Denice Sheehan

Level of cancer pain knowledge among baccalaureate student nurses

Inadequate nursing education is a major impediment to effective pain relief for cancer patients throughout the world. This study was conducted to identify the level of cancer pain knowledge among baccalaureate student nurses and to determine whether specific activities affect this level of knowledge. Two questionnaires were administered to 82 baccalaureate student nurses in the final course of their program. Although the students displayed a realistic perspective about the severity and prevalence of cancer pain and psychological dependence, specific knowledge deficits and negative attitudes suggest the possibility of inadequate pain management. Specifically, the students believed that (a) maximal analgesic therapy should be delayed until the patients prognosis was less than 12 months; (b) the proportion of patients whose pain can be controlled by appropriate therapy is less than is possible; (c) increasing pain is related to tolerance rather than to progression of the disease; (d) the preferred route of administration is intravenous rather than oral; and (e) the degree of respiratory depression, rather than constipation, does not decrease with repeated administration. Significant positive correlations (P < or = 0.05) were found between age and cancer pain knowledge and between attendance at seminars/workshops and time spent reading professional journal articles. Of the 30% of the participants who perceived a particular person to be a source for obtaining information about cancer pain management, 52% specified a practicing registered nurse. Seminars and workshops were chosen by 59% of the students as the most effective way for nurses to increase their knowledge.(ABSTRACT TRUNCATED AT 250 WORDS)

Interaction Patterns Between Parents with Advanced Cancer and Their Adolescent Children

Objective: Advanced cancer profoundly affects those with the illness and their families. The interaction patterns between parents with advanced cancer and their adolescent children are likely to influence how a family experiences a parents dying process. There is little information on such interactions. This study aimed to develop an explanatory model that explains interaction patterns between parents with advanced cancer and their adolescent children and to identify strategies to prepare children for their lives after a parent dies.

Aggressive Events in Adolescent Dating Violence

This purpose of this paper is to present a typology of common aggressive events that occur in the context of adolescent dating violence. The typology is based on 42 transcripts of interviews with young adults, ages 18 to 21, who described dating violence they had experienced when adolescents (ages 13–18). One-hundred and eighty-four text units that contained a description of an event involving aggression or violence between the participant and a dating partner were extracted from the transcripts. Cross-case analysis was used to create categories of events that shared similar characteristics. The analysis yielded eight types of aggressive events: (a) tumultuous, (b) explosive, (c) scuffling, (d) violating, (e) threatening, (f) controlling, (g) disparaging, and (h) rejecting, ignoring, or disrespecting. The typology can provide a foundation for further research on adolescent dating violence from a situational perspective and can be used as a tool to promote discussion of dating violence with victimized or at-risk youth.

Preferences for Care Near the End of Life: Instrument Validation for Clinical Practice

This article presents descriptive data and a psychometric evaluation of the Preferences for Care Near the End of Life (PCEOL) tool developed by Gauthier and Froman. The PCEOL tool identifies dimensions related to care near end of life and asks respondents to consider personal preferences in the context of their values. Analyses were conducted on data from a convenience sample of 68 adults recruited at a workshop series on anticipatory guidance for end-of-life care. Participants included nurses, nursing students, nursing assistants, social workers, and older adults. Findings supporting a 3-factor structure (personal autonomy, healthcare provider input, and spirituality and family) are interpreted and discussed. Implications are given for using the PCEOL tool in nursing care situations.

Recruiting for end of life research: lessons learned in family research.

A main hurdle for end of life research is recruitment of patients. Researchers can enroll interested patients and their families for end of life studies by gaining the trust of the hospice staff, who can make valuable referrals of patients nearing the end of life. Participants in the study should be made as comfortable as possible and not be coerced into the interview process. Once the patients have confidence in the researchers, they are more than willing to be a part of the research process because it can prove to be cathartic to many of the patients and their family members.

An Examination of Interactions between Hospice Health Care Providers and Adolescents with a Parent in Hospice.

Interviews conducted with adolescents living with a dying parent were examined to identify the type of interactions the adolescents had with members of a hospice health care team. Four types of interactions were identified: no interactions, in-passing interactions, engaged interactions, and formal interactions. Results indicated that most of the adolescents had no contact with the hospice health care team or interacted with providers only briefly. Some adolescents reported more engagement with 1 or more hospice health care team members, and a few received formal counseling services from the hospice health care team or outside provider. Overall, limited contact occurred because of logistics or because the teens perceived that hospice services were exclusively targeted to dying patients, not their families. Based on these findings, strategies to increase engagement between adolescents and hospice health care team are discussed.

Family caregiver recruitment via social media: challenges, opportunities and lessons

BACKGROUND Illness blogs are a way seriously ill people communicate publicly about their illness journey. As communication about serious illness increases on social media, it is important to evaluate how this affects the family caregiver. However, identifying and accessing family caregivers remains challenging, especially via social media. PURPOSE The aim of this article is to report the opportunities, challenges and lessons learned from using social media to recruit family caregivers. METHODS Recruitment methods included posting study invitations on illness blogs, advertising through Facebook and placing study fliers in the community. RESULTS Using social media to recruit was inexpensive and provided a wide geographical reach. One important finding was discovering the importance of using language in the recruitment materials that family caregivers could identify with to help deem themselves as eligible to participate in the study.

Support for using five attributes to describe spirituality among families with a parent in hospice.

OBJECTIVE The importance of spirituality in the dying process is well documented. However, what spirituality means in these situations is hard to discern because few people (patients, families, researchers, or caregivers) will view spirituality in the same way. The present research supports the use of a spiritual framework consisting of five common attributes (meaning, beliefs, connections, self-transcendence, and value) as a mechanism for viewing spirituality for people nearing the end of life. Using qualitative interviews from two related studies, our study aims to describe the prevalence of spirituality and its nature according to these five spiritual attributes. METHODS Data from two previous studies were analyzed. The first employed the methods of grounded theory to understand the strategies adolescents used to manage the impending death of a parent. Some 61 participants from 26 families were interviewed, including ill parents/patients, well parents/caregivers, and adolescents. The second study consisted of 15 interviews with the surviving parent and adolescents from 6 of these families after the death of the parent. RESULTS The original research from which these data were drawn did not seek to describe spirituality. However, spiritual themes were prevalent in the stories of many participants and included each of the five spiritual attributes. SIGNIFICANCE OF RESULTS Our findings demonstrate the prevalence of spirituality in the everyday lives of these families and supports the use of the spiritual framework according to the five common attributes to describe spirituality.

The Spiritual Nature of Uncertainty Among Hospice Patients

People with protracted and life-limiting illness engage in end-of-life transitions as they prepare for death. The end of life is a time of mystery that elicits uncertainties in the form of questions, worries, and doubts. If not managed properly, uncertainties can contribute to emotional distress and feelings of lost control. Currently, uncertainty occurring at the end of life is underresearched. Phenomenology was used to explore the experience of uncertainty for 6 hospice patients using semistructured interviews. A 4-member, interpretive team analyzed the data. The participants were asked to describe the uncertainties that they had while they were dying. Interestingly, most of the stories about uncertainty were spiritual in nature. An overall theme of “uncertainty as a bridge” emerged from the data as the way uncertainties affected their dying. Two subthemes of “uncertainties about dying” and “uncertainties about important relationships” also emerge as the areas of greatest concern for participants. These findings support uncertainty as an important phenomenon for people preparing for death and one that providers of end-of-life care should understand.