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Biomedical subjects

S L Dibble

Publications and source records attributed to S L Dibble.

46 records · Page 3Linked to original sources
PubMedDate not supplied

Use of herbs in women diagnosed with ovarian cancer.

Of 113 consecutive ovarian cancer patients identified in a gynecologic clinic in a major academic medical center in San Francisco, 41 patients were successfully contacted, were eligible, and participated in a telephone survey. We contacted women identified consecutively in the clinic database as having ovarian cancer and sent a letter introducing our research team and asking for help. Members of the research team then contacted the women to conduct the telephone interviews. Fifty-one percent (95% CI 35-67) of the women had taken herbs sometime since they were diagnosed with ovarian cancer. Most herb uses occurred concurrently with chemotherapy. Only 12% (95% CI 4-26) used an herbalist or other health practitioner for guidance in herb use. Only one woman took herbs instead of chemotherapy. A large number of women attending our practice in the San Francisco Bay area use herbs as complementary medicine during their cancer treatment.

Attitude to Health↗
PubMedDate not supplied

Gender differences for the predictors of depression in young adults with genital herpes.

Genital herpes is a chronic, stigmatizing, sexually transmitted disease (STD), which is increasing despite efforts to control its spread. Depression is commonly reported among people diagnosed with genital herpes and differences in depression by gender have been reported. Therefore, the purpose of this study was to identify gender differences in the predictors of depression in young adults with genital herpes by secondary analyses of baseline data from a randomized clinical trial (RCT). For the RCT, young adults (193 females, 59 males) with genital herpes were recruited from newspaper advertisements. Participants completed questionnaires measuring illness burden, attitudes toward herpes, stress symptoms, mood states, depression, self-concealment, self-disclosure, substance use, and demographics. Univariate analyses and multiple regression techniques were used to identify variables predictive of depression in this sample. In women, increased anger, decreased vigor, increased confusion, a negative attitude toward herpes, self-concealment, and stress symptoms from genital herpes predicted more depression (R2 = 0.63). In men, increased depression was predicted by increased anger, a negative attitude toward herpes, and a decreased willingness to share personal information with a stranger (R2 = 0.51). Findings suggest that future psychoeducational interventions should address anger as a predictor of depression in this population. Gender-specific interventions need to be developed in order to assist young adults who are living with genital herpes.

Adaptation, Psychological↗
PubMedDate not supplied

Developing multisite research in critical care.

Conducting a clinical critical care research project simultaneously in a variety of institutions requires careful and comprehensive planning. The authors outline the steps in the planning and development of a multisite research project, stressing those areas requiring special attention and decision making.

Critical Care↗
PubMedDate not supplied

Acupressure for nausea: results of a pilot study.

PURPOSE/OBJECTIVES: To compare differences in nausea experience and intensity in women undergoing chemotherapy for breast cancer between those receiving usual care plus acupressure training and treatment and those receiving only usual care. DESIGN: Single-cycle, randomized clinical trial. SETTING: Outpatient oncology clinic in a major teaching medical center and a private outpatient oncology practice. SAMPLE: Seventeen women participated in the study. The typical participant was 49.5 years old (SD = 6.0), Caucasian (59%), not married/partnered (76%), on disability (53%), born a U.S. citizen (76%), and heterosexual (88%); lived alone (59%); had at least graduated from high school (100%); and had an annual personal income of $50,000 or greater (65%). METHODS: The intervention included finger acupressure bilaterally at P6 and ST36, acupressure points located on the forearm and by the knee. Baseline and poststudy questionnaires plus a daily log were used to collect data. MAIN RESEARCH VARIABLES: Nausea experience measured by the Rhodes inventory of Nausea, Vomiting, and Retching and nausea intensity. FINDINGS: Significant differences existed between the two groups in regard to nausea experience (p < 0.01) and nausea intensity (p < 0.04) during the first 10 days of the chemotherapy cycle, with the acupressure group reporting less intensity and experience of nausea. CONCLUSIONS: Finger acupressure may decrease nausea among women undergoing chemotherapy for breast cancer. IMPLICATIONS FOR NURSING PRACTICE: This study must be replicated prior to advising patients about the efficacy of acupressure for the treatment of nausea.

Acupressure↗
PubMedDate not supplied

MacDibbs Mouth Assessment. A new tool to evaluate mucositis in the radiation therapy patient.

PURPOSE: The purposes of this descriptive, longitudinal study were to evaluate the MacDibbs Mouth Assessment instrument for the assessment of mucositis in the radiation therapy patient being treated for head and neck cancer and to describe the course of radiation-induced mucositis in these patients. DESCRIPTION OF STUDY: This pilot study used self-report and provider assessment, as well as medical record review, to obtain data about ambulatory radiation therapy outpatients (n = 10). The participants were primarily male, white, middle-aged, married or partnered, unemployed, edentulous, currently smoking, and using alcohol. RESULTS: One or more mucositis ulcers were observed in all patients and occurred at an average of 2858.2 cGy. The corresponding Mouth Symptom Score was 5.9 (instrument range 0-21). Interrater reliability for 13 of the 14 items was 100%. The one difficulty encountered with the MacDibbs was in the measurement of ulcers longer than the periodontal probe used to measure them. CLINICAL IMPLICATIONS: The MacDibbs should prove useful for clinicians and researchers because it is efficient, easy to use, emphasizes accurate diagnosis of oral changes, has an easily discernible endpoint, and assesses signs and symptoms.

