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Biomedical subjects

M J Dodd

Publications and source records attributed to M J Dodd.

At least 37 records · Page 2Linked to original sources
PubMed1996

Differences in nausea, vomiting, and retching between younger and older outpatients receiving cancer chemotherapy.

The purpose of this study was to determine whether there were differences in the side effects of nausea, vomiting, and retching (N, V, and R) between younger ( < 65 years, n = 102) and older ( > or = 65 years, n = 25) persons receiving outpatient chemotherapy. A longitudinal 4-month study was used for the 127 participants recruited from 18 settings. Participants completed two questionnaires (Inventory of N, V, and R and Behavior Checklist) over the course of the study. The pattern between the younger and older patients' N, V, and R subscale scores was consistent in that the younger patients' scores were consistently (except on one occasion) higher than the older patients' scores, but this difference was statistically insignificant. This study furthers our understanding of N, V, and R and has several clinical implications.

Adult↗
PubMed1996

Future doc 2025.

Explore the source record for details and available documents.

Delivery of Health Care↗
PubMed1996

Informed consent: process and clinical issues.

PURPOSE/OBJECTIVES: To review the issues related to informed consent in a clinical cancer care setting and suggest strategies to improve the informed consent process. DATA SOURCES: Published books, journal articles, and clinical research experience. DATA SYNTHESIS: Clinicians and researchers are ethically obligated to maintain the informed consent process when treating participants in clinical cancer research. Nurse clinicians, clinical trial nurses, and nurse researchers often encounter dilemmas while ensuring proper informed consent. Nurses involved in pediatric cancer care must address specific consent issues relevant to children and youth. CONCLUSIONS: Informed consent does not end with a patient's signature on a form. Establishing and maintaining informed consent is a multidisciplinary effort in cancer clinical trials. Nurses can improve the informed consent process by ensuring adequate time for patient consideration and understanding and by reassessing consent during the study. IMPLICATIONS FOR NURSING PRACTICE: Clinical trial nurses and nurse investigators in both adult and pediatric oncology have a duty and obligation to maintain continued informed consent throughout a study and to be involved in all aspects of study planning and implementation.

Adolescent↗
PubMed1996

Randomized clinical trial of chlorhexidine versus placebo for prevention of oral mucositis in patients receiving chemotherapy.

PURPOSE/OBJECTIVES: To test the effectiveness of a nurse-initiated systematic oral hygiene teaching program-PRO-SELF: Mouth Aware (PSMA)-in conjunction with two mouthwashes (0.12% chlorhexidine or sterile water) in preventing chemotherapy-induced oral mucositis. DESIGN: Randomized, double-blind, placebo-controlled, clinical trial. SETTINGS: 23 outpatient clinics and office practices in California. SAMPLE: 222 patients who were starting a cycle of mucositis-inducing chemotherapy. METHOD: Participants were followed over three chemotherapy cycles. All patients were provided the PSMA program. Random assignment to a mouthwash occurred prior to the development of oral mucositis. Researchers used the Oral Assessment Guide to assess the patients oral cavities monthly (with the patients cycles of chemotherapy) and when patients reported any oral changes between cycles. MAIN RESEARCH VARIABLES: Type of mouthwash, incidence, days to onset, and severity of chemotherapy-induced oral mucositis. FINDINGS: No significant differences existed between the two mouthwashes in regard to incidence, days to onset, and severity of mucositis. CONCLUSIONS: Because chlorhexidine (S20 per pint) was no more effective than water, a substantial cost savings can be realized by rinsing with water. Interestingly, the PSMA program appeared to reduce the incidence of mucositis from on a prior estimate of 44% to less than 26%. IMPLICATIONS FOR NURSING PRACTICE: A nursing prescription of a systematic oral hygiene program using water as a mouth rinse is cost efficient and may be effective in preventing oral mucositis.

Adult↗
PubMed1995

Mood states of oncology outpatients: does pain make a difference?

The purposes of this study were to determine if there were significant differences in the mood states of oncology outpatients who had cancer-related pain and those who were pain free, and to evaluate the relationships between pain intensity and duration and mood states in those patients with pain. Two hundred (54.2%) patients experienced cancer-related pain during the previous month and 169 (45.8%) patients were pain free. Those patients who experienced cancer-related pain scored significantly higher on all of the subscale scores of the Profile of Mood States, except vigor, and had a significantly higher total mood disturbance (TMD) score than did pain-free patients. In addition, the subscale scores of tension, depression, anger, fatigue, confusion, and TMD scores were moderately correlated with increases in pain intensity. Also, depression, fatigue, confusion, and TMD scores were moderately correlated with increasing duration of pain. These data suggest that there is a relationship between pain and mood in oncology outpatients and that health-care professionals need to assess for mood disturbances in this population and develop appropriate treatment strategies.

