This study explores the facilitation of preparation for breast cancer surgery. The aim of the study was to develop a reasonably comprehensive scheme of categories that would describe, from the perspective of women with breast cancer, what facilitates or hinders positive psychological preparation for breast cancer surgery and, therefore, identify and conceptually organize a broad array of these experiences. The research method involved interviews with 30 women who underwent an operation for breast cancer 6-12 months prior to their interviews. The Critical Incident Technique was used to collect and analyze the data. The women were interviewed and asked to recall incidents that were helpful or hindering in their preparation for a breast cancer surgery. A total of 362 incidents from 30 participants were collected, analyzed, and placed into categories. These incidents were organized into twenty-three categories: Receiving Educational Materials and/or Information; Obtaining an Explanation of Medical Procedures or Problems; Discussing Problems with Loved One; Getting Support and Encouragement from Others; Being Accompanied to a Medical Appointment; Helping Others; Engaging Oneself in Physical and Creative Activities; Developing Helpful Habits; Taking Action on Realizing Own Mortality; Experiencing Physical Closeness; Experiencing Deep Emotional Closeness; Realizing Shift in Relationship with Loved Ones; Healing Through Spiritual Experience and Visualization; Changing Perspective Through Comparison; Using Inspiring, Comforting Material; Getting Alternative Treatment; Establishing Professional Communication; Waiting for Medical Results; Sharing Experiences in Support Groups and Counseling; Perceiving Professional Manners; Experiencing Positive Medical Settings; Getting a Recommendation/Approval of Medical Personnel, Questioning Competence of Medical Care or Personnel. The data also included information about participants' decision-making process regarding the type of operation for breast cancer and some observations on them were drawn. Several procedures were used to examine validity, soundness and trustworthiness of the categories and subcategories. Three narrative accounts were analyzed in an effort to provide meaning and action to these categories. The findings of this study may serve as a basis for better understanding of the process of preparation for breast cancer surgery. Through further examination of the categories and narratives some suggestions and recommendation for research and practice were made. / Education, Faculty of / Educational and Counselling Psychology, and Special Education (ECPS), Department of / Graduate

No description available.

published_or_final_version / Nursing Studies / Master / Master of Nursing in Advanced Practice

published_or_final_version / Nursing Studies / Master / Master of Nursing

Despite the increasing acceptance of biopsychosocial models of pain and multidisciplinary treatments for pain, relatively little is known about the specific psychological variables and social processes related to postoperative pain in children, especially in an outpatient setting. The present study examined demographic, medical, and psychological predictors of children's pain and parents' administration of pain medication. Two hundred and thirty-six families with children aged 2 to 12 undergoing day surgery participated in the study. This included a subset of 100 children aged 6 to 12, who were asked to complete self-report measures of anxiety, expected pain, coping style, and pain. Parents of all children completed measures of expected pain, expected benefit from medication, perspective taking, and negative attitudes towards analgesics. Parents and school-aged children completed pain diaries on the day of surgery and two days following surgery. The prevalence of clinically significant pain was somewhat lower than in previous studies, but both pain and undertreatment (parents who gave less than the recommended amount of pain medication) remained common. Predictors of pain were examined by multiple regression, using data from the subset of 100 children aged 6 to 12. More intense pain was related to more invasive surgery, a constellation of analgesic-related variables (more doses of analgesia given, the use of a regional block, the use of local infiltration), high anxiety, high expectations of pain, and a tendency to cope with pain by acting out and catastrophizing. Predictors of dosing were examined by multiple regression, using data from the entire sample of 236 children. Parents gave more medication when their children had invasive surgery and high levels of pain, when they expected a lot of pain, and when they were relatively unconcerned about the negative effects of pain medication. In each case, the psychological variables, entered as a block, were significant predictors of pain even after controlling for demographic and medical variables. Health care providers should be aware of psychological factors predicting pain, as they may help to identify families that are at "high risk" for pain and undermedication. In addition, the variables identified in this study are appropriate targets for further research on psychological factors that cause, mediate or contribute to pain processes, and as such may contribute to the development of theoretical models of pain and pain management.

