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1.
Artigo em Inglês | MEDLINE | ID: mdl-34449251

RESUMO

Introduction: Acupuncture has demonstrated effectiveness for symptom management among breast cancer survivors. This meta-analysis aims to evaluate the effect of acupuncture on treatment-related symptoms among breast cancer survivors. Methods: The authors searched PubMed, CINAHL, and EMBASE for relevant randomized clinical trials (RCTs) of acupuncture for managing treatment-related symptoms published in English through June 2021. They appraised the quality of each article using the Cochrane Collaboration Risk of Bias Criteria. The primary outcomes were pain, hot flashes, sleep disturbance, fatigue, depression, lymphedema, and neuropathy as individual symptoms. They also evaluated adverse events reported in acupuncture studies. Results: Of 26 selected trials (2055 patients), 20 (1709 patients) were included in the meta-analysis. Acupuncture was more effective than control groups in improving pain intensity [standardized mean difference (SMD) = -0.60, 95% confidence intervals (CI) -1.06 to -0.15], fatigue [SMD = -0.62, 95% CI -1.03 to -0.20], and hot flash severity [SMD = -0.52, 95% CI -0.82 to -0.22]. The subgroup analysis indicated that acupuncture showed trends but not significant effects on all the treatment-related symptoms compared with the sham acupuncture groups. Compared with waitlist control and usual care groups, the acupuncture groups showed significant reductions in pain intensity, fatigue, depression, hot flash severity, and neuropathy. No serious adverse events were reported related to acupuncture intervention. Mild adverse events (i.e., bruising, pain, swelling, skin infection, hematoma, headache, menstrual bleeding) were reported in 11 studies. Conclusion: This systematic review and meta-analysis suggest that acupuncture significantly reduces multiple treatment-related symptoms compared with the usual care or waitlist control group among breast cancer survivors. The safety of acupuncture was inadequately reported in the included studies. Based on the available data, acupuncture seems to be generally a safe treatment with some mild adverse events. These findings provide evidence-based recommendations for incorporating acupuncture into clinical breast cancer symptom management. Due to the high risk of bias and blinding issues in some RCTs, more rigorous trials are needed to confirm the efficacy of acupuncture in reducing multiple treatment-related symptoms among breast cancer survivors.

2.
BMC Cancer ; 21(1): 855, 2021 Jul 26.
Artigo em Inglês | MEDLINE | ID: mdl-34311713

RESUMO

BACKGROUND: Fatigue is one of the most common and burdensome symptoms experienced by cancer patients. In interventions intended to reduce fatigue in such patients, fatigability, or perception of fatigue contextualized to activities of fixed intensity and duration, may also be measured. This study investigated the effects of a 15-month intervention on fatigue and fatigability in breast cancer survivors (BCS); explored the fatigue-fatigability relationship; and evaluated the impacts of fatigue and fatigability on anxiety, depression, sleep disturbance, and endocrine symptoms. METHODS: A randomized controlled trial design was applied to an exercise program called BLESS (Better Life after cancer, Energy, Strength, and Support). The intervention included this 12-week exercise program and four follow-up contacts intended to promote exercise adherence over the following year. Participants were women aged 20 to 69 who had been diagnosed with stage I, II, or III breast cancer; had completed active treatment; and had moderate or higher fatigue. At the completion of the intervention, the survey responses of 40 BCS were evaluated using the chi-square test and multiple regression analysis. The Korean versions of the Revised Piper Fatigue Scale and Pittsburgh Fatigability Scale were used to measure fatigue and fatigability, respectively. RESULTS: There was no significant difference in fatigue or fatigability between the experimental and control groups at intervention completion. However, the control group showed a stronger association than the experimental group between fatigue and physical fatigability. In the control group, fatigue and fatigability were significantly associated with anxiety, depression, sleep disturbance, and endocrine symptoms. In the experimental group, only the cognitive/mood fatigue score and depression were significantly associated. Only endocrine symptoms influenced mental fatigability (B = - 0.185, P < 0.05), and only depression influenced cognitive/mood fatigue (B = 1.469, P < 0.05). CONCLUSIONS: Fatigue and fatigability showed different correlations with cancer-related symptoms after the exercise intervention. Future assessments of fatigability in intervention studies will allow measurement of the spectrum of patients' abilities to overcome fatigue at various physical activity levels while capturing different aspects of cancer-related symptoms. TRIAL REGISTRATION: This study was retrospectively registered on Clinical Research Information Service ( KCT0005763 ; date of registration: 31/12/2020).


