Biomedical subjects

Margaret I Fitch

Publications and source records attributed to Margaret I Fitch.

At least 19 recordsLinked to original sources

PubMed2006

'Nothing fit me': nationwide consultations with young women with breast cancer.

OBJECTIVE: There exists little research about the experience of breast cancer for young women in Canada. To address this gap, the Canadian Breast Cancer Network (CBCN) and the Ontario Breast Cancer Community Research Initiative undertook a research project to explore the information and support experiences, needs and recommendations of geographically diverse Canadian young women with breast cancer. SETTING AND PARTICIPANTS: We consulted with 65 young women in 10 focus groups held across Canada. All women had been diagnosed with breast cancer at, or before, 45 years of age. During the consultations the women were asked to discuss their information and support experiences and needs, as well as resource recommendations related to their diagnosis, treatment and survivorship. MAIN RESULTS: The overarching theme, 'Nothing Fit Me', revealed that accessed information, support and programmes/services did not 'fit' or match the women's age or life stage. When we asked for their recommendations the young women suggested that information and support match their age and life stage and that health-care providers create and implement several topical workshops concerning, for example, sexuality, lymphedema and reconstruction. CONCLUSION: The findings will be used by the CBCN as a general platform from which to conduct further research and/or action strategies. The CBCN will also implement the recommendations from this groundbreaking work as this network formulates a national strategy for young women with breast cancer.

Adult↗

PubMed2006

Understanding the symptoms experienced by individuals with lung cancer.

The purpose of this study was to gain a better understanding of patients' experience of symptoms of lung cancer upon a first visit to a regional cancer centre and two months later. Sixteen patients were interviewed on two occasions about the symptoms, their impact and what they found most troublesome. Patients were also asked to describe any strategies they used to manage the symptoms. The most commonly identified symptoms were fatigue and pain. Participants described coping with multiple symptoms simultaneously, how those symptoms intensified over time, and using very few strategies. Participants described symptoms as troublesome because they interfered with activities of daily living or evoked emotional or cognitive responses. Fatigue was reported most frequently as troublesome. This work has implications for how patient assessments are conducted and how health care professionals listen to the patients. The patients' descriptions of their symptoms and what strategies they applied is often embedded within the patients' stories about living day-to-day with their lung cancer.

Aged↗

PubMed2006

Caring for the caregivers: Innovative program for oncology nurses.

An innovative program, Care for the Professional Caregiver, was designed to provide staff nurses in a cancer program with the opportunity to learn about coping with stress in their practice. The program was evaluated using quantitative and qualitative methods. The findings clearly describe the benefits of the program on both a short- and long-term basis. The value of connecting with other cancer nurses, supporting each other, and sharing stories about their work life experiences resulted in benefits to the nurse as an individual, as a team member, and as a professional practitioner. The program achieved its aims and is recommended for ongoing implementation.

Adaptation, Psychological↗

PubMed2006

Oncology nursing: Finding the balance in a changing health care system.

Health care restructuring has resulted in significant changes in the workload and work environment for oncology nurses. While recent studies describe the impact of these changes on the general nursing workforce in several countries, there have been no published studies that have focused on worklife issues of Canadian oncology nurses. Therefore, a qualitative study was conducted to gain insight about how oncology nursing has changed over the past decade and how Canadian oncology nurses are managing these changes. Analysis of telephone interviews with 51 practising oncology nurses employed across Canada revealed three major themes. The first theme, "health care milieu", portrayed a picture of the cancer care environment and patient and professional changes that occurred over the past decade. The second theme, "conflicting demands", reflects how the elements of change and social forces have challenged professional oncology nursing practice. The third theme, "finding the way", describes the patterns of behaviour that nurses used to manage the changing health care environment and make meaning out of nurses' work in cancer care. Overall, the findings portray a picture of Canadian oncology nurses in "survival mode". They face many workplace challenges, but are able to keep going "for now" because they find ways to balance their responsibilities on a daily basis and because they know and believe that their specialized nursing knowledge and skills make a difference in patient care.

