Early symptom recognition and symptom management among exacerbation COPD patients: A qualitative study.

BACKGROUND: An acute exacerbation of chronic obstructive pulmonary disease (AECOPD) is the most cause of deaths in COPD patient. It induces COPD patients often end in unexpected or unpredictable death. OBJECTIVES: The purposes were to explore the lived experiences of symptom recognition and to explain the pattern of symptom management successfully among exacerbation COPD patients. DESIGN: A Heideggerian hermeneutic phenomenology approach. SETTING: The interviews took place in participants' home by using android or iOS (iPhone) phone. PARTICIPANTS: Twenty participants were recruited until saturation by purposive sampling technique. METHODS: The semi-structured interview was used to capture detailed experiences verbatim. Data analysis based on a seven-stage hermeneutical process. RESULTS: Two constitutive patterns with relational themes were identified. First, symptom recognition, consisted of four themes: meaning of AECOPD, pattern of AECOPD, warning signs and prodromal symptoms, and risk factors of AECOPD. Second, symptom management, consisted of four themes: methods of symptom management (during AECOPD state), methods of symptom management (during stable COPD state for helping to prevent AECOPD state), knowledge source of symptom management, and factors influencing symptom recognition and symptom management. CONCLUSIONS: The use of a Heideggerian hermeneutic phenomenology as a research methodology fulfilled the aims of this study. It will enable healthcare professionals to select and advise the strategies or methods that will be the most likely to appropriate within the limits set by individual capabilities for promoting the best quality of life in COPD patients.

Adding Ritualized Chanting to the Palliative Care of Cancer Patients at the End of Life: A Randomized Controlled Trial.

This study examined the changes in comfort when adding ritualized chanting to the palliative care of cancer patients at the end of life. The method was a randomized control trial (RCT) performed with 60 cancer patients. Comfort was measured using the End of Life Planning Questionnaire (EOLPQ) with 30 participants in each group [ritualized chanting with palliative care (RCPC) and palliative care alone (PCA)] at baseline (T1), at a 3-week (T2) and the 6-week (T3) time frame. Comfort data were analyzed using two (groups) X three (time) repeated measures MANOVA. There were no significant statistical differences between the groups at baseline. Between-group differences indicated that comfort experienced by participants with the addition of ritualized chanting to palliative care significantly increased (p < .001) over time. The addition of ritualized chanting to the palliative care for cancer patients at the end of life can create changes in their comfort.

The Lived Experiences of Patients with Head and Neck Cancer during Concurrent Chemoradiation Therapy Care Process.

PURPOSE: An exploration of concurrent chemoradiation therapy care process from the perspective of patients with head and neck cancer can provide an insight to their lived experience and the difficulties they encounter in daily life towards a deeper understanding of this phenomenon to shape nursing service delivery. The aims of this study were to explore the lived experiences of patients with head and neck cancer while receiving concurrent chemoradiation therapy. METHODS: Data were generated from individual in-depth interviews with fifteen head and neck cancer patients, according to the semi-structured interview guidelines, at the out-patient radiation oncology department, Chulabhorn Cancer Center, Bangkok, Thailand. RESULTS: By using Graneheim and Lundman's content analysis, three categories from the data analysis of patients with head and neck cancer receiving concurrent chemoradiation therapy were isolated: 1) overwhelming information, 2) unpleasant symptom cluster, and 3) strategy for adherence to treatment regimen. CONCLUSION: The findings help to provide a better understanding of the lived experiences of patients with head and neck cancer during concurrent chemoradiation therapy, in terms of their suffering from various unpleasant side effects and how these impact their life along the treatment journey. This perspective on the care process in these patients enhances the development of a nursing care model based on patient-centered care toward positive patient outcomes.

Daily living practice of the life-satisfied Thai elderly.

The purpose of this study was to determine whether the life satisfaction of Thai elderly depends on their daily living practice. A comparative design was used to study 73 matched pairs of elderly people who perceive themselves as life satisfied or life dissatisfied. Scores of 85% and above on the life satisfaction instrument were used as a criteria to identify the elderly with life satisfaction. The sample was drawn from elderly clubs in four provinces of the eastern border of Thailand. Data were collected using structured interviews regarding the elderly's daily living practices on physical, mental, social, and economic domains. A two-tailed dependent t test was used to reveal mean scores both overall and for each domain of the daily living practices of the elderly participants. It was found that the life satisfaction group of elderly had significantly higher scores than their dissatisfied counterparts. The findings suggest the importance of Thai elderly's good practice on food habits, regular exercise, seeking knowledge toward health, religious activity involvement, good relationships with others, and well-planned income and expenses resulting in life satisfaction. Thus, nurses can promote life satisfaction of Thai elderly by motivating these factors that are generally uncommon practices in the Thai elderly culture. Future studies using a longitudinal quasi-experimental design to employ these positive daily living practice to promote life satisfaction of the life dissatisfied elderly is recommended.