Assuntos
Ansiedade/epidemiologia , Neoplasias da Mama/complicações , Neoplasias da Mama/epidemiologia , Sobreviventes de Câncer , Depressão/epidemiologia , Fadiga/epidemiologia , Transtornos do Sono-Vigília/epidemiologia , Adulto , Idoso , Idoso de 80 Anos ou mais , Ansiedade/etiologia , Sobreviventes de Câncer/psicologia , Depressão/etiologia , Exercício Físico , Fadiga/etiologia , Feminino , Humanos , Pessoa de Meia-Idade , Qualidade de Vida , República da Coreia , Transtornos do Sono-Vigília/etiologia , Avaliação de Sintomas
3.
Health Qual Life Outcomes ; 19(1): 179, 2021 Jul 12.
Artigo em Inglês | MEDLINE | ID: mdl-34247645

RESUMO

BACKGROUND: Fatigability has recently emerged in oncology as a concept that anchors patients' perceptions of fatigue to defined activities of specified duration and intensity. This study aimed to examine the psychometric properties of the Korean version of the Pittsburgh Fatigability Scale (K-PFS) for women with breast cancer. METHODS: This cross-sectional study involved 196 women with breast cancer recruited from a tertiary hospital in Seoul, Korea. Reliability was evaluated using Cronbach's alpha, and confirmatory factor analysis was conducted to examine the factor structure of the K-PFS. Four goodness-of-fit values were evaluated: (1) the comparative fit index (CFI), (2) the Tucker-Lewis index (TLI), (3) the root mean square error of approximation (RMSEA), and (4) the standardized root mean square residual (SRMR). RESULTS: Of the 196 survivors, 71.1% had greater physical fatigability (K-PFS Physical score ≥ 15) and 52.6% had greater mental fatigability (K-PFS Mental score ≥ 13). The Cronbach's alpha coefficient for the total K-PFS scale was 0.926, and the coefficients for the physical and mental fatigability domains were 0.870 and 0.864, respectively. In the confirmatory factor analysis for physical fatigability, the SRMR value (0.076) supported goodness of fit, but other model fit statistics did not (CFI = 0.888, TLI = 0.826, and RMSEA = 0.224). For mental fatigability, although three goodness-of-fit values were acceptable (CFI = 0.948, TLI = 0.919, and SRMR = 0.057), the RMSEA value (0.149) did not indicate good model fit. However, each item coefficient was statistically significant (> 0.5), and the K-PFS was therefore found to be valid from a theoretical perspective. CONCLUSION: This study provides meaningful information on the reliability and validity of the K-PFS instrument, which was developed to meet an important need in the context of breast cancer survivors. Additional research should examine its test-retest reliability and construct validity with performance measures.


Assuntos
Neoplasias da Mama/psicologia , Sobreviventes de Câncer/psicologia , Fadiga/psicologia , Qualidade de Vida , Inquéritos e Questionários/normas , Adulto , Neoplasias da Mama/complicações , Estudos Transversais , Análise Fatorial , Fadiga/complicações , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Psicometria/instrumentação , Reprodutibilidade dos Testes , República da Coreia
4.
Cancer Nurs ; 2021 May 28.
Artigo em Inglês | MEDLINE | ID: mdl-34054070

