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Biomedical subjects

Elizabeth Ann Coleman

Publications and source records attributed to Elizabeth Ann Coleman.

10 recordsLinked to original sources

Use of a supportive care team for screening and preemptive intervention among multiple myeloma patients receiving stem cell transplantation.

Although peripheral blood stem-cell transplantation (PBSCT) has assumed a growing role in the treatment of multiple myeloma, very few studies have examined the functional and quality-of-life changes experienced by myeloma patients in the transplant setting. Multiple myeloma is characterized by a range of debilitating physical and psychosocial symptoms. However, supportive care needs for patients with this disease are often overlooked or managed only episodically. The current study pilot-tested an interdisciplinary supportive care program designed to provide screening and identify patients at risk early in the course of care. Participants in this pilot project were 61 patients with hematological disorders, predominantly multiple myeloma (85.3%), evaluated during their initial workup. Mean time since diagnosis was 7.4 months. Participants were interviewed by an advanced-practice nurse and completed standardized measures of heath-related quality of life (SF-12), fatigue (POMS-Fatigue), nutritional risk (PG-SGA), pain (Brief Pain Inventory), emotional functioning (Hospital Anxiety and Depression Scale), and sexual concerns (FACIT). Results indicated that difficulties were prevalent across multiple functional domains; 61.4% of patients displayed significant nutritional deficits. Physical functioning was below age-adjusted national norms for 53.5%. Moderate-to-severe fatigue was reported by 39.0%, and one third experienced clinically significant levels of pain, impaired daily functioning associated with pain, and emotional distress. A similar proportion of respondents (33.9%) reported disrupted sexual functioning and difficulty with body image. Findings suggest that early, systematic screening is feasible in a busy transplant center. The prevalence of symptoms highlights the importance of providing screening and proactive intervention for multiple myeloma patients early in the course of treatment and even prior to beginning protocols for high-dose therapy and transplantation.

Aged↗

Strategies for increasing physicians', nurses', and mammography technicians' participation in research.

BACKGROUND: Breast cancer screening in physicians' daily practices needs greater emphasis. Increasing provider participation in research in this area can be a challenge as demonstrated in our study to test interventions targeting rural health care providers. METHOD: Recruitment methods for the randomized controlled trial involving 27 counties in the Mississippi River Delta region of Arkansas included the following: introductory letters and return postcards, mailed questionnaires, telephone calls, attendance at local medical staff meetings, and telephoning the primary care offices to set a time to meet the providers at their practice sites. This final recruitment strategy of telephoning the primary care offices and arranging with the office manager to bring a CME/CEU credit program included an on-site demonstration of a CBE technique and a free lunch. RESULTS: Only the final strategy yielded provider participation for the study and was more successful in the experimental than the control counties. Providers in the control group could not receive the education program until after their post-test. CONCLUSION: Successful approaches to enrolling physicians and nurses in a study involve careful use of their time and providing benefits.

Allied Health Personnel↗

General characteristics and experiences of specialized standardized patients: breast teaching associate professionals.

BACKGROUND: Standardized patients and teaching associates provide, reinforce, and evaluate the teaching of clinical skills to students and health care providers. As new needs and roles emerge for this method of teaching and evaluation, information is needed for recruitment, training, and retention. METHODS: This article addresses the general characteristics and experiences of 12 Breast Teaching Associate Professionals (BTAPs) in a two-year NCI-funded study aimed to improve breast cancer screening practices of rural primary health care providers in Eastern Arkansas. RESULTS: Areas of focus are demographic characteristics, motivations for serving as BTAPs, their perceptions of the advantages and disadvantages of the BTAP role, and the influence or impact the role had on their own health behaviors or personal lives. CONCLUSION: The evolving commitment to the value of this method of teaching and to health care education on this campus became stronger for many of the women as participation continued into other projects with further learning and specialization.

Adult↗

Botulism.

Explore the source record for details and available documents.

Bioterrorism↗

Symptom management and successful outpatient transplantation for patients with multiple myeloma.

