportunities for cardiovascular CNSs in the new health care environment, as well as serve as a benchmark for educators of CNSs.

Adult↗
PubMed1995

Mood states of oncology outpatients: does pain make a difference?

The purposes of this study were to determine if there were significant differences in the mood states of oncology outpatients who had cancer-related pain and those who were pain free, and to evaluate the relationships between pain intensity and duration and mood states in those patients with pain. Two hundred (54.2%) patients experienced cancer-related pain during the previous month and 169 (45.8%) patients were pain free. Those patients who experienced cancer-related pain scored significantly higher on all of the subscale scores of the Profile of Mood States, except vigor, and had a significantly higher total mood disturbance (TMD) score than did pain-free patients. In addition, the subscale scores of tension, depression, anger, fatigue, confusion, and TMD scores were moderately correlated with increases in pain intensity. Also, depression, fatigue, confusion, and TMD scores were moderately correlated with increasing duration of pain. These data suggest that there is a relationship between pain and mood in oncology outpatients and that health-care professionals need to assess for mood disturbances in this population and develop appropriate treatment strategies.

Affect↗
PubMed1995

A description of the gender differences in risk behaviors in young adults with genital herpes.

The purpose of this paper is to describe gender differences in risk behaviors--substance use and sexual behavior--in young adults with genital herpes. Two-hundred fifty-two young adults with genital herpes were recruited into the study via newspaper advertisements in a West Coast metropolitan area. As a part of a large randomized clinical trial, participants completed questionnaires measuring demographic characteristics and the risk behaviors of substance use and sexual behavior. Participants had a mean age of 27.1 years and were largely Caucasian, employed, college-educated, and heterosexual. Women were two years younger than men and had less income. Gender differences were found in both substance use and sexual behavior. Men were more likely to report current use of illicit drugs than were women. Men were also more likely to report a history of gonorrhea, and urethral discharge. Women reported initiating sex at an older age and having fewer sexual partners over their lifetimes than men. There were no gender differences in use of condoms or spermicides specifically to prevent transmission of genital herpes. Further study is needed of these young adults as they are at high risk for transmission of the disease and also for contracting other sexually transmitted diseases (STDs), including human immunodeficiency virus (HIV) infection. Sensitive interventions are needed with this high-risk population.

Adolescent↗
PubMed1995

Clinical features and psychosocial factors in young adults with genital herpes.

Clinical features of genital herpes, perceived causes, stress symptoms, treatments, and psychosocial factors in 70 young adults as compared to normative data for non-patient controls are described. The clinical features of the disease were congruent with those of other groups studied. Stress was viewed as the major cause of recurrence, headaches the major stress symptom, and acyclovir (an antiviral drug), was the major treatment. Statistically significant differences were found between scores obtained from the sample of young adults with genital herpes on three of four standardized psychological instruments when compared with normative data for non patient controls. Young adults with genital herpes had a lower self concept, more psychopathology, a greater frequency of daily hassles, and less intensity of uplifts. No differences were found, however, between the two groups in scores on depression.

Adult↗
PubMed1995

The problem of pain in outpatients with breast cancer.

PURPOSE/OBJECTIVES: To determine the prevalence and causes of pain in a group of outpatients with breast cancer and to evaluate the effects of pain on the patient's activities of daily living (ADL), mood, and quality of life (QOL). DESIGN: Descriptive and correlational. SETTING: Sixteen outpatient facilities that are part of the Oncology Nursing Research Network. SAMPLE: A convenience sample of 97 outpatients who were actively being treated for breast cancer. METHODS: Patients completed a demographic questionnaire, a cancer pain questionnaire, the Profile of Mood States, and the Multidimensional Quality of Life Scale--Cancer. Patients' medical records were reviewed. MAIN RESEARCH VARIABLES: Pain intensity, pain duration, changes in ADL, changes in mood, and changes in QOL. FINDINGS: Forty-seven percent of the patients with breast cancer reported experiencing cancer-related pain. Patients with cancer-related pain had significantly higher mood disturbance scores and significantly lower QOL scores. CONCLUSIONS: Pain is a significant problem for outpatients with breast cancer that negatively affects mood, QOL, and functional status. IMPLICATIONS FOR NURSING PRACTICE: Future research is needed to determine the most effective strategies for treating pain associated with breast cancer. In addition, oncology nurses should perform ongoing assessments of patients' pain and the impact of the pain on various aspects of patients' lives.

Activities of Daily Living↗
PubMed1995

Perceptions of the mammography experience.

The 1993 projections for breast cancer indicate a morbidity of 183,000 women with a mortality rate of 18%. Mammography is one of three approaches available for the early detection of breast cancer. However, underutilization has been reported and attributed to pain associated with the procedure, the expense to the consumer, and lack of referral by physicians. Other reasons for the low utilization rates include fears on the part of the woman of a positive diagnosis, radiation, and a possible mastectomy. This study provides an analysis of the responses of a convenience sample of 272 women, aged 30-90 years, to two open-ended questions about the mammography experience. The words and phrases women used to describe the mammography experience and the sensations experienced in their breasts during mammography were subjected to content analysis. The results of this study suggest that the word descriptors women use to describe their experience during mammography are highly individualistic and may not be totally captured by numeric or descriptive rating scales of pain intensity.

Adult↗
PubMed1995

Differences in pain knowledge and perception of the pain experience between outpatients with cancer and their family caregivers.

PURPOSE/OBJECTIVES: To determine if knowledge about pain and the perception of the pain experience differ when comparing outpatients experiencing cancer-related pain with their family caregivers. DESIGN: Quantitative, descriptive. SETTING: Sixteen oncology outpatient settings that are part of the Oncology Nursing Research Network. SAMPLE: Eighty-six outpatients with cancer-related pain and their family caregivers. METHODS: Patients and their family caregivers were recruited in the outpatient setting and asked to complete a demographic questionnaire and the Pain Experience Scale. The patients also were asked to complete the Karnofsky Performance Scale. MAIN RESEARCH VARIABLES: Patients' and their family caregivers' knowledge about pain and their perception of the pain experience. FINDINGS: No significant differences in knowledge scores were found between the patients and their family caregivers. A significant difference in the perception of the pain experience was found, with the family caregivers viewing the experience more negatively than the patients did. Family caregivers reported that (a) patients had significantly higher levels of pain compared to patient reports, (b) patients experienced significantly greater distress from their pain than the patients reported for themselves, and (c) family caregivers experienced significantly greater distress from the patients' pain than the patients reported for their caregiver. CONCLUSIONS: Outpatients with cancer and their family caregivers possess limited knowledge about pain and pain management and perceive the pain experience differently. IMPLICATIONS FOR NURSING PRACTICE: Outpatients and their family caregivers need to be better educated about how to manage cancer-related pain. In addition, to reduce patient and caregiver distress, oncology nurses need to facilitate communication between patients and family caregivers about the pain experience.

Caregivers↗