Daily assessment of stressful events and coping among post-menopausal women with breast cancer treated with adjuvant chemotherapy

The purpose of the study was twofold: to examine what type of daily stressful events post-menopausal woman with breast cancer experience during adjuvant chemotherapy and how bothersome these are and to identify coping strategies used by these women used to manage such stressful events. The patient group comprised 75 consecutively invited women (≥55 years of age) at two university hospitals and one county hospital in Sweden. The Daily Coping Assessment was used to collect data over time. Data were analysed both qualitatively and quantitatively. Six categories of stressful events were identified: 'nausea and vomiting', 'fatigue', 'other symptoms', 'isolation and alienation', 'fear of the unknown' and 'being controlled by the treatment'. The first three categories were subsumed under the domain physical problems and the latter three under psychosocial problems. Almost 30% of the diary entries recorded no stressful event. Physical problems were three times as frequent as psychosocial problems. 'Nausea/vomiting' was the most frequently observed stressful event (21.6%). 'Isolation and alienation' and 'fear of the unknown' were less frequent, but when they occurred they were rated as the most distressing. Several coping strategies were used to manage each stressful event. The most common strategies were acceptance, relaxation and distraction. Religion was rarely used as a coping strategy.     

Nursing Home Care Intervention Post Stroke (SHARE) 1 year effect on the burden of family caregivers for older adults in Brazil: A randomized controlled trial

The purpose of this study is to evaluate the effect of home-care nursing intervention on the burden of family caregivers for older adults surviving a stroke. A randomised clinical trial blinded for outcome evaluation. Forty-eight family caregivers of older adults surviving a stroke took part in the study. The intervention group (IG) received three home visits by nurses in 1 month after hospital discharge for guidance on the disease and care activities for the elderly people. The control group (CG) relied on the service network that had access. The Caregiver Burden Scale was applied to assess the burden outcome 1 week, 60 days and 1 year after hospital discharge. The caregivers of the intervention and CGs had no difference regarding baseline data. There was an interaction effect between the CG and the IG in the isolation domain (p = 0.037) and in the emotional involvement domain (p = 0.003) over time. These findings provide support for strengthening a care line for the elderly people after a stroke, with adequate discharge planning, indicating the importance of integrating care network services such as primary care, home care and hospital care with a view to achieving an effective care transition. It is also necessary to construct a specific instrument to evaluate other outcomes, such as the knowledge and learning of caregivers in relation to the care activities taught. This study is registered in the Clinical Trials with name Nursing Home Care Intervention Post Stroke (SHARE) and under number NCT02807012.     

Comparison of patients' needs and doctors' perceptions of information requirements related to a diagnosis of oesophageal or gastric cancer

WITTMANN E., BEATON C., LEWIS W.G., HOPPER A.N., ZAMAWI F., JACKSON C., DAVE B., BOWEN R., WILLACOMBE A., BLACKSHAW G. & CROSBY T.D.L. (2010) European Journal of Cancer Care 20 , 187–195 Comparison of patients' needs and doctors' perceptions of information requirements related to a diagnosis of oesophageal or gastric cancer The aim of this study was to assess the information needs of patients diagnosed with oesophageal and gastric cancer and to compare these with their perceived information needs in the opinion of junior doctors. One hundred patients and 100 doctors responded to a questionnaire regarding the information needs of cancer patients. Seventy‐nine per cent of patients wanted as much information as possible about their diagnosis, but only 35% of doctors were willing to give all the available information (P < 0.0001). Seventy‐seven per cent of patients wanted to receive their diagnosis from a consultant whereas only 5% of doctors believed that patients should receive their diagnoses from a consultant (P < 0.0001). Eighty‐four per cent of doctors were willing to communicate a serious illness with a good prognosis, yet only 43% would communicate a diagnosis with a poor prognosis (P < 0.0001). All 100 doctors had received formal training in breaking bad news, but 20 considered this inadequate. Socio‐economic deprivation was associated with poor access to supplementary Internet derived information (P < 0.001). The majority of patients with a diagnosis of oesophagogastric cancer want a great deal of information regarding their illness, which contrasts with doctors' perceptions. Adequate training in information disclosure may help address this issue.     

蒙药好必斯清糖片的药效学研究

实验表明，降血糖蒙的好必斯清糖片对正常小鼠有显著的降低血糖（P＜0．01），增加肝糖原含量（P＜0．01）作用；对四氧嘧啶所致高血糖动物模型具有显著的降低血糖水平（P＜0．05），增加血清胰岛素的含量（P＜0．01）作用。     

Patients'' experience of being critically ill or severely injured and cared for in an intensive care unit in relation to the ICU syndrome. Part I

The intensive care unit (ICU) syndrome is regarded principally as a complex interaction of several contributory factors, all of which can be seen as partly responsible for the development of the syndrome. The purpose of this study was to describe and give a deeper insight into patients' experiences and memory recall, both during and after their stay in the ICU. Nineteen patients who had been respirator treated (ventilated), and had stayed at least 36 hours in the ICU, were interviewed about one week after discharge, and again 4-8 weeks after their discharge from the ICU. Patients' experiences are interpreted and related to previous views held concerning the syndrome, together with an awareness of other important and significant phenomena, i.e. a hermeneutic approach. This study partly confirms the findings of earlier studies concerning the ICU syndrome, but also reveals some new aspects, which have not previously been considered. The patients described themselves as experiencing some sort of state of chaos following the onset of their sickness, injury or accident, which resulted in feelings of extreme instability, vulnerability and fear, often experienced as prolonged inner tension. It was reported that even the most trivial events in circumstances or routines could trigger changes-either an increase or decrease-in patients' feelings of fear or inner tension. The caring relationship was perceived as providing an important degree of security and comfort. Nursing care actions can therefore be seen as vital factors in patients overcoming the accompanying horrific experiences to which they can be subjected. This state of chaotic feeling, and how it is combated and treated, appear to be one critical factor in the development and progression of the ICU syndrome.