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Biomedical subjects

L Sarna

Publications and source records attributed to L Sarna.

At least 37 records · Page 2Linked to original sources
PubMed1994

Weight change and lung cancer: relationships with symptom distress, functional status, and smoking.

The pattern of weight change (at five 6-week intervals beginning 2 months after diagnosis of advanced disease) is described in adults with progressive lung cancer (N = 60). Weight loss of 10% or more at study entry occurred in 35% of subjects; 37% lost weight at three or more intervals; and 25% lost weight at only one interval. Pre-illness weight loss was moderately correlated with subsequent decreased functional status (Enforced Social Dependency Scale) at Times 1, 2, and 3 (r = -.49, r = -.43, r = -.48, p < .001). Weight loss correlated with subsequent increased symptom distress (Symptom Distress Scale, SDS) at three times (Times 2, 4, and 5: r = -.34, r = -.30, r = -.43, p < .05). Chemotherapy (50% of subjects) and smoking (25% at study entry) predicted weight loss from Time 1 to 5, explaining 28% of the variance.

Adenocarcinoma↗
PubMed1994

Functional status in women with lung cancer.

Lung cancer remains the number one cause of cancer-related death and the third most common cancer for women in the United States. The major purpose of this study was to describe physical functional status in a sample of women with lung cancer. Functional status was objectively measured by the Karnofsky Performance Status Scale, and subjectively by the Rand Physical Function Scale, and the Physical Function Subscale of the CARES-Short Form. A convenience sample of 69 women participated in a one-time data collection. The typical subject was < 65 years of age, had lived with primary or recurrent lung cancer for > 12 months, had non-small cell limited disease, and was not currently receiving treatment. The most prevalent disruptions in physical function were reduced energy (59%), difficulty with household chores (33%), and interference with work (28%). A third of the sample had serious limitations in three or more activities. Approximately 26% of the sample had severe limitations in moderate activities, 20% in walking short distances, and 16% in walking one flight of stairs. Only a quarter were satisfied with their level of activity. Physical function was different by income category (one-way analysis of variance), with those with the lowest income having the poorest function.

Activities of Daily Living↗
PubMed1993

Women with lung cancer: impact on quality of life.

The purpose of this study was to describe disruptions in quality of life (QOL) in women suffering from lung cancer, the leading cause of cancer-related death in the United States. QOL was measured with the CARES-SF. Symptom distress was measured with the modified Symptom Distress Scale, and functional status was measured with the Karnofsky Performance Status Scale. Sixty-nine women with lung cancer participated in a one-time data collection. The typical subject was under 65 years of age, married, has had primary or recurrent non-small cell lung cancer for over 12 months, had limited disease, and was not currently receiving treatment. Subjects had greater disruptions in global QOL and its dimensions compared to a normative heterogeneous female cancer sample. The most prevalent serious disruptions were fatigue, difficulty with household chores, worry about ability to care for self, and worry about cancer progression. The global CARES-SF score was moderately correlated to functional status (r = 0.69, p = < 0.001), and to symptom distress (r = 0.72, p = < 0.001). Symptom distress was associated strongly with the physical subscale of QOL (r = 0.80, p = 0.001) and significantly but less strongly with all other dimensions of QOL. Significantly greater differences in disruptions of quality of life occurred in women younger than 65 years (p = 0.04), women with recurrent disease (p = 0.003), and women with low income (p = 0.008). In stepwise regression, symptom distress predicted 53% of the variance followed by functional status (59%) and recurrence (63%) when QOL was the outcome variable.

Activities of Daily Living↗
PubMed1993

Fluctuations in physical function: adults with non-small cell lung cancer.

Disruptions in physical activities (functional status) were measured over a 1-month period in 24 patients with non-small cell lung cancer with the Karnofsky Performance Status Index and two patient self-report measures. Changes over time were noted for the whole group, and mean scores of the treated subgroup were compared with an untreated cohort. Prior weight loss was significantly associated with baseline functional status. Age was not significantly associated with degree of functional disruption, though 42% of the sample was aged 65 years or older. The greatest disruptions in physical activity were noted in ambulation. A third of the sample had difficulty walking one block or more. Serious fatigue was experienced by 79% of the subjects and 44% had difficulty with household chores. Only 21% were completely satisfied with their level of activity. Pain improved in the treated subjects over time. Despite no significant differences at baseline, untreated subjects had more limitations in physical activities than treated subjects over time. All three instruments were significantly correlated. Careful monitoring of physical difficulties may help nurses focus interventions and decrease the physical distress associated with illness and treatment. In this study, those receiving chemotherapy did not experience significantly greater physical dysfunction. In fact, the untreated patients, who might not receive vigilant nursing assessment, demonstrated greater physical decline.

