Abstract:
:Recent empirical studies revealed that fostering patients' perception of meaning in their life is an essential task for palliative care clinicians. However, few studies have reported the effects of training programs for nurses specifically aimed at improving skills to relieve the meaninglessness of terminally ill cancer patients, and we have had no specific measurement instruments. The primary aims of this study were 1) to validate measurement tools to quantify nurses' self-reported practice and attitudes toward caring for terminally ill cancer patients feeling meaninglessness and 2) to explore the effects of the five-hour educational workshop focusing on meaninglessness on nurses' self-reported practice, attitudes toward caring for such patients, confidence, burnout, death anxiety, and meaning of life. A quasi-experimental pre-post questionnaire survey was performed on 147 nurses. The questionnaire was distributed before the intervention workshop and one and six months after. The workshop consisted of lecture, role-play, and the exercise of assessment and care planning based on two vignette verbatim records. First, using the first questionnaire sample and an additional sample of 20 nurses for the test-retest examination, we validated a six-item Self-Reported Practice scale, and an eight-item Attitudes Toward Caring for Patients Feeling Meaninglessness scale with three subscales (Willingness to Help, Positive Appraisal, and Helplessness). The nurses also completed a scale to assess confidence in caring for terminally ill patients with meaninglessness, the Maslach Burnout Inventory, the Death Attitude Inventory, the Frommelt Attitudes Toward Care of the Dying scale, the Self-Reported Practice Score in General Communication, and the three pain-related items from the Palliative Care Quiz for Nursing. For the Self-Reported Practice scale and the subscales of the Attitudes Toward Caring for Patients Feeling Meaninglessness scale, the Cronbach's alpha coefficients were 0.63-0.91, and the intra-class correlations were 0.89-0.94. The Self-Reported Practice scale significantly, but moderately, correlated with the Self-Reported Practice Score in General Communication (P=0.41). The Willingness to Help and Helplessness subscales significantly but weakly correlated with the Frommelt scale (P=-0.27, 0.21). Both scales did not correlate or minimally correlated with the Palliative Care Quiz for Nursing (P<0.20). The construct validity was confirmed using factor analysis. At the follow-up, of 147 nurses who participated in this workshop, 91 (62%) and 80 (54%) nurses responded. Self-reported practice and confidence significantly improved, whereas helplessness, emotional exhaustion, and death anxiety significantly decreased. The percentages of nurses who evaluated this program as "useful" or "very useful" were 79% (to understand the conceptual framework in caring for terminally ill patients with meaninglessness), 73% (to help in self-disclosing nurses' personal beliefs, values, and life goals), and 80% (to help in learning how to provide care for patients with meaninglessness). The Self-Reported Practice scale and the Attitudes Toward Caring for Patients Feeling Meaninglessness scale are reliable and valid tools to specifically quantify nurses' self-reported practice and attitudes toward caring for terminally ill cancer patients feeling meaninglessness of life. The five-hour workshop appeared to have a modest but significant beneficial effect on nurse-reported practice, attitudes, and confidence in providing care for terminally ill cancer patients feeling meaninglessness. Further educational intervention trials with control groups are promising.
journal_name
J Pain Symptom Managejournal_title
Journal of pain and symptom managementauthors
Morita T,Murata H,Hirai K,Tamura K,Kataoka J,Ohnishi H,Akizuki N,Kurihara Y,Akechi T,Uchitomi Y,Japanese Spiritual Care Task Force.doi
10.1016/j.jpainsymman.2006.10.021subject
Has Abstractpub_date
2007-08-01 00:00:00pages
160-70issue
2eissn
0885-3924issn
1873-6513pii
S0885-3924(07)00274-6journal_volume
34pub_type
杂志文章abstract:CONTEXT:Adequate symptom management is essential to ensure quality cancer care, but symptom management is not always evidence based. Adapting and automating national guidelines for use at the point of care may enhance use by clinicians. OBJECTIVES:This article reports on a process of adapting research evidence for use...
journal_title:Journal of pain and symptom management
pub_type: 杂志文章
doi:10.1016/j.jpainsymman.2013.01.016
更新日期:2013-12-01 00:00:00
abstract::Research in affective disorders has shown that there is a clear link between mood and light exposure, and that exposure to bright wide-spectrum light (phototherapy) may be an effective antidepressant treatment in some clinical situations. Cancer patients, especially those in the terminal phase of illness, have a high ...
