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Biomedical subjects

M Grant

Publications and source records attributed to M Grant.

At least 91 records · Page 5Linked to original sources
PubMed1996

Young black males and trauma: predisposing factors to presentation in an urban trauma unit.

Young black males are disproportionately represented as patients in trauma units. Unemployment, low educational level, and family composition may predispose young black males to trauma unit admission. To test this hypothesis, 300 males between the ages of 18 and 40 admitted to the Cook County Hospital Trauma Unit were surveyed with respect to demographic data, family composition, educational level, and employment background. The majority of patients were black (87%) and unemployed (68%). The most common diagnoses were penetrating trauma (53.2%) and assault (33.5%). Highest unemployment and lowest educational levels were found among patients who were victims of penetrating trauma or assault. Sixty-six percent reported the presence of an adult male in the household while growing up, and 93% reported the consistent presence of their biological mother. There was a significant correlation between race, trauma mechanism, unemployment, low educational level, and family composition. Recognition and amelioration of the economic and educational inequities that may exist in this population might reduce the incidence of trauma significantly.

Adolescent↗
PubMed1995

Measurement of the quality of life in cancer survivors.

A QOL instrument was developed to measure the specific concerns of long term cancer survivors. The QOL-CS is based on previous versions of the QOL instrument developed by researchers at the City of Hope National Medical Centre (Grant, Padilla, and Ferrell). This instrument was revised over a one year pilot by Hassey-Dow and Ferrell. The revised instrument included 41 items representing the four domains of quality of life incorporating physical, psychological, social, and spiritual well being. The present study was conducted as a mail survey to the membership (n = 1,200) of the National Coalition for Cancer Survivorship with 686 subjects responding to the survey. This survey included a Demographic tool, QOL-CS and the FACT-G tool developed by Cella. Psychometric analysis, performed on 686 respondents, included measures of reliability and validity. Two measures of reliability included test-retest and internal consistency. The overall QOL-CS tool test-retest reliability was 0.89 with subscales of Physical r = 0.88, Psychological r = 0.88, Social r = 0.81, and Spiritual, r = 0.90. The second measure of reliability was computation of internal consistency using Cronbach's alpha coefficient as a measure of agreement between items and subscales. Analysis revealed an overall r = 0.93. Subscale alphas average ranged from r = 0.71 for spiritual well being, r = 0.77 for physical, r = 0.81 for social, and r = 0.89 for psychological. Several measures of validity were used to determine the extent to which the instrument measured the concept of QOL in cancer survivors. The first method of content validity was based on a panel of QOL researchers and nurses with expertise in oncology. The second measure used stepwise multiple regression to determine factors most predictive of overall QOL in cancer survivors. Seventeen variables were found to be statistically significant accounting for 91% of the variance in overall QOL. The fourth measure of validity used Pearson's correlations to estimate the relationships between the subscales of QOL-CS and the subscales of the established FACT-G tool. There was moderate to strong correlation between associated subscales including QOL-CS physical to FACT physical (r = 0.74), QOL-CS Psych to FACT Emotional (r = 0.65), QOL Social to FACT Social (r = 0.44). The overall QOL-CS correlation with the FACT-G was 0.78. Additional measures of validity included correlations of individual items of the QOL-CS tool, factor analysis, and construct validity discriminating known groups of cancer survivors. Findings demonstrated that the QOL-CS and its subscales adequately measured QOL in this growing population of cancer survivors.

Adult↗
PubMed1995

Survey of the provision of supportive care services at National Cancer Institute-designated cancer centers.

PURPOSE: The purpose of this survey was to determine the scope of supportive care services (SCS) designed to promote quality of life during cancer therapies at National Cancer Institute (NCI)-designated cancer centers. METHODS: A survey was mailed to the medical directors and nursing directors of 52 NCI-designated comprehensive (n = 26), clinical (n = 11), and planning cancer centers (n = 15) in the United States. Only one survey was completed from each institution. Survey questions identified services provided such as pain management, terminal care, psychosocial programs, and spiritual care. RESULTS: Thirty-nine questionnaires were received for a total response rate of 75%. Of the respondents, 45% were comprehensive cancer centers, 24% clinical cancer centers, and 29% planning centers. One center did not identify their NCI designation. Sixty-one percent of the centers reported research programs in supportive care. Outside funding was reported in 51% of the respondents, with 39% having American Cancer Society (ACS) or National Institutes of Health (NIH) funding and 28% having private industry funding. Overall SCS self-ratings improved from a 21% rating of excellent to very good 5 years ago to the current 54% rating. CONCLUSION: Survey results provide data on SCS across a representative sample of NCI cancer centers and can be used to develop standards for future cancer control programs.

Cancer Care Facilities↗
PubMed1995

An institutional commitment to pain management.

