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Biomedical subjects

V A Rhodes

Publications and source records attributed to V A Rhodes.

At least 19 recordsLinked to original sources
PubMed1998

Development of a preparatory sensory information videotape for women receiving chemotherapy for breast cancer.

This study describes the development and testing of a preparatory sensory information (PSI) videotape for women receiving chemotherapy for breast cancer. In telephone interviews, 40 women described the sensations they experienced before, during, and after receiving chemotherapy. Sensations described by the women were linked with procedural and temporal elements identified by certified advanced practice oncology nurses to develop a script for the PSI videotape. Women currently receiving chemotherapy or who had completed chemotherapy within the last 6 months were asked to share their experiences on videotape. After editing, a 20-minute PSI videotape was produced. Pilot testing with a group of 20 women demonstrated that the intervention helped to prepare them for the sensory experiences associated with chemotherapy and was helpful in developing anticipatory coping and self-care behaviors.

Antineoplastic Agents↗
PubMed1998

Hospice patients' and nurses' perceptions of self-care deficits based on symptom experience.

Although the relief and/or control of physically, emotionally, and spiritually distressing symptoms are the hallmarks of hospice care, accurate assessment of the individual's unique and often rapidly changing symptom experience is lacking. The purpose of this descriptive, correlational study was to assess and quantify hospice patients' perceptions of their symptom experiences and those of the hospice nurse assessing them. A convenience sample of 53 hospice patients (32 males, 21 females), with a mean age of 69 years, from a large midwestern home-based hospice completed the Adapted Symptom Distress Scale Form 2 (ASDS-2) at admission, and at 2 and 4 weeks after admission. The Hospice Admission Intake was completed at admission. Individual hospice nurses completed the ASDS-2 within 24 hours of their hands-on assessment, in addition to the demographic characteristics profile. Findings indicated an improvement in symptom experience, distress, and occurrence scores from admission to week 2, and in the symptom experience and distress scores from admission to week 4. Hospice nurses tended to give higher symptom experience scores than the patients gave to themselves. These findings demonstrate the importance of obtaining information about symptom experience from the patient as well as the nurse.

Adolescent↗
PubMed1998

Phase I study of docetaxel dose escalation in combination with fixed weekly gemcitabine in patients with advanced malignancies.

PURPOSE: To determine the maximum-tolerated dose of monthly docetaxel combined with fixed-dose weekly gemcitabine and describe the dose-limiting toxicities (DLTs) of the combination. PATIENTS AND METHODS: Patients with refractory solid tumors were treated with gemcitabine days 1, 8, and 15 every 4 weeks at a fixed dose of 800 mg/m2. Two docetaxel administration schedules were studied, with the drug administered either day 1 or day 15 at doses of 45, 60, 75, and 100 mg/m2 per cycle. RESULTS: Forty patients received 132 cycles of chemotherapy. On the day-1 schedule, the maximum-tolerated docetaxel dose was the highest planned dose of 100 mg/m2 with two DLT episodes among 12 patients treated with 34 cycles at this dose level. On the day-15 schedule, delivery of the planned docetaxel doses was not feasible because of thrombocytopenia and hepatic dysfunction. Hematologic toxicities included grade 4 neutropenia in 16 patients, with three episodes of febrile neutropenia; grades 3 to 4 thrombocytopenia in nine patients; and anemia that required RBC transfusions in 10 patients. For patients treated at the highest docetaxel dose level, myelosuppression was not dose limiting and only one of 34 cycles was complicated by febrile neutropenia. The most common nonhematologic toxicities were asthenia, flu-like symptoms, and fluid retention. Antineoplastic activity was noteworthy, with partial responses in nine of 21 patients with pretreated non-small-cell lung cancer (NSCLC; 43%; 95% confidence interval, 22 to 66), in four of seven patients with breast cancer, and in one patient with esophageal adenocarcinoma. CONCLUSION: Gemcitabine 800 mg/m2 days 1,8, and 15 can be safely combined with docetaxel 100 mg/m2 day 1 of a 28-day cycle. The observed antitumor activity warrants phase II evaluation.

Adult↗
PubMed1998

Establishing mechanisms to conduct multi-institutional research--fatigue in patients with cancer: an exercise intervention.