journal_title:Journal of pain and symptom management
pub_type: 杂志文章
doi:10.1016/0885-3924(94)90116-3
更新日期:1994-11-01 00:00:00
abstract::A treatment program was developed involving cognitive and behavioral strategies for the treatment of migraine headaches with adolescents at the Children's Hospital of Eastern Ontario. These techniques include: a headache diary, progressive relaxation techniques, cognitive restructuring, distraction or attention focusi...
journal_title:Journal of pain and symptom management
pub_type: 杂志文章
doi:10.1016/0885-3924(89)90007-9
更新日期:1989-09-01 00:00:00
abstract::Quality palliative care depends on a deep understanding of distress facing patients nearing death. Yet, many aspects of psychosocial, existential and spiritual distress are often overlooked. The aim of this study was to test a novel psychometric--the Patient Dignity Inventory (PDI)--designed to measure various sources...
journal_title:Journal of pain and symptom management
pub_type: 杂志文章
doi:10.1016/j.jpainsymman.2007.12.018
更新日期:2008-12-01 00:00:00
abstract::The United States Agency for Health Care Policy and Research (AHCPR) Acute Pain Management Guidelines were written to provide a scientific basis for practice. Educational programs designed to promote use of the guidelines may change practice in community hospitals. This article describes the development and implementa...
journal_title:Journal of pain and symptom management
pub_type: 杂志文章
doi:10.1016/s0885-3924(98)00142-0
更新日期:1999-04-01 00:00:00
abstract:CONTEXT:Socioeconomic status (SES) is an important determinant of disparities in health services and may affect the utilization of hospice care services during end-of-life (EOL) treatment in patients with cancer. However, previous studies evaluating the association between SES and utilization of hospice care services a...
journal_title:Journal of pain and symptom management
pub_type: 杂志文章
doi:10.1016/j.jpainsymman.2020.03.015
更新日期:2020-08-01 00:00:00
abstract:CONTEXT:Breast cancer morbidity and mortality disproportionately affect medically underserved women. Most studies of the experience of living with advanced breast cancer do not focus on this population. A deeper understanding of racial/ethnic minorities' and low-income patients' experiences is needed to reduce breast c...
journal_title:Journal of pain and symptom management
pub_type: 杂志文章
doi:10.1016/j.jpainsymman.2019.08.006
更新日期:2019-12-01 00:00:00
abstract::Perception of discomfort in dying patients is a risk factor for distress and bereavement among relatives. This study determined the perception of discomfort, the frequency of observed behaviors, and their association among relatives and among nurses who care for unresponsive dying patients. Sixty unresponsive dying pa...
journal_title:Journal of pain and symptom management
pub_type: 杂志文章
doi:10.1016/s0885-3924(03)00286-0
更新日期:2003-09-01 00:00:00
abstract::As many as 90% of patients with cancer-related pain can attain satisfactory relief through available pharmacological and medical means. However, as many as 45% of patients in the earlier stages of cancer and 75% of patients in the advanced stages experience at least some pain. Although published guidelines are availab...
journal_title:Journal of pain and symptom management
pub_type: 杂志文章,评审
doi:10.1016/s0885-3924(99)00097-4
更新日期:1999-11-01 00:00:00
abstract:CONTEXT:Accurate documentation of inpatient code status discussions (CSDs) is important because of frequent patient care handoffs. OBJECTIVES:To examine the quality of inpatient CSD documentation and compare documentation quality across physician services. METHODS:This was a retrospective study of patients hospitaliz...
journal_title:Journal of pain and symptom management
pub_type: 杂志文章
doi:10.1016/j.jpainsymman.2013.11.014
更新日期:2014-10-01 00:00:00
abstract:CONTEXT:Pain has been reported as the second most commonly reported symptom in people living with HIV/AIDS. In South Africa, there are more than five million people living with HIV/AIDS. Approximately, two million belong to the Xhosa cultural group. The prevalence of pain in amaXhosa living with HIV/AIDS was unknown at...