Activities of Daily Living↗
PubMed1993

Nutritional intake, weight change, symptom distress, and functional status over time in adults with lung cancer.

The purpose of this descriptive longitudinal study was to describe the relationship of nutritional intake to weight change, symptom distress, and functional status over a six-month period in 28 subjects with progressive lung cancer. The majority of the subjects had non-small cell lung cancer and had lost less than 10% of their body weight at the time of study entry. Body weight, hunger, symptom distress, and functional status were measured every six weeks, beginning two months after diagnosis, for a six-month period. Three-day diet records, which were completed immediately prior to each time point, were averaged to obtain nutrient intake data. Average weight change and nutritional intake showed little variation over time, but the ranges were large. Lower intake of kilocalories was moderately related to functional status at Times 1 and 5 (r = -0.56; r = -0.66, respectively). Kilocalorie intake at a previous time was related to subsequent functional decline at two of the six-week data points (r = -0.71; r = -0.75). Weight change was not directly related to kilocalorie intake. Percentage of weight loss over time was greater in subjects younger than 65 years of age, in those with small cell lung cancer, and in those who received chemotherapy. Symptom distress and symptoms of hunger, nausea, and appetite disturbance showed subtle fluctuations over the six-month period and had inconsistent relationships with food intake over time. Further study is needed to describe nutritional changes that follow a diagnosis of lung cancer and to identify areas for nursing intervention.

Activities of Daily Living↗
PubMed1991

Sodium dodecyl sulphate-polyacrylamide gel electrophoresis of human parotid salivary proteins.

The proteins in human parotid saliva have been separated by sodium dodecyl sulphate-polyacrylamide gel electrophoresis into 20 or more well resolved species. The Coomassie Brilliant Blue (CBB) R-250 and silver staining procedures have been modified to overcome the problems encountered with staining of proline-rich proteins. By means of the CBB R-250 procedure which stains proline-rich proteins pink-violet, immunoblotting, concanavalin A binding, periodate-Schiff staining and zinc binding, all of the major proteins have been characterised. Substantial individual-to-individual differences were observed in the protein patterns formed. Comparison of parotid, submandibular, and whole saliva from a single individual indicated that fewer proline-rich proteins are expressed in submandibular saliva than in parotid, but whole saliva contains much lower levels than either duct secretion. The results will form a useful base for future research into the functions of salivary proteins.

Electrophoresis, Polyacrylamide Gel↗
PubMedDate not supplied

Dimensions of symptom distress in women with advanced lung cancer: a factor analysis.

OBJECTIVE: To explore the structure of symptom distress in women with advanced lung cancer. DESIGN: Descriptive. SETTING: Oncology clinics and private offices. SUBJECTS: Sixty women with advanced lung cancer (71% non-small-cell); the majority received palliative treatment (88%). OUTCOME MEASURES: Symptom Distress Scale and Karnofsky Performance Status Scale. METHOD: Factor analytic techniques (principal components, varimax rotation) to investigate combinations of all symptoms in the Symptom Distress Scale and combinations of serious symptoms. RESULTS: Fatigue, disruptions in outlook, frequent pain, and difficulties in sleeping were rated the most distressing and were the most prevalent serious disruptions. A four-factor solution for the symptom distress ratings explained 63.3% of the variance and revealed groups of items representing emotional and physical suffering, gastrointestinal distress, respiratory distress, and malaise. Symptoms with a rating of serious distress were represented by five factors with emotional and physical suffering as separate factors. Symptoms were significantly related to Karnofsky Performance Status. CONCLUSIONS: Multiple symptoms formed distinct congregations of distress. Symptom control requires consideration as a multivariate approach.

Adult↗
PubMedDate not supplied

Cancer screening among Korean Americans.

PURPOSE: Cancer is a leading cause of death among Korean Americans (KAs), one of the most rapidly growing ethnic minority communities in the United States. An understanding about cancer screening practices among Koreans (Ks) living in Korea can be useful in designing culturally sensitive health promotion programs in the United States. The purpose of this study was to describe the cancer screening knowledge and behaviors of a sample of KAs in Los Angeles, California, compared with a similar sample of Ks in Korea. DESCRIPTION OF STUDY: This descriptive survey used a convenience sample of 140 KAs age 40 and older, living in Los Angeles, California, in 1998. A random sample of 149 Ks from Pusan, Korea, in 1995 to 1996 was used as a comparison group. KAs had lived in the United States for an average of 15 years. A Korean and English language 58-item self-administered questionnaire assessed knowledge of cancer screening tests and personal cancer screening practices. RESULTS: The findings demonstrate that both KAs and Ks had low participation in cancer screening. Breast cancer screening was significantly more likely among KA women than among Ks; screening rates for cervical cancer and gastrointestinal malignancies were not significantly different between the two groups. CLINICAL IMPLICATIONS: These data can be used to assist healthcare professionals in the development of educational tools and strategies for promoting cancer screening programs for KAs. The unique contribution of this study was the opportunity to compare findings from an immigrant Korean population with a similar population in the country of origin.

