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Abstract
Moderate-to-severe pain is a common problem experienced by patients with cancer. Although analgesic drugs are effective, adverse side effects are common and some analgesic drugs are addictive. Nonpharmacological treatment may be a way to treat cancer pain without causing negative side effects. Mindfulness is used as an effective nonpharmacological treatment to improve quality of life (QoL) and to address psychological problems including distress, anxiety, stress, and depression. However, the effect of mindfulness on pain severity has not been sufficiently investigated. Therefore, a systematic review was undertaken to describe the effectiveness of mindfulness interventions for pain and its underlying pathophysiologic mechanisms. The search was conducted in PubMed, Ovid MEDLINE, and CINAHL and included only empirical studies published from 2008 to 2017. Search terms included mindfulness, mindfulness-based intervention, meditation, cancer, pain, and cancer-related pain. Six studies met the search criteria. These studies tested several types of intervention including mindfulness-based stress reduction, mindfulness-based cognitive therapy, meditation with massage, and mindful awareness practices. Study outcomes include improved pain severity, anxiety, stress, depression, and QoL. However, most studies reviewed were conducted in the United States and Denmark. Further research is needed to test culturally appropriate mindfulness interventions to reduce pain.
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Affiliation(s)
- Srisuda Ngamkham
- Department of Nursing Administration and Professional Development, Boromarajonani College of Nursing Sawanpracharak Nakhonsawan, Nakhonsawan, Thailand
| | - Janean E Holden
- Department of Health Behavior and Biological Sciences, School of Nursing, University of Michigan, Ann Arbor, MI, USA
| | - Ellen Lavoie Smith
- Department of Health Behavior and Biological Sciences, School of Nursing, University of Michigan, Ann Arbor, MI, USA
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2
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Aguilar BA. The Efficacy of Art Therapy in Pediatric Oncology Patients: An Integrative Literature Review. J Pediatr Nurs 2017; 36:173-178. [PMID: 28888499 DOI: 10.1016/j.pedn.2017.06.015] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/29/2016] [Revised: 06/16/2017] [Accepted: 06/20/2017] [Indexed: 10/19/2022]
Abstract
PROBLEM Children undergoing cancer treatment experience detrimental adverse side effects that may be addressed with complementary and alternative medicine (CAM) such as art therapy. The purpose of this research was to examine the effects of art therapy in pediatric patients living with cancer. ELIGIBILITY CRITERIA An integrative literature review was conducted using the CINAHL, OVID Medline, and PsycINFO databases. Studies were included if they were a primary source utilizing an art therapy intervention in children with cancer age birth to 18years old, was published between the year 2000 and 2016, and written in the English language. SAMPLE Seven primary sources met inclusion criteria. RESULTS Few studies were reported in this review. Findings of this review suggest that children who participated in various forms of drawing interventions exhibited enhanced communication with family members and healthcare providers. Additionally, children were able to better express underlying emotions, developed more effective coping skills, and experienced a reduction in adverse side effects. CONCLUSIONS Implementing a drawing intervention or other forms of art into the holistic care of a pediatric oncology patient may assist in maximizing quality of life and allow for a more tolerable lifestyle. IMPLICATIONS Acquiring a means of proper communication with children through art allows nurses to gain insight on the needs of this special patient population, resulting in a higher quality plan of care.
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Affiliation(s)
- Bree A Aguilar
- DePaul University (Rosalind Franklin University of Medicine and Science Campus), North Chicago, IL, United States.
