Jane E. Graydon

Uncertainty, symptom distress, and information needs after surgery for cancer of the colon.

The purpose of this study was to determine the relationships between uncertainty, symptom distress, and discharge information needs in individuals after a colon resection for cancer. The theoretical framework for the study was derived from Lazarus and Folkmans stress, appraisal, and coping model, and Mishels theory of uncertainty in illness. Uncertainty was measured by the Mishel Uncertainty Illness Scale (MUIS); symptom distress of pain, fatigue, constipation, diarrhea and loss of appetite by visual analogue scales; and discharge information needs by the Patient Learning Need Scale (PLNS). Forty individuals with a first diagnosis of cancer were interviewed after surgical resection of colon cancer. The study results indicated that they had moderate levels of uncertainty, low levels of symptom distress, and a moderate number of discharge information needs. Information related to treatment, complications, and activities of living were identified as highly important. An increase in uncertainty was significantly associated with an increase in discharge information needs. Increased attention to information needs at discharge may decrease an individuals level of uncertainty and facilitate the transition from hospital to home.

A comparison of two methods of measuring fatigue in patients on chronic haemodialysis: visual analogue vs Likert scale

The study compared level of fatigue measured by two self-report instruments in 43 patients on chronic haemodialysis. The two fatigue measures were the multi-item fatigue subscale of the Profile of Mood States (POMS) and a single-item visual analogue scale (VAS). There was a significant relationship between the two measures (r = 0.80); however, the shared variance was only 64%. Males and females, as well as subjects of different ages, responded to the two scales in different ways. Nurses need to know that different tools may give different results, even when the same concept, that is fatigue, is being measured in the same subjects at the same time.

Information needs and preference for information of women with breast cancer over a first course of radiation therapy

The study assessed the information needs of women receiving a course of radiation therapy (RT) for breast cancer and the relationship between information needs and preference for information. Thirty-three women were interviewed during the first (T1), third (T2), and last week of RT (T3), and one month later (T4) using the Toronto Informational Needs Questionnaire--Breast Cancer and the Information Subscale of the Health Opinion Survey. Information need scores were high and did not differ significantly across time. Information need and preference for information were correlated only at T1. Findings indicate that women with breast cancer receiving RT have high information needs and preference for information may not be a meaningful indicator of their desire for information. Health care providers need to assess the womens information needs frequently and be prepared to offer on-going educational support.

The information needs at time of hospital discharge of male and female patients who have undergone coronary artery bypass grafting : A pilot study

OBJECTIVE To compare the information needs 24 to 48 hours before hospital discharge of male and female patients who have undergone first-time coronary artery bypass surgery. DESIGN Cross-sectional, descriptive-comparative. SETTING Teaching hospital in a city in central Canada. SAMPLE The sample consisted of 20 men and 20 women who had undergone elective coronary artery bypass surgery for the first time. INSTRUMENTS Patient Learning Needs Scale and open-ended question. RESULTS No differences were found in information needs between men and women. The highest areas of information needs included: treatment and complications, activities, medications, and enhancing quality of life. CONCLUSION Men and women have similar information needs after coronary artery bypass surgery. They both want information concerning treatment and complications, activities of living, enhancing their quality of life, and medications.

Sickness impact profile: A measure of dysfunction with chronic pain patients

Although chronic pain may affect all facets of a patients life, there is no generally accepted method of measuring the extent of the disability experienced. This component of a larger study examined changes in usual activities and relationships for patients experiencing chronic nonmalignant pain, in order to understand the impact of pain on an individuals life. The effect of pain intensity and depression on the performance of usual daily activities was assessed by the Sickness Impact Profile (SIP). The sample of 34 subjects, 17 women and 17 men, rated their pain as moderate to severe on a linear analogue scale (mean 64). Thirty percent of subjects were moderately to severely depressed as measured by the Beck Depression Inventory (mean 21). The SIP scores indicated severe disruption in daily activities and relationships for this sample. Significant correlations between the SIP and visual analogue scales measuring coping adequacy and activity levels were interesting and warrant further study.

The Therapeutic Use of Music for Dyspnea and Anxiety in Patients with COPD who Live at Home

The purposes of this repeated measures study were to examine the feasibility of using music as an intervention for dyspnea and anxiety in patients with chronic obstructive pulminary disease (COPD) who live in their homes and to examine the effect of music on anxiety and dyspnea. Twenty-four participants who experienced dyspnea at least once a week were studied over a 5-week period. Baseline data were collected on Week 1. Measures of anxiety and dyspnea were taken on Week 2, prior to and immediately following the use of music. These measures were repeated on Week 5. There was a significant decrease in dyspnea following the use of music as reported in the music diary (p < .001). There was a significant decline in anxiety (p < .05) and dyspnea (p < .01) following the use of music on Week 2. There was no significant change in anxiety or dyspnea over the 5-week period.

Uncertainty in hospitalized patients with chronic obstructive pulmonary disease.

The purpose of this study was to describe the perceptions of uncertainty of hospitalized patients with chronic bronchitis and/or emphysema. Fourteen men and 11 women were interviewed. Content analysis of the data yielded three themes of uncertainty, including managing home- and self-care, planning for the future, and the unpredictable course of the illness. Two themes that reflect coping resources also emerged from the data. These were positive thinking, and social support and material resources. The subjects were perceiving uncertainty in relation to their illness and hospitalization, and were endeavouring to manage it through the process of cognitive coping.