The management of pain is a primary issue in burn care. Patients hospitalized for burn injuries experience severe pain on a daily basis, immediately after the injury and during the healing of the burn wound. Our clinical experience is that the intensity of pain is increased by wound infection. The purpose of this study was to investigate retrospectively whether patients experience increased pain intensity in conjunction with wound infection. A total of 165 patients with burn injuries were included, 60 of whom were diagnosed with infection. The results of this study showed a significant increase in pain intensity in association with infection. An increase in pain is one of the factors to be considered among the many assessments, tests, and treatments for patients with burn injuries.
A nurse-led clinic focusing on education and self-care for patients with advanced renal failure was introduced in a renal outpatient clinic in Sweden. The purpose was to enhance patients' disease-related knowledge, involvement, and self-care ability. This article reports the results of a study comparing patient outcomes with the nurse-led clinic to the previous model of care. The hypothesis was that the nurse-led clinic would increase medical control and self-care outcomes. The participants in the nurse-led clinic chose and started dialysis in a self-care alternative and also had a functioning, permanent dialysis access to a greater extent than the patients in the comparison group. Those choosing home-hemodialysis rated their self-care ability higher. The participants rated self-care and effects of treatment options on family and everyday life as the most important disease-related areas of knowledge.
This paper is a presentation of general/secular coping strategies and strategies related to the caritas orientation that nurses in cancer care use when encountering stress. As a concept, caritas indicates the will to do good. The paper tries to provide an answer to the question of which functional and dysfunctional coping strategies nurses use when coping with work-related stress. The study is qualitative and hypothesis-generating. The material analysed consists of 15 interviews with Swedish registered nurses and is based on a life-story approach. Pargament's coping theory related to the psychology of religion has been applied for interpretation purposes. The nurses use several coping strategies with the dominant strategy being a general boundary demarcation. Other strategies that were used for coping included emotional outlets, caritas--oblivion and periodically changing activity. The strategies can be used in a functional or dysfunctional way; e.g. dysfunctional coping was present when there was a lack of human support and boundary demarcation.
The Multidimensional Fatigue Inventory (MFI-20) scale is widely used for measuring fatigue in cancer care. This questionnaire has been translated into Swedish and used in Swedish cancer populations, and the aim of this study was to test the validity and reliability of the Swedish version in four populations, with a total of 584 patients. The participants were classified into four groups: palliative cancer patients, cancer patients receiving radiation therapy, non-cancer outpatients, and a group of hospital staff. The MFI-20 consists of five subscales of fatigue: General Fatigue (GF), Physical Fatigue (PF), Reduced Motivation (RM), Reduced Activity (RA) and Mental Fatigue (MF). We have tested the convergent validity of the MFI-20 using the Category Ratio instrument (CR-10). The validity and the reliability of MFI-20 were acceptable. All subscales of the MFI-20 were correlated, and all were also correlated with the CR-10 score (p
Unit of Esophageal and Gastric Research, Department of Molecular Medicine and Surgery P9:03, Karolinska Institutet, Karolinska University Hospital, SE-171 76 Stockholm, Sweden. email@example.com
To assess quality of life (QoL) and symptoms after oesophageal cancer surgery, a prospective nationwide population-based study was conducted in 2001-2005, including most surgically treated oesophageal cancer patients in Sweden. Six months postoperatively patients responded to an EORTC quality of life core questionnaire (QLQ C-30) with an oesophageal-specific module (OES-18). Mean scores were calculated. Mann-Whitney test was used for group comparisons. Among 282 patients, QoL was considerably reduced compared to a reference general population (P
PURPOSE: This study explores what dimensions of a health-related quality of life (HRQOL) questionnaire predict global ratings of overall quality of life (QOL) in lung cancer patients in assessments by patients and significant others, respectively. MATERIAL AND METHODS: The analyses were based on dyadic assessments from lung cancer patients and their significant others. A subset of scales and items from the Swedish version of the European Organization for Research and Treatment of Cancer (EORTC) QLQ C30 and the lung-cancer-specific module, LC-13, was selected. Using multiple regression procedures, the relative importance of different symptoms and of functional impairments in predicting overall QOL was examined. RESULTS: The multiple regressions revealed that emotional functioning and fatigue were the only significant predictors of overall QOL for both the patients and the significant others' assessments. In addition, physical functioning was found to be another predictor in the significant others' assessments. CONCLUSION: The results emphasize that it is essential to consider both emotional functioning and fatigue as important areas for overall QOL in lung cancer patients.
While the use of chemotherapy has significantly improved survival rates, the symptoms associated with chemotherapy remain a major burden for patients. Preventing or appropriately managing side effects significantly improves patients' functional status and quality of life, ultimately leading to greater patient acceptance of chemotherapy. However, symptom assessment and management are fraught with difficulties such as poor patient recall, retrospective assessment conducted by clinicians and lack of appropriate, clinically relevant and patient friendly symptom assessment and management tools. Furthermore the differences between clinician and patient perceptions of stresses and distress during chemotherapy are well recognised. This study aimed to evaluate the impact of a nursing intervention incorporating structured symptom assessment and management, facilitated by information technology, on chemotherapy-related symptoms, nausea, vomiting, fatigue and mucositis. This pan-European study, involved 8 clinical sites from Belgium, Denmark, England, Ireland and Scotland. Adults (n=249) receiving first line chemotherapy for breast, lung, ovarian or colorectal cancer, osteosarcoma, acute myeloid leukaemia (AML), acute lymphoblastic leukaemia (ALL) or lymphoma were recruited to the study. Patients completed daily symptom assessment questionnaires for 14 days following consecutive cycles of chemotherapy. Symptom outcomes were compared before and after the introduction of the intervention with positive impact on patients' experiences of nausea, vomiting and oral problems. Fatigue was not significantly improved.