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The purpose of this study was to identify and compare information and decision preferences of men with prostate cancer and their partners at the time of diagnosis. A convenience sample of 80 couples was recruited from The Prostate Centre in Vancouver, Canada. Participants used a computerized version of two previously used measures with this population: Control Preferences Scale and Information Survey Questionnaire. Results showed that men had a preference to play either an active or a collaborative role in decision making with their physician (92.5%) and partners (100%). The majority (55%) of partners wanted to play a collaborative role in treatment decision making. Couples identified prognosis, stage of disease, treatment options, and side effects as the top 4 information preferences. Men ranked information on sexuality more important than partners, and partners ranked information on home self-care higher than men. Men who had sons, a positive family history, and lower levels of education ranked heredity risk significantly higher. Profiles of information categories did not differ according to role preferences of either men or partners. The computer program has been shown to be a reliable and acceptable method of assessing information and decision preferences of these couples. An individualized approach is suggested, given the high reliability of individual's profiles.  相似文献   

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A critical review of the literature was carried out in the United Kingdom to identify the information needs and information-seeking behaviors of men with prostate cancer and their partners. Relevant papers published between 1990 and 2000 were reviewed and despite having several methodologic limitations, a number of conclusions can still be drawn from this review. First, men with prostate cancer have distinct information needs and information-seeking behaviors throughout their cancer journeys. Although there is considerable variation in the amount and type of information that men require, the majority of men with prostate cancer are satisfied with the information they receive. Second, although partners of men with prostate cancer have needs for information, these needs are often unmet. Partners undergo an information-seeking pattern that is comparable with, if not more active than, patients' information-seeking behaviors. These findings have a number of implications for cancer nursing practice and research, which are discussed in the article.  相似文献   

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The inappropriate endogenous secretion of tumour necrosis factor (TNF) could play a role in the pathogenesis of acute respiratory distress syndrome (ARDS), one of the most frequent causes of death in cancer patients. Because of its capacity to inhibit TNF secretion in vitro, pentoxifylline (PTX) could be extremely useful in ARDS therapy. In this study 30 advanced cancer patients with ARDS were randomized to receive either the conventional care or conventional care plus PTX (100 mg i.v. twice a day for 7 days followed by an oral administration of 400 mg three times a day) to evaluate the efficacy of PTX in reducing TNF serum levels and in improving the symptoms of this syndrome. Serum levels of TNF were measured before and after 7 days of therapy. The percentage of patients alive at 7 days was significantly higher in the PTX-treated group than in the controls (12/15 versus 3/15; P<0.001). The mean survival time was significantly higher in the PTX-treated group than in the controls. A clinical and/or radiological improvement was obtained in 11/15 patients treated with PTX and in only 2/15 patients in the conventional care group (P<0.01). TNF mean levels significantly decrease in the PTX-treated group. These data confirm in vivo the capacity of PTX to inhibit TNF secretion in patients with ARDS. Moreover PTX therapy may improve the symptoms related to ARDS without particular toxic effects.  相似文献   

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Chronic obstructive and pulmonary disease (COPD) has detrimental effects on individuals with the disease. COPD causes breathlessness, morbidity and associated psychosocial distress. This study was guided by the phenomenological question what is it like to have COPD and situated in Van Manen's phenomenology of practice. Experiential material was gathered through phenomenological interviews. Four themes emerged from the lived experiences of patients living with COPD: breath as a possibility; being vigilant; fighting a losing battle; and feeling isolated from others. For patients with COPD, breathing becomes ever-present and shifts from the invisible background of daily living to the central activity around which everyday life is organised. COPD patients always monitor their own breath and scrutinise the environment on possible dangers that can affect their breathing. Whenever moving or being involved in an activity, a part of their mind is preoccupied with the breathing. Although COPD patients realise that no amount of good behaviour will matter and that the decline of their lungs is inevitable, they make every effort to take good care of their body. They anticipate and avoid triggers of breathlessness isolating them from social interactions and activities. The appearance of the body as a source of social embarrassment also has an isolating effect. This study shows that breathlessness is a constant horizon that frames the experience of COPD patients. It is a limiting factor and determines their entire life. A more profound understanding of these experiences in healthcare professionals will contribute to person-centred care for COPD patients.  相似文献   