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3
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Rhondali W, Chirac A, Filbet M. L’art-thérapie en soins palliatifs : une étude qualitative. Médecine Palliative : Soins de Support - Accompagnement - Éthique 2013. [DOI: 10.1016/j.medpal.2012.11.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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4
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Tse MM, Ho SS. Pain Management for Older Persons Living in Nursing Homes: A Pilot Study. Pain Manag Nurs 2013; 14:e10-21. [DOI: 10.1016/j.pmn.2011.01.004] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2009] [Revised: 01/04/2011] [Accepted: 01/12/2011] [Indexed: 11/24/2022]
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Kumar SP. Cancer Pain: A Critical Review of Mechanism-based Classification and Physical Therapy Management in Palliative Care. Indian J Palliat Care 2011; 17:116-26. [PMID: 21976851 PMCID: PMC3183600 DOI: 10.4103/0973-1075.84532] [Citation(s) in RCA: 43] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
Mechanism-based classification and physical therapy management of pain is essential to effectively manage painful symptoms in patients attending palliative care. The objective of this review is to provide a detailed review of mechanism-based classification and physical therapy management of patients with cancer pain. Cancer pain can be classified based upon pain symptoms, pain mechanisms and pain syndromes. Classification based upon mechanisms not only addresses the underlying pathophysiology but also provides us with an understanding behind patient's symptoms and treatment responses. Existing evidence suggests that the five mechanisms – central sensitization, peripheral sensitization, sympathetically maintained pain, nociceptive and cognitive-affective – operate in patients with cancer pain. Summary of studies showing evidence for physical therapy treatment methods for cancer pain follows with suggested therapeutic implications. Effective palliative physical therapy care using a mechanism-based classification model should be tailored to suit each patient's findings, using a biopsychosocial model of pain.
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Affiliation(s)
- Senthil P Kumar
- Department of Physiotherapy, Kasturba Medical College, Manipal University, Mangalore, India
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6
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Tse MMY, Lo APK, Cheng TLY, Chan EKK, Chan AHY, Chung HSW. Humor therapy: relieving chronic pain and enhancing happiness for older adults. J Aging Res 2010; 2010:343574. [PMID: 21151506 PMCID: PMC2989702 DOI: 10.4061/2010/343574] [Citation(s) in RCA: 61] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2009] [Revised: 04/15/2010] [Accepted: 05/25/2010] [Indexed: 12/31/2022] Open
Abstract
The present study examined the effectiveness of a humor therapy program in relieving chronic pain, enhancing happiness and life satisfaction, and reducing loneliness among older persons with chronic pain. It was a quasiexperimental pretest-posttest controlled design. Older persons in a nursing home were invited to join an 8-week humor therapy program (experimental group), while those in another nursing home were treated as a control group and were not offered the program. There were 36 older people in the experimental group and 34 in the control group. Upon completion of the humor therapy program, there were significant decreases in pain and perception of loneliness, and significant increases in happiness and life satisfaction for the experimental group, but not for the control group. The use of humor therapy appears to be an effective nonpharmacological intervention. Nurses and other healthcare professionals could incorporate humor in caring for their patients.
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Affiliation(s)
- Mimi M. Y. Tse
- School of Nursing, The Hong Kong Polytechnic University, Kowloon, Hong Kong
| | - Anna P. K. Lo
- Department of Medicine, Queen Elizabeth Hospital, Hong Kong
| | - Tracy L. Y. Cheng
- Department of Medicine, Pamela Youde Nethersole Eastern Hospital, Hong Kong
| | - Eva K. K. Chan
- Department of Surgery, Queen Elizabeth Hospital, Hong Kong
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Tse MMY, Chan MF, Benzie IFF. The Effect of Music Therapy on Postoperative Pain, Heart Rate, Systolic Blood Pressure and Analgesic Use Following Nasal Surgery. J Pain Palliat Care Pharmacother 2009. [DOI: 10.1080/j354v19n03_05] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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8
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Kwekkeboom KL, Wanta B, Bumpus M. Individual difference variables and the effects of progressive muscle relaxation and analgesic imagery interventions on cancer pain. J Pain Symptom Manage 2008; 36:604-15. [PMID: 18504089 PMCID: PMC2638086 DOI: 10.1016/j.jpainsymman.2007.12.011] [Citation(s) in RCA: 42] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/05/2007] [Revised: 11/27/2007] [Accepted: 12/10/2007] [Indexed: 11/30/2022]
Abstract
