Cancer nursing
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Multicenter Study
Factors influencing family caregivers' ability to cope with providing end-of-life cancer care at home.
Dying at home is a goal promoted by many healthcare providers and governments as a way to enhance the dying experience for cancer patients and their family members. A key element to realizing this goal is the availability of a family member who is willing to provide care at home. Little research has been conducted on the factors that influence family caregivers' ability to cope with providing end-of-life cancer care at home. ⋯ Semistructured interviews with 29 active family caregivers were conducted and thematically analyzed. Our findings suggest 5 factors that influenced the caregivers' ability to cope: (1) the caregiver's approach to life, (2) the patient's illness experience, (3) the patient's recognition of the caregivers' contribution to his or her care, (4) the quality of the relationship between the caregiver and the dying person, and (5) the caregiver's sense of security. Findings provide important information to assist in informing health services and policies directed at enhancing family caregivers' coping abilities.
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This study aimed to compare cognitive function of cancer pain patients being given opioids during their cancer treatment (n = 14) with that of patients receiving treatment without opioids (n = 12). Correlations between cognitive function, pain intensity, and opioid dose were analyzed. Patients were assessed 3 times in a 1-month period, using the Trail-Making Test, Mini-Mental State Examination, Digit Span, and Brief Cognitive Screening Battery. ⋯ Opioid dose did not correlate with any of the measures of cognitive performance. However, the patients with the worst performance scores were those with more severe pain. Further studies are needed to clearly distinguish between the effects of opioids versus the effects of pain.
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The aim of this study was to understand present knowledge, attitudes, and behavioral intentions of clinical nurses providing artificial nutrition and hydration (ANH) for terminal cancer patients. Study subjects were composed of 197 nurses from the gastroenterology, general surgery, and intensive care units of Taipei Veterans General Hospital in Taiwan. Subjects were surveyed between April and June 2005 via self-developed structural questionnaires. ⋯ In subjective norms, "attending physicians and/or superiors" (45.3%) and, secondarily, "patients" (38.4%) were important influencing persons on nurses' support for ANH. Other influencing factors were communication difficulties with patients and/or family members (3.40 [0.83]), staff disagreements (3.01 [0.78]), and fear of medical dispute (3.42 [0.95]). Study results suggest that reinforcing in-service education to enhance nurses' knowledge of providing ANH for terminal cancer patients and building up positive attitudes and behavioral intentions may strengthen nurses' efforts to actively communicate and cooperate with physicians in assisting patients and families to make the most appropriate medical decisions.