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AimThis study evaluated the process and outcome of a psychosocial intervention for men with prostate cancer and their partners. As more men survive prostate cancer, they and their partners need help and support to help them cope with the physical and psychosocial effects of the disease and treatment. There is a lack of psychosocial interventions for men with prostate cancer and their partners.MethodsA randomized controlled trial was conducted with 34 participants to measure the effects of the intervention on selected psychosocial outcomes, post-intervention and at one month’ follow-up. The nine-week program (CONNECT) consisted of three group and two telephone sessions. It focused on symptom management, sexual dysfunction, uncertainty management, positive thinking and couple communication. The outcomes, measured by validated tools were: self-efficacy, quality of life, symptom distress, communication, uncertainty and illness benefits.ResultsThe men in the intervention group did better on two outcomes (communication and support) than controls. Partners in the intervention group did better than controls on most outcomes. Less participants than expected participated in the trial. The reasons for non-participation included partners not wishing to participate, men not interested in group work, and not understanding the core purpose of the intervention. The cost of training facilitators and for delivering the intervention appeared to be low.ConclusionThe knowledge generated from this study will be beneficial for all those grappling with the challenges of developing, implementing and evaluating complex psychosocial interventions. This study has also highlighted the difficulties in recruiting men and their partners in clinical trials.  相似文献   

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Oesophageal cancer (OC) is a debilitating disease with significant social, psychological and physical impacts on health and lifestyle (Mills and Sullivan, 2000). The research presented in this paper uses a survey method, and reveals that patients require honest communication and more help with everyday living from nurses to facilitate recovery. Each patient is unique but commonalities can be established that improve experience and outcome. Three themes emerged from the data: food, activity and positivity. To meet long-term needs, the Oesophageal Patients Association is fundamental for patients and carers in order adapt to this major life-changing event.  相似文献   

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目的:探讨中青年晚期癌症患者心理痛苦体验,为实施全人照顾提供参考依据。方法:采用目的抽样法,抽取2017年5-7月在我院中西医结合科住院的12例中青年晚期癌症患者作为研究对象,所选患者心理痛苦评分(Distress Thermometer,DT)均≥4分,进行深度访谈,采用现象学分析访谈内容,整理提炼主题。结果:生理方面,对患者痛苦最大的前3位症状包括疲乏、疼痛、恶心呕吐;心理方面,主要存在担心、恐惧、病耻感及自我负担感;家庭社会方面,经济问题、无精力照顾孩子和老人、家属过分关心给患者带来很大心理痛苦;灵性方面,患者主要存在失去希望、绝望、自杀意图,怨天尤人,感叹不公,不放心,孤立隔绝等问题。结论:中青年晚期癌症患者存在身、心、社、灵等多方面心理痛苦,医护人员在临床工作中在重视患者症状管理的同时也要关注患者心理痛苦体验并给予针对性心理疏导,做到全人照顾,提高患者终末期生活质量。  相似文献   

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A three-phase program of research consisted of: (1) data collection at eight data points across one year on predictors and outcomes of adjustment among 128 women diagnosed with breast cancer and 121 partners; (2) development of phase-specific interventions: standardized education by videotape (SE), and telephone counseling (TC); and (3) a pilot study among 12 patient-partner pairs. Four phases were identified: diagnostic, post-surgical, adjuvant therapy, and ongoing recovery. Needs were categorized as those related to: (1) physical well-being, (2) emotional well-being; (3) support; and (4) the healthcare system. In the pilot study, each group consisted of 4 patient-partner pairs, randomly assigned to one of four groups. At each of the four phases, all groups received the currently accepted disease management (DM). Group 1: DM * Group 2: DM+SE * Group 3: DM+TC * Group 4: DM+SE+TC. Measures of outcomes validated in the longitudinal study were administered. The feasibility of a confirmatory randomized clinical trial was demonstrated. Preliminary evidence indicates the importance of research-based, phase-specific educational and counseling interventions that have a positive effect on adjustment among both patients and their families.  相似文献   