RESUMO

BACKGROUND: Among people with cancer undergoing chemotherapy, generalized loss of muscle mass, termed secondary sarcopenia, is associated with treatment toxicities and physical disability. OBJECTIVE: This systematic review and meta-analysis aimed to provide an overview of current interventions for sarcopenia in cancer patients receiving chemotherapy and to assess potentially effective interventions. METHODS: We searched PubMed, Scopus, CINAHL (Cumulative Index to Nursing and Allied Health Literature) Plus, and EMBASE for primary original research of exercise and nutrition interventions for sarcopenia published in English. The review used PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-analyses) guidelines. Standardized mean difference and 95% confidence interval (CI) were calculated as effect measures by applying the random-effects model. RESULTS: The 6 included studies showed a trend toward significantly increasing skeletal muscle mass after intervention (mean difference, 0.168; 95% CI, -0.015 to 0.352; P = .072), with no significant changes in lean body mass loss after intervention (mean difference, -0.014; 95% CI, -1.291 to 1.264; P = .983). Resistance exercise and combined exercise and nutrition intervention were more effective at preserving or increasing muscle mass. CONCLUSIONS: Early implementation of a resistance exercise intervention or a combined exercise and nutrition intervention is a promising strategy for avoiding muscle mass loss during chemotherapy. Additional evidence-based assessments of interventions for secondary sarcopenia are needed to identify the most effective approach. IMPLICATIONS FOR PRACTICE: In clinical practice, oncology nurses should frequently assess cancer patients' muscle mass and when warranted should implement the most feasible early sarcopenia intervention to minimize the adverse outcomes of this condition.

5.
Artigo em Inglês | MEDLINE | ID: mdl-33725222

RESUMO

Asian American women, both immigrant and US-born, are known to have low mammography screening rates. To reduce health disparities and address community health needs, we undertook a systematic review to identify factors that affect mammography uptake among Asian American women following a mammography screening intervention. Following the PRISMA guidelines, we searched four databases and selected 12 studies that met our inclusion criteria. We identified 22 relevant factors and developed a new conceptual model that comprehensively captures these sociodemographic; cultural; knowledge, attitude, and perception; health history; health care accessibility and availability; and intervention factors, including components and mode of intervention. This conceptual model can be used to guide development of interventions that effectively promote mammography screening. Future research should focus on the effect of acculturation on screening behaviors and the importance of culturally tailored intervention and information-sharing elements to improving mammography screening among Asian Americans.

6.
J Cancer Surviv ; 15(3): 427-451, 2021 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-32949353

RESUMO

PURPOSE: People with cancer experience significant physical and psychological symptoms, during as well as after primary treatment. Acceptance and Commitment Therapy (ACT), a psychological intervention, reduces both types of symptoms among individuals with chronic pain and emotional distress. Due to the unique challenges of cancer survivorship, this systematic review critically evaluates and synthesizes the literature on the context, mechanisms, and effect of ACT among adult cancer survivors. METHODS: Articles were retrieved from the CINAHL, MEDLINE via Ovid, Web of Science, PsycInfo, Scopus, Embase, Google Scholar, and Cochrane databases. Selected grey literature portals, clinical trial registries, and conference proceedings were also searched. The NIH tools were used to assess study quality and the revised Cochrane Risk-of-Bias tool to assess risk of bias RESULTS: Thirteen articles, reporting on 537 cancer survivors with various cancer types, were included. ACT significantly reduced anxiety, depression, and fear of cancer recurrence and improved psychological flexibility and quality of life. Outcomes such as pain and insomnia were understudied. Lack of participant blinding and non-random assignment were the most common methodological issues. A conceptual model is proposed that describes the possible influencing factors of an ACT-based intervention in cancer survivors. CONCLUSION: Review findings suggest that ACT is an effective intervention to improve some of the common concerns among cancer survivors. While all the studies in the review were recent (published 2015-2019), they examined only a limited number of outcomes. Hence, more methodologically rigorous studies which examine the effect of ACT on other troubling symptoms among cancer survivors are warranted. IMPLICATIONS FOR CANCER SURVIVORS: Incorporating ACT into comprehensive post-treatment survivorship care can enhance psychological flexibility and reduce anxiety, depression, and fear.