This retrospective descriptive study compared symptoms and symptom management in patients who completed autologous peripheral blood stem cell transplantation without hospital admission with those of patients who required unplanned hospital admission during the transplantation period. The sample consisted of 87 patients with multiple myeloma treated as outpatients during a 16-month period. Medical records and electronic database records review for each patient provided data on patient characteristics, medical factors, and symptoms/symptom management. Neither age, gender, religion, payer source, treatment on or off protocol, nor positive blood culture made a difference in hospital admission. The percentage of outpatient visits that included documented teaching on self-care made a significant difference (P = .008). Longitudinal analyses of patients' documented symptoms before admission compared with nonadmitted patients captured changes over time in symptoms/symptoms management. Overall, the patients' symptoms were managed well. Significant differences were fatigue, measured as the percentage of usual energy (P = .017), and the amount of oral hydration in a 24-hour period (P < .001). Results call attention to the role that fatigue and the amount of oral hydration may have in unplanned hospital admissions and to the importance of teaching on self-care.

Adult↗

An analysis of telephone interview data collected in 1992 from 820 women who reported problems with their breast implants to the food and drug administration.

How health care providers deal with concerns and feelings of women who have problems with their breast implants affects the women's satisfaction with their breast implants, yet in 1992 little was known about the concerns and feelings of these women. A qualitative analysis of in-depth telephone interviews conducted in 1992 with 820 women from all regions of the United States who reported problems with their breast implants to the Food and Drug Administration and responded to an invitation to be interviewed provided data. Respondents were primarily 40 to 69 years of age at the time of interview, Caucasian, married, and educated beyond high school. The sample was almost equally divided in reason for breast implants, with 65 percent being dissatisfied with their breast implants. Nearly all of the women had heard of problems with silicone gel-filled implants. Their main sources of information were television, newspapers, and magazines rather than their physicians or the breast implant manufacturers. Some women tried to avoid hearing the reports, and many tried to put the reported problems out of their minds. However, a majority (88.7 percent) wanted more information. The women expressed feelings of anger, regret, and worry, and repeatedly said they needed more information. Women who contacted the Food and Drug Administration about breast implant problems needed accurate and honest information from health care professionals. They wanted their physicians to explore their symptoms, fears, and concerns.

Adult↗

Developing and testing lay literature about breast cancer screening for African American women.

Written materials about breast cancer screening for African American women with low literacy skills are needed. Available materials were not at or below third-grade reading levels, were not culturally sensitive, and were not accurate in illustrating correct breast self-examination (BSE) techniques. Focus groups representing the target population helped the authors design a pamphlet describing how to perform BSE and a motivational picture book to help women overcome barriers to screening. The authors chose a food theme for the cover of the pamphlet written at a third-grade level and suggested a photographic version. In the motivational book, two women address barriers to screening and replace myths and fears with facts and actions. Data from 162 women showed that they learned from both the photographic and illustrated versions. Women in the photographic group found significantly more lumps in the silicone models, so the authors chose that version to use in final testing. Finally, nurses pretested a group of patients before they reviewed the materials and post-tested another group after they reviewed them. The group who had reviewed the materials had greater knowledge of and intent to follow the guidelines and received higher scores on BSE techniques.

Adult↗

The Delta project: increasing breast cancer screening among rural minority and older women by targeting rural healthcare providers.

PURPOSE/OBJECTIVES: To test a multimethod approach designed for rural healthcare providers to increase breast cancer screening among low-income, African American, and older women. DESIGN: Two-year experimental pretest/post-test with random assignment by group. SETTING: Primary healthcare providers' offices. SAMPLE: 224 nurses, physicians, and mammography technicians. METHODS: Standardized patients to observe and record healthcare providers' performances, followed by direct feedback, newsletters, posters, pocket reminder cards, and lay literature about screening to use in clinics. MAIN RESEARCH VARIABLES: Healthcare providers' knowledge and attitudes as measured by survey responses, skills as measured by a checklist, and the provision of breast cancer screening as measured by mammography facilities' data. FINDINGS: Healthcare providers significantly improved in demonstration of breast cancer screening practice after the intervention. Nurses performed significantly better than physicians on the breast examination during the post-test. More women older than 50 received mammograms in the experimental counties than in the comparison counties. Culturally sensitive lay literature is needed for African American women with low literacy. CONCLUSIONS: Successful interventions included use of standardized patients to teach healthcare providers in their office settings, prompts such as posters and pocket reminder cards, and easy-to-read newsletters. IMPLICATIONS FOR NURSING: Physicians and nurses play a powerful role in motivating women to have mammograms and clinical breast examinations and to practice breast self-examination. Interventions that help these providers fulfill that role should be implemented.

Adult↗