Adult↗
PubMedDate not supplied

Comparison of perceived symptoms of patients undergoing bone marrow transplant and the nurses caring for them.

This study describes the symptomatology of patients hospitalized for bone marrow transplant (BMT) (n = 30) and compares their perceptions of these symptoms to those of nurses (n = 28). Patients and nurses responded to the Symptom Distress Scale (SDS) four times: within 48 hours of BMT day one (T1); day 7-10 post-BMT (T2); day 20-23 post-BMT (T3); and day 30-34 post-BMT (T4). Patients also completed the Profile of Mood States at T1. Each time, the investigators completed a Karnofsky Performance Status evaluation of each patient. Patients perceived significantly more distress from their symptoms at T1 than their nurses perceived that they were experiencing. Over time, patients' SDS scores did not change significantly. However, nurses' SDS scores indicated significant differences, with their SDS scores at T1 less than those at T2 and T3. The results indicate the importance of nurses exploring the perceived symptom experiences of patients undergoing BMT. Any incongruence between nurses' and patients' perceptions potentially could prevent patients' symptoms from being managed effectively.

Activities of Daily Living↗
PubMedDate not supplied

Patients' perspectives of fatigue while undergoing chemotherapy.

PURPOSE/OBJECTIVES: To explore the experience of fatigue from the perspective of patients undergoing chemotherapy. DESIGN: Qualitative research and secondary analysis of data from a larger study. SETTING: Participants were recruited from 18 sites, including large outpatient chemotherapy clinics and private medical oncologists' offices. SAMPLE: 127 adult patients who were beginning their first protocol of chemotherapy. METHODS: Data were collected through individual and open-ended interviews and a qualitative, thematic analysis of the participants' responses using grounded theory techniques. MAIN RESEARCH VARIABLE: The experience of fatigue as perceived by patients undergoing chemotherapy. FINDINGS: The analysis resulted in eight major thematic categories: (a) experiencing fatigue, (b) effects on well-being, (c) attribution of origin, (d) awareness and expectations, (e) emotional reactions, (f) activity, (g) the "biggest" concern, and (h) strategies and plans. CONCLUSIONS: This study demonstrates the variation, extent, duration, and temporality of fatigue among patients receiving chemotherapy and the dynamic, changing aspects of the experience. IMPLICATIONS FOR NURSING PRACTICE: Fatigue must be considered within the context of patients' daily lives and environments, disease processes, and treatment modalities. Nurses must listen carefully to patients' own descriptions of being tired. Further research examining patients' perspectives of and experiences related to fatigue is necessary to increase the theoretical understanding of fatigue and to improve therapeutic nursing interventions.

Activities of Daily Living↗
PubMedDate not supplied

Comparison of methods to determine the prevalence and nature of oral mucositis.

PURPOSE: Chemotherapy-induced oral mucositis may cause considerable patient morbidity. Its prevalence has been reported as ranging from 30% to 39%, although a prevalence as high as 75% has been reported with 5-fluorouracil. This variation may be a function, in part, of the methods of measurement used across different studies. The first purpose of this study was to determine the prevalence of oral mucositis in a sample of 127 patients receiving specific chemotherapy. The second purpose was to compare different instruments and techniques for assessing oral mucositis. DESCRIPTION OF STUDY: A longitudinal design was used to collect data at four monthly chemotherapy cycles during drug nadir. The methods of measuring oral mucositis included interview (conducted monthly x 4); Eiler's Oral Assessment Guide (monthly x 4); Chemotherapy Knowledge Questionnaire and Behavior Checklist (both at the fourth month); Self-Care Behavior Log (ongoing over 4 months); and medical record review (collected at 4 months). RESULTS: The mucositis prevalence in this one sample ranged from 30% to 69% depending on the method of measurement. The use of multiple instruments and techniques captured a clinical picture of oral mucositis far more detailed than published reports--a picture not revealed with any one instrument or technique. The chart record severely underdocumented the prevalence of mucositis compared to the interview. This discrepancy could reflect under-reporting by the patients, inadequate history taking at provider visits, or perhaps the documentation of only the more severe mucositis or mouth problems in the medical record. CLINICAL IMPLICATIONS: Clinicians and researchers must choose their method of measurement carefully in relation to the purpose of assessment. For subjective tolerance of symptoms, the interview technique may be most useful. To test interventions, the use of a quantitative rating instrument is desirable. Intervention studies using multiple measures may require a combination of subjective and objective measures.

Adult↗