Perceptions and experiences of the subjective well-being of people with glioblastoma: a longitudinal phenomenological study.

Background: Glioblastoma (GBM) is a devastating form of brain cancer, with a short life expectancy. In addition to this poor prognosis, people with GBM often experience symptoms that may have a profound impact on their subjective well-being (SWB). The aim of this study was to investigate the lived experiences and perceptions of people with GBM regarding their SWB. Methods: The study adopted a longitudinal, hermeneutical phenomenological approach. Twenty-seven interviews were conducted with 15 patients over a period of two years. Most participants were interviewed twice on a face-to-face basis (during combined chemotherapy and radiotherapy, and again during adjuvant chemotherapy). The hermeneutic circle was used to guide data analysis. Results: Data analysis identified four key themes that depicted the lived experiences and perceptions of SWB of people with GBM. "Experience of the disease" focuses on the impact of diagnosis, symptoms and side effects. "Daily life" relates to daily activities, family roles, work and social lives. "Coping" includes the importance of normality and goal-setting. "Experiences of care" focuses on the impact of the treatment schedule, experiences of care and impressions of the monitoring of QoL. Conclusion: SWB is affected by a variety of factors throughout the GBM disease and treatment journey. The findings of this study suggest that healthcare professionals can enhance the SWB of people with GBM by providing personalized care that supports people to set themselves goals for the future and retain a degree of normality wherever possible.

A re-examination of the individual differences approach that explains occupational resilience and psychological adjustment among nurses.

AIMS: This study re-examines the validity of a model of occupational resilience for use by nursing managers, which focused on an individual differences approach that explained buffering factors against negative outcomes such as burnout for nurses. BACKGROUND: The International Collaboration of Workforce Resilience model (Rees et al., 2015, Frontiers in Psychology, 6, 73) provided initial evidence of its value as a parsimonious model of resilience, and resilience antecedents and outcomes (e.g., burnout). Whether this model's adequacy was largely sample dependent, or a valid explanation of occupational resilience, has been subsequently un-examined in the literature to date. To address this question, we re-examined the model with a larger and an entirely new sample of student nurses. METHODS: A sample of nursing students (n = 708, AgeM ( SD ) = 26.4 (7.7) years), with data examined via a rigorous latent factor structural equation model. RESULTS: The model upheld many of its relationship predictions following further testing. CONCLUSIONS: The model was able to explain the individual differences, antecedents, and burnout-related outcomes, of resilience within a nursing context. IMPLICATIONS FOR NURSING MANAGEMENT: The results highlight the importance of skills training to develop mindfulness and self-efficacy among nurses as a means of fostering resilience and positive psychological adjustment.

The impact on quality of life for people with brain tumours of entering a research trial involving new anti-cancer agents.

PURPOSE: The intention of this study was to offer an alternative perspective to the quantitative findings of larger randomised controlled trials by using a phenomenological approach to explore the impact on Quality of Life (QoL) for people with brain tumours of entering a research trial involving new anti-cancer agents. METHOD: Given the subjective nature of the proposed topic, a phenomenological approach was adopted. Sample size was limited to five participants. A semi-structured interview technique was used. Interviews were digitally audio recorded with permission from those involved. In order to guide data analysis for this study, Colaizzi's framework was utilised. RESULTS: As a result of data analysis, two major themes were identified. These were 'Hope and optimism' and 'The therapeutic relationship'. Three minor themes were also found. These were 'A complex symptom profile', 'The importance of non-medical coping strategies' and 'Impressions of the QoL tools used'. CONCLUSIONS: This phenomenological study has highlighted key themes relating to QoL which are not addressed in some of the widely used assessment tools such as the EORTC QLQ C30 and BN20. They generally focus on health status, and do not capture issues identified in this study as being of significant importance to the QoL of participants such as hope and optimism, and the importance of the therapeutic relationship. They also omit reference to coping and management strategies.

Outcomes in cephalic vs noncephalic presentation in the setting of preterm premature rupture of membranes.

OBJECTIVE: This study was conducted to determine whether fetal position at the time of preterm premature rupture of membranes (PPROM) diagnosis affects outcomes. STUDY DESIGN: A retrospective study was designed to assess differences in outcomes between cephalic and noncephalic presentation at PPROM diagnosis between 24 and 34 weeks' gestation. RESULTS: Five hundred sixty-six cases of PPROM were identified; 108 cases (19.1%) were noncephalic at time of PPROM diagnosis. The 2 groups were similar with regard to demographics. Although membrane rupture and delivery occurred earlier in the noncephalic group, there was no difference in latency between groups (cephalic group, 6.22 days vs noncephalic group, 7.85 days; P = .07). Noncephalic pregnancies were substantially more likely to be complicated by oligohydramnios, abruption, intrauterine fetal death, and infectious morbidity. CONCLUSION: Noncephalic presentation at the time of diagnosis of PPROM independently and significantly increases the risk of maternal complications in such affected pregnancies.