7.
Biol Res Nurs ; 23(3): 341-361, 2021 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-33138637

RESUMO

BACKGROUND: Individuals with cancer experience stress throughout the cancer trajectory. Allostatic load (AL), a cumulative multi-system measure, may have a greater value in stress assessment and the associated biological burden than individual biomarkers. A better understanding of the use of AL and its operationalization in cancer could aid in early detection and prevention or alleviation of AL in this population. PURPOSE: To consolidate findings on the operationalization, antecedents, and outcomes of AL in cancer. METHODS: Seven databases (CINAHL, Ovid MEDLINE, Web of Science, APA PsycInfo, Scopus, Embase, and Cochrane CENTRAL) were searched for articles published through April 2020. The NIH tools were used to assess study quality. RESULTS: Twelve studies met inclusion criteria for this review. Although variability existed in the estimation of AL, biomarkers of cardiovascular, metabolic, and immune systems were mostly used. Associations of AL with cancer-specific variables were examined mostly utilizing population-databases. Significant associations of AL with variables such as cancer-related stress, positive cancer history, post traumatic growth, resilience, tumor pathology, and cancer-specific mortality were found. Mini meta-analysis found that a one-unit increase in AL was associated with a 9% increased risk of cancer-specific mortality. CONCLUSION: This review reveals heterogeneity in operationalization of AL in cancer research and lack of clarity regarding causal direction between AL and cancer. Nevertheless, AL holds a significant promise in cancer research and practice. AL could be included as a screening tool for high-risk individuals or a health outcome in cancer. Optimal standardized approaches to measure AL would improve its clinical utility.

8.
Cancer Nurs ; 2020 Nov 30.
Artigo em Inglês | MEDLINE | ID: mdl-33259375

RESUMO

BACKGROUND: Cancer-related fatigue (CRF) is a major issue facing breast cancer survivors (BCS) that can negatively impact their symptoms and quality of life. OBJECTIVES: The aims of this study were to examine levels of fatigue, identify preferred types of fatigue self-management, and explore the relationship between fatigue levels and management choices by cancer stage. METHODS: This cross-sectional descriptive study included 229 BCS recruited from 5 hospitals in Korea. The study inclusion criteria were limited to BCS between 20 and 69 years old in stages 1, 2, or 3 who were undergoing or had completed active therapy. The Revised Piper Fatigue Scale and a questionnaire developed for fatigue management were used for data collection. RESULTS: The stage 2 group experienced more fatigue (mean, 5.31) than the other cancer stage groups, and significant differences in fatigue were found between stages 1 and 2 (P < .001). Fatigue self-management choices showed different correlations with fatigue levels in each stage. Physical activity control was most frequently used in stage 1, whereas exercise was most frequently used in stages 2 and 3. Multivariate regression analysis showed that exercise consistently and effectively decreased all fatigue dimensions. CONCLUSION: Stage 2 BCS experienced the greatest level of CRF, and fatigue levels and management choices differed in BCS by cancer stage. IMPLICATIONS FOR PRACTICE: Recognizing how CRF and patients' preferences for fatigue self-management may differ by cancer stage can alert clinicians in assessing CRF and tailoring effective fatigue management for BCS.

9.
Cancer Nurs ; 2020 Sep 25.
Artigo em Inglês | MEDLINE | ID: mdl-33003122

RESUMO

BACKGROUND: A culture of serious overwork in South Korea, more than other developed countries, may impact symptoms and quality of life (QOL) experienced by Korean breast cancer survivors (BCS). OBJECTIVES: The aim of this study was to examine health-related QOL and influencing factors in BCS in Seoul, Korea, who have recovered from treatment for at least 1 year and returned to normal life and work. METHODS: In a cross-sectional study, 199 BCS completed a self-administered questionnaire in Seoul, Korea. RESULTS: Mean QOL scores were lower than expected, with 49% of the variance explained by depressive symptoms, physical fatigability, cognitive impairment, and social support. Psychological distress was high (67.8%), along with anxiety (47.2%) and depressive symptoms (36.7%). Participants reported a high prevalence of physical fatigability (71.1%), sleeping an average of only 6 hours per night, with 58.9% reporting poor quality sleep. CONCLUSIONS: Quality of life was lower in Korean BCS than comparable studies in the United States, although participants received care at a premiere medical center. Depressive symptoms and anxiety were common and did not taper off over the 5 years after diagnosis, unlike BCS elsewhere. Korean survivors experienced significant physical fatigability, much higher than reported in a US study of mixed male and female cancer survivors. Overwork was not a significant predictor of QOL, although 30% of employed women reported working 45 to 90 hours weekly. IMPLICATIONS FOR PRACTICE: Findings demonstrate the importance of continued efforts to mitigate these symptoms in clinical survivorship care, as well as future research, to provide avenues for improving QOL for BCS, particularly in Korea.

