Although both the assumptions and methods of qualitative and quantitative approaches in nursing research are different, both have the goal of furthering the scientific basis for practice. A variety of qualitative approaches are available, and which approach to use depends on the purpose of the research. In general, qualitative investigations address broad questions related to description, discovery, or theory building, and, as a consequence, the researcher is concerned with the entire context surrounding the phenomenon of interest rather than concentrating on specific variables thought to influence that phenomenon. The type of data collected and the methods of analysis differ, but qualitative research demands the same careful attention to selecting a design appropriate to answer the research question and the same assurance of rigor in conducting the research and interpreting the results as is required in quantitative studies. When these issues are thoroughly addressed, the clinician has a basis for judging both the accuracy and the applicability of qualitative research findings.

Anthropology, Cultural↗

PubMedDate not supplied

Self-care and breast cancer recovery.

PURPOSE: This study identified self-care behaviors used by women during and after radiation therapy for early-stage breast cancer. DESCRIPTION OF STUDY: Interviews with 23 women 7 months post-radiation therapy for breast cancer were analyzed for descriptions of self-care. The interviews were part of the final data collection in a longitudinal study investigating experiences post-treatment. RESULTS: Self-care behaviors reported most frequently were establishing a good support network, living life to the fullest despite illness, regulating feelings, managing stress, and taking responsibility for one's own health. Results suggest that breast cancer patients have many needs that continue to require attention post-radiation therapy, making self-care an important consideration throughout recovery. CLINICAL IMPLICATIONS: Quality of self-care may make a significant difference to women after treatment for breast cancer. Healthcare providers can promote self-care by encouraging patients to conserve energy, to engage in relationships, and to maintain a positive outlook and by suggesting activities that help patients cope, adapt, and manage symptoms during and after treatment.

Adaptation, Psychological↗

PubMedDate not supplied

Psychometric testing of fatigue instruments for use with cancer patients.

BACKGROUND: Cancer treatment-related fatigue (CRF) is a common side effect of cancer treatment. A problem identified in most reviews of CRF is lack of sound approaches to measurement that are congruent with the conceptualization of CRF as a self-perceived state. The diversity of instruments available to measure fatigue and the lack of comprehensive testing of several promising instruments with cancer patients undergoing treatment provided the rationale for this study. The purpose of this article is to report the results of psychometric testing of several fatigue instruments in patients undergoing cancer treatment. OBJECTIVES: The aims of this study were to determine the reliability, validity, and responsiveness of each instrument and to determine the ability of each instrument to capture CRF. METHODS: Existing fatigue instruments with published psychometric information that indicated suitability for further testing were selected and included the Profile of Mood States Short Form fatigue subscale (F_POMS-sf), Multidimensional Assessment of Fatigue (MAF), Lee Fatigue Scale (LFS), and the Multidimensional Fatigue Inventory (MFI). Data were collected at a university-based clinical cancer center and a freestanding comprehensive cancer center. Subjects completed all study instruments, which were presented in random order, at a time when CRF was expected to be high and again when it was expected to be low. A subset of subjects completed the instruments within 48 hours of one of the data collection points when CRF was expected to be relatively unchanged to provide stability data. RESULTS: Reliability estimates using Cronbach's alpha indicated that all instruments examined had good internal consistency. Test-retest correlations showed good stability for total scores on all the instruments, but some subscales of the LFS and MFI had marginal stability. Factor analysis of all instruments indicated that only the LFS and the F_POMS-sf fully supported their construct validity. All of the instruments showed responsiveness to changes in CRF related to treatment. CONCLUSIONS: The results of the study provide researchers and clinicians with detailed comparisons of the performance of established fatigue measures in cancer patients undergoing treatment to use when selecting measures of CRF.

Adult↗

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Hepatic microsomal 3-hydroxy-3-methylglutaryl-CoA reductase activity in the lactating rat.

Liver microsomal 3-hydroxy-3-methylglutaryl-CoA (HMGCoA) reductase activity increases after parturition in the female rat. The elevated activity observed within 24- to 36-h postpartum was sustained throughout lactation but declined to control levels by day 30, the natural weaning age of the pups. Premature weaning, induced by removal of the offspring, returned HMGCoA reductase activity to normal within 2-4 days. The elevation in HMGCoA reductase was not due to elimination or inversion of the natural diurnal rhythm of this enzyme, which was similar in phase, but not in amplitude, in lactating and control animals. Elevated feed intake in the lactating animal may have contributed to the increase in HMGCoA reductase since pair feeding with a nonpregnant, nonlactating control rat abolished the elevation in enzyme activity observed during lactation. Elevated food intake did not induce the elevation in HMGCoA reductase in lactating rats, however, since the major change in food intake occurred after the initial increase in enzyme activity.

Animals↗

PubMedDate not supplied

Adjustment of husbands and wives to breast cancer.

PURPOSE: The purpose of this descriptive study was to explore selected elements within the spousal relationship on fear of recurrence and emotional distress among women treated for breast cancer within the past 3 years and their husbands. DESCRIPTION OF STUDY: Fifty-eight married couples completed questionnaires designed to investigate the association between three relationship elements and adjustment (fear of recurrence and emotional distress) among husbands and wives. The relationship elements investigated were 1) adaptability and cohesion of the couple; 2) perceptions of support from the spouse; and 3) communication about the illness. The influence of the wife's age, treatment, and time since treatment also were considered. RESULTS: Both husbands and wives reported similar perceptions of dyadic functioning, level of support received from the spouse, and extent of communication about the illness. Interdependent elements within the couple relationship were associated with both fear of recurrence and emotional distress. Overall, the amount of communication about the illness explained the most variance in adjustment for both spouses, with communication increasing as fear of recurrence increased. There was some suggestion that current or past membership in a support group was related both to more communication by wives and to husbands' greater satisfaction with communication. For wives, age was the demographic variable most highly correlated with adjustment; the younger the wife, the greater was her fear of recurrence. Significant emotional distress was observed in a small subset of husbands. In addition, when either the husband or wife scored in the top 25% of the sample on fear of recurrence, the fear of recurrence score for the corresponding spouse was elevated in only two cases. This same pattern was true for emotional distress. CLINICAL IMPLICATIONS: This study adds to a growing body of information supporting the need to view women who have had breast cancer and their spouses as a unit. Four areas for heightened clinical assessment were noted; 1) greater fear of recurrence in younger women; 2) significant emotional distress in a small number of husbands; 3) the demonstration of compensation mechanisms by one spouse when the other is experiencing elevated fear of recurrence or emotional distress; and 4) an increased fear of recurrence in association with increased communication about the illness. Further investigation is necessary to determine whether communication between spouses is directed at problem solving or is an expression of emotional distress.

Adaptation, Psychological↗