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Biomedical subjects

M Rehwaldt

Publications and source records attributed to M Rehwaldt.

7 recordsLinked to original sources

Taste changes experienced by patients receiving chemotherapy.

PURPOSE/OBJECTIVES: To increase knowledge about the nature, frequency, and quality-of-life (QOL) effects associated with taste changes after chemotherapy. DESIGN: Cross-sectional, descriptive. SETTING: 11 outpatient urban and suburban oncology centers. SAMPLE: 284 adults who had received at least two chemotherapy cycles. METHODS: Patients completed a taste change questionnaire and the Functional Assessment of Cancer Therapy-General, and nurses collected demographic and disease-related information. Descriptive statistics, Spearman correlations, chi-square, Mann-Whitney, and Kruskal-Wallis one-way analysis of variance were calculated. FINDINGS: Taste changes were frequent and at least moderately severe for many patients, who often reported dry mouth, decreased appetite, nausea, and vomiting. Cisplatin and doxorubicin were the agents most likely to be related to severe taste changes and to have caused greater distress from taste changes, which also were associated with decreased QOL. Oncology nurses and physicians rarely discussed taste changes with patients, who often tried changing the ways they seasoned their food. CONCLUSIONS: Taste changes are a frequent and significant problem for patients receiving chemotherapy and have negative effects on patients' QOL. Oncology nurses and physicians typically do not offer self-management suggestions to patients. IMPLICATIONS FOR NURSING RESEARCH AND PRACTICE: Repeated-measures research may provide a clearer understanding of chemotherapy-associated taste changes over time. Studies to examine strategies suggested from this and other research as well as clinical literature may determine which self-care interventions are most useful. Nurses should inform patients that taste changes may occur following chemotherapy, provide self-management information, and assess for related problems that could increase chemotherapy morbidity.

Adult↗

Relationships between cognitive behavioral techniques, temperament, observed distress, and pain reports in children and adolescents during lumbar puncture.

A limited number of studies have examined relationships between temperament and children's/adolescents' responses to painful procedures and have identified several different dimensions of temperament that are related to children's pain response. The focus of these studies was one-time, acute pain experiences, such as immunization and postoperative pain. In this study, children and adolescents' responses to a moderately painful procedure, lumbar puncture, were examined as they related to temperament. Nineteen children and adolescents, ages 4 to 18 years, who were receiving treatment for cancer, were participants in this study. Parents completed one of three age-appropriate temperament questionnaires at the beginning of the study and prior to the parent and child learning cognitive-behavioral techniques. Behavior during the procedure was videotaped at baseline, and for up to four visits after baseline and coded using the Observation Scale of Behavioral Distress (OSBD). Pain reports were collected after the procedure using the Oucher pain self-report scale. Improvement in the level of behavioral distress was determined by examining the differences between pre- and post-treatment OSBD scores and self-reported pain ratings. There was a significant improvement in pain reports over the 5-month period, but behavioral distress did not change significantly. At the baseline visit, the temperament dimensions of more positive mood, lower activity, less persistence, and lower distractibility were related to higher pain reports, but not behavioral distress. However, after 5 months, only the dimension of positive mood was significantly correlated with improvement in pain reports. The amount of time parents and children practiced the techniques, their comfort with the techniques and their perceived effectiveness also were correlated with positive mood.

Adolescent↗

Breast and ovarian cancer: genetic update and implications for nursing.

Advances in genetics are changing approaches to detecting and treating breast and ovarian cancer. Scientific breakthroughs and thus implications for clinical care and patient education are essential areas of knowledge for all medical-surgical nurses. Future discoveries promise to change drastically the prevention and treatment of these diseases.

Breast Neoplasms↗

Collaborative research under the unification model.

The research role of the clinical nurse specialist is often the most difficult to implement. At the masters level, efforts are generally directed at utilization and evaluation of research more than design and implementation. Collaboration between several investigators, however, is an efficient and effective method of pooling the resources of a variety of researchers, allowing the actualization of all aspects of the research process. A collaborative effort to look at the clinical problem of fatigue was undertaken by a group of masters-prepared oncology nurses. Strategies for effective collaboration are outlined. Issues related to gaining group commitment and to delineating roles at the onset, voluntary participation, and timely communication are discussed. A realistic timetable and regular informal meetings helped to sustain the momentum of the study. All members were able to contribute a part of the completed project and to experience the professional and personal satisfaction of "owning" a research project from start to finish.

Humans↗

Communication and control: parent, child, and health care professional interactions during painful procedures.

Through use of a qualitative ethological approach, observations of 17 children who were undergoing 44 painful procedures during cancer diagnosis or treatment were videotaped and analyzed. The children, aged 4 to 18 years, were part of a larger study testing the effectiveness of nonpharmacologic pain management techniques. Analysis of the videotaped observations revealed that several distinct patterns of conversation between caregivers, parents, and children varied greatly among situations. Both child-centered and nonchild-centered communications were demonstrated. During periods of quiet, nonchild-centered behaviors increased. As a child's distress increased, parents actively changed behaviors to redirect verbal support back to the child and to the pain control interventions. Nurses' encouraging parents to be actively involved and physically close during painful treatments may results in less distress and discomfort for the child. In addition, health care professionals need to be aware of the various patterns of child-parent-caregiver interactions and the need to stay focused on the child during painful procedures to enhance the child's ability to cope.

Adaptation, Psychological↗