Clinicians in acute care settings are often called upon to manage cancer pain unrelieved by medications. Cognitive-behavioral strategies, such as relaxation and imagery, are recommended for cancer pain management; however, there appear to be individual differences in their effects. This pilot study examined variation in pain outcomes achieved with progressive muscle relaxation (PMR) and analgesic imagery interventions among hospitalized patients with cancer pain, and assessed the influence of four individual difference variables (cognitive ability, outcome expectancy, previous experience, and concurrent symptoms) on pain relief achieved with each intervention. A crossover design was used in which 40 hospitalized cancer patients received two trials of PMR, two trials of analgesic imagery, and two trials of a control condition. In comparing means between treatment and control conditions, both PMR and analgesic imagery produced greater improvements in pain intensity, pain-related distress, and perceived control over pain than the control condition. However, individual responder analysis revealed that only half of the participants achieved a clinically meaningful improvement in pain with each intervention. Patients who achieved a meaningful improvement in pain with analgesic imagery reported greater imaging ability, more positive outcome expectancy, and fewer concurrent symptoms than those who did not achieve a meaningful reduction in pain. Similar relationships were not significant for the PMR intervention. Investigators should continue efforts to identify factors that moderate the effects of cognitive-behavioral pain coping strategies so that clinicians can identify the most beneficial treatments for individual patients.
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Kwekkeboom KL, Hau H, Wanta B, Bumpus M. Patients' perceptions of the effectiveness of guided imagery and progressive muscle relaxation interventions used for cancer pain. Complement Ther Clin Pract 2008; 14:185-94. [PMID: 18640630 DOI: 10.1016/j.ctcp.2008.04.002] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
Relaxation and guided imagery are useful strategies for cancer pain; however, their effects vary from patient to patient. Patients' perceptions of these treatments and factors that contribute to their effectiveness have not previously been described. Data from interviews conducted after a trial of guided imagery and progressive muscle relaxation (PMR) interventions were analyzed to compare patients' perceptions of treatment effects with observed changes in pain scores, and to explore patients' ideas about factors that contributed to the effectiveness of each intervention. Post-study interviews were conducted with 26 hospitalized patients with cancer pain who had completed trials of guided imagery and PMR. In most cases, participants' perceptions of treatment effects matched observed changes in pain scores. Participants described treatment and patient characteristics that influenced effectiveness of the interventions such as active involvement in the intervention, guided instructions, providing a source of distraction, stimulating relaxation, individual abilities and preferences, and pain qualities.
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Affiliation(s)
- Kristine L Kwekkeboom
- University of Wisconsin-Madison, School of Nursing, K6/336 Clinical Science Center, 600 Highland Avenue, Madison, WI 53792, USA.
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10
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Abstract
PURPOSE This pilot study describes pain and anxiety associated with allergy testing; tests distraction, specifically self-selected distraction; and examines the relationship between pain, anxiety, and engagement with distraction. DESIGN AND METHODS An experimental design was used with a convenience sample of 32 adolescents from an allergist's office randomly assigned to three groups. Pain was measured by the adolescent pediatric pain tool (APPT) and FACES scale. RESULTS No differences in pain ratings were found among the groups. Less pain was associated with lower anxiety and greater engagement with distraction. Greater engagement with distraction occurred with less anxiety. PRACTICE IMPLICATIONS Knowledge about allergy testing pain, anxiety, and engagement with distraction can assist nurses in preparing adolescents for this procedure.
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Abstract
INSERTION OF AN IV CATHETER is a commonly performed and painful procedure. The use of cognitive-behavioral interventions (CBIs) may decrease pain by diverting the patient's attention to stimuli other than pain. THIS RANDOMIZED, CONTROLLED TRIAL examined the effect of three CBIs--music, kaleidoscope, and guided imagery--on IV insertion pain in 324 patients. NO STATISTICALLY SIGNIFICANT differences in IV insertion pain were found among the treatment and control groups or between choosing versus being assigned a CBI. Insertion attempts were more difficult in women, and insertion difficulty was correlated with pain intensity and pain distress. Pain intensity was related to insertion site and catheter gauge.