10.
Biol Res Nurs ; 22(4): 472-484, 2020 10.
Artigo em Inglês | MEDLINE | ID: mdl-32602357

RESUMO

The co-occurrence of multiple psychoneurological symptoms, including pain, sleep disturbance, fatigue, depression, anxiety, and cognitive disturbance among adult cancer survivors led us to question which common biological mechanisms are shared among these conditions. Variances in tryptophan (Trp) levels and downstream metabolites of the kynurenine (Kyn) metabolic pathway are known to affect immune response and psychoneurological symptoms. The objective of this systematic review was to help us (a) better understand the role of the Kyn pathway in psychoneurological symptoms among adult cancer survivors and (b) identify common significant biomarkers across psychoneurological symptoms as a guide for future research. Some evidence has shown that decreased Trp levels and increased Kyn, Trp/Kyn ratio, and kynurenic acid/Trp ratio in parallel with immune activation are correlated with some psychoneurological symptoms among people undergoing cancer treatment, although discrepancies exist between studies. Kyn pathway activation could also be associated with psychoneurological symptoms among adult cancer survivors, but further research is needed to confirm its exact etiological role with respect to psychoneurological symptoms.


Assuntos
Biomarcadores/sangue , Ácido Cinurênico/sangue , Cinurenina/sangue , Neoplasias/sangue , Neoplasias/complicações , Neoplasias/fisiopatologia , Triptofano/sangue , Adulto , Idoso , Idoso de 80 Anos ou mais , Biomarcadores/metabolismo , Sobreviventes de Câncer , Feminino , Humanos , Ácido Cinurênico/metabolismo , Cinurenina/metabolismo , Masculino , Redes e Vias Metabólicas , Pessoa de Meia-Idade , Triptofano/metabolismo
11.
Omega (Westport) ; : 30222820921586, 2020 May 12.
Artigo em Inglês | MEDLINE | ID: mdl-32397814

RESUMO

Few studies of death preparation in South Korea are available. This article describes South Koreans' experiences of death and a funeral in a hospital setting to improve health care providers' ability to care for dying patients and their family. Using Colaizzi's phenomenological method, we conducted semistructured interviews with 40 South Koreans who had lost a family member in a hospital setting. Participants' statements were classified into 12 themes, 5 theme clusters, and 3 categories: (a) vagueness of funeral culture, (b) distortion of meaning in funeral culture, and (c) the need to prepare for death and process grief. Our findings are relevant to hospital-based health care providers who care for dying patients and their family. Targeted educational information could help health care providers better serve patients and family. Policy changes could improve quality of care by allowing health care providers to transition with the family from hospital units to a hospital-based funeral setting.

12.
Anticancer Res ; 40(5): 2409-2418, 2020 May.
Artigo em Inglês | MEDLINE | ID: mdl-32366384

RESUMO

BACKGROUND/AIM: Skeletal muscle mass loss is an emerging concern in oncology. Our systematic review and meta-analysis identified the mean difference in skeletal muscle index pre- to post-chemotherapy and synthesized potential key factors. MATERIALS AND METHODS: We searched primary original research published through October 2019 in four databases: MEDLINE via PubMed, Scopus, CINAHL, and Embase. RESULTS: Fifteen studies were included, 60% published in the past 2 years (2018-2019). Advanced non-small cell lung cancer was the most frequently reported cancer, and overall survival the most often identified key related factor. Mean difference in skeletal muscle index during chemotherapy was 2.72 (95%CI=1.77-3.67, p=0.00), with muscle loss in males (4.52, 95%CI=3.34-5.71, p=0.00) about 1.6 times higher than that in females (2.86, 95%CI=0.81-4.92, p=0.01). CONCLUSION: Oncologists should recognize sex-specific differences in skeletal muscle mass loss during chemotherapy and consider adjusting treatment accordingly.


