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Biomedical subjects

D Y Brockopp

Publications and source records attributed to D Y Brockopp.

At least 19 recordsLinked to original sources
PubMed2004

Nurses' clinical decision-making regarding the management of pain.

Effective pain management remains an elusive goal within the profession of nursing. While considerable improvement has occurred, patients continue to experience inappropriate levels of pain. To date, research has focused on objective factors that influence pain management. Few studies have examined attitudinal factors that may influence nurses' decision-making. This quasi-experiment was based on preliminary data showing that nurses' preconceived notions regarding certain patient groups influenced their management of pain. An intervention was tested for its' effect on nurses' preconceived notions regarding specific patient groups. A significant difference in a positive direction was found. Nurses were more willing to spend time and energy managing pain across all patient groups following the intervention.

Adult↗
PubMed2001

Hope among patients with cancer hospitalized for bone marrow transplantation: a phenomenologic study.

This article describes a phenomenologic study designed to further an understanding concerning the concept of hope in a purposive sample of nine patients with cancer hospitalized for bone marrow transplantation. The strategies these patients use to sustain and foster hope are examined. Data collection consisted of a one-time semistructured interview using open-ended questions. A phenomenologic-hermeneutic approach to data analysis was used to identify major themes. The findings showed that participants used six strategies to foster their hope during preparation for BMT: feeling connected with God, affirming relationships, staying positive, anticipating survival, living in the present, and fostering ongoing accomplishment. Religious practices and family members were the most frequently identified sources of hope. The findings of this study provide a base for the improvement of nursing practice.

Adult↗
PubMed2001

Quality of life one year following bone marrow transplantation: psychometric evaluation of the quality of life in bone marrow transplant survivors tool.

PURPOSE/OBJECTIVES: To examine a comprehensive view of quality of life (QOL) post-bone marrow transplant (post-BMT) and to evaluate the psychometric properties of an instrument designed to measure QOL in this population. DESIGN: Cross-sectional, descriptive, mailed survey. SETTING: A large, major BMT referral center for central, eastern, and southern Kentucky. SAMPLE: 41 BMT survivors with an age range of 18-71 years who were an average of 30 months post-BMT. METHODS: Seven mailed questionnaires, including an investigator-developed demographic questionnaire and the Quality of Life in Bone Marrow Transplant Survivors Tool (QOL-BMT-ST). MAIN RESEARCH VARIABLES: QOL, BMT treatment, sexual activities, employment, and uncertainty. FINDINGS: Global QOL was good (x = 6.4 on a 0-10 scale). Subjects experienced several long-term areas of concern: physical strength, sexual activities, fear of cancer recurrence, fear of developing a secondary cancer, unemployment, family distress, and uncertainty toward the future. Psychometric testing of the QOL-BMT-ST revealed adequate to excellent reliability and validity. CONCLUSIONS: Most BMT survivors reported few long-term disruptions and above average QOL. The QOL-BMT-ST has a promising utility in clinical trials. IMPLICATIONS FOR NURSING PRACTICE: Individually structured pre- and post-BMT assessment of physical, psychosocial, and spiritual functioning is significant in identifying vulnerable patients and treating them accordingly.

Adaptation, Psychological↗
PubMed1999

Self-transformation as a factor in the self-esteem and well-being of breast cancer survivors.

Diagnosis with a life-threatening illness can lead to many changes in one's self. These changes, called self-transformation, are not well understood. The present study used triangulation of methods and measures to (i) describe individual differences in self-transformation among breast cancer survivors, (ii) examine factors associated with self-transformation in breast cancer survivors, and (iii) examine the relationships between self-transformation and self-esteem and well-being in breast cancer survivors and age-matched comparison women without cancer. Cancer survivors (n = 60) participated in structured interviews and both survivors and comparison women (n = 60) completed a set of questionnaires. Narrative analysis revealed three categories of transformation among breast cancer survivors: positive transformation, minimal transformation and feeling stuck. These groups differed by age, marital status and income, but not by disease or treatment variables. Breast cancer survivors in the positive transformation group had significantly higher self-esteem and well-being in comparison with (i) survivors grouped as feeling stuck and (ii) age-matched counterparts without cancer. Cancer survivors who reported feeling stuck had significantly lower self-esteem and well-being than the other groups of survivors and lower well-being in comparison with healthy women of the same age. Findings provide support for the concept of self-transformation and a new understanding of disease, demographic and treatment factors associated with the concept. Findings also suggest that self-transformation may be a factor in the self-esteem and well-being of breast cancer survivors.

Adaptation, Psychological↗
PubMed1998

Barriers to change: a pain management project.

Although considerable effort has been directed toward improving the management of acute pain, ineffective pain management practices remain in many institutions across this country. While educational efforts have increased health care providers' knowledge regarding the management of pain, a concomitant change in practice has not occurred. This project was designed to examine barriers to the effective management of pain encountered in acute care settings. A repeated case study of attempts to change was conducted in six institutions located in the southeastern United States. Results identified seven major barriers to pain management: lack of knowledge, non-facilitative attitudes, inconsistent leadership, poor working relationships, cultural and religious biases, physicians' fears of legal repercussions and a lack of resources.

Acute Disease↗
PubMed1996

Elderly hospice patients' perspective on pain management.