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Affiliation(s)
- Ann F Jacobson
- Kent State University College of Nursing, Kent, Ohio, USA
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12
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Abstract
Existing research identifies numerous variables that may influence children's distress responses during medical procedures. In preparation for a large multisite study to test relationships among these numerous variables and parent distraction coaching, a pilot study of instruments was performed that measured the more complex constructs, namely anxiety, coping, temperament, attention, and parenting style. This article describes the benefits, process, and results of evaluating research instruments before initiating a large study on children's distress during ;medical procedures. A convenience sample of 68 children (4-12 years old) and their parents participated in this study. Children completed state and trait anxiety measures and a coping style scale. Parents completed questionnaires about their child's temperament, attention behavior, anxiety, and coping during a recent medical procedure, and about their own anxiety and parenting style. Coefficients of reliability of the measures were examined and understandability of the instruments was assessed. A forward regression showed that nurturing parenting style, parent's state anxiety, and child's state anxiety accounted for 32% of the variance in child distress during a recent medical procedure.
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Abstract
The purpose of this article is to present a model of factors that may influence a child's response to a painful procedure when parents are distraction coaches during the procedure. Nonpharmacological interventions, in particular, distraction, and parents as coaches for their children during procedures are discussed. A conceptual model is presented that illustrates the multiple factors and their possible relationships. A selected review of studies is provided that supports the inclusion of these factors in the model. The model and literature review focus on three major areas: characteristics of the child, characteristics of the parent, and procedural variables. The model presented is currently being tested in a large multisite study on the use of distraction during intravenous line insertion.
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14
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Abstract
With increasing life expectancy, the incidence of chronic illness and chronic pain also increase. Chronic pain robs older people of their quality of life, and limits functional mobility and ambulation, which leads to muscle atrophy. Older people are often reluctant to request pain relief, attempting to endure pain as a "normal" part of ageing. Innovative non-pharmacological interventions in pain management are appealing. In this study, affective images and pictures were used in 15 elderly patients (12 female and three male) in chronic pain who needed to perform stretching and standing exercises in their physiotherapy sessions. Pain scores were measured by the Visual Analogue Scale (VAS), and health-related quality of life was measured by the Medical Outcomes Study Short Form 36 (SF-36). VAS and SF-36 were administered in weeks 1 and in 6. Pain scores were measured during physiotherapy session in the following weeks. There was a significant decreased in VAS from week 1 to week 6 (t = 3.607; df = 14; p < 0.05). Also, a significant decrease in VAS occurred when the patients were watching affective pictures while performing the physiotherapy exercise in weeks 2 and 3, but not in weeks 4 and 5. SF-36 increased in week 6, which indicated an increase in health-related quality of life, though not statistically significant. Affective images and pictures appear to be an effective non-pharmacological intervention in pain management for the older person.
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Affiliation(s)
- Mimi M Y Tse
- School of Nursing, The Hong Kong Polytechnic University, Kowloon, Hong Kong.
