The University of Rochester Pain Center's Second Annual Hugh Cumming Memorial Teaching Day on Cancer Pain. Cancer pain and the war on drugs.
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Drug and Narcotic Control↗
Biomedical subjects
D Greene
Publications and source records attributed to D Greene.
The use of service learning in client environments to enhance ethical reasoning in students.
OBJECTIVES: This study examined the effects of two service-learning experiences on the psychosocial and moral reasoning development of occupational therapy students. The assumption was that ethical reasoning ability can be facilitated through participation in value-laden experiences. METHOD: Participants visited older adults in nursing homes (n = 19) or interacted with persons with disabilities in community settings (n = 33). All participants reflected on their experiences through weekly journals. Psychosocial and moral reasoning development were measured at the beginning and end of the experiences with the Student Development Task and Lifestyle Inventory and the Sociomoral Reflection Measure-Short Form. RESULTS: Participants in both groups exhibited a significant time-related increase in psychosocial development but no increase in moral reasoning. Participants interacting with persons with disabilities exhibited a decrease over time in moral reasoning compared with the participants interacting with older adults. CONCLUSION: Service learning effected a change in the participants' psychosocial development indicative of developing an appreciation for dignity, equality, and justice. These are core concepts in occupational therapy and are viewed as important in ethical reasoning. The lack of advancement and current level of moral reasoning in these undergraduate students raises a question as to their readiness to engage in ethical reasoning as entry-level practitioners.
Activities of Daily Living↗
Nursing care by telephone: describing practice in an ambulatory oncology center.
Ambulatory oncology nursing care focuses on providing patients and families with the knowledge and resources needed to manage the symptoms of disease and the side effects of treatment. Nurses practicing in ambulatory care settings have limited face-to-face interaction with patients and families. As a result, telephone contact is used to give information, provide encouragement, and assess the patient's condition. To develop and test methods of delivering care to oncology patients by telephone, current practices must be documented. This study describes the use of the telephone in ambulatory oncology nursing in one patient care setting. Over a six-month period, nurses reported on 1,844 patient calls. Data collected on these telephone calls included: duration, initiator, purpose, nurse's assessment of urgency level, impact on the nursing care plan, and changes made in the use of healthcare services. The Outcome Standards for Cancer Nursing Practice of The American Nurses' Association and the Oncology Nursing Society most frequently addressed during the calls were information, comfort, and coping. Nurses in this setting functioned independently, handling 91% of the calls they received and using consultation for 52% of the calls.
Adaptation, Psychological↗
A comparison of patient-reported side effects among three chemotherapy regimens for breast cancer.
Patient's perceptions of side effects and the influence of treatment on daily activities are important considerations in choosing a chemotherapy regimen. However, there are no studies comparing patients' experiences with three commonly used chemotherapy regimens for breast cancer. The authors compared the patient-reported side effects and disruption in usual activities for cyclophosphamide and fluorouracil combined with methotrexate (CMF), doxorubicin (CAF), or mitoxantrone (CNF) in 86 women receiving treatment for breast cancer. The incidence and severity of side effects and disruption in usual activities were recorded by patients in a self-care diary (SCD) 2 and 5 days after the first and second drug cycles. Patients reported a mean of 3.2 to 4.9 side effects at each point in time. Fatigue, nausea, anorexia, taste changes, and headache were the most frequently reported side effects and did not differ in incidence among the three drug regimens. When repeated measures analysis of covariance was conducted using mean substitution for missing data and controlling for stage of disease, women receiving CAF reported more severe nausea than women receiving CMF or CNF (P < 0.05). Fatigue was significant for time; however, a distinct clinical pattern of fatigue was not apparent. Patients reported moderate levels of disruption in activities of daily living, with those receiving CAF having greater disruption. There was no difference among treatment groups in reports of overall disruption in activities. These data on patient reported experiences with side effects of chemotherapy can be used to prepare patients for specific side effects of treatment and facilitate symptom management.
Activities of Daily Living↗