Effects of information supply on satisfaction with information and quality of life in cancer patients receiving curative radiation therapy.

In order to test the efficacy of various information inputs, 210 consecutive cancer patients were randomized to one of three information conditions before the start of curative radiation treatment: (1) standard information plus group and repeated individual information (n=70), (2) standard information plus brochure (n=70), and (3) standard information only (n=70). Patients completed questions regarding satisfaction with information, anxiety, depression, subjective distress and quality of life at inclusion, and 1h before the start of the radiation therapy treatment (approximately 4 weeks later). Patients receiving standard information plus group and repeated individual information were significantly more satisfied with the information than were patients in the remaining two groups. There were no differences with respect to any of the other outcome measures. This study has shown that the nurses group and individual information was of significant importance in preparing the patients for the procedure of receiving radiation therapy.

Coping with radiation therapy: strategies used by women with breast cancer.

The purpose of this qualitative study was to describe coping strategies used by women with breast cancer during and after radiation therapy. Content analysis was used to structure the statements provided by the patients in the Wheel Questionnaire. The patients used several problem- and emotion-focused strategies to cope with the treatment, and the strategies changed over time. Family and friends had a positive impact on the coping process for the three points of measurement: before treatment started, on completion of treatment, and 3 months after treatment. Contact with colleagues at work also provided the women with a sense of normalcy. The women used a broad spectrum of own activities to aid recovery, instead of leaving their treatment solely to medicine. The women also found that a hopeful and optimistic attitude was a helpful strategy for coping with the treatment.

Coping with radiation therapy: effects of a nursing intervention on coping ability for women with breast cancer.

A randomized study was carried out to investigate whether a nursing intervention, using Orem's self-care theory as a framework, would affect the coping ability of women with breast cancer during and following radiation therapy. The intervention consisted of promoting of behaviours to support the patient to restore, maintain or increase their abilities to interact with the situation and adapt to the demands of radiation treatment. The control and experimental groups both consisted of 67 patients. The Wheel Questionnaire was used to evaluate the effect of the intervention. Our results showed that the intervention provided patients older than 59 years the ability to cope with the treatment (df = 2, F = 3.463, P = > 0.05). The present study supports the idea that individual interventions aimed at improving well-being helps patients. It also highlights the fact that individual approaches to improving well-being are needed. Such interventions should be directed to patients at risk for poor adjustment, such as those older than 50 years of age.

Perceived symptoms and quality of life in women with breast cancer receiving radiation therapy.

The purpose of this study was to describe symptoms, side-effects and quality of life (QoL) of women with breast cancer during and following treatment with radiation therapy. The sample consisted of 134 women with breast cancer. Symptoms were measured using a modified version of the Oncology Treatment Toxicity Tool (OTTAT) and QoL was measured using the Cancer Rehabilitation Evaluation System-short form (CARES-sf). The results showed an increase in experienced symptoms and their severity as the treatment progressed. QoL was perceived as poorest at baseline before treatment had started. During the treatment, QoL scores leveled out and an improvement could be seen after completion of treatment. The study findings provide directions and suggestions for assessment and management of perceived symptoms for women receiving radiation therapy for breast cancer from the second week and up to 2 weeks after completion of therapy is the critical time-period for targeting interventions for experienced symptoms and side-effects from radiation therapy.

Effects of a nursing intervention on subjective distress, side effects and quality of life of breast cancer patients receiving curative radiation therapy--a randomized study.

The purpose of this randomized study was to investigate whether a nursing intervention using Orem's self-care theory as a framework would affect subjective distress, side effects and quality of life as perceived by breast cancer patients receiving curative radiation therapy. The intervention consisted of five 30-min sessions once a week during the treatment period and two follow-up sessions after completion of treatment. The experimental group consisted of 67 patients, as did the control group. Measurements were collected five times: at baseline before commencement of treatment, at weeks 3 and 5 (completion of treatment) and follow-up periods of 2 weeks and 3 months. No measurable effect of the nursing intervention was found for side effects or quality of life but nursing intervention proved to have a positive effect in minimizing stress reactions (p = < 0.05). It is suggested that a nursing intervention should be implemented for breast cancer patients receiving curative radiation therapy.