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15
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Sherwood P, Given BA, Given CW, Champion VL, Doorenbos AZ, Azzouz F, Kozachik S, Wagler-Ziner K, Monahan PO. A cognitive behavioral intervention for symptom management in patients with advanced cancer. Oncol Nurs Forum 2005; 32:1190-8. [PMID: 16270114 PMCID: PMC1805479 DOI: 10.1188/05.onf.1190-1198] [Citation(s) in RCA: 87] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
PURPOSE/OBJECTIVES To evaluate the effectiveness of a cognitive behavioral intervention in decreasing symptom severity in patients with advanced cancer undergoing chemotherapy. DESIGN Prospective, randomized clinical trial based on cognitive behavioral theory. SETTING Six urban cancer centers in the midwestern United States. SAMPLE 124 patients 21 years of age or older were recruited and randomized to receive conventional care or conventional care and an intervention. Participants were newly diagnosed with stage III, stage IV, or recurrent cancer (solid tumor or non-Hodgkin lymphoma), undergoing chemotherapy, cognitively intact, and able to read and speak English. METHODS Data were gathered via telephone interviews at baseline and 10 and 20 weeks after randomization. Nurses with experience in oncology delivered a five-contact, eight-week intervention aimed at teaching patients problem-solving techniques to affect symptom severity. MAIN RESEARCH VARIABLES Gender, site of cancer, age, symptom severity and depressive symptoms at baseline, group (i.e., experimental versus control), and total symptom severity. FINDINGS Patients in the experimental group and those with lower symptom severity at baseline had significantly lower symptom severity at 10 and 20 weeks; the experimental difference at 20 weeks occurred primarily in those 60 years of age and younger. Depressive symptoms at baseline predicted symptom severity at 20 weeks; however, age, gender, and site of cancer did not affect symptom severity at either time point. CONCLUSIONS A cognitive behavioral intervention to teach problem-solving skills can be effective for patient symptom self-management during and following an intervention. IMPLICATIONS FOR NURSING Problem-solving strategies should be included in educational programs for patients with advanced cancer, particularly those 60 years of age and younger.
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Affiliation(s)
- Paula Sherwood
- School of Nursing, University of Pittsburgh, Pittsburgh, PA, USA.
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Abstract
This article investigates the mind-body connection in chronic pain. A discussion of pain physiology is designed to identify the role of the neurological system in chronic pain perception. The gate control theory and the neurotransmitter theory of pain are explored. A description of mind-body and pain management methods, and an illustrative case study are provided. The information presented concerning mind-body connection in chronic pain perception will enable practicing nurses to be more fully aware of the chronic pain phenomenon, and lead to better chronic pain assessment, management, and evaluation.
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Affiliation(s)
- Ruth McCaffrey
- Christine E. Lynn College of Nursing, Florida Atlantic University, 777 Glades Rd, Boca Raton, FL 33431, USA.
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17
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Abstract
Cognitive-behavioral therapy focuses on the cognitive, affective, and behavioral components of the pain experience. Cognitive-behavioral strategies can be used to treat chronic pain and chronic intermittent pain. The strategies concentrate on emotional, behavioral, and social responses, helping patients to increase their feelings of control or feelings of self efficacy regarding control.
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Affiliation(s)
- Jo Ann Dalton
- School of Nursing, University of North Carolina at Chapel Hill, 7460 Carrington Hall, Chapel Hill, NC 27599, USA.
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18
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Affiliation(s)
- Randy M. Caine
- Randy M. Caine is a professor of nursing and the director of the nurse practitioner programs at California State University, Los Angeles, Calif
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19
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Smith DW, Arnstein P, Rosa KC, Wells-Federman C. Effects of integrating therapeutic touch into a cognitive behavioral pain treatment program. Report of a pilot clinical trial. J Holist Nurs 2002; 20:367-87. [PMID: 12484105 DOI: 10.1177/089801002237593] [Citation(s) in RCA: 19] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
The purpose of this study was to investigate the effects of offering Therapeutic Touch (TT) as an adjunct to cognitive behavioral therapy (CBT) for people with chronic pain. Patients were randomized to relaxation training (control group) or TT plus relaxation (experimental). Subsequently, all participants attended a CBT program. Preprogram and postprogram data were examined to identify patterns of change in pain intensity, self-efficacy, unitary power, disability, and perceived distress. In addition, patterns of attrition were examined. Patients in this study who were randomized to receive TT fared better in terms of enhanced self-efficacy and unitary power, as well as having lower attrition rates. Trends associated TT with less distress and disability. This pilot study suggests that offering TT as an adjunct to CBT may help to improve clinical outcomes, reduce program attrition, and promote unitary power in those who suffer with chronic pain.
