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Biomedical subjects

T van Achterberg

Publications and source records attributed to T van Achterberg.

10 recordsLinked to original sources
PubMed2007

Symptoms in the palliative phase of children with cancer.

BACKGROUND: The aim of the study was to make a comprehensive inventory of the physical, psychological, and social symptoms of children with cancer and their parents during the palliative phase and the extent to which health professionals address those symptoms. PROCEDURE: Forty parents of children who died 1-3 years prior to data collection (structured questionnaire) were invited to participate in the study. RESULTS: The response rate was 32 out of 40 parents (80%). Most frequently mentioned physical symptoms were pain, poor appetite, and fatigue. The children's most mentioned psychological symptoms were sadness, difficulty in talking to their parents about their feelings regarding illness and death and fear of being alone. The symptoms of fear of death of the child and fear of physical symptoms were most frequently mentioned parents' psychological symptoms. Health professionals addressed 82% of the children's physical symptoms, 43% of the children's psychological symptoms, and 56% of the parents' psychological symptoms. Parents indicated that after professional attention the proportion of children's physical symptoms that were completely or partially resolved was 18 and 26%, respectively. For children's psychological symptoms the figures were 9 and 25%, respectively, and for parents' psychological symptoms 2 and 23%, respectively. CONCLUSIONS: The burden of symptoms of the child with cancer during the palliative phase and their parents is high. Health professionals focus mainly on the physical symptoms of the child. Relief of symptoms could not be achieved for a large proportion of symptoms. Further prospective research is necessary to investigate the kind, frequency and intensity of symptoms in order to tailor optimal palliative care to the needs of both child and parent.

Adolescent↗
PubMed2006

[Dutch observation scales to assess cognitive abilities of the aged].

Assessment of complex geriatric health problems by nurses is important for diagnosis, especially assessment of cognitive functioning through daily observations. However, it is unclear which Dutch observation scales are available to assess cognitive abilities. In this study, we present an overview of these scales. A systematic review was performed. Beforehand we determined criteria for inclusion of scales and we searched through Dutch and English databases up till May 2005. Thirteen behavioural observation scales were found. The number of dimensions of cognitive functioning assessed in the scales varied greatly, from two to eight in number. Memory and psychomotor behaviour were always included; consciousness and thinking were frequently included, while alertness, perception, executive functions and language were least included. Extensive assessment of cognitive functioning is highly relevant for a geriatric hospital ward in which patients are admitted for diagnosis. Of all scales that we traced, the A-one is the most extensive: all eight dimensions are included. Little is known about the potential for using the A-one scale in nursing practice; further exploration is indicated. For now, nurses should become acquainted with the different dimensions of cognitive functioning and start to integrate observations in these dimensions in their reporting.

Aged↗
PubMed2005

Applying ICF in nursing practice: classifying elements of nursing diagnoses.

AIM: This study explores the relevance of the International Classification of Functioning, Disability and Health (ICF) to nursing diagnoses. BACKGROUND: As a multidisciplinary classification of human functioning, the ICF (previously known as ICIDH-2) is potentially relevant to nursing care. However, nurses have rarely used the classification during the 23 years of its existence. METHOD: In part 1 of the study, 51 nursing diagnoses from anonymous patients were deliberately selected for diversity from an existing database. The 427 diagnostic elements from these diagnoses (problem statements, aetiological factors, signs and symptoms) were classified, using the ICF, by a panel of six nurses. In part 2 of the study, the panel classified 223 elements from 30 diagnoses of patients they had actually cared for. RESULTS: Nearly all diagnostic elements could be classified, most often in the sub-dimensions of body functions and activities. Agreement on appropriate ICF components was 61% for anonymous patients and 75% for familiar patients. Agreement at the more detailed 3-digit level of the classification was 42% for anonymous and 60% for familiar patients. CONCLUSION: The ICF has relevance to nursing care. As a general classification, it was not designed by nurses or specifically for nursing care. This can explain some difficulties in using the classification that were identified in this study, as well as the rather low levels of agreement. To resolve these issues and to further improve the classification, nurses should further explore the use of the ICF and participate in future revision processes.

Academic Medical Centers↗
PubMed2004

Psychosocial interventions for patients with advanced cancer - a systematic review of the literature.