Assuntos
Músculo Esquelético/patologia , Neoplasias/complicações , Sarcopenia/etiologia , Sarcopenia/patologia , Protocolos de Quimioterapia Combinada Antineoplásica/efeitos adversos , Protocolos de Quimioterapia Combinada Antineoplásica/uso terapêutico , Humanos , Neoplasias/tratamento farmacológico , Tamanho do Órgão
13.
World Neurosurg ; 133: e633-e639, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31604133

RESUMO

BACKGROUND: Patients with nonfunctioning pituitary macroadenomas commonly experience headaches before and after surgery, and headaches have been reported to significantly detract from the quality of life. Despite this adverse impact, few studies have examined the prevalence and pattern of headaches on a long-term basis. Thus, this study employed a longitudinal cohort design to identify headache prevalence and severity during a 6-month postoperative period and its predictors. METHODS: Forty patients with nonfunctioning pituitary macroadenomas who underwent transsphenoidal surgery were enrolled as subjects, and Headache Impact Test-6 (HIT-6) was performed at 4 time points: before and 1, 3, and 6 months after surgery. RESULTS: This study revealed that patients with nonfunctioning pituitary macroadenoma suffered from headaches at each of the 4 time points and that 37.5%, 27.8%, 17.9%, and 12.8% of the patients experienced "substantial and severe impact headaches" before and 1, 3, and 6 months after surgery, respectively. In addition, total HIT-6 scores 1 month after surgery were a significant predictor (B = 0.41, P < 0.001) of headaches 3 and 6 months after surgery. Among the HIT-6 items, pain (B = 0.09, P < 0.001), cognitive function (B = 0.07, P < 0.001), and psychological distress (B = 0.07, P < 0.001) showed the greatest impact on long-term headaches. CONCLUSION: Headaches adversely affected patients even 6 months after surgery. In addition, headaches 1 month after surgery predicted the prevalence of long-term headaches at 3 and 6 months, demonstrating the importance of timely postsurgical measurement of headaches to anticipate patients' long-term headache patterns.


Assuntos
Adenoma/complicações , Adenoma/cirurgia , Cefaleia/epidemiologia , Cefaleia/etiologia , Neoplasias Hipofisárias/complicações , Neoplasias Hipofisárias/cirurgia , Adulto , Idoso , Estudos de Coortes , Feminino , Humanos , Estudos Longitudinais , Masculino , Pessoa de Meia-Idade , Procedimentos Neurocirúrgicos , Prevalência , Qualidade de Vida , Resultado do Tratamento , Adulto Jovem
14.
J Neurosci Nurs ; 52(1): 30-36, 2020 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-31842029

RESUMO

BACKGROUND: Patients with pituitary macroadenoma commonly experience symptoms such as headache, visual disturbance, and olfactory dysfunction due to tumor effects. Even after undergoing surgery for tumor removal, patients continue to experience these symptoms and have difficulty resuming their general activities, decreasing their quality of life (QOL). Although some studies have focused on QOL in pituitary macroadenoma, few studies have examined the relationship between postoperative symptoms and patient QOL in the period after surgery. This study aimed to identify the relationships between postoperative symptoms and QOL among pituitary macroadenoma patients. METHODS: This study used a descriptive cross-sectional design to identify relationships between postoperative symptoms and QOL in pituitary macroadenoma patients. Medical records of 62 patients with pituitary macroadenomas who had undergone surgery were retrieved and reviewed 3 months after surgery; at that time, all participants completed a self-report survey addressing their current symptoms and QOL. The researchers then evaluated patient QOL and 3 common symptoms-headache, objectively measured visual disturbance, and olfactory dysfunction-using correlation analysis and multiple linear regression. RESULTS: Three months after surgery, patients still experienced headache and lack of olfactory function. Headache showed a strong negative correlation with physical (r = -0.501, P < .001, R = 36%) and mental (r = -0.448, P < .001, R = 26%) QOL. Headache was a significant factor influencing QOL. CONCLUSION: Study findings show that continuous assessment and intervention for headache are essential for improving QOL in pituitary macroadenoma patients after surgery. Nurses should prioritize assessment and management of postoperative headache in long-term care for such patients. The study findings support development of a clinical guideline for managing headache in such patients and thus improving their QOL.


