Health professionals' views of the feasibility and acceptability of an oral care diary by patients during chemotherapy.
Explore the source record for details and available documents.
Attitude of Health Personnel↗
Biomedical subjects
Suzanne Hagen
Publications and source records attributed to Suzanne Hagen.
Evaluation of the feasibility and acceptability of an oral care diary by patients during chemotherapy.
BACKGROUND: A significant proportion of patients undergoing chemotherapy for many cancer types may experience oral problems, such as mucositis and any deterioration in the health of the oral cavity can have a significant effect on a person's well-being. Trends towards shorter hospital stays and the increase in out-patient chemotherapy mean that patients are required to adopt increasingly participatory roles in their self-care and are subsequently coping with mouth problems while they are at home without the direct support of oncology health professionals. OBJECTIVES: This study aimed to evaluate the acceptability and feasibility of an oral care diary by patients receiving chemotherapy. DESIGN: An oral care diary was developed to incorporate oral assessment using the Oral Assessment Guide (Eilier, J., Berger, A., Peterson, M., 1988. Development, testing and application of the oral assessment guide. Oncology Nurse Forum 15, 325-330) and guidance about oral self-care. This exploratory study utilised purpose designed pre- and post-study questionnaires and semi-structured interviews to evaluate patients' perceptions and experiences of the oral care diary. SETTING: The study took place in 2-day chemotherapy units in Scotland: 1 in a cancer centre and 1 in a district general hospital. PARTICIPANTS: A consecutive sample of patients (n=45) receiving out-patient chemotherapy for a range of cancer diagnoses participated in the study over 2 cycles of chemotherapy. METHODS: Following recruitment, patients were instructed in the use of the oral care diary to assess their mouth daily while at home on a daily basis. Patients were asked to complete 2 structured purpose designed questionnaires-the first prior to starting diary completion and the second following their participation in the study. Nine patients participated in semi-structured interviews to explore their actual experiences of using the oral care diary in more depth. RESULTS: The participants found the oral care diary acceptable and feasible. Awareness of oral symptoms and related mouth self-care post-chemotherapy improved. CONCLUSIONS: The oral care diary is an acceptable and feasible method of enhancing oral self-care during a course of chemotherapy. Further study is required to evaluate its impact on clinical outcomes.
Adaptation, Psychological↗
The relationship between UK hospital nurse staffing and emotional exhaustion and job dissatisfaction.
AIM: To explore the relationship between nurse outcomes (dissatisfaction and emotional exhaustion) and nurse workload, nurse characteristics and hospital variables. BACKGROUND: Concern about the impact of restructuring of nurse staffing, and reports of nurse shortages, on nurse and patient outcomes led to the research being reported on in this article. METHODS: A questionnaire survey of registered nurses in Scotland and England. A questionnaire survey of the hospitals in which these nurses worked. RESULTS: Respondents in the two countries were similar in terms of demographic, work and employment characteristics. Significant relationships were found using the combined English and Scottish data between nurse patient ratios and (1) emotional exhaustion and (2) dissatisfaction with current job reported by nurses. CONCLUSIONS: Increasing numbers of patients to nurses was associated with increasing risk of emotional exhaustion and dissatisfaction with current job.
Adult↗
Psychometric properties of the SF-36 in the early post-stroke phase.
BACKGROUND: Patients who have had a stroke are a large group in whom long-term disability is common and therefore impaired general health is likely. The Short Form 36 (SF-36) is a popular measure of general health that has been used with this patient group, but not all aspects of its psychometric properties have been established for use in this context, and its use in the early post-stroke phase has been neglected. AIMS: To examine the reliability, validity and sensitivity to change of the SF-36 (UK version I) in patients in the early post-stroke period. DESIGN: A prospective, observational study of stroke outcomes was carried out. RESEARCH METHODS: From May 1996 to April 1997, patients who had had a stroke were identified by 24 general practices in Scotland and were recruited within 1 month of their stroke, whether in hospital or at home. Outcome measures including the SF-36 were administered at one, 3 and 6 months after onset. RESULTS: The internal consistency of the eight subscales at all three time-points was good except for 1 month Vitality (alpha = 0.6824) and 3 month General Health (alpha = 0.6650), which were borderline in comparison with the criterion value of 0.7. Construct validity was adequate overall, although correlations between Role Physical and General Health and the Barthel Index and Canadian Neurological Scale were lower than hypothesized. Most SF-36 subscales were sensitive to change between 1 and 3 months post-stroke, but none detected change between 3 and 6 months. CONCLUSIONS: There were some practical problems in using the SF-36 in an acutely unwell stroke population. However, analysis of psychometric properties suggested that most of the subscales were adequately reliable and valid. Sensitivity to change was poorer in the later stages of the study.
Aged↗
Does perineal suturing make a difference? The SUNS trial.
OBJECTIVE: To examine differences in outcome between primiparous women who do and who do not have suturing to first or second degree perineal lacerations sustained during spontaneous vaginal births after 37 weeks of gestation. DESIGN: Parallel group randomised controlled trial. SETTING: Bellshill Maternity Hospital, Lanarkshire, and St John's Hospital, Livingston. POPULATION: Primigravidae with perineal lacerations following spontaneous birth. METHODS: One thousand and three hundred fourteen women were recruited to the trial antenatally from whom 74 were randomised either to be sutured or not sutured immediately after giving birth. Randomisation was stratified by degree of tear. MAIN OUTCOME MEASURES: Using standardised measures, perineal pain and healing were measured at 1 and 10 days and 6 weeks postpartum. In addition, postnatal depression was assessed at 10 days and 6 weeks postpartum. RESULTS: Findings indicated that there were no significant differences between the groups with regard to pain or depression but there were differences with regard to healing. At six weeks, there remained a significant difference in wound closure between the groups, with women who had not been sutured having poorer wound approximation. CONCLUSIONS: While acknowledging the small sample size, the results are nonetheless important, showing persistent evidence of poorer wound approximation in those women who had not been sutured. Practitioners need to review the present practices of not suturing perineal lacerations until research examining the longer term implications is undertaken.
Depression, Postpartum↗
Test-retest reliability, validity, and sensitivity to change of the urogenital distress inventory and the incontinence impact questionnaire.
AIMS: To evaluate two quality of life measures for urinary incontinence (UI) in Scottish females. METHODS: Three groups with UI from two regions in Scotland were studied. Two groups were receiving treatment for incontinence; the third was not. Women completed the UDI and IIQ twice to allow assessment of test-retest reliability and validity. Treatment groups completed the questionnaires again, postintervention, to assess ability of the measures to detect change. Other measures used to assess validity were the SF-36, HADS, weight of urine leaked, and number of incontinence episodes. By design, the three subject groups differed significantly in their characteristics, ensuring a diverse sample of women. RESULTS: Analysis of reliability showed a clinically trivial but statistically significant decrease in total UDI (mean, -6.1; 95% CI, -11.0 to -1.5) and IIQ (mean, -9.7; 95% CI, -15.5 to -3.9) scores between test and retest assessments, possibly due to a research effect. Most items of the UDI (18 of 19) and IIQ (28 of 30) performed very well on test-retest. The UDI and IIQ were valid in that higher scores (indicating more bothersomeness of symptoms/impact on daily living) were associated with greater severity of UI. Additionally the IIQ showed the expected associations with measures of anxiety and health status. CONCLUSIONS: Both the UDI and IIQ detected changes in women's conditions due to intervention. The measures had good psychometric properties, including test-retest reliability, across subject groups.
Adult↗