Adult↗

PubMed2006

Ovarian cancer.

Ovarian cancer is the leading cause of death from gynecologic cancers. Although approximately 2,400 women are diagnosed each year in Canada, most women know little about the disease. While it is not common, ovarian cancer is a devastating diagnosis. The symptoms of ovarian cancer are non-specific and there is no effective screening tool. Surgery, chemotherapy and radiation given alone or in combination are most commonly used to treat ovarian cancer. Surgery can result in premature menopause for women in their child-bearing years. Chemotherapy may cause a multiplicity of distressing side-effects. Women with ovarian cancer are living longer and with an improved quality of life. Nurses are in a key position to increase awareness and provide support and information about coping with the disease and side-effects of treatment.

Antineoplastic Combined Chemotherapy Protocols↗

PubMed2005

Two Black men with prostate cancer: a narrative approach.

OBJECTIVES: This paper demonstrates the value of a narrative approach for health psychology. It focuses on the lives of two Black men with prostate cancer, drawn from a larger study investigating the links between masculinities and prostate cancer. DESIGN: The study was a qualitative, interview-based study. Each participant was interviewed four times. METHODS AND ANALYSIS: The men were asked to describe and discuss their prostate cancer experience, as well as their lives prior to illness. In order to gain a perspective on individual experiences of men with prostate cancer, we took a narrative approach to gathering and analysing data. Results are reported through two descriptive narratives. CONCLUSIONS: The narratives of the men described in the paper show how the interaction of race with health and illness is neither predictable nor consistent at the individual level. Black men, like all men with prostate cancer, have diverse experiences and are influenced by a wide array of personal and societal factors. While the high risk of prostate cancer among Black men makes proactive interventions advisable, such interventions will be most effective if the heterogeneity of men's experiences are taken into account.

Attitude to Health↗

PubMed2005

Travelling for radiation cancer treatment: patient satisfaction.

This study was conducted for the purpose of describing cancer patients' satisfaction with their care when they had to travel unexpectedly away from home for treatment. Ontario initiated a rereferral program for cancer patients who needed radiation therapy when the waiting lists in southern Ontario became lengthy. Patients travelled to the United States or northern Ontario for their care. A standardized survey containing 25 items with five-point Likert scale responses was mailed to all patients who participated in the rereferral program, following completion of their treatment. Items covered patient experiences before leaving home, in preparing for travel, and staying at the cancer facilities away from home. A total of 466 (55.8%) patients returned the survey. Overall, patients were satisfied with their care. However, there were a number of areas identified by patients where improvements could be made. These areas included access to support prior to leaving home, access to information about supportive care services while away from home, and sensitivity to personal needs in making arrangements for travel. Provision of information and support are important to cancer patients having to travel for cancer treatment.

Aged↗

PubMed2005

Needs of patients living with advanced disease.

When a person has a life-threatening illness, many changes occur. These changes are more than just physical changes and include psychosocial, practical and spiritual consequences. If disease progresses, the impact of these changes intensifies. Nurses who are caring for patients with advancing disease must be able to provide appropriate interventions if they are to help individuals cope. This paper highlights information regarding the needs of patients with advanced disease and emphasizes approaches that could be taken by cancer nurses in their care of these patients. The material is drawn from over a decade of interviewing patients about their experiences with cancer, the literature about patient needs, and discussions with care providers. The over-arching perspective is one of seeing human beings as bio-psychosocial-spiritual entities. Holding this perspective has implications for assessment and interventions in caring for patients with advanced disease.

Adaptation, Psychological↗

PubMed2004

A consultation with Canadian rural women with breast cancer.