Assuntos
Adenoma/cirurgia , Neoplasias Hipofisárias/cirurgia , Complicações Pós-Operatórias , Qualidade de Vida/psicologia , Estudos Transversais , Feminino , Cefaleia/etiologia , Humanos , Masculino , Pessoa de Meia-Idade , Enfermagem em Neurociência , Transtornos do Olfato/etiologia , Inquéritos e Questionários , Transtornos da Visão/etiologia
15.
Jpn J Nurs Sci ; 17(2): e12301, 2020 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-31721460

RESUMO

AIM: During cross-cultural instrument development, a gap commonly exists between the intended meaning of questionnaire items and the extent to which the participant understands that meaning. Because cognitive interviewing can provide such a powerful means for ensuring an accurate interpretation of items, the purpose of this report is to provide a practical guide to encourage its use in nursing research. METHODS: This report provides in-depth information describing: (a) advantages of cognitive interviewing, particularly for cross-cultural instrument development; (b) specific problems it can identify and solve; (c) strategies for performing cognitive interviews, including the four-step model of the question-and-answer process; (d) practical guidance for conducting successful cognitive interviews. RESULTS: To achieve linguistic validity as well as cultural relevance, a variety of factors need to be considered in addition to language, such as cultural interpretations, attitudes, and values. Examples of health-related studies are presented, demonstrating the advantages of cognitive interviewing for instrument development and cross-cultural research. These examples show how cognitive interviewing can be productively used to verify question clarity, patient comprehension, and patients' ease of response and judgment while also helping to establish content validity based on patients' perspectives. CONCLUSIONS: Cognitive interviewing can help nurse researchers discover potential instrument flaws and correct them in advance, subsequently avoiding collection of inaccurate data. Thus, cognitive interviewing should be considered an effective pretesting method for development of accurate instruments, particularly in cross-cultural nursing research.


Assuntos
Comparação Transcultural , Pesquisa em Enfermagem , Inquéritos e Questionários , Adulto , Cognição , Feminino , Humanos , Masculino , Projetos de Pesquisa
16.
J Clin Nurs ; 29(5-6): 758-769, 2020 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-31769562

RESUMO

AIMS AND OBJECTIVES: To identify the experience of breast cancer survivors regarding cancer-related fatigue, exercise and exercise adherence. BACKGROUND: Cancer-related fatigue is a common symptom among cancer survivors that limits quality of life. Despite exercise being recommended as a viable solution to manage cancer-related fatigue, relatively few research studies on the experience of cancer-related fatigue and exercise adherence have been conducted. DESIGN: This was a qualitative study to identify breast cancer survivors' experience of cancer-related fatigue, exercise and exercise adherence. This paper adhered to the COREQ checklist in reporting. METHODS: Four focus group interviews were conducted with 16 breast cancer survivors who had fatigue score of 4 out of 10 (moderate fatigue) or greater. Ethical approval was obtained and participants met for focus group interview discussion. The interview guide included questions on cancer-related fatigue, barriers and facilitators of exercising, strategies for exercise adherence and suggestions for a supportive programme. RESULTS: Four themes were identified through thematic analysis: (a) The insidious and overpowering nature of cancer-related fatigue; (b) exercising when experiencing fatigue surrounded by prevailing myths; (c) multiple barriers to exercise; and (d) facilitative factors to continue exercising despite fatigue. CONCLUSIONS: Participants' experience of moderate or greater cancer-related fatigue prevented them from exercising, despite knowing its importance, and limited them to passive activities. Misconceptions that exercise is associated with lymphedema and risk of recurrence, poor psychosocial self-image and lack of clear knowledge and exercise programmes for cancer survivors further limited adherence to exercise. In contrast, finding comfort and strength through exercising and interacting with other breast cancer survivors were facilitative factors. RELEVANCE TO CLINICAL PRACTICE: The insights shared by breast cancer survivors experiencing cancer-related fatigue can contribute to developing an exercise adherence programme as a way to manage and alleviate fatigue and establish healthy survivorship care.


