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Biomedical subjects

W Duggleby

Publications and source records attributed to W Duggleby.

18 recordsLinked to original sources
PubMed2000

Enduring suffering: a grounded theory analysis of the pain experience of elderly hospice patients with cancer.

PURPOSE/OBJECTIVES: To identify, describe, and generate a theoretical analysis of the pain experience of elderly hospice patients with cancer. DESIGN: Qualitative, grounded theory. SETTING: Participants' homes in rural east Texas counties. SAMPLE: 11 participants older than 65 years who were receiving services from a for-profit hospice. METHODS: Broad, unstructured, face-to-face audiotaped interviews transcribed verbatim and analyzed using constant-comparative method of analysis. MAIN RESEARCH VARIABLES: Participants' descriptions of their pain experience. FINDINGS: Suffering is the basic social problem of pain. Participants deal with suffering through the basic social process of enduring. Enduring has two subprocesses: maintaining hope and adjusting. Trusting in a higher being and finding meaning are ways of maintaining hope. Dealing with uncertainty, accepting, and minimizing pain are ways of adjusting. CONCLUSIONS: Findings provide the basis for assessment of and interventions to foster enduring. Faith, caring relationships, and strategies to decrease pain helped elderly hospice patients to endure. IMPLICATIONS FOR NURSING PRACTICE: Nurses need to recognize and value the hard work of enduring to deal with suffering. Enduring may be fostered by assisting elderly hospice patients with cancer to maintain hope and adjust.

Adaptation, Psychological↗
PubMed1998

Improving undergraduate nursing research education: the effectiveness of collecting and analyzing oral histories.

Nine oral histories of retired RNs (age range from 60 to 77) were collected by trained senior nursing students in their nursing research class. Attitudes toward nursing research of the 18 undergraduate baccalaureate nursing students participating in the collection and analysis of oral histories were compared with 20 students who did not participate. Both groups of students completed a pretest and posttest Attitudes Toward Nursing Research Questionnaire. The participating students had significantly positive changes in their attitudes toward nursing research. The nonparticipating group did not. While reminiscing about their careers, the retired RNs related historical events that influenced their nursing practice. Three themes emerged: World War II, technology, and intensive care units. Through an open-ended, written questionnaire following the interview, the nurses expressed positive benefits of participation. The collection and analysis of oral histories was an effective experiential learning strategy with positive outcomes for the students and the retired nurses who were interviewed.

Adult↗
PubMed1994

Cognitive status and postoperative pain: older adults.

The purpose of this study was to assess older adults to determine (a) the course of postoperative pain, (b) influences of pain and analgesics on mental status, and (c) relationships among age, mental status and pain. Sixty adults, aged 50-80 yr, who had total hip replacement surgery were included in this study. All subjects had met a preoperative criterion for mental status. Data collection took place over 5 days following surgery. Pain intensity and distress were assessed three times a day for 5 days. Recalled night pain intensity, pain distress, and sleep disturbance from pain were assessed daily in the early morning prior to assessment of mental status. Although no within day or day-to-day pain patterns were observed, the greatest decreases in pain occurred during the first 2 days. Night pain also improved after the third day. One-third of subjects recorded one or more episodes where mental status declined below criterion after surgery. Multivariate analysis indicated that pain, not analgesic intake, predicted mental status decline. Age was not related to pain or mental status. In general, pain was poorly managed in this group of subjects. The results suggest an explanation for acute confusion in older patients after surgery and recommend improved pain management.

Aged↗
PubMed1992

Patient-controlled analgesia for older adults.

Use of patient-controlled analgesia (PCA) was compared with nurse-administered intermittent intramuscular (IM) injections of morphine in older adults during their postoperative recovery. Data analyses indicated that the PCA and IM groups did not differ in pain intensity, pain distress, and satisfaction. The PCA group had significantly less sleep disturbance from pain than the IM group. Neither group was considered to have acceptable pain management.

Aged↗
PubMedDate not supplied

Elderly hospice cancer patients' descriptions of their pain experiences.

A qualitative research design was used to identify and describe the pain experience of elderly hospice patients with cancer. Eleven participants over the age of 65 receiving hospice services from a for-profit hospice in east Texas were interviewed in their homes. On the basis of a constant-comparative method of analysis, participants identified: (a) multiple sites of pain; (b) hierarchy of pain; and (c) strategies used to decrease pain. Participants differentiated "physical" and "psychological" pain, based on the source of pain. Pain was described as a hierarchy of chronic, acute, and psychological pain, with psychological being the worst. Pharmacological and nonpharmacological strategies were used to decrease their "physical" pain, but participants perceived that there was little they could do about their "psychological" pain.

Activities of Daily Living↗
PubMedDate not supplied

Implementation and evaluation of a quality improvement process to improve pain management in a hospice setting.

The purpose of this article is to describe the implementation and evaluation of a quality improvement process to improve pain management in a hospice setting. A retrospective chart audit of 702 patient visits pre- and 536 patient visits post-implementation of quality improvement strategies measured five aspects of pain management: complaints of pain, severity of pain, changes in patient's pain medication regime required, patient and family teaching, and use of complementary therapies. Of these measures a significant change was found in the documentation of pain assessment, recognition of changes required in the medication regime, and patient and family teaching.

Hospice Care↗