PURPOSE: To share the development, implementation, and evaluation of a program called "An Institutional Commitment to Pain Management," which is based on the philosophy of organizational influence on pain management. METHODS: A tested pain education model was disseminated to 32 physician/nurse teams in settings throughout California, after which the 64 professionals returned to their institutions to serve as role models and catalysts to change the practice of pain management. Each team member completed a 39-item survey about knowledge and attitudes related to pain, which was developed by B.R.F. and colleagues, and also identified three goals for the implementation of course information. Precourse data also included administration of the knowledge and attitudes survey to participating physicians' and nurses' colleagues (10 physicians and 20 nurses per institution). Each team completed five chart audits using the pain audit tool (PAT), which was developed by B.R.F. and colleagues at the City of Hope National Medical Center. The PAT identifies how pain is managed currently at the institutional level. Final course evaluation 8 months after course completion included a summary of activities implemented by the teams as well as the factors that served as barriers and benefits to improve the quality of pain management. RESULTS: Two hundred seventy-two physicians and 629 nurses completed the survey about knowledge and attitudes related to pain, and 154 PATs were submitted. These results, as well as evaluation at the completion of the course, are discussed. CONCLUSION: The Institutional Commitment to Pain Management program is an evolving model that was developed to overcome barriers to pain relief by obtaining the commitment from institutions to improve the management of pain for their patients.

Adult↗
PubMed1995

Unscheduled readmissions for uncontrolled symptoms. A health care challenge for nurses.

The purpose of this study was to measure the impact of nursing strategies to improve cancer pain management on hospital readmission for uncontrolled pain. Strategies include implementing a pain resource nurse program (PRN), making pain management a focus in the continuous quality improvement process of the institution and creating a supportive care service. Admissions were compared before and after implementation of the strategies. Results for 1989 to 1990 revealed 5772 total admission with 4.4% (255) admissions for uncontrolled pain; results for 1992 to 1993 revealed 4066 total admissions with 3.0% (121) admissions for uncontrolled pain. Findings indicate that strategies were effective in reducing the number of readmissions for uncontrolled pain.

Adolescent↗
PubMed1995

Not a business matter.

Some Canadians believe that turning Canada's public health care system into a privately based operation is the panacea for the health care debt. The Alberta government is at the forefront of this movement toward a privately managed, business-oriented health system.

Alberta↗
PubMed1995

Nurses' perceptions of the meaning of quality of life for bone marrow transplant survivors.

Nurses play an integral role in the care of bone marrow transplant (BMT) patients from pre-transplant to posttransplant. The purpose of this study was to explore the nurses' perceptions of the impact of transplant on the quality of life (QOL) of survivors. The conceptual framework for the study was the model of QOL developed by Ferrell, Grant, Schmidt, Rhiner, Whitehead, and Forman (1992). It depicts the QOL domains of physical well-being, psychological well-being, social concerns, and spiritual well-being. One hundred fifty nurses responded to a mailed survey. The items were based on the Quality of Life-BMT Survey used previously with patients. Nurses' and patients' responses to the same item were compared. Results reflect that transplant nurses generally perceived patients as having a poorer QOL than they actually reported. Nurses described transplant as having both positive and negative consequences. Transplant was seen as providing patients with a second chance at life and an opportunity to increase their QOL. Nurses described negative consequences as resulting from physical losses, psychological distress, financial distress, and loss of relationships. The findings of the study have implications for training future transplant nurses and for improving nursing care for transplant patients.

Adult↗
PubMed1995

The impact of cancer pain education on family caregivers of elderly patients.

PURPOSE/OBJECTIVES: To examine the impact of pain education on family members providing home care to elderly patients with cancer. DESIGN: Quasiexperimental. SETTING: Homes of selected patients from two California medical centers. SAMPLE: Fifty family caregivers of patients experiencing cancer-related pain. METHODS: The pain education program included three components: pain assessment, pharmacologic interventions, and nonpharmacologic interventions. Patients and their family caregivers were evaluated prior to initiation of the program and at one and three weeks following the interventions. MAIN RESEARCH VARIABLES: Quality of life (QOL); knowledge and attitudes about pain; and caregiver burden. FINDINGS: Findings based on measures of QOL and caregiver burden demonstrated the physical and psychological impact of family caregiving and pain management. Comparison between elderly patients with cancer and family caregivers revealed the pain experience's significant impact on family members caring for a loved one in pain. CONCLUSIONS: The pain education program was effective in improving knowledge and attitudes regarding pain management. IMPLICATIONS FOR NURSING PRACTICE: Pain management is a priority for nurses, and use of interventions such as structured pain education improves QOL outcomes for elderly patients and their family caregivers.

Adaptation, Psychological↗