OBJECTIVE: Relatively little research has been carried out on the health and supportive care needs of rural women living with breast cancer. In this study, results from a Canadian focus group study are used to highlight issues of importance to rural women. SETTING AND PARTICIPANTS: A total of 276 rural women with breast cancer divided into 17 focus groups participated in the study conducted across Canada. A standardized protocol for discussion was employed. Issues of access to information, support and services were discussed, with women describing their experiences in trying to find appropriate programmes and services. MAIN RESULTS: The major theme identified through analysis of qualitative data was 'becoming aware of and/or gaining access to health care information, support and services.' Other major themes included: (1) dealing with isolation; (2) having to travel; (3) feeling the financial burden and (4) coping with changing work. CONCLUSIONS: Rural women with breast cancer have supportive care challenges related to their circumstances. A series of recommendations were generated through the consultation process which are contributing to the development of a national strategy focusing on the development and extension of programmes for rural women with breast cancer. Although the research on the project was not to specified standards, and suffered from less attention than community capacity building and advocacy, it proved to be of worth and revealed potential benefits from collaborations between researchers and community organizations.

Breast Neoplasms↗

PubMed2004

Beyond publication.

Explore the source record for details and available documents.

Information Dissemination↗

PubMed2003

Psychosocial management of patients with recurrent ovarian cancer: treating the whole patient to improve quality of life.

OBJECTIVES: To describe the psychosocial issues affecting women with recurrent ovarian cancer and provide suggestions for screening to provide appropriate referrals. DATA SOURCES: Research articles and textbooks. CONCLUSION: Nursing care may involve practical, informational, and emotional support. Screening patients for psychosocial distress can be conducted quickly and is important to identify patients requiring additional interventions. IMPLICATIONS FOR NURSING PRACTICE: Nurses should be familiar with the National Comprehensive Cancer Network guidelines regarding distress management. Psychosocial support requires a commitment to addressing the individual psychosocial needs of each patient. Nurses play an invaluable role in helping to improve the quality of life for women with recurrent ovarian cancer.

Family↗

PubMed2003

Impact of ovarian cancer perceived by women.

Ovarian cancer may be particularly challenging for women, both physically and psychologically, because of the advanced nature of the disease at the time of diagnosis, the side effects of the disease, the repetitive cycles of aggressive therapy, and the perceived loss of femininity from the removal of reproductive organs. In addition, women with this disease rarely have an opportunity for cure. Most will face the very real possibility of dying. This qualitative study examined the perspectives of women living with ovarian cancer. Eighteen women participated in interviews, in which they described their experiences living with the disease. Women reported the myriad day-to-day changes in their lives, the major challenges they had to face, and the sources to which they turned for support. Implications for the practice of oncology nurses involve assessment, an understanding of the profound impact that this illness has on both the woman and her family, and the need to access a variety of supportive care programs.

Activities of Daily Living↗

PubMed2003

Women's experiences with recurrent ovarian cancer.

Most women with a diagnosis of ovarian cancer, because of the advanced nature of the disease at the time of diagnosis, will face the very real possibility of an early death. Thus the disease can have a significant impact on women who play a central role in the day-to-day management of family life, the nurture of children, and the care of extended family. This article reports the perspectives of women living with ovarian cancer regarding their experiences confronting recurrent disease. For this qualitative study 18 women were interviewed. Four primary themes emerged from the analysis of the verbatim interview transcripts: waiting for recurrence, facing the diagnosis of recurrence, managing treatment-related concerns, and attempting to regain control. The practice implications for oncology nurses involve understanding the significant meaning associated with monitoring tumor markers and recurrent disease, assisting women in accessing information and support, and engaging in sensitive communication.

Adaptation, Psychological↗

PubMed2003

Reactions of health professionals to a research-based theatre production.