PURPOSES/OBJECTIVES: To describe the process of establishing a multi-institutional interdisciplinary team of oncology researchers and conducting a pilot study of an exercise intervention for fatigue. DATA SOURCES: Project meeting minutes and records, research team members' logs, subjects' research records, the research study proposal, and team members' individual and collective shared experiences. DATA SYNTHESIS: Site investigators established research teams at five academic medical centers. Fifty subjects were enrolled in the study and tested during their cancer treatment. Study methods, including instrumentation, were evaluated carefully and revised. CONCLUSIONS: The multi-institutional network of researchers is an effective and efficient model for testing an intervention to manage fatigue during cancer treatment. IMPLICATIONS FOR NURSING PRACTICE: Exercise is a feasible and potentially beneficial intervention to combat distressing cancer treatment-related fatigue. A pilot study is essential to determine the best methods for conducting a clinical trial and to develop the teams of researchers necessary for such a project.

Exercise Therapy↗
PubMed1997

Criteria for assessment of nausea, vomiting, and retching.

PURPOSE/OBJECTIVES: To promote accurate patient assessment, effective patient teaching, and useful research design and outcomes by defining the concepts of nausea, vomiting, and retching; to review the usefulness of self-care guides in assessing the patient's symptom experience. DATA SOURCES: Journal articles, the author's clinical experiences. DATA SYNTHESIS: The concepts of nausea, vomiting, and retching may be difficult for patients to describe and for nurses to assess. Measurement and assessment methods that accurately reflect the patient's experience are critical. CONCLUSION: Management of the individual symptoms of nausea, vomiting, and retching requires expert ongoing assessment of the patient's symptom experience that extends beyond the clinic or hospital visit. Information about symptom occurrence and distress and about self-care strategies used can play a crucial role in the identification, prevention, and management of symptom experience, with the good of improving the patient's quality of life. IMPLICATIONS FOR NURSING PRACTICE: Effective management of the patient's symptom experience depends on the oncology nurse's ability to differentiate occurrence and distress of the individual symptoms and to implement current knowledge not only of chemotherapy, antiemetic drugs, and nonpharmacologic interventions but of unerring ongoing assessments that lead to cost-effective, clinically useful patient outcomes. Basic scientific knowledge for research, practice, and education necessitates reliable, valid measurement tools that differentiate the components and dimensions of the individual symptoms.

Culture↗
PubMed1995

Symptom experience.

OBJECTIVE: To provide an overview of symptom experience, symptom occurrence, and symptom distress. DATA SOURCES: Published articles relating to the symptom experience, symptom occurrence, and symptom distress of patients with cancer. CONCLUSIONS: Symptom experience must include both the occurrence and distress associated with the symptom. To adequately assess symptom experience, obtaining information from patient about the occurrence and distress of the symptom experience is essential. IMPLICATIONS FOR NURSING PRACTICE: Nurses and other health care professionals can perform an essential role in the identification and management of symptom experience, thereby improving patient quality of life.

Humans↗
PubMed1995

Nausea, vomiting, and retching: the management of the symptom experience.

OBJECTIVES: To examine the physiology of nausea, vomiting, and retching (NVR); the impact of NVR on the patient: current measures to control NVR; and selfcare interventions. DATA SOURCES: Research studies, abstracts, and review articles relating to NVR associated with cancer treatment as well as pharmacological and nonpharmacological interventions. CONCLUSIONS: Management of the individual symptoms of NVR require expert, ongoing assessment of the patient's symptom experience that extends beyond the clinic or hospital visit. Although a number of pharmacological antiemetic agents are currently available and additional antiemetic drugs are in phase II or II trials, nonpharmacological interventions are essential to achieve effective management. IMPLICATIONS FOR NURSING PRACTICE: Continual assessment of the individual's symptom experience is imperative. Effective management of the symptom experience depends on the oncology nurses's ability to implement current knowledge of antiemetic, and other drugs; non-pharmacological interventions; and cost-effective and clinically useful patient outcomes.

Antiemetics↗
PubMed1995

Sensory perceptions of women receiving tamoxifen for breast cancer.