Coronary bypass surgery is an increasingly common occurrence. Current literature does not validate the coping mechanisms involved for patients facing this life-threatening event. Lazarus’ theory of stress and coping was utilized as the framework for the study. The purpose of the study was to identify the degree of threat coronary bypass surgery presents and coping mechanisms utilized with this specific insult. The significance of the study was to assist nurses in identification of perceived risks/benefits of having open heart surgery from the patient’s perspective. The population included patients from a private cardiovascular practice in Indianapolis, Indiana. The convenience sample included 38 subjects recovering from coronary bypass graft surgery. Subjects were identified as uncomplicated post-operative surgical patients and were mailed questionnaires one month after discharge from the hospital. The Jalowiec Coping Scale and a questionnaire for demographic data were utilized to collect data. Procedures for protection of human subjects were followed. The research design was non-experimental and descriptive, correlational procedures were utilized to analyze data.The data supported the notions that clients utilized both problem-focused coping and emotion-focused coping, and emotion-focused coping strategies were more effective in reducing the threat. Education was significantly related to emotive coping styles and clients that perceived a higher threat intensity utilized more emotion-focused coping strategies. Recognition of the need to minimize stressors can be an important role the nurse facilitates. Through participatory care, the nurse may assist in finding the meaning for the stressor and encourage open communication patterns and emotional responses. Allowing for reduction of threat perception and intensity may enhance the outcome of the experience. / School of Nursing

The experience of living through an unexpected, life-threatening cardiovascular surgery can be a profound. This study examined the experience of 4 men who had survived ruptured aortic aneurysm using a phenomenological research design.Audio-taped interviews were analyzed for common themes and patterns. Two strong, opposing constitutive patterns were found. The patterns the data conveyed were: 1) fear as a response to overwhelming pain and clouded perceptions, and 2) gratitude for recovery in an atmosphere of caring support.This study was significant in beginning to bring to understanding the phenomenon of surviving major, unexpected cardiovascular surgical trauma. It is recommended that health care providers be more attentive to similar patients' experiences and listen to how their lives have changed as a result of their experiences. / School of Nursing

Despite the increasing acceptance of biopsychosocial models of pain and multidisciplinary treatments for pain, relatively little is known about the specific psychological variables and social processes related to postoperative pain in children, especially in an outpatient setting. The present study examined demographic, medical, and psychological predictors of children's pain and parents' administration of pain medication. Two hundred and thirty-six families with children aged 2 to 12 undergoing day surgery participated in the study. This included a subset of 100 children aged 6 to 12, who were asked to complete self-report measures of anxiety, expected pain, coping style, and pain. Parents of all children completed measures of expected pain, expected benefit from medication, perspective taking, and negative attitudes towards analgesics. Parents and school-aged children completed pain diaries on the day of surgery and two days following surgery. The prevalence of clinically significant pain was somewhat lower than in previous studies, but both pain and undertreatment (parents who gave less than the recommended amount of pain medication) remained common. Predictors of pain were examined by multiple regression, using data from the subset of 100 children aged 6 to 12. More intense pain was related to more invasive surgery, a constellation of analgesic-related variables (more doses of analgesia given, the use of a regional block, the use of local infiltration), high anxiety, high expectations of pain, and a tendency to cope with pain by acting out and catastrophizing. Predictors of dosing were examined by multiple regression, using data from the entire sample of 236 children. Parents gave more medication when their children had invasive surgery and high levels of pain, when they expected a lot of pain, and when they were relatively unconcerned about the negative effects of pain medication. In each case, the psychological variables, entered as a block, were significant predictors of pain even after controlling for demographic and medical variables. Health care providers should be aware of psychological factors predicting pain, as they may help to identify families that are at "high risk" for pain and undermedication. In addition, the variables identified in this study are appropriate targets for further research on psychological factors that cause, mediate or contribute to pain processes, and as such may contribute to the development of theoretical models of pain and pain management. / Arts, Faculty of / Psychology, Department of / Graduate

No description available.

This is a study of some of the families in the Loma Linda University Medical Center infant heart transplant program.