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Biomedical subjects

Sheila H Ridner

Publications and source records attributed to Sheila H Ridner.

7 recordsLinked to original sources
PubMed2006

Pretreatment lymphedema education and identified educational resources in breast cancer patients.

OBJECTIVE: In 1998, the American Cancer Society (ACS) Lymphedema Workshop, called for a three phase approach to patient lymphedema education: (1) pretreatment, (2) postoperatively, and (3) continuing education. The objectives of this study were: to compare recalled pretreatment lymphedema education before and after the 1998 ACS call; compare recalled lymphedema pretreatment education between women with and without breast cancer treatment-related lymphedema; and identify breast cancer survivors perceived sources of lymphedema education. METHODS: One hundred and forty-nine breast cancer survivors (74 with lymphedema and 75 without lymphedema) were asked: (1) Prior to having breast cancer treatment did anyone talk to you about your risk for lymphedema? If yes, who? (2) Prior to having breast cancer treatment did anyone talk to you about ways to decrease your risk for lymphedema? If yes, who? (3) If you want to learn more about lymphedema occurring after breast cancer treatment who would you ask or where would you look for information? RESULTS: Individuals with lymphedema consistently recalled receiving less education and a decline in recalled risk reduction education in the lymphedema group occurred after 1998. DISCUSSION: Barriers exist to the integration of ACS suggested pretreatment lymphedema educational protocols and risk reduction education may influence risk of developing lymphedema. CONCLUSION: Pretreatment lymphedema education may improve breast cancer survivor's recall of educational information received about lymphedema. PRACTICE IMPLICATIONS: Healthcare providers must be well versed about breast cancer treatment-related lymphedema and communicate this knowledge to patients on a consistent basis.

Adult↗
PubMed2005

Is sternal skin conductance monitoring a valid measure of hot flash intensity or distress?

OBJECTIVE: To examine the validity of using sternal skin conductance monitoring as a measure of hot flash intensity and hot flash distress. DESIGN: Descriptive, prospective, longitudinal data from the 2-week baseline of a larger hot flash intervention study; 73 breast cancer survivors with daily hot flashes wore a hot flash monitor and completed a hot flash diary during two 24-hour assessment periods that were separated in time by 1 week. RESULTS: Data consisted of 569 diary rated hot flashes; 46.9% had magnitude of less than 2.0 micromhos (insufficient to meet objective hot flash criterion) and 26.3% had magnitude of 0.0 micromho (no change in skin conductance). Results from mixed-linear modeling indicated that, although magnitude significantly predicted hot flash intensity and distress, effect sizes were very small: less than 2% when using all observations, and less than 1% when using only the subset meeting objective hot flash criteria. Even after adjusting for covariates that were associated with intensity or distress, magnitude explained very little variance in intensity or distress (<2.2%). Scatterplots and locally weighted smooth regression curves also revealed very little relationship between magnitude and either intensity or distress. CONCLUSIONS: Findings indicate that objective change in sternal skin conductance, an indicator of sweat gland activity, should not be used as a proxy measure of subjective hot flash intensity or distress. Future research should continue to subjectively measure hot flash intensity and distress when these are important outcome variables to consider.

Female↗
PubMed2005

Quality of life and a symptom cluster associated with breast cancer treatment-related lymphedema.

OBJECTIVES: The aim of this study was to compare quality of life and symptoms between breast cancer survivors who have developed and undergone treatment for chronic lymphedema with those who have not developed lymphedema. PATIENTS AND METHODS: The cross-sectional, mixed-methods design included 64 breast cancer survivors with lymphedema and 64 breast cancer survivors without lymphedema. Variables assessed quantitatively included sociodemographic information, medical data, body mass index (BMI), arm extracellular fluid volume, quality of life (QOL), and physical and emotional symptoms. For the qualitative component, individuals with lymphedema responded in writing to the question: During the past week what other difficulties have you experienced because of your lymphedema? RESULTS: Compared with those without lymphedema, breast cancer survivors with lymphedema reported poorer QOL. A symptom cluster that included alteration in limb sensation, loss of confidence in body, decreased physical activity, fatigue, and psychological distress was identified. Perception of limb size influenced the cumulative symptom experience more than objective arm volume. Qualitative data revealed multiple QOL, physical health, and psychological concerns. BMI correlated with multiple outcomes. CONCLUSIONS: Findings suggest that current lymphedema treatments, although beneficial, may not provide complete relief of symptoms associated with lymphedema and complementary interventions are needed. The poorer QOL in breast cancer survivors with lymphedema may relate to the presence of an untreated symptom cluster.

Breast Neoplasms↗
PubMed2004

Psychological distress: concept analysis.