Affect↗
PubMed1994

Comorbidity, nutritional intake, social support, weight, and functional status over time in older cancer patients receiving radiotherapy.

It is essential that nurses gain insight about the responses of older adults to standard anticancer therapies because there is ongoing concern about whether the elderly are affected adversely by the prescribed therapy. The purpose of this longitudinal prospective study was to describe selected outcomes and their relationships in a sample of 45 elderly (mean age 69.8 years; range 61-86) patients receiving radiotherapy for either breast (42%) or lung (58%) cancer. The outcome variables were weight and multidimensional functional status; moderator variables were co-morbidity, nutritional intake, estimated adequacy of intake, radiation dose, side effects, and social support. Data were collected at the beginning of radiation (T1), the middle of therapy (T2), the conclusion of therapy (T3), and three months post radiation (T4). Although 81.4% had some concurrent condition, those with a comorbid condition did not respond significantly differently from those without a comorbid condition on any of the major variables at any of the four times. At none of the four times was the caloric intake adequate to meet the estimated energy requirements for usual activity (range 67.9-71.5%). However, caloric intake was not significantly related to weight at any of the four times. There was a significant weight decrease from beginning of therapy to the middle of therapy and from the beginning of therapy to conclusion of therapy. The percentage of calories contributed by protein was significantly correlated with weight during radiotherapy, and protein calories consumed at the previous time were correlated with weight at T2 and T3. In contrast, the percentage of calories contributed by carbohydrate intake was significantly negatively correlated with two of the four functional status measures at each time, but was not related to weight. In addition carbohydrate calories consumed at the previous time also were related to one or more functional status measures at succeeding time points. Almost no relationships were found between social support and the outcome measures of weight and functional status. Scores on three of the four functional status measures suggest improvement over time from initiation of radiation to 3 months after therapy. Scores on the fourth measure, Overall Health Rating, suggest a slight decline; however, the average score reflects good overall health. These findings provide evidence that this group of elderly, the great majority of whom had at least one comorbid condition, tolerated the course of radiation with less than adequate intake for usual activity, a slight decrease in mean weight, but without major disruptions in functional status.(ABSTRACT TRUNCATED AT 400 WORDS)

Activities of Daily Living↗
PubMed1993

The stress process in family caregivers of persons receiving chemotherapy.

The purpose of this analysis was to explore strain and depression among family caregivers of persons receiving chemotherapy for cancer using the Pearlin Stress Process Model. Seventy-five family caregivers of persons receiving chemotherapy participated, completing the Caregiver Strain Index and the Depression Subscale of the Profile of Mood States within 3 weeks of the initiation of chemotherapy. Hierarchical regression analyses indicated that 44% of the variance in strain and 40% of the variance in depression were explained by the antecedent variables of caregiver age and gender, patient age and gender, patient functional status, the presence of recurrent disease, perceived efficacy of coping strategies, and perceived adequacy of social support. Further analysis aimed at delineating the mechanisms through which coping and social support operate in the model found no evidence for a moderating or stress-buffering effect. However, coping mediated the relationship between strain and depression and social support mediated the relationship between functional status and depression.

Activities of Daily Living↗
PubMed1993

Predictors of concerns and coping strategies of cancer chemotherapy outpatients.

The purpose of this study was to determine predictor variables of the number of concerns and coping strategies of cancer patients during a 6-month period of chemotherapy. The adult patients (N = 64) were diagnosed with selected types of cancer. Patients kept logs in which they recorded concerns and strategies for managing those concerns. Three significant predictors of patients who experienced greater numbers of concerns were identified. Patients with less vigor-activity, less of an internal locus of control, and who perceived the goal of their chemotherapy treatment to be curative reported greater concerns. These factors explained 55% of the total variance in the number of concerns. No significant predictors of coping strategies were obtained.

Adaptation, Psychological↗
PubMed1993

Family problems during cancer chemotherapy.

Although reports suggest that a cancer diagnosis affects all members of a family, limited descriptions are available of the types of problems families experience when a family member has cancer. Adult patients with cancer (n = 100) and their family members (n = 126) were interviewed in their homes at 1 1/2 weeks, 7 1/2 weeks, and 6 months following the initiation of chemotherapy. The Problem Centered Family Coping Interview, a semistructured tool with established content validity, was used to identify family problems that occurred in the previous month. Content analysis was performed on interviews using empirically based categories. Families reported from one to eight problems occurring in the previous month (mean = 3.4). Cancer-related health concerns accounted for 48%-52% of the problems identified at all three interviews. This study's findings enhance knowledge about the family's cancer experience.

Adaptation, Psychological↗
PubMed1993

Predictors of self-care: a test of Orem's model.

