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Biomedical subjects

B R Ferrell

Publications and source records attributed to B R Ferrell.

At least 127 records · Page 7Linked to original sources
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Pain as a metaphor for illness. Part I: Impact of cancer pain on family caregivers.

While previous research has focused on patients' or professional caregivers' perspective of pain, this study describes cancer pain from the family caregivers' perspective. Chronic pain, which is associated with malignant disease, produces an intense burden on the patient as well as on the entire family. This qualitative study included 85 family caregivers of patients with cancer pain. Data were collected using an interview guide, and verbatim responses were analyzed for themes. The results identified four themes surrounding family descriptions of pain (anatomic descriptions, hidden pain, family fear and suffering, and overwhelming/unendurable pain) and three themes surrounding family experience of pain (helplessness, coping by denying feelings, and a wish for death). This study documents the important role that family members play in cancer treatment. If the number of patients receiving care in the home from family members continues to grow, this role will become even more important. Part I of this two-part paper focuses on the impact that cancer pain has on family caregivers and concludes that pain does have a tremendous impact on the family because it is perceived as a metaphor of progressive illness and death.

Adaptation, Psychological↗
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Pain as a metaphor for illness. Part II: Family caregivers' management of pain.

Changes in the healthcare system have made the patient's home the primary site of cancer care. Family members, already burdened with the psychological impact of having a loved one with cancer, take on caregiving roles to meet the multiple and complex needs of the patient. Part I of this two-part article focused on family caregivers' descriptions of the patients' pain and the impact of this pain on caregivers. A model of the Caregiver Experience of Pain is provided along with implications for future inquiry and clinical practice. Themes identified in caregiver roles in medication administration included deciding what to give, deciding when to give, night duty, reminding/encouraging, keeping records, fear of addiction, and doing everything. Caregiver roles in nondrug interventions included positioning/mobility, massage, use of ointments/lotions, cold, heat, being there through touch, avoiding touch, and talk and other distractions. Caregiver perceptions of what doctors or nurses could do better included themes of being there, explain, be honest/listen, addiction concern, and giving medication. Caregiver questions included areas of future, understanding why, death, concern about medications, and fear about what to do at home. The study results offer important suggestions for oncology nurses in supporting family caregivers in the management of the patient in pain.

Analgesics↗
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1991 Oncology Nursing Society Research Priorities Survey.

Documenting current research priorities is an ongoing process that is important to furthering the research agenda of oncology nursing. The purpose of this study was to update and partially replicate previous Oncology Nursing Society (ONS) research priorities surveys. Questionnaires were sent to a convenience sample of 429 ONS members involved in research or in ONS leadership. The response rate was 70% (N = 310). Respondents identified a combination of clinical problems, research issues, and cancer care economic factors among their top 10 research priorities. Quality of life and symptom management consistently were ranked as the highest priority items across all three methods used to rank-order the items. Respondents also provided suggestions for future ONS/Oncology Nursing Foundation small grants and for expansion of current ONS research activities. These findings provide direction for the focus of oncology nursing research by suggesting topics for research, by identifying areas that require additional research funding, by recommending new research activities for ONS, and by promoting research as the basis for oncology nursing practice.

Humans↗
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Professional and ethical considerations in the use of high-tech pain management.

Pain management, a primary focus of the oncology nurse, is undergoing a technologic boom. Assessment of high-tech treatments in medicine is an underdeveloped and controversial area. This paper is intended to promote critical thinking about methods of high-tech pain relief such as subcutaneous, IV, and intraspinal analgesia and anesthesia delivered by ambulatory, implanted, or patient-controlled devices. These issues are described within an ethical framework that focuses on the principles of autonomy, beneficence, nonmaleficence, and justice. Application of these principles to the clinical practice setting and recommendations for practice conclude this paper.

Aged↗
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On writing abstracts.

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Abstracting and Indexing↗
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Fatigue in patients with cancer receiving interferon alpha.

Fatigue is the most frequently reported symptom of patients with cancer. The purpose of this study was to describe the experience of fatigue over time in patients with cancer receiving treatment with interferon alpha. Piper's Integrated Fatigue Model guided this study. A descriptive repeated-measures design was used. A convenience sample of 30 patients with malignant melanoma was drawn from a comprehensive cancer center in Southern California. Two instruments were used in data collection, the Symptom Distress Scale and the Piper Fatigue Scale. Study findings revealed descriptive data on patients' perceptions of the causes and remedies for fatigue while receiving active treatment for cancer. The pattern of fatigue was consistent over the five points of time during treatment, with the most extreme fatigue scores in the affective domain, followed by the sensory, temporal, total fatigue, and fatigue severity scores. The patterns and dimensions of fatigue provide implications for care of patients receiving interferon alpha, and for further investigation in the area of fatigue as a critical aspect of quality of life.