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《Journal of substance use》2013,18(2):148-160
Background: The prevalence of psychological distress among persons in opioid maintenance treatments (OMT) is high. It is important to assess psychological distress among OMT mothers and their partners because such psychological distress increases the risk of relapse to substance use.

Methods: A national cohort of pregnant women in OMT (n = 37) and their partners (n = 23) were taking part in a prospective study. They were interviewed during third trimester of pregnancy and 1 year after giving birth with the European Addiction Severity Index and completed Symptom Checklist 25 during the last month of pregnancy, 6 months and 2 years after the children were born.

Results: Among the women there was a significant reduction in depressive symptoms from pregnancy to 6 months after giving birth (p < 0.01) and an increase in depressive symptoms from 6 months to 2 years after giving birth. Among the partners there was a significant decrease in psychological distress from pregnancy to 1 year after the children were born (p < 0.05).

Conclusion: The overall results indicate a reduction in psychological distress for both OMT women and their male partners during the first period after birth, probably affecting parenting abilities and treatment outcome in a positive way.  相似文献   

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Background

Cachexia in advanced malignancy is a debilitating syndrome which contributes to approximately two million deaths worldwide annually. In spite of advances in understanding the biomedical aspects of cancer cachexia, little attention has been paid to exploring its holistic impact on patients and those who care for them.

Objective

The aim of this paper is to describe the lived experience of cachexia from the perspective of patients with cancer and their family members.

Design

An interpretative phenomenological approach was employed.

Setting and participants

A purposive sampling strategy recruited 15 patients and 12 family members from the Regional Cancer Centre in Northern Ireland.

Method

Each participant was interviewed during 2004/2005 using an unstructured interview. All interviews were recorded and transcribed verbatim. Analysis combined a two stage approach using thematic and interpretative phenomenological analysis.

Results

Analysis generated six superordinate themes that reflected the complex dynamics of the cachexia experience. Themes were: physiological changes in appetite; visuality of cachexia; weight loss interpreted as a bad sign; response from health care professionals; conflict over food; and coping responses.

Conclusions

Findings confirmed that cancer cachexia has far reaching implications for patients and their families, extending beyond physical problems into psychological, social and emotional issues. This insight is a critical first step in the development of more responsive care for these clients.  相似文献   

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中青年晚期癌症患者心理痛苦现况分析   总被引:1,自引:0,他引:1  
目的:调查中青年晚期癌症患者心理痛苦现状及影响因素。方法:采用便利抽样的方法,选取2017年1月至6月住院的284例中青年晚期癌症患者做为研究对象,采用一般资料调查问卷和心理痛苦管理筛查工具(DMSM)对研究对象进行问卷调查,患者入院24小时之内由研究者完成资料的收集。结果:中青年晚期癌症患者心理痛苦得分(3.55±2.70)分,心理痛苦检出率为41.5%;患者人口学特征中性别、家庭月收入对患者心理痛苦程度有影响,心理痛苦问题列表中实际问题得分最高,其次是情绪问题和身体问题,交往问题得分最低,前五位的问题分别是:经济问题(57.7%)、疲乏(32.4%)、无时间经历照顾孩子/老人(28.9%)、担忧(28.9%)、疼痛(24.6%)。结论:中青年晚期癌症患者具有较高的心理痛苦水平,提示在今后的临床工作中医务人员要给予这部分人群更多的关注及心理支持,以降低其心理痛苦水平,改善生活质量。  相似文献   

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