journal_title:Journal of pain and symptom management
pub_type: 杂志文章
doi:10.1016/j.jpainsymman.2015.08.004
更新日期:2016-01-01 00:00:00
abstract:CONTEXT:Palliative care for the older person is often limited, resulting in poor quality of dying. Pharmacological management can be one of the components to achieve better symptom control. OBJECTIVES:To describe the anticipatory prescription of medication for symptomatic treatment and the deprescription of potentiall...
journal_title:Journal of pain and symptom management
pub_type: 杂志文章,多中心研究
doi:10.1016/j.jpainsymman.2015.12.325
更新日期:2016-06-01 00:00:00
abstract:CONTEXT:Many surveys have evaluated patient-related barriers to pain management. OBJECTIVES:To explore associations between a preference for opioids and general attitudes toward drugs, the experience and information received as a bereaved family, and beliefs regarding a good death. METHODS:A cross-sectional survey, p...
journal_title:Journal of pain and symptom management
pub_type: 杂志文章
doi:10.1016/j.jpainsymman.2014.04.015
更新日期:2015-01-01 00:00:00
abstract:CONTEXT:Symptom management is essential in the end-of-life care of long-term care facility residents. OBJECTIVES:To study discrepancies and possible associated factors in staff and family carers' symptom assessment scores for residents in the last week of life. METHODS:A postmortem survey in Belgium, The Netherlands,...
journal_title:Journal of pain and symptom management
pub_type: 杂志文章
doi:10.1016/j.jpainsymman.2020.03.002
更新日期:2020-08-01 00:00:00
abstract:CONTEXT:Previous work has found that facilitated advance care planning (ACP) interventions are effective in increasing ACP uptake among patients with severe respiratory disease. OBJECTIVES:The objective of this study was to investigate whether a nurse-led, facilitated ACP intervention among participants with severe re...
journal_title:Journal of pain and symptom management
pub_type: 杂志文章
doi:10.1016/j.jpainsymman.2019.11.018
更新日期:2020-04-01 00:00:00
abstract::Chronic refractory angina is an increasingly prevalent, complex chronic pain condition, which results in frequent hospitalization for chest pain. We have previously shown that a novel outpatient cognitive-behavioral chronic disease management program (CB-CDMP) improves angina status and quality of life in such patient...
journal_title:Journal of pain and symptom management
pub_type: 杂志文章
doi:10.1016/j.jpainsymman.2006.10.009
更新日期:2007-03-01 00:00:00
abstract::Octreotide, a synthetic analogue of the hormone somatostatin, is primarily used in palliative medicine because of its antisecretory effect and has been shown to be effective in the management of bowel obstruction, nausea, and diarrhea. Octreotide also has been successfully used for the management of bronchorrhea in bo...
journal_title:Journal of pain and symptom management
pub_type: 杂志文章
doi:10.1016/j.jpainsymman.2013.06.008
更新日期:2014-04-01 00:00:00
abstract:CONTEXT:Fatigue is one of the most common symptoms reported by cancer survivors, and fatigue worsens when patients are engaged in muscle exertion, which results in early motor task failure. Central fatigue plays a significant role, more than muscle (peripheral) fatigue, in contributing to early task failure in cancer-r...
journal_title:Journal of pain and symptom management
pub_type: 杂志文章
doi:10.1016/j.jpainsymman.2011.08.007
更新日期:2012-09-01 00:00:00
abstract::The need to treat dehydration in terminally ill patients to minimize symptom distress remains a controversial issue. Hypodermoclysis (HDC) is a simple technique for rehydration that offers many advantages over the intravenous route. In this prospective open study of 100 consecutive patients who died on a palliative ca...
journal_title:Journal of pain and symptom management
pub_type: 临床试验,杂志文章
doi:10.1016/0885-3924(94)90187-2
更新日期:1994-07-01 00:00:00
abstract::Palliative care research is challenged by a disagreement as to what palliative care is, when it should be offered and what conditions warrant specialized palliative care services. These challenges became evident when we used a population-based data linkage to evaluate the delivery of palliative care services in Wester...
journal_title:Journal of pain and symptom management
pub_type: 杂志文章
doi:10.1016/j.jpainsymman.2005.12.018
更新日期:2006-07-01 00:00:00
abstract::The drive for good quality evidence has highlighted the importance of well-conducted systematic reviews and meta-analyses that critically evaluate and grade studies for new or existing therapies. A systematic review and meta-analysis was performed to review the efficacy, safety, and cost effectiveness of spinal cord s...