Advanced cancer is associated with emotional distress, especially depression and feelings of sadness. To date, it is unclear which is the most effective way to address these problems. This review focuses on the effects of psychosocial interventions on the quality of life (QoL) of patients with advanced cancer. It was hypothesised that patients will benefit from psychosocial interventions by improving QoL, especially in the domain of emotional functioning. The review was conducted using systematic review methodology involving a systematic search of the literature published between 1990 and 2002, quality assessment of included studies, systematic data extraction and narrative data synthesis. In all, 10 randomised controlled studies involving 13 trials were included. Overall interventions and outcome measures across studies were heterogeneous. Outcome measures, pertaining to the QoL dimension of emotional functioning, were most frequently measured. A total of 12 trials evaluating behaviour therapy found positive effects on one or more indicators of QoL, for example, depression. The results of the review support recommendation of behaviour therapy in the care of patients with advanced cancer.

Clinical Trials as Topic↗
PubMed2004

A test instrument for palliative care.

This article describes a methodological study concerning the development of a test instrument that can be used for measuring the effects of a course in palliative care on registered nurses and licensed practical nurses. This test instrument is comprised of two parts: an expertise and insight test and a self-efficacy instrument and is tested in three panels. The expertise and insight test appears to be usable for measuring the effects of a course in palliative care. The reliability and validity of the test were found to be adequate for evaluation of the effects of a post-basic palliative care course. The generality of the self-efficacy instrument was reduced because high-scoring items in the area of communication had to be removed. Moreover, the scores of the various categories of respondents discriminate less than expected on the basis of their previous education and the test results. Many respondents, regardless of their background, believed themselves to have a high level of competency. The self-efficacy instrument must therefore be used cautiously.

Analysis of Variance↗
PubMed1996

Predictors of professional and non-professional community care for care-dependent adults.

The increasing number of elderly people in most industrialized countries makes reforms in health care necessary. However, knowledge of factors that determine the use of care is scarce. The study described in this article focuses on predictors of the diversity of professional and non-professional care used by care-dependent adults who live in the community. A group of 177 care-dependent adults was identified by means of a large scale telephone survey in the Dutch community of Tegelen. Potential predictors of the diversity of professional and non-professional care were derived from Andersen's Behavioral Model of Health Services [4,5] and Litwak's Task Specifity Model [12]. Both models proved to be valuable for the explanation of variance in the diversity of care. Potential predictors derived from the two models could account for 21% of the variance for total care, 25% of the variance for professional care, and 34% of the variance for non-professional care.

Caregivers↗
PubMed1995

Implementing coordination of care--task performance and problems encountered.

In recent years the effects of interventions in the field of coordination of care have been well reported. However, the implementation of coordination of care is hardly addressed. This article focuses on the implementation of coordination of care for the elderly in three community settings in The Netherlands. A group of 38 professional and non-professional care-givers functioned as coordinators during a period of one year. Open interviews with coordinators, minutes from group meetings and forms and logbooks were used as sources of data. Major problems during implementation involved conflicting roles, preserving the client's privacy, lack of recognition and the perception that coordination was not always necessary. Coordinators had no difficulty in making a care inventory and in organizing care. On the other hand, introducing oneself as a coordinator, and planning and evaluating are tasks that need more attention in future interventions.

Aged↗
PubMed1993

Cross-cultural testing of the "appraisal of self-care agency: ASA scale" in Norway.

The purpose of this study was to test the discriminant validity and interrater reliability of an instrument that measures aspects of self-care agency using Norwegian populations. The ASA scale forms A and B, which had been tested in the Netherlands previously, were translated into Norwegian and administered to two groups of elderly subjects and to a sample of geriatric nurses and nursing assistants in Norway. The subjects, one group from two geriatric rehabilitation units, and another from those living independently who were attending activity centres, completed the ASA-A scale. The nurses filled out the ASA-B scale. The results were supportive of the validity and reliability. Discriminant validity of the ASA scales was demonstrated.

Activities of Daily Living↗
PubMed1991

The Norwegian, Danish and Dutch version of the Appraisal of Self-care Agency Scale; comparing reliability aspects.

This study was designed to test reliability aspects of a scale that was developed to measure the theoretical concept of self-care agency (Orem 1985). Equivalence and internal consistency of the scale were studied with populations of elderly patients and their nurses in The Netherlands, Norway and Denmark. Data was provided by 120 patients and 233 nurses. Not all criteria for reliability could be met for the Danish and the Norwegian versions of the scale. Nevertheless it is concluded that the results are indications for the reliability of the Dutch, as well as the Danish and Norwegian versions of the scale.

Denmark↗