PubMed · 15500229
This article provides an overview of total hip replacement and the nurse's role in caring for patients undergoing this procedure.
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Jenny Temple. Total hip replacement.. https://doi.org/10.7748/ns2004.09.19.3.44.c3703
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PURPOSE/OBJECTIVES: To describe patterns of symptom distress over time in older women receiving surgical treatment for breast cancer and to examine the relationship of selected patient and clinical characteristics to symptom distress. DESIGN: Secondary analysis of breast cancer data from a prospective, longitudinal study of older patients with several types of cancer. SETTING: Large mid-Atlantic teaching hospital. SAMPLE: 57 patients with breast cancer participated. Subjects had a mean age of 68 and were predominantly white, not Hispanic, married, Protestant, retired, and in stage I or II. A total of 55 subjects completed the study. METHODS: The Symptom Distress Scale was used. Data were collected on discharge and at three and six months postdischarge. Descriptive statistics, t test, analysis of variance, correlation coefficients, and stepwise multiple regression were analyzed. MAIN RESEARCH VARIABLES: Total symptom distress and 13 individual symptom scores. FINDINGS: Fatigue, frequency of pain, outlook, and insomnia consistently were most prevalent and severe. Symptoms decreased gradually. Younger, more educated, and married women experienced more distress. CONCLUSIONS: Interactions among symptoms are complex. Later symptom distress may be predicted by early experience and demographic characteristics. IMPLICATIONS FOR NURSING: Clinicians should inquire about symptom distress at each encounter, expect multiple symptoms, and anticipate greater symptom distress in patients who are younger, more educated, or married or living with a partner. In women with more severe, earlier symptom distress, nurses should intervene promptly. Research should determine interrelationships of symptoms and how they might be affected by contextual variables, describe critical attributes of the nurse-patient interaction that might mitigate symptom distress, characterize the relationship of symptom intensity and distress, clarify the mechanism of the relationship between marital status and symptom distress, and identify the effect of symptoms, individually and collectively, on survival and quality of life.
The aim of this study was to quantify the effects of separate phases of an invitational screening program on breast cancer incidence at different ages. Our database included detailed municipality-specific information about invitations for mass-screening for breast cancer in 267 Finnish municipalities from time period 1987-2001. The age range was 50-74. For this study, the program was divided into 7 separate phases, and those that had not been invited served as a baseline. The incidence rate was modeled using Poisson regression. To study the differences between age groups within each program phase, an interaction term between age group and phase of screening was included in the model. The modeling was done separately for localized breast cancers, nonlocalized breast cancers and all stages combined. For localized cancers, the risk compared to the noninvited increased during the first years of the 2-year screening rounds in all age groups, and declined below the baseline during the second years. This effect was larger during the first round compared to the subsequent ones. In nonlocalized cancers, a clear incidence peak was detected only during the first year of the first round. A decreasing post screening effect was detected in nonlocalized cancers in women aged 60-69, but not in localized cancers. Cumulating over ages 50-74, extra incidence caused by regular screening in localized cancers was 5.2% if the program was continued up to age 59, and 28.0% if it continued up to age 69. Corresponding figures for nonlocalized cancers were decreases of 19.8% and 20.9%, respectively.
BACKGROUND: No other studies have compared the relationship between body mass index (BMI) and health-related quality of life (HRQL) on more than one utility measure. Estimating the HRQL effects of obesity on a (common) utility scale enables the relative cost-effectiveness of interventions designed to alleviate obesity to be estimated. OBJECTIVE: To examine the relationship between BMI and HRQL according to the EQ-5D, EuroQol visual analogue scale (EQ-VAS) and SF-6D. METHODS: Patients aged >/=45 years at one UK general practice were asked to complete the EQ-5D, EQ-VAS, SF-36 questionnaire (used to derive the SF-6D), and information on their characteristics and co-morbidity. Body mass index was categorized according to the World Health Organization (WHO) recommendations. Regression analysis was used to compare the HRQL of normal BMI patients to the HRQL of patients in other BMI categories, while controlling for patient characteristics and co-morbidity. RESULTS: A total of 1865 patients responded (67%), mean BMI 26.0 kg/m(2), 16% obese (BMI>/=30). Patients with back pain, hip pain, knee pain, asthma, diabetes or osteoarthritis were also significantly more likely to be obese. After controlling for other factors, compared to normal BMI patients, obese patients had a lower HRQL according to the EQ-5D (P<0.01), EQ-VAS (P<0.001) and SF-6D (P<0.001). Pre-obese patients were not estimated to have a significantly lower HRQL, and underweight patients were only estimated to have a significantly lower HRQL according to the SF-6D. These results arose because, on the EQ-5D, obese patients were found to have significantly more problems with mobility and pain, compared to physical functioning, social functioning and role limitations on the SF-6D. Whereas, according to the SF-6D, underweight patients had significantly more problems on the dimension of role limitation. CONCLUSION: The EQ-5D, EQ-VAS and SF-6D were in agreement that, relative to a normal BMI, obesity is associated with a lower HRQL, even after controlling for patient characteristics and co-morbidity. These three measures are thereby sensitive to the HRQL effects of obesity and can be used to estimate the cost-effectiveness of interventions designed to alleviate obesity.