BACKGROUND: There is a recent trend in the social sciences--predominantly among researchers engaged with qualitative methodologies--to translate research finding into artistic and narrative forms. In this paper, we describe our work in translating finding about the experiences of men with prostate cancer and their spouses into a dramatic production, No Big Deal? We then report upon, and provide commentary about data from interviews with health professionals who attended a performance. METHODS: Health professionals (N = 26) were interviewed within 2 weeks of attending a performance of No Big Deal? and again 6 months later (N = 23). RESULTS: After attendance at the performance, many study participants reported (at both interview times): new awareness or understanding about the issues facing prostate cancer patients; reinforcements of their positive attitudes and behaviors in relation to patients; an increased sense of connection with ill people; and plans to alter their clinical practices to better meet patient needs. CONCLUSIONS: Narrative and dramatic forms are viable ways to communicate vital information about the possibilities for professionals to be helpful to patients--and they are the wave of the future for educational and dissemination practices.

Attitude of Health Personnel↗

PubMed2003

Living with ovarian cancer: women's perspectives on treatment and treatment decision-making.

In the year 2002, 2,500 women will have been diagnosed with ovarian cancer. Treatment for ovarian cancer is arduous, involving invasive surgery, chemotherapy, and/or radiation therapy. Studies have described the side effects of ovarian cancer treatment, but little has been written about women's perspectives on receiving that treatment. This work was undertaken to describe women's perceptions of living with ovarian cancer and their experiences with treatment. Eighteen women who had been diagnosed with ovarian cancer were interviewed in depth and theme analysis was undertaken with their transcripts. Three prominent themes emerged during the analysis: 1) initial treatment plans were overwhelming, 2) involvement in treatment decision-making was minimal, and 3) treatment had many side effects and complications.

Adult↗

PubMed2003

Patient perspectives on the impact of receiving radioactive iodine: implications for practice.

The purpose of this study was to identify the needs of patients undergoing treatment with radioactive iodine (I131). This descriptive study used a standardized survey which was completed by 190 patients selected from eight programs across Canada that deliver I131. One hundred were treated as inpatients and 90 were treated as outpatients. Data from this study indicate there is a variation in patients' perceptions about how precautions are to be implemented during I131 treatment. Patients expressed a desire for more information regarding many aspects of the treatment experience and the medium through which information is provided. There are also implications for support of patients in terms of dealing with psychosocial issues which emerge when living with thyroid disease.

Adolescent↗

PubMed2003

The needs of family members of patients receiving radioactive iodine.

The current literature on radionuclide therapy is heavily based on health care professionals' perspectives and provides little insight regarding what patients or family members identify as their needs or concerns. Family members (N = 130) of patients undergoing treatment with radioactive iodine were selected from eight programs across Canada to participate in a survey to identify the needs they had when a close relative was undergoing treatment with radioactive iodine. The results of the survey indicated family members experienced worries and concerns about the patient being at home after treatment, and there was variation in their knowledge about what precautions were needed. Family members provided evidence that many experienced psychosocial distress, but very few received adequate assistance for their difficulties.

Adult↗

PubMed2003

Cancer nursing in Ontario: defining nursing roles.

The delivery of cancer care in Ontario is facing unprecedented challenges. Shortages in nursing, as in all professional disciplines, are having an impact on the delivery of cancer care. Oncology nurses have a major role to play in the delivery of optimum cancer care. Oncology nursing, when adequately defined and supported, can benefit the cancer delivery system, patients, and families. A primary nursing model is seen as being key to the delivery of optimum cancer care. Primary nursing as a philosophy facilitates continuity of care, coordination of a patient's care plan, and a meaningful ongoing relationship with the patient and his/her family. Primary nursing, when delivered in the collaboration of a nurse-physician team, allows for medical resources to be used appropriately. Defined roles enable nurses to manage patients within their scope of practice in collaboration with physicians. Enacting other nursing roles, such as nurse practitioners and advanced practice nurses, can also enable the health care system to manage a broader number of patients with more complex needs. This article presents a position paper originally written as the basis for an advocacy and education initiative in Ontario. It is shared in anticipation that the work may be useful to oncology nurses in other jurisdictions in their efforts to advance oncology nursing and improvement of patient care.

Humans↗