Adult↗
PubMedDate not supplied

Mammography screening behavior in older women caregivers.

The purposes of this study are to explore older caregivers' mammography participation and the facilitators and barriers to mammography screening. Of the 52 older female caregivers with a mean age of 65 years (range 50-90) interviewed by telephone, 80.8% had had a mammogram within 12 months. Significant facilitators included health care provider recommendation and beliefs in the efficacy of treatment. Significant barriers included health care providers' failure to recommend mammograms, caregiver procrastination, fear of pain, and lack of symptoms. Caregivers with higher burden reported less frequent self- and provider-conducted breast examinations.

Aged↗
PubMedDate not supplied

Quality of life in patients with heart failure: do gender differences exist?

OBJECTIVE: The purpose of this study was to evaluate gender differences in quality of life (QOL) in a large sample of age-matched and ejection fraction (EF)-matched patients with heart failure. DESIGN: Matched comparisons of secondary data were used. SETTING: The setting consisted of multicenter Studies of Left Ventricular Dysfunction trials. SAMPLE: The sample included 1382 patients (691 men and 691 women) who were age-matched and EF-matched. OUTCOME MEASURES: Global QOL and the QOL dimensions of physical function, emotional distress, social health, and general health were measured using the Ladder of Life, items from the Profile of Mood States Inventory, the Functional Status Questionnaire, the beta-Blocker Heart Attack Trial instrument, and an item from the RAND Medical Outcomes Study instrument. RESULTS: Women had significantly worse general life satisfaction, physical function, and social and general health scores than men. There were no significant differences found between gender groups for current life situation or emotional distress. After controlling for New York Heart Association classification, women still had significantly worse ratings for intermediate activities of daily living (a sub-dimension of physical functioning) and social activity. CONCLUSIONS: Despite controlling for age, EF, and New York Heart Association classification, women had worse QOL ratings than did men for intermediate activities of daily living and social activity. Research should focus on identifying why differences exist and developing measures to improve QOL, particularly physical functioning, in women with heart failure.

Female↗
PubMedDate not supplied

Barriers to tobacco cessation in clinical practice: report from a National Survey of Oncology Nurses.

This study describes the survey results of a national random sample of members of the Oncology Nursing Society who reported the greatest number of barriers to delivering a tobacco cessation intervention with their patients. Nurses who perceived the greatest number of barriers were more likely to be current smokers and to be young and were less likely to have an advanced degree, to be a nurse practitioner, or to have administrative responsibilities. Those with greater barriers were less likely to deliver tobacco cessation interventions.

Adult↗
PubMedDate not supplied

Emotional distress in women with symptomatic HIV disease.

This article describes emotional distress in 44 women with Human Immunodeficiency Virus (HIV) symptomatic disease. Measures of self-reported symptoms of anxiety and depression revealed that emotional distress was prevalent in this group and may be sufficiently robust to warrant clinical diagnoses. Limits to functioning and disruptions in physical well-being were found to be associated with both anxiety and depression. Additionally, level of optimism was inversely related to anxiety and depression, and social support was inversely related to anxiety. These findings indicate that emotional distress in women with HIV disease is associated with, and could be ameliorated by, interventions targeted at functional status, social support, and level of optimism.

Activities of Daily Living↗
PubMedDate not supplied

Smoking status among women in households with young children.

PURPOSE: To identify sociodemographic and health related correlates of smoking status among women in households with young children. DESIGN: A secondary analysis of the 1992 California Behavioral Risk Factor Surveillance System public-use data tape. PARTICIPANTS: Women (N = 520) in households with very young children (< or = 5 years of age). MAIN OUTCOME MEASURES: Current smoking status. RESULTS: Approximately 18% were current smokers; more than 40% smoked more than 10 cigarettes each day. A majority of smokers indicated a high level of nicotine addiction, but had plans to quit. Smoking prevalence varied by sociodemographic variables with higher rates for unmarried, less than college educated, and unemployed participants. Health status also was related to smoking, with higher rates among those with poor health and those limited in activities. CONCLUSIONS: Smoking is one way of coping with the stressors of daily life, including those associated with caring for young children. Special cessation efforts may be needed for the unemployed, the unmarried woman, and for those in poor health.

Adult↗