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Biomedical subjects

R McCorkle

Publications and source records attributed to R McCorkle.

At least 55 records · Page 3Linked to original sources
PubMed1993

Gender bias in the measurement properties of the Center for Epidemiologic Studies Depression Scale (CES-D).

Confirmatory factor-analytic models are used to examine gender biases of individual items of the Center for Epidemiologic Studies Depression (CES-D) Scale. In samples containing 708 cancer patients and 504 caregivers of the chronically ill elderly, two CES-D items are identified as producing biased responses in comparisons of male and female respondents. Three additional CES-D items are excluded on the basis of other psychometric problems, yielding a subset of 15 CES-D items that capture almost all the information of the original 20-item CES-D scale but are free of any gender bias. Gender differences in mean levels of depressive symptomatology are significantly reduced, but not eliminated, when the 15-item scale is used.

Activities of Daily Living↗
PubMed1993

Needs of family caregivers of persons with cancer: a review.

The focus of cancer patient care has moved from the hospital to the home as a result of shortened acute-care stays and subsequent early discharges. Thus, family members and friends frequently must assume the caregiving role. Research has provided information regarding who in the family assumes the responsibility for care of the cancer patient, the needs of these family caregivers, community resources available, and service gaps within the present health care system.

Caregivers↗
PubMed1993

Incorporating midmanagement skills in an oncology CNS program.

Today's health care system requires that CNSs be prepared to manage care within complex organizations as well as deliver expert care to individuals and their families. The integration of midmanagement preparation with clinical knowledge and skills is critical. In this paper, we (1) review the literature pertaining to the role of oncology CNS and management preparation, (2) describe the program at the University of Pennsylvania School of Nursing, and (3) identify the management content that was added to strengthen the theoretical and clinical components of the program and to prepare our graduates in assuming leadership positions.

Curriculum↗
PubMed1993

Choosing a master's program in cancer nursing in the United States.

Returning to school to obtain a master's degree in cancer nursing in the United States is an undertaking that requires much thought. Going to school is an investment in oneself and, like any investment, many questions must be addressed before taking the step. Questions such as "Why go to school?" and "When to go?" need to be answered. The question "How will I pay for my education?" also needs to be answered. "Where to go to school?" often is the most difficult question. This article offers you some things to think about and some questions to ask when trying to choose a graduate program. In the final analysis, you will need to determine what is important to you and what school can best meet your personal needs to fulfill your professional goals.

Education, Nursing, Graduate↗
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↗
PubMed1993

Unmet needs of black patients with cancer posthospitalization: a descriptive study.

This article describes self-reported unmet needs of black patients with cancer posthospitalization and suggests a plan of research. The study sample consisted of 63 black patients with solid cancerous tumors who were discharged from seven hospitals in the Philadelphia, PA, area. The investigators collected data using the Enforced Social Dependency Scale (ESDS) and the Symptom Distress Scale (SDS). They added a checklist to the end of the ESDS to collect self-reported needs areas. The patients reported demographic data such as race and income. The investigators abstracted other demographic data, along with medical factors and complex problems, from the patients' hospital or home health agency medical records. Descriptive statistics and t-tests were used to analyze the data. Personal care and home activity needs were not being met adequately for this sample of low-income, urban-dwelling, black patients with cancer. The SDS revealed that the patients had significantly greater symptom distress related to frequency of nausea, intensity of pain, and difficulty breathing. Overall, patients with breast and gynecologic cancers reported the highest levels of symptom distress. Women who were elderly, black, alone, poor, and chronically ill were likely to have unmet needs and high levels of symptom distress.

Activities of Daily Living↗
PubMed1993

Relaxation training and psychoimmunological status of bereaved spouses. A pilot study.

The death of a family member is one of the most stressful and disruptive life events. Although the literature abounds with subjective pieces concerning bereavement, little is known about the complex biological processes that follow in its wake. However, there is a growing body of evidence that psychological distress may compromise immunocompetence and that support strategies may enhance immune function. Our exploratory study examined the influence of relaxation training on the immunological and psychological status (including anxiety and depression) of bereaved spouses. Nine female spouses, all survivors of patients who died from cancer, were recruited from two hospice programs to participate in this relaxation-training program. Standardized psychological instruments and immunological assays were completed at three data-collection points: before the initiation of the relaxation training (approximately 6 weeks after the death of the spouse); at the conclusion of the training; and 4 weeks after the relaxation training. The subjects received a 1-h relaxation-training program weekly for 4 weeks. It included progressive muscle relaxation training and guided imagery supervised by a psychiatric nurse clinical specialist. The results indicated that the relaxation-training program was well-received by the subjects, with promising psychoimmunological trends that merit more rigorous investigation. This exploratory study has demonstrated the feasibility of conducting a relaxation-training intervention for bereaved spouses and has laid the foundation for continuing research to study the physiological and psychological responses of the bereaved.

Adult↗
PubMed1992

Gaps and contract: evaluating the diffusion of new information. Part I. A description of the strategy.

Time and fiscal constraints on oncology nurses require that continuing education programs yield demonstrable benefit to the clinician, the institution, and patient outcomes. This article describes "gaps and contract," a strategy that provides nurses with a tool to transfer knowledge from theory to practice, in a measurable form. The framework for this strategy lies within the concept of innovation diffusion. This strategy was used by two universities collaborating to educate 912 oncology health professionals in 38 continuing education programs. Part II of this article will describe the measurement of this strategy.

Child↗
PubMed1992

Gaps and contract: evaluating the diffusion of new information. Part II. The measurement of the strategy.

