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OBJECTIVES: This study measured the perceptions of cancer patients and caregivers in Utah concerning knowledge about and adequacy of pharmacologic cancer pain control. MATERIALS AND METHODS: A descriptive survey was sent to a stratified random sample of adult cancer patients obtained from the Utah Tumor Registry. Questionnaires asked cancer patients and caregivers about their knowledge of pain control and about perceptions of the adequacy of pharmacologic cancer pain management. RESULTS: The study had a 52% response rate (259 of 500) after two mailings. Eighty-five percent (219 of 259) of the respondents stated that they had no cancer pain. With the first mailing, a "no pain" response was not offered as an option. When the researchers realized that this might be a possible response, a second mailing was sent, which may be the reason for the high response rate. CONCLUSIONS: Cancer literature indicates that much cancer pain is not effectively controlled. The majority of the respondents of this study reported no pain. Because this result is different than that reported in the literature, it may indicate that education of healthcare providers, patients, and families can improve cancer pain management and control. It may also indicate an inability of the study to obtain data from those patients having cancer pain. This study should be repeated with a focused population of advanced stage cancer patients with types of cancer typically producing high levels of cancer pain.
OBJECTIVE: To describe challenges in conducting research with hospitalized geriatric patients. DESIGN: Quasi-experimental longitudinal study with inperson interviews at baseline and discharge and a three-month postdischarge telephone interview. Study protocol required baseline interviews within 48 hours of admission for patients or 72 hours for proxies. SETTING: 813-bed urban teaching hospital. PARTICIPANTS: 240 patients, mean age 83.8 years, at moderate to high risk for functional decline during hospitalization, admitted from the emergency room to a general medical unit. MEASUREMENTS: Delays starting or interruptions continuing interviews; patient and environmental conditions potentially affecting data quality; and information on proxy use. RESULTS: Timely access to patients or proxies was a major difficulty, resulting in the screening of only 53.1% of 867 potentially eligible patients. Multiple patient contacts and visits were required to complete interviews. Only 61.3% of baseline and 28.1% of follow-up interviews were completed on the initial day of contact. Despite having on-site interviewers 7 days a week, 29% of discharge interviews were conducted by telephone. Interviews were >90% complete in 487 of 503 of encounters (97%). Baseline delays and interruptions were usually due to the presence of medical staff, off-unit tests, patient illness, nurse unavailability for interview, and need for a proxy. Most in-hospital interviews were conducted with others present. Proxies were required for approximately one-third of patients at all three interviews. CONCLUSION: Conducting clinical research with older adults in the current inpatient setting, where patients are more severely ill yet have shorter lengths of stay now than in the past, proves a challenging yet achievable goal. Effective procedures for negotiating the acute care environment are critical to successful studies.
Tobacco use is treatable and the benefits of smoking cessation are impressive, yet like other health care providers, psychiatric nurses have failed to consistently assess and treat tobacco use effectively. Tobacco use continues to cause illness, disability, and death at unprecedented rates. Nicotine addiction is drug abuse and it is a chronic disease and needs to be treated as such. There are clear health benefits to smoking cessation regardless of the age of smoking initiation or the age of smoking cessation. Advanced practice psychiatric nurses (APPNs) are in a unique position to make an impact on a smoker's risk of suffering from tobacco-related diseases: the treatment of choice is the combination of pharmacotherapy and psychosocial interventions, both within the realm of APPN practice; psychiatric and substance abusing patients consistently demonstrate increased rates of cigarette smoking compared with healthy controls; and tobacco use is drug abuse, a treatable chronic disease. The ability of APPNs to deliver psychotherapeutic and pharmacologic care secures a position in the forefront of treating tobacco use. In addition to intervention, psychiatric nurses need to step up and take an active role in initiating and supporting tobacco control policy and legislation.
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Approximately 90% of all upper respiratory infections are caused by viruses, yet antibiotics are prescribed for 50% to 70% of patients who seek medical care for these conditions (Neiderman, Skerrett, & Yamauchi, 1998). Prescribing antibiotics for conditions for which there is no proven benefit is not a harmless practice; it contributes to the development of antibiotic resistance (Ware, 2000). This article will discuss the magnitude of the problem of antibiotic resistance as it relates to pediatric outpatient upper respiratory tract infection and otitis media, analyze practitioner prescribing practices that contribute to widespread antibiotic use, and suggest provider and patient intervention to improve the rational use of antibiotics.
OBJECTIVES: To discuss the relationship between dietary factors and cancer risk reduction, the status of prevention trials in progress, and current dietary recommendations. DATA SOURCES: Published research and review articles, medical books, and web sites. CONCLUSIONS: Evidence indicates that dietary factors can reduce the risk of developing cancer. The dietary recommendations for cancer risk reduction are consistent with those for prevention of other chronic diseases and are thus useful for the majority of the population. IMPLICATIONS FOR NURSING PRACTICE: In their role as educators, it is essential for nurses to provide accurate and timely information on diet and cancer risk reduction to their patients and the public and to encourage compliance with dietary recommendations.
OBJECTIVES: To explore the implications of the internet for oncology nursing practice, education, and research. DATA SOURCES: Published articles, texts, research studies, review articles, and online documents pertaining to the internet. CONCLUSIONS: The internet has influenced nearly every aspect of society. As the worldwide communications infrastructure strengthens, access devices become affordable, and more countries contribute content in their native language, this technology becomes a truly global phenomenon. This affords oncology nursing a voice that extends beyond the community support group to millions of internet users. IMPLICATIONS FOR NURSING PRACTICE: Internet access, quality of information, and privacy of data transmitted are among the greatest challenges that face oncology nurses who integrate this technology into practice.
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In Germany the prevalence of bronchial asthma in adults is 5 % and up to 10 % in children. This explains its enormous medical and economic importance. Bronchial asthma is not only the most-frequent allergic lung disease; it is the most prevalent chronic illness of the childhood. Alongside with other atopic diseases--allergic rhinitis and atopic dermatitis--in the last decades the incidence increased significantly. Allergic and non allergic rhinitis and sinusitis are strongly correlated with asthma. This explains why ENT-specialists are often consulted first by patients with chronic inflammations of both the upper and lower airways. Hence, the ENT-specialist should clearly understand the pathophysiologic mechanisms of the disease, become familiar with the typical clinical findings and get a broader knowledge of the standard diagnostic methods and therapeutic issues. This article gives a detailed overview on these topics and the current guidelines.
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