Family Caregivers' Burden, Patients' Resourcefulness, and Health-Related Quality of Life in Patients With Colorectal Cancer.

OBJECTIVES: To examine how family caregivers' burden and patients' resourcefulness influence each other and health-related quality of life (HRQOL) in patients with colorectal cancer. SAMPLE & SETTING: This study was conducted in an outpatient clinic at a medical center in Taichung, Taiwan. A total of 84 patient-caregiver dyads were recruited, and 43 patients had advanced-stage cancer. Patients and their caregivers signed consent forms individually. Patients were aged 29-77 years, and caregivers were aged 22-75 years. METHODS & VARIABLES: The theory of resourceful-ness and QOL guided this study. An F test and multiple regression analyses were conducted to examine the relationships among demographic characteristics, family caregivers' burden, patients' resourcefulness, and patients' HRQOL. RESULTS: Higher-resourcefulness patients tended to have caregivers with higher self-esteem and fewer health impacts. Caregivers with fewer impacts to health and finances and higher self-esteem were predictive of higher resourcefulness in patients. Higher patient resourcefulness, fewer caregiver disruptions to daily schedule and impacts to finances, and higher caregiver self-esteem were predictors of patients' HRQOL. IMPLICATIONS FOR NURSING: When developing and evaluating education programs about cognitive skills training for patients with cancer, nurses should take family caregivers' burden into consideration to support optimal patient outcomes and HRQOL.

The effectiveness of music in relieving pain in cancer patients: a randomized controlled trial.

OBJECTIVES: To examine effects of sedative music on cancer pain. DESIGN: A randomized controlled trial. SETTINGS: Two large medical centers in Kaoshiung City, in southern Taiwan. PARTICIPANTS: 126 hospitalized persons with cancer pain. METHODS: Participants were randomly assigned to an experimental (n=62) or a control group (n=64), with computerized minimization, stratifying on gender, pain, and hospital unit. Music choices included folk songs, Buddhist hymns (Taiwanese music), plus harp, and piano (American). The experimental group listened to music for 30 min; the control group rested in bed. Sensation and distress of pain were rated on 100mm VAS before and after the 30-min test. RESULTS: Using MANCOVA, there was significantly less posttest pain in the music versus the control group, p<.001. Effect sizes were large, Cohen's d=.64, sensation, d=.70, distress, indicating that music was very helpful for pain. Thirty minutes of music provided 50% relief in 42% of the music group compared to 8% of the controls. The number needed to treat (NNT) to find one with 50% sensation relief was three patients. More patients chose Taiwanese music (71%) than American music (29%), but both were liked and effective. CONCLUSIONS: Offering a choice of familiar, culturally appropriate music was a key element of the intervention. Findings extend the Good and Moore theory (1996) to cancer pain. Soft music was safe, effective, and liked by participants. It provided greater relief of cancer pain than analgesics alone. Thus nurses should offer calming, familiar music to supplement analgesic medication for persons with cancer pain.

Parotid tumors: a 10-year experience.

PURPOSE: The aim of the present study was to analyze the clinical presentation, histopathology, and complications of parotid tumors, as well as the management of malignant parotid tumors. METHODS: We retrospectively reviewed the medical records of 271 patients who underwent parotidectomy from August 1996 to July 2006. Data including age, sex, clinical signs and symptoms, histologic findings, complications, malignant tumor stage, and prognosis were collected from medical charts. RESULTS: Of the 271 patients who underwent parotidectomy, 229 (85%) had benign tumors, 33 (12%) had malignant tumors, and 9 had chronic inflammatory disease (3%). The most common benign tumor was pleomorphic adenoma (51%), and the most common malignant tumor was mucoepidermoid carcinoma (3%). The 5-year overall survival rate was 42%, and the disease-specific survival rate for malignant tumor was 72%. Only disease stage was the statistically significant prognostic factor of malignancy. The most common complication of parotidectomy was transient facial palsy (18%). CONCLUSIONS: Standardized superficial and total parotidectomy are safe procedures for treating parotid tumors. Management of malignant tumors depends on tumor stage and histologic grade. Advanced tumor stage is a predictor of poor outcome.