Assessing nursing problems of importance for the development of nursing care in a radiation therapy department.

The challenges to nurses working in the rapidly changing milieu of radiotherapy in cancer care are great. New treatment regimens continually require reexamination of old assumptions about patients' needs and communication between colleagues. In order to continue the development of the nursing care in the radiation therapy department, the purpose of this study was to assess the nursing problems experienced in the care of the cancer patients and the nursing problems experienced in work with other professionals from the nurse's perspective. Eighteen of the 38 nurses in the radiation therapy department were invited to participate in the study. The mean age of the nurses was 39 years (range 25-57 years). The study was carried out by using a three-phase, structured, communication-process method according to the Delphi technique. The nurses reported "poor follow-up of patients who have completed radiation therapy," closely followed by "finding time to document the nursing care" and "finding time to treat the scheduled patients" as the most problematic areas of importance for the development of nursing care. The nursing problems considered to be the most difficult in the work with other professionals were "lack of communication," "lack of knowledge of our work and competence," and "lack of comprehension of each other's professions." With the present trend in the health care system toward smaller financial resources, it is necessary to find new ways of organizing nursing care in order to find time to take care of the patient's problems during and after the radiation therapy. This study constituted the base for organizing a nursing care clinic in the department with sufficient time to assess and monitor side effects, patient education, sexual counselling, and coping assistance.

A follow-up of psychological state in relatives of cancer patients one year after the patient's death. Effects of an activation programme.

A follow-up of psychological state in relatives of cancer patients twelve months after the patient's death was carried out in a controlled study. Relatives who were offered an activation programme (activation group) were compared with relatives not offered this programme (comparison group). A translation of Holland and Sgroi's standardized rating schedule for psychologic states and an interview based upon Bowlby's attachment theory were used to assess psychological outcome. Relatives in the activation group reported better mental state and less depression than those in the comparison group. Relatives in the activation group also reported fewer problems with health and anger than those in the comparison group. Furthermore, relatives in the activation group showed a more positive attitude to the care than those in the comparison group. All the differences mentioned were statistically significant.

Attitudes to increased involvement of relatives in the care of cancer patients. Evaluation of an activation program.

The present study explored whether an "activation program" for relatives of cancer patients increases the frequency and duration of the relatives' visits at the hospital. It also explored the willingness of relatives to participate in patient care at the hospital and at home. Similarly, the patients' willingness to contribute to this process was examined. Relatives offered an activation program were compared by interview with relatives subjected to a routine program. Interviews were repeated at intervals of 3-4 weeks. The attitude of 67 relatives (31 in the activation group and 36 in the comparison group) were examined twice during the patient's treatment period. Of these relatives, a subgroup of 42 (22 in the activation group and 20 in the comparison group) experienced the death of the patient during the study period. At the time of the last interview, there was a difference between the groups in relatives' willingness to care for the patient at home. Contrary to expectations, more of the relatives (of all patients receiving treatment as well as the subgroup of patients who died) in the activation group were "completely unwilling" to care for the patient at home (p less than 0.05 and p less than 0.01, respectively).

Elevation of glycosylated hemoglobin in a severe crisis situation--cancer in a close relative.

In the present study, 58 relatives of cancer patients (50 women and 8 men, mean age 53) who experienced the grief and tension induced by severe illness in the family were followed. The aim of the study was to examine possible associations between anxiety, depression, and mental exhaustion, on one hand, and glycosylated hemoglobin (HbAlC) level and changes in HbAlC level on the other hand. The relatives were studied approximately once a month during part of the patient's period of illness. On each occasion their psychiatric state was evaluated by means of a standardized observation and interview technique. A blood sample in the nonfasting state was taken for HbAlC assay. The main finding is that a high level of anxiety during the course of a close relative's cancer illness is associated with increasing HbAlC levels (p less than .01).