Despite advancements in self-care for people with cancer, a profile of individuals who perform self-care behaviors has not been determined. Without these data, interventions cannot be targeted to specific patient groups that demonstrate the most need. This study's investigators used Orem's model of self-care to determine predictors of self-care behavior. The sample consisted of 127 adults with cancer who were to receive their first dose of chemotherapy (e.g., doxorubicin, methotrexate, 5-fluorouracil, cyclophosphamide, or cisplatin, given alone or in combination). Data were collected from the subjects prior to the first cycle and at drug nadir for each of the four chemotherapy cycles. Potential predictors of self-care included demographic variables, performance status, affective state, social support, ability to manage a situation, self-care ability, and prior health-promoting activities. Self-care was measured using a 40-item behavior checklist. Multiple regression techniques were used to obtain four significant predictors of self-care, which accounted for 47% of the variance. Subjects with lower performance status, higher anxiety, less social support, and more education performed more self-care. These findings clarify Orem's model with this clinical population and provide a patient profile of self-care for practice.

Activities of Daily Living↗
PubMed1993

Coping amid uncertainty: an illness trajectory perspective.

This paper offers an alternative to the conventional social/psychological definition of "coping." Using a theoretical framework of "illness trajectory," the authors examine the uncertainty of temporality, body, and identity inherent in coping with cancer. Analysis then turns to the interaction among these uncertain conditions and the complex work processes described by people with cancer, as they tolerate, i.e., "cope with," the disease. Although presented separately for purposes of clarity, these processes and their related activities are experienced in varying combinations and with varying and fluctuating importance by each individual. Viewed comprehensively, however, they constitute the larger process of coping with cancer, with implications for other diseases as well.

Adaptation, Psychological↗
PubMed1993

Influence of age on problems experienced by patients with lung cancer undergoing radiation therapy.

The purpose of this prospective, longitudinal study was to determine if patients with lung cancer who are 65 years of age or older experience problems differently than do patients younger than age 65 during and following radiation treatment. The moderator and outcome variables selected for study were recognized attendant problems that may develop during lung cancer treatment and that may influence the treatment regimen and response. No statistically significant differences were found between patients age 65 or older and those younger than age 65 on caloric intake, adequacy of energy intake, total radiation dose, concurrent illnesses, and social support at any of four data-collection periods. Similarly, there were no significant differences on weight, body mass index, and multidimensional functional status. The relationship between the social support subscales and functional status measures for the 65-or-older group suggested that those subjects with lower social support perceived themselves to have better functional status. There was no relationship between social support and two functional status measures for the under-65 group. The significant relationships between social support and the overall health rating were in opposite directions for the two age groups. The results suggest that chronologic age alone may not be a sufficient criterion to determine therapeutic regimen or to suggest that unique problems may result.

Activities of Daily Living↗
PubMed1992

Outpatient chemotherapy: patients' and family members' concerns and coping strategies.

Since the majority of cancer chemotherapy is given on an outpatient basis, it is important for nurses in the community to understand the concerns that patients and family members experience during the treatment and how they manage these concerns. The 64 adult patients were diagnosed with selected solid tumors or lymphoma and were initiating a course of chemotherapy. Sixty-nine family members participated as well. Each participant kept a log in which to record concerns and strategies taken to manage them. Patients reported fewer concerns than their families, but both had similar concerns and rated them as high in intensity. Patients performed more strategies than family members, but both rated the effectiveness of their strategies as moderately high and cited themselves as the sources of the strategies.

Adaptation, Psychological↗
PubMed1992

The relationship of visual acuity, tactile sensitivity, and mobility of the upper extremities to proficient breast self-examination in women 65 and older.

The purpose of this study was to describe the relationship of visual acuity, tactile sensitivity, and mobility of the upper extremities to the performance of proficient breast self-examination (BSE) in women 65 and older. A convenience sample of 32 women, ages 66-89, met with the investigator to have their visual acuity, tactile sensitivity, and upper extremity mobility tested. Their ability to perform the visual, tactile, and upper extremity components of proficient BSE also was tested by using simulated breast models (SBMs). Thirty of the women had adequate visual acuity (< or = 20/40 Snellen equivalent) but were unable to visually detect the abnormalities on the SBM. Thirty of the women had tactile sensitivity of 10 mm (1 cm) or better on the static two-point discrimination test of the second, third, and fourth digits of each hand. Yet, only 13 of these women were able to locate the 1 cm lump; only 12 were able to locate the 5 mm lumps; and none were able to locate the 3 mm lump. The subjects' ability to pass the upper extremity mobility component of proficient BSE was significantly related to their ability to pass the upper extremity range of motion criteria. Limitations and deficits, mostly of the hands and shoulders, were revealed. When teaching BSE to older women, nurses are responsible for assessing limitations and deficits in their ability to perform proficient BSE and, if necessary, for intervening with alternatives. The need for further research in this area is indicated to improve assessment and education of older women regarding the use of proficient BSE for early detection of breast cancer.

Age Factors↗