journal_title:Journal of pain and symptom management
pub_type: 杂志文章,meta分析,评审
doi:10.1016/j.jpainsymman.2005.12.010
更新日期:2006-04-01 00:00:00
abstract::Methylnaltrexone, a peripherally acting mu-opioid receptor antagonist with restricted ability to cross the blood-brain barrier, reverses opioid-induced constipation (OIC) without affecting analgesia. A double-blind study in patients with advanced illness and OIC demonstrated that methylnaltrexone significantly induced...
journal_title:Journal of pain and symptom management
pub_type: 杂志文章,随机对照试验
doi:10.1016/j.jpainsymman.2009.02.234
更新日期:2009-11-01 00:00:00
abstract::Brain death is a traumatic and sudden event following a severe injury to the brain. Most patients with brain death spend the last days of life in an intensive care unit (ICU), where some families will be approached to ask for organ donation. This qualitative study was carried out with relatives of patients who had die...
journal_title:Journal of pain and symptom management
pub_type: 杂志文章
doi:10.1016/j.jpainsymman.2008.04.013
更新日期:2009-04-01 00:00:00
abstract::Studies applying exercise, relaxation training, and psychoeducation have each indicated a positive impact on physical performance and/or psychological factors in patients diagnosed with cancer. We explored the longitudinal effect of a combination of these interventions on treatment-related symptoms in patients undergo...
journal_title:Journal of pain and symptom management
pub_type: 杂志文章,随机对照试验
doi:10.1016/j.jpainsymman.2008.09.005
更新日期:2009-08-01 00:00:00
abstract:CONTEXT:Advance care planning is not included in regular clinical care for patients on dialysis. Insight into life-sustaining treatment preferences and communication about end-of-life care is necessary to develop interventions to improve advance care planning for patients on dialysis. OBJECTIVES:This cross-sectional o...
journal_title:Journal of pain and symptom management
pub_type: 杂志文章
doi:10.1016/j.jpainsymman.2012.01.010
更新日期:2013-01-01 00:00:00
abstract::Advanced dementia patients may be at substantial risk for undetected or undertreated pain. To examine the treatment of pain following hip fracture, a prospective cohort study was conducted in an academic teaching hospital. Fifty-nine cognitively intact elderly patients with hip fracture and 38 patients with hip fractu...
journal_title:Journal of pain and symptom management
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1016/s0885-3924(00)00113-5
更新日期:2000-04-01 00:00:00
abstract::This report describes a pharmacokinetic study and a clinical study of three different formulations of oral tramadol: once-daily tramadol tablets 150 and 200 mg, and normal release tramadol capsules 50 mg 8-hourly. The randomized, open-label, crossover pharmacokinetic study included 22 subjects. The three treatments sh...
journal_title:Journal of pain and symptom management
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1016/s0885-3924(02)00642-5
更新日期:2003-02-01 00:00:00
abstract::Although sialorrhea and drooling are uncommon symptoms in cancer patients, they can cause considerable discomfort, inconvenience and social embarrassment. In this article we describe a patient with tongue cancer who was successfully treated with oral glycopyrrolate 0.4 mg 3 times daily. Glycopyrrolate is a quaternary ...
journal_title:Journal of pain and symptom management
pub_type: 杂志文章
doi:10.1016/s0885-3924(99)00080-9
更新日期:1999-10-01 00:00:00
abstract:CONTEXT:Increasing numbers of patients with advanced cancer are receiving anticancer and/or palliative treatment in outpatient settings, and palliative care for outpatients with advanced cancer is being recognized as one of the most important areas for comprehensive cancer treatment. OBJECTIVES:The aim of this study w...
journal_title:Journal of pain and symptom management
pub_type: 杂志文章,多中心研究
doi:10.1016/j.jpainsymman.2011.04.025
更新日期:2012-03-01 00:00:00
abstract::Increasing numbers of patients with refractory pain are receiving intrathecal drug delivery systems (IDDS). We describe a case to illustrate the clinical manifestations and management implications of inadvertent overdose with drugs used in IDDS, including opioids, clonidine, baclofen, and local anesthetics. An IDDS pa...
journal_title:Journal of pain and symptom management
pub_type: 杂志文章
doi:10.1016/j.jpainsymman.2003.11.011
更新日期:2004-09-01 00:00:00