Tamoxifen has been used as adjuvant treatment in advanced and early-stage breast cancer for the past decade. Recently this synthetic antiestrogen drug assumed a new role of chemoprevention for women at risk of developing breast cancer. The commonly occurring side effects associated with tamoxifen administration contribute to the acceptance of this antineoplastic drug for palliation and cure. However, there are no data about the sensory effects of women receiving tamoxifen. The purpose of this study was to elicit subjects' descriptions of sensory experiences while receiving tamoxifen. These descriptions are essential for developing nursing interventions to help patients use self-care behaviors and cope with the side effects of tamoxifen. Sensory data were collected from 20 women who had been receiving tamoxifen for at least 1 month and were not receiving any other chemotherapy. Subjects provided descriptors about all senses. The senses for which subjects most frequently provided descriptors were touch, taste, and sight.

Adaptation, Psychological↗
PubMed1995

Nurses' perceptions of antiemetic effectiveness.

PURPOSES: To determine which antiemetics are being used with ondansetron (Zofran, Cerenex Pharmaceuticals, Research Triangle Park, NC) for patients receiving emetogenic chemotherapy, identify the more frequently administered antiemetic regimens, and ascertain nurses' perceptions of the effectiveness of these regimens. DESIGN: Descriptive survey. SETTING: Continental United States. SAMPLE: A random sample (N = 962) of Oncology Nursing Society members who designate themselves as practicing in the area of chemotherapy. METHODS: The Antiemetic Drug(s)/Drug Combination(s) Inventory, an open-ended questionnaire soliciting information on first- and second-line antiemetic regimens for emetogenic chemotherapy protocols, was mailed to 5,950 oncology nurses. Descriptive statistics and nondistributive analysis were used to analyze the data. FINDINGS: Ondansetron was used in 7 of 10 antiemetic regimens, which accounted for 50% of the most frequently used regimens. Nurses rated first-line antiemetic combinations as highly effective. Ondansetron alone was ranked as the seventh most effective first-line antiemetic for cisplatin protocols and fifth for noncisplatin protocols. Nurses noted limitations of ondansetron use, which included delayed nausea and vomiting and the drug's high cost. CONCLUSIONS: Study participants indicated that a variety of drugs were used in antiemetic regimens. Ondansetron use has improved the control of post-chemotherapy nausea, vomiting, and retching. IMPLICATIONS FOR NURSING PRACTICE: Antiemetics are administered regularly in the hospital and home to decrease chemotherapy-related nausea, vomiting, and retching. Managing these side-effects requires superior assessment skills and extensive knowledge of pharmacologic actions. Patient and family education on antiemetics is essential in light of increased administration of outpatient chemotherapy.

Antiemetics↗
PubMed1994

Sensory perception of patients on selected antineoplastic chemotherapy protocols.

Antineoplastic chemotherapy (ANCT) is a primary and adjuvant treatment modality for cancer. Although researchers have found that patients who are given preparatory sensory information before various health-care procedures experience less discomfort, literature describing subject's sensory experience before, during, and after ANCT is lacking. The purpose of this study was to elicit sensory responses from subjects before, during, and after one of six cycles of their initial course of treatment on one of two emetogenic ANCT protocols. These descriptions will be used to develop a preparatory sensory nursing intervention that may promote self-care and help cancer patients cope with the distress of chemotherapy. The Sensory Information Questionnaire was administered to a sample of 44 subjects who had just completed a cycle of ANCT. Subjects provided descriptors of all senses. The senses for which subjects most frequently provided descriptors were taste, touch, and smell. Descriptors varied for some sensations according to the chemotherapy drug protocols.

Adaptation, Psychological↗
PubMed1990

Nausea, vomiting, and retching.

Although nausea, vomiting, and retching have plagued mankind since antiquity, limited attention has been given to the three symptoms as separate entities. Although knowledge of symptom occurrence is essential to practice, nurses must focus on patients' response or distress to the occurrence of symptoms. The differentiation of symptom occurrence and symptom distress of nausea, vomiting, and retching is critical to the management and self-care demands of patients and the enhancement of their quality of life. Basic research on patterns of these individual symptoms and their components promises to provide a more progressive and fruitful approach to the patient response to these symptoms.

Humans↗