This article is the second of a two-part series describing "gaps and contract," a strategy that provides nurses with a mechanism to transfer knowledge from theory into practice in a measurable format. Two universities under contract from the Pennsylvania state cancer plan used this strategy to evaluate the effectiveness of a cancer continuing education program. Two hundred seventy-four (274) contracts from one setting and 205 from a second setting are described. Recommendations for using this strategy to measure the efficacy of cancer continuing education programs are included.

Adult↗
PubMed1990

Quality of life issues in patients with disseminated breast cancer.

Over half the women treated for breast cancer will experience advanced disease, and issues related to quality of life are particularly important. This article has reviewed components of quality of life specific to women with advanced breast cancer following two clinical courses:those who develop a recurrence and those who present with advanced disease. It is clear that additional research is warranted on the quality of life in women with advanced breast cancer. Work to date has clearly indicated that the management of women with advanced disease requires the resources available from a multidisciplinary perspective. Efforts to manage advanced breast cancer must include both current medical therapies and attention to the critical factors associated with enhancing the quality of their lives. Of final concern is the relationship of social class to advanced disease. Following Freeman's recent outline of the agenda for the American Cancer Society, more attention must be given to people who are economically disadvantaged because cancer incidence and mortality are greater among poor people than among the affluent. It is possible that over 50% of women presenting with advanced cancer of the breast are economically disadvantaged. Validation of this problem through research should lead to prevention programs targeted to this population. Women with breast cancer who are economically disadvantaged may be particularly receptive to interventions that will enhance their quality of life.

Breast Neoplasms↗
PubMed1990

Continuing care in the community.

Early discharge from the hospital or home health agency necessitates effective continuity of care planning in order to assure that patients and families will have their health care needs met after discontinuance of formal health care services. In this article, we have defined continuity of care from several perspectives, presented two theoretical viewpoints on this concept, and, with four models of care that have actually been implemented, analyzed the commonalities and differences among models. In addition, recommendations for future research and care delivery for the purpose of enhancement of continuity of care have been made.

Community Health Services↗
PubMed1990

Measurement of stress in clinical nursing.

The Nurse Stress Checklist was developed to measure stress in clinical nursing as a multidimensional construct. The instrument was formulated within a transactional model of stress. The items were derived from five domains thought to contribute to nurse stress in clinical settings and were organized into a questionnaire. Holmes Schedule of Recent Events was included as a validity measure. The instrument was tested on 104 staff nurses working in three institutions in an urban community. Exploratory factor analysis was applied to the 74 items presented to subjects in Likert-type format. Five factors were derived and subjected to psychometric evaluation. Internal consistency reliability for the five factors was good, ranging from 0.80 to 0.91. Means and measures of dispersion supported the potential of the five subscales to discriminate among respondents on the attributes being measured. Intercorrelations of the factors provided evidence of the distinctiveness of the five components of stress, although factor loadings showed some overlap between Personal Reactions and Work Concerns and Work Concerns and Work Completion Concerns. Validity of the factors also was supported by correlations with Holmes' Schedule of Recent Events. Content validity was supported by comparison of these results with findings of other investigators. Limitations of the results are discussed, and recommendations for future work on the instrument are offered.

Adult↗
PubMed1990

Evidence against extended DR3-related haplotypes in Graves' disease.

Three HLA-DR3-linked polymorphisms of the DPA, DPB and DRB genes, previously associated with myasthenia gravis or coeliac disease, have been examined in Caucasian patients with Graves' disease. The patients did not differ from healthy DR3 subjects, indicating an absence of any association of Graves' disease with specific DR3 subtypes.

Graves Disease↗
PubMed1989

A randomized clinical trial of home nursing care for lung cancer patients.

A randomized clinical trial was conducted to assess the effects of home nursing care for patients with progressive lung cancer. One hundred sixty-six patients were assigned to either an oncology home care group (OHC) that received care from oncology home care nurses, a standard home care group (SHC) that received care from regular home care nurses, or an office care group (OC) that received whatever care they needed except for home care. Patients were entered into the study 2 months after diagnosis and followed for 6 months. Patients were interviewed at 6-week intervals across five occasions. At the end of the study, there were no differences in pain, mood disturbance, and concerns among the three groups. There were significant differences in symptom distress, enforced social dependency, and health perceptions. The two home nursing care groups had less distress and greater independence 6 weeks longer than the office care group. In addition, the two home nursing care groups steadily reported worse health perceptions over time. Thus, it was remarkable that the office care group, which indicated more symptom distress and social dependency with time, also indicated perceptions of improved health with time. These results suggest that home nursing care assists patients with forestalling distress from symptoms and maintaining their independence longer in comparison to no home nursing care. Home care may also include assisting patients in acknowledging the reality of their situation.

Adult↗
PubMed1989

Work disability among cancer patients.

To identify factors affecting the ability of persons with recent cancer diagnoses to remain in the labor force and retain premorbid levels of work performance, the investigators analyzed data on 247 individuals with lung, pancreatic, prostatic, or cervical cancer. Subjects were selected from a population-based tumor registry. According to Pearson correlations, ordinary least squares multiple regression, and logistic analysis, physical factors related to disease were the strongest predictors of work disability, defined as either leaving the labor force or functioning less fully at work than before becoming ill. The strongest predictors of work disability were physical dysfunction measured by the Sickness Impact Profile (SIP) and disease stage. Social background factors such as age, sex, income, and education were not statistically significant predictors. Two job characteristics, (1) physical demands of work and (2) discretion over hours worked and how much work would be done, predicted work disability, the latter appearing to help prevent this condition. Strictly disease-related factors appear more important here in predicting work disability than in studies of other diseases. Still, it appears that increasing flexibility of working hours and the pace of work could help some individuals with cancer histories remain in the labor force. Unwillingness of employers to facilitate such accommodation where technically feasible may constitute a form of discrimination against the cancer patient.

Activities of Daily Living↗