Adaptation, Psychological↗
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The family experience of cancer pain management in children.

This study describes the family perspective of cancer pain management in pediatric patients. Family caregiver knowledge and attitudes regarding pain, caregiver burden associated with pain, and caregiver moods were identified. This study was conducted in a children's hospital (n = 31) and a community hospice (n = 8) with family caregivers of pediatric cancer patients as the participants. Pain intensity was rated by children and family caregivers using pain assessment scales applicable to children with cancer. Differences in pain ratings were reported. The Family Pain Questionnaire was used to identify parents' knowledge and attitudes about pain and its management. Areas for family teaching were identified with the questionnaire. Understanding the pain experience from the perspective of family caregivers and their role in pain management can assist healthcare providers in relieving pain in children with cancer.

Adolescent↗
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Ethical decision making in oncology: a case study approach.

Every day healthcare professionals are involved in making difficult clinical decisions. This has become more apparent as society changes, in part due to technologic growth and diminishing resources. This article identifies basic principles of bioethics, applies those principles to situations that occur in the process of providing care to oncology patients, and identifies concerns expressed by nurses attending an oncology conference that are related to those patient situations. Bioethical principles are described and include autonomy, beneficence, nonmaleficence, and justice. A decision-making model is provided as a tool to resolve ethical dilemmas.

Adult↗
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To know suffering.

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Anxiety↗
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A structured nondrug intervention program for cancer pain.

The management of cancer pain has been a primary focus in the authors' program of oncology nursing research. A study currently in progress entitled, "Assessment and Management of Pain for Elderly Cancer Patients at Home," applies knowledge of the authors' earlier work in an educational nursing intervention for patients with cancer and their family care-givers in the home. The program consists of three parts: (1) an overview of pain, (2) pharmacologic management of pain, and (3) nondrug interventions for pain. The nondrug component of this program is particularly unique in providing structured implementation of nonpharmacologic techniques, which are often neglected in pain management. Five categories of nondrug intervention are used including heat, cold, massage/vibration, distraction, and relaxation. The purpose of this article is to report on the development and initial results of the nondrug portion of a pain education program.

Analgesia↗
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Portraits of cancer survivorship: a glimpse through the lens of survivors' eyes.

Cancer survivorship is a tumultuous experience of balancing the elation of surviving life-threatening illness with the demands of chronic health concerns and altered life meaning. Increased awareness of the needs of cancer survivors is enhanced by large studies of this growing population, but also by appreciation of individual stories of survivorship. "Portraits" of survival, in the form of personal narratives, contribute to our understanding of the experience of cancer. Select portraits from a study exploring quality of life in cancer survivorship are shared to convey themes of rendering an old life, transition to a different life, and living an altered life after cancer diagnosis.

Adaptation, Psychological↗
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Quality of life in breast cancer.

PURPOSE: Currently, 1,721,700 women are living with breast cancer in the United States. As the number of survivors of breast cancer continues to rise, so must our knowledge about unique quality-of-life concerns. This article reports the results of a study on quality of life in women with breast cancer and validates the model of quality of life in this population. DESCRIPTION OF STUDY: To explore these concerns and to validate a breast cancer quality-of-life model, 21 survivors of breast cancer, across three age strata (younger than 40 years, 40 to 60 years, and older than 60 years), were interviewed and asked to complete quantitative surveys on pain and quality of life. RESULTS: Across all age groups, unique issues of survivorship include those related to physical, psychological, social, and spiritual well-being. In the domain of physical well-being, the areas of worst outcome were in menstrual changes and fertility, fatigue, and pain. In the domain of psychological well-being, predominant needs were in the areas of fear of the spread of cancer, distress from surgery, recurrence, fear of second cancer, impact on self-concept, and fear of future tests. The social well-being subscale identified the greatest disruption in the area of family distress. The spiritual well-being subscale showed greatest disruption in the area of uncertainty, although other aspects of this domain were usually rated in a positive direction (e.g., importance of religious activities). CLINICAL IMPLICATIONS: The data demonstrated the need for further research, assessment, and intervention across each of the quality-of-life domains. There is a significant need to address physical problems; however, the psychological domain demonstrated the greatest area of distress. The multidimensional needs of breast cancer survivors emphasize the need for multidisciplinary collaboration.

Adult↗