The literature reports that 70% of cancer patients with advanced disease experience pain. Even with increased emphasis on research and education, problems with effective pain management are still evident. Hospice patients' knowledge and attitudes about pain may contribute to this complex problem. To gain an understanding of hospice patients' perspective on the management of pain, 57 hospice patients were asked to describe their knowledge of pain management and their attitudes toward controlling pain. Results showed non-facilitative attitudes and gaps in knowledge that may contribute to ineffective pain management among hospice patients.

Aged↗
PubMed1994

Evaluation of self-esteem of women with cancer receiving chemotherapy.

PURPOSE/OBJECTIVE: To examine the concept of self-esteem as it relates to female patients with cancer before diagnosis and while experiencing chemotherapy-induced alopecia. DESIGN: Descriptive-analytic. SETTING: Oncology unit of a community hospital and an outpatient oncology clinic in a southeastern city of the United States. SAMPLE: 30 women receiving chemotherapy and who have experienced some degree of alopecia. METHODS: Subjects answered demographic questions and were evaluated for degree of hair loss. Subjects completed the Cantril Self-Anchoring Scale (CSA) on the day of the interview and retrospectively prior to their diagnosis. In addition they completed the Rosenberg Self-Esteem Scale (RSE). MAIN RESEARCH VARIABLES: Self-esteem, change over time, degree of alopecia, length of time since diagnosis. FINDINGS: A significant decrease in self-esteem from before cancer diagnosis levels to time of experiencing chemotherapy-induced alopecia; modest correlation between the CSA and the RSE. Four categories of characteristics (physical, spiritual, psychological, social) influencing self-esteem emerged from analysis of the CSA responses. CONCLUSIONS: Self-esteem was not stable in this group of women. Postdiagnosis levels were lower than those before the diagnosis; however, lower levels did not necessarily translate into low self-esteem. The CSA may be a more comprehensive and sensitive measure of self-esteem in patients with cancer because it is based on individual definitions of high and low self-esteem. IMPLICATIONS FOR NURSING PRACTICE: Understanding what specifically may lower an individual's self-esteem can be useful in identifying patient-specific interventions. Future research must explore ways to determine self-esteem consistently and easily.

Adult↗
PubMed1993

Nursing knowledge: acute postoperative pain management in the elderly.

1. The inadequate management of acute postoperative pain among adults is well documented. Studies have shown that 75% or more of hospitalized adult patients following surgery suffer moderate or intense pain even with the use of analgesics. Also, physicians under-prescribe narcotic analgesics and nurses administer less than the patient could receive. 2. Nurses' ineffective approaches to the management of pain have been attributed to inappropriate fears of addiction and respiratory depression, rigid attitudes regarding what constitutes adequate pain relief, and misunderstandings about the physiologic and psychologic components of pain. 3. The results of this study support McCaffery's (1989) finding that nurses do not understand the effective use of narcotics in relation to pain management.

Adult↗
PubMed1992

The role of prior pain experience and expectations on postoperative pain.

The present study was designed to examine previous pain experiences as they relate to expectations of postoperative pain. In the study, 101 patients aged 55-87 (47 men, 54 women) participated in a structured interview that examined 13 factors thought to be associated with presurgical expectations of postsurgical pain. These factors relating to prior pain experience were identified from the literature as well as the experience of clinicians in the areas of anesthesiology, nursing and psychology. The two variables that correlated significantly (multiple r = 0.51) with pain expected postoperatively were: a single item from the general attitude questionnaire about pain (pain is to be expected after surgery even with medicine) and the total of the global ratings of past pain experience. A follow-up study will examine these variables in relation to actual pain experience.

Aged↗
PubMed1992

Patients' knowledge of their caregivers' names. A teaching-hospital study.

In busy hospitals--particularly teaching hospitals--ensuring that patients know the names of those attending them is a task often given low priority. Yet such knowledge is a crucial element in establishing the high-priority patient-provider relationship, and certainly one within hospitals' control. In a university teaching hospital, the authors tested patients' knowledge of names before and after the use of an information sheet listing their particular caregivers.

Awareness↗
PubMed1992

Fiscal and clinical evaluation of patient care. A case management model for the future.

The cost of healthcare within the United States continues to climb as does the number of individuals who have limited access to the healthcare system. By the year 2000, healthcare costs are predicted to comprise 15% of the gross national product. Over the last 10 years, the number of Americans who do not have financial protection from medical costs has risen dramatically. Presently, an estimated 35 million individuals have no insurance or other coverage.

Adult↗
PubMed1989

Personal control and the needs for hope and information among adults diagnosed with cancer.

Cancer patients inevitably experience situations in which their sense of personal control is diminished. Identifying the strategies used by these individuals to maintain or regain control can be an important component in the planning of care. This study examined the relationship between levels of perceived personal control and the needs for hope and information among 56 adult cancer patients. Subjects responded to the Needs Assessment Inventory and the Spheres of Control Scales. Data were analyzed using responses from the total group (n = 56), male subjects (n = 23), and female subjects (n = 33). Significant correlations were found between perceived level of control and eight issues related to hope and information-seeking.

Adult↗
PubMed1984

Eating disorders: a teen-age epidemic.

This article presents a personal and professional view of two eating disorders that are presently affecting large numbers of adolescents and young adults throughout the country. Bulimia and anorexia nervosa may be prevented and treated if the public receives sufficient and appropriate education.

Adolescent↗