BACKGROUND: The term 'distress' is frequently used in nursing literature to describe patient discomfort related to signs and symptoms of acute or chronic illness, pre- or post-treatment anxiety or compromised status of fetuses or the respiratory system. 'Psychological distress' may more accurately describe the patient condition to which nurses respond than does the term 'distress'. Psychological distress is seldom defined as a distinct concept and is often embedded in the context of strain, stress and distress. This creates confusion for nurses attempting to manage the care of people experiencing psychological distress. AIMS: This paper is a concept analysis of psychological distress based on Walker and Avant's (1995) criteria that identifies the attributes, antecedents, and consequences of psychological distress based upon the findings of the literature review. In addition, empirical references are identified and constructed cases presented. METHODS: A literature search was conducted using MEDLINE, CINAHL, Ovid, PsychINFO, and Cancer Lit databases over the last 50 years. The purposes of this concept analysis were: (1) to establish the concept of psychological distress as a clear and distinct concept, separate from strain, stress and distress, and (2) to provide nurses with a base of knowledge from which to plan effective clinical interventions. FINDINGS: Content analysis of the literature revealed that, although used frequently in health care literature, the origin of the concept of psychological distress has not been clearly articulated and is ill-defined. CONCLUSIONS: Psychological distress is a serious problem faced by many of the people whom nurses encounter on a daily basis. An understanding of the concept of psychological distress will help nurses ameliorate this problem in patients. Nursing research related to the exploration of psychological distress is also needed.

Humans↗
PubMed2004

Sleep, fatigue, and depressive symptoms in breast cancer survivors and matched healthy women experiencing hot flashes.

PURPOSES/OBJECTIVES: To compare sleep quality and disturbance, fatigue, and depressive symptoms between breast cancer survivors and healthy women experiencing hot flashes and to examine relationships among sleep and remaining variables (fatigue, depressive symptoms, and frequency of hot flashes). DESIGN: Cross-sectional, descriptive, comparative pilot study. SETTING: University-based outpatient setting. SAMPLE: 15 breast cancer survivors and 15 healthy women matched on age, race, and menopausal status. All women had untreated hot flashes (no hormone replacement therapy or other hot flash treatments). METHODS: Questionnaires (sleep quality and disturbance, fatigue, and depression); two ambulatory, 24-hour sternal skin conductance monitoring sessions (hot flash frequency); and medical records review. MAIN RESEARCH VARIABLES: Sleep quality and disturbance, fatigue, depressive symptoms, and objective hot flash frequency. FINDINGS: The majority of participants evidenced poor sleep quality and high sleep disturbance (73% of breast cancer survivors and 67% of healthy women above a cutoff score of 5). Sleep duration was significantly shorter for breast cancer survivors in contrast to healthy women. Nighttime flashes were experienced by 67% of breast cancer survivors and 37% of healthy women. No group differences were found in fatigue, depressive symptoms, or objective hot flash frequency. Global sleep scores were significantly positively correlated with fatigue and depression but not with hot flash frequency. CONCLUSIONS: Findings suggest that sleep disturbance is common in menopausal breast cancer survivors and healthy women, is not necessarily related to hot flashes, and may stem from a multifactorial etiology. IMPLICATIONS FOR NURSING: Menopausal breast cancer survivors who present with any one of these symptoms should be screened for all symptoms both during and after treatment.

Breast Neoplasms↗
PubMed2002

Breast cancer lymphedema: pathophysiology and risk reduction guidelines.

PURPOSE/OBJECTIVES: To review the normal physiology of the blood capillary-interstitial-lymphatic vessel interface, describe the pathophysiology of lymphedema secondary to treatment for breast cancer, and summarize the physiologic bases of the current National Lymphedema Network (NLN) risk reduction guidelines. DATA SOURCES: Journal articles, anatomy and physiology textbooks, published research data, and Web sites. DATA SYNTHESIS: Lymphedema occurring after treatment for breast cancer significantly affects physical, psychological, and sexual functioning. About 28% of breast cancer survivors develop lymphedema. When arterial capillary filtration exceeds lymphatic transport capacity, lymphedema occurs. NLN risk reduction guidelines may decrease lymphedema risk. CONCLUSION: Lymphedema is chronic and disfiguring. Most NLN risk reduction guidelines, although not evidence-based, are based on sound physiologic principles. Evidence-based research of the effectiveness of NLN risk reduction guidelines is indicated. IMPLICATIONS FOR NURSING: Until evidence-based research contradicts NLN's risk reduction guidelines, nurses should inform patients with breast cancer about their risk for lymphedema, guidelines to reduce that risk, and the physiologic rationale for the guidelines.

Adult↗