Assuntos
Neoplasias da Mama/complicações , Sobreviventes de Câncer/psicologia , Exercício Físico/psicologia , Fadiga/etiologia , Adulto , Idoso , Neoplasias da Mama/psicologia , Terapia por Exercício/métodos , Fadiga/classificação , Fadiga/psicologia , Feminino , Grupos Focais , Conhecimentos, Atitudes e Prática em Saúde , Humanos , Pessoa de Meia-Idade , Cooperação do Paciente , Pesquisa Qualitativa , Qualidade de Vida
17.
Res Nurs Health ; 42(6): 429-435, 2019 12.
Artigo em Inglês | MEDLINE | ID: mdl-31599468

RESUMO

With mounting pressure to move toward precision health care and implementation science, nurse researchers are faced with the challenge of producing evidence that their interventions are applicable in real-world clinical settings. Pragmatic clinical trials are critically important to generate evidence that is relevant to clinical practice. Pragmatic designs closely replicate true-to-life settings thereby expediting research translation and improving health outcomes. The Sequential Multiple Assignment Randomized Trial (SMART) is a valuable a pragmatic trial design that is receiving greater attention in nursing. SMART designs can be used to provide relevant clinical evidence by comparative evaluation of two or more alternative interventions. The objectives of this article are to provide: (a) A description of the main considerations and key components of SMART designs, and (b) a summary of three different nursing studies using SMART designs. Information provided by pragmatic nursing trials using SMART designs, which more closely mirror clinical practice, will facilitate evidence-based clinical practice.


Assuntos
Enfermagem Baseada em Evidências , Pesquisa em Enfermagem , Projetos de Pesquisa , Humanos , Ciência da Implementação
18.
Workplace Health Saf ; 67(12): 592-601, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-31448704

RESUMO

Background: High job stress is positively associated with reduced quality of life in workers, detrimental effects on worker health, and increased worker absenteeism and lower productivity. Exercise is a proven approach for coping with psychological stress in general. However, relatively few research studies have examined the effects of workplace exercise interventions on job stress reduction. The purpose of this systematic review was to identify associations between workplace exercise interventions and job stress reduction among employees. Methods: A literature search was performed using five databases (i.e., CINAHL, Medline via PubMed, Scopus, PsycINFO, and Embase), and eligible studies were written in English, and were published between January 1990 and October 2018. Studies were included if worker participants were subjected to a workplace exercise intervention, and their job stress was measured before and after the intervention. To assess the quality of these studies, van Tulder's risk of bias assessment tool was applied. Findings: Eight studies were identified, and six of those (75%) were found to be of relatively good quality. In only two of the studies (25%) was the workplace exercise program associated with a statistically significant reduction in job stress. The study findings suggest that relationships between workplace exercise interventions and job stress reduction have not been sufficiently evaluated in the literature. Conclusion and Application to Practice: Based on the limited data available, future intervention research should focus on randomized controlled trials of interventions incorporating both exercise and multidimensional strategies to reduce job stress.


Assuntos
Exercício Físico , Estresse Ocupacional/prevenção & controle , Local de Trabalho , Humanos , Serviços de Saúde do Trabalhador/métodos
19.
ANS Adv Nurs Sci ; 42(4): 325-340, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31299690

RESUMO

Health-related quality of life is increasingly used as a predictor in nursing research and practice because its multidimensional constructs encompass the holistic spectrum of care. This article comprehensively analyzes and evaluates the conceptual model of health-related quality of life of Ferrans and colleagues using Fawcett and Desanto-Madeya's 2013 framework. The model encompasses all relevant concepts and propositions in its theoretical foundation while maintaining consistency with the nursing metaparadigm. Also, the model has comprehensive content, appropriate context, and social and theoretical significance. To maximize the model's empirical and pragmatic adequacy, researchers should carefully define the variables associated with each concept.


Assuntos
Modelos Psicológicos , Qualidade de Vida , Autoeficácia , Saúde Holística/normas , Humanos , Pesquisa em Enfermagem
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