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Abstract
A number of studies on cancer pain have been conducted but the researchers rarely considered gender and ethnic differences in cancer pain. In this article, nursing research on cancer pain is critiqued from a feminist perspective, and directions for future nursing research are proposed. A total of 82 nursing articles published in the United States were retrieved through MEDLINE and MELVYL data retrieval systems, and analyzed and critiqued in terms of four basic elements of research from a feminist perspective (bias as resources, dependability, credibility and adequacy, and intersubjectivity). In this article, the critique is presented with four themes that may provide reasons why nursing research on cancer pain rarely incorporated gender and ethnic differences: absence of participants' own views and experiences, androcentrism and ethnocentrism, lack of consideration on contextual factors, and distant relationships between researchers and research participants. To overcome the limitations, six critical elements including gender and ethnic sensitivity, avoidance of distorted views, respectfor participants' own views and interests, trust and openness, empowerment, and multiple methods are suggested to be incorporated in future nursing research on cancer pain.
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Affiliation(s)
- E O Im
- School of Nursing, University of Wisconsin-Milwaukee, USA
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Hallas CN, Patel N, Oo A, Jackson M, Murphy P, Drakeley MJ, Soorae A, Page RD. Five-year survival following oesophageal cancer resection: Psychosocial functioning and quality of life. PSYCHOL HEALTH MED 2001. [DOI: 10.1080/13548500124671] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
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Abstract
INTRODUCTION Guided imagery has been suggested as an intervention to help children cope with noxious symptoms associated with medical care. A measure of imaging ability, that is, the ability to generate vivid mental images and to experience those images as if they were real, could be helpful in identifying children most likely to succeed in relieving symptoms with guided imagery. The purpose of this study was to test psychometric properties of a new instrument, the Kids Imaging Ability Questionnaire (KIAQ). METHOD Three expert clinicians and researchers were asked to review the KIAQ to assess content validity. A convenience sample of 58 children were invited to complete the questionnaire twice to obtain data for tests of reliability and criterion-related validity. RESULTS Content validity, internal consistency (alpha =.75-.76), and test-retest reliability (r =.73) were acceptable. Criterion-related validity using the Singer Fantasy Proneness Interview as a standard was poor (rho =.31-.46). DISCUSSION Some psychometric properties were acceptable; however, continued research will be necessary to test validity of the questionnaire and demonstrate a relationship between KIAQ score and success with imagery. With continued research, pediatric nurses may use the KIAQ in practice to identify children most likely to benefit from guided imagery.
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Affiliation(s)
- K L Kwekkeboom
- College of Nursing, University of Iowa, Iowa City 52242-1121, USA
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Gaston-Johansson F, Fall-Dickson JM, Nanda J, Ohly KV, Stillman S, Krumm S, Kennedy MJ. The effectiveness of the comprehensive coping strategy program on clinical outcomes in breast cancer autologous bone marrow transplantation. Cancer Nurs 2000; 23:277-85. [PMID: 10939175 DOI: 10.1097/00002820-200008000-00004] [Citation(s) in RCA: 104] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
Patients with breast cancer who undergo autologous bone marrow/peripheral blood stem cell transplantation (ABMT) cope not only with a life-threatening medical treatment, but also with multiple, interrelated symptoms including pain, fatigue, psychological distress, and nausea. The purpose of this study was to determine, in a randomized controlled clinical trial, whether a comprehensive coping strategy program (CCSP) was effective in significantly reducing pain, fatigue, psychological distress, and nausea in patients with breast cancer who underwent ABMT. The CCSP was composed of preparatory information, cognitive restructuring, and relaxation with guided imagery. Randomization placed 52 patients in the CCSP treatment group and 58 patients in the control group. The CCSP was found to be effective in significantly reducing nausea as well as nausea combined with fatigue 7 days after the ABMT when the side effects of treatment were most severe. These results are important given the high incidence of nausea and fatigue in the ABMT population. The CCSP-treated group experienced mild anxiety as compared with the control group who reported moderate anxiety. The greatest effectiveness of CCSP may correspond to the time of the greatest morbidity for patients with breast cancer who have undergone ABM.
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Affiliation(s)
- F Gaston-Johansson
- International and Extramural Programs, Johns Hopkins University School of Nursing, Baltimore, Maryland 21205-2110, USA
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