41 research outputs found
Factors perceived to influence exercise adherence in women with breast cancer participating in an exercise programme during adjuvant chemotherapy: a focus group study
Aims and objectives. To explore factors influencing exercise adherence among women with breast cancer while following an exercise programme.
Background. Earlier research shows that women with breast cancer decrease physical activity following the cancer diagnosis and that adhering to exercise interventions can be a challenge. Research is needed to identify motivational factors and barriers for exercise adherence among women during treatment for
breast cancer.
Design. This was a qualitative study to explore patientâs perceptions of the challenges to exercise adherence during a randomised, controlled trial.
Methods. Twenty-seven women with early-stage breast cancer were purposively sampled for focus group interviews during 2011â2012 from their participation in the exercise intervention group during 2010â2012. Five focus groups were performed,
and data analysis was completed using the systematic text condensation method.
Results. During the focus group study, five main themes were identified, which described factors participants perceived to influence their adherence to exercise during chemotherapy: âside effects of breast cancer treatment as a barrier to exerciseâ, ârestoring and maintaining normality in daily life motivates exerciseâ, âother valued activities compete with exerciseâ, âconstructive support enhances exerciseâ and âpositive beliefs about efficacy and outcomes motivate exerciseâ.
Conclusion. Adherence to exercise in women with breast cancer is challenged by internal and external conditions and may be improved by attention to the impact of treatment side effects and by supporting patient self-efficacy towards changing
health behaviour.
Relevance to clinical practice. Nurses should be aware that exercise adherence could be a challenge among women with breast cancer. They should help identify obstacles to exercise for women and ways to overcome them, as well as support them in their beliefs that they are capable of changing their health behaviou
Exercise: a path to wellness during adjuvant chemotherapy for breast cancer?
Background: Breast cancer treatment can represent a threat to a patientâs wellness. The role of exercise in perceived wellness in women with breast cancer merits further study.
Objective: The objective of this study was to describe how
exercise is perceived by women to influence their physical and psychosocial wellness at the time they were receiving chemotherapy.
Methods: Five focus group interviews with a total of 27 women with early-stage breast cancer were conducted. Prior to the focus groups, the women had participated in an exercise intervention during chemotherapy treatment.
Results: Three themes emerged from the analysis: exercise shapes feelings of psychological wellness; exercise stimulates feelings of physical wellness; and exercise influences social wellness. The women reported feeling stronger in a psychological sense after exercising, that the strength exercise
improved their upper-limb functioning, and that engaging in exercise triggered social support and interactions.
Conclusions: Exercise during breast cancer treatment is perceived to enhance the patientsâ wellness on several dimensions and in particular psychological wellness. Exercise might support the patientsâ efforts to restore their sense of wellness and enhance their level of daily life functioning.
Implications for Practice: Cancer nurses should promote exercise as a wellness-fostering intervention during chemotherapy treatment. Focusing on how
exercise can contribute to feelings of wellness may help women with breast cancer choose exercise as a health-promoting activity that contributes to their recovery
Do direct oral anticoagulants (DOACs) cause delayed surgery, longer length of hospital stay, and poorer outcome for hip fracture patients?
Purpose
The perioperative consequences of direct oral anticoagulants (DOACs) in hip fracture patients are not sufficiently investigated. The primary aim of this study was to determine whether DOAC-users have delayed surgery compared to non-users. Secondarily, we studied whether length of hospital stay, mortality, reoperations and bleeding complications were influenced by the use of DOAC.
Methods
The medical records of 314 patients operated for a hip fracture between 2016 and 2017 in a single trauma center were assessed. Patients agedâ<â60 and patients using other forms of anticoagulation than DOACs were excluded. Patients were followed from admission to 6 months postoperatively. Surgical delay was defined as time from admission to surgery. Secondary outcomes included length of hospital stay, transfusion rates, perioperative bleeding loss, postoperative wound ooze, mortality and risk of reoperation. The use of general versus neuraxial anaesthesia was registered. Continuous outcomes were analysed using Students t test, while categorical outcomes were expressed by Odds ratios.
Results
47 hip fracture patients (15%) were using DOACs. No difference in surgical delay (29 vs 26 h, pâ=â0.26) or length of hospital stay (6.6 vs 6.1 days, pâ=â0.34) were found between DOAC-users and non-users. DOAC-users operated with neuraxial anaesthesia had longer surgical delay compared to DOAC-users operated with general anaesthesia (35 h vs 22 h, pâ<â0.001). Perioperative blood loss, transfusion rate, risk of bleeding complications and mortality were similar between groups.
Conclusion
Hip fracture patients using DOAC did not have increased surgical delay, length of stay or risk of reported bleeding complications than patients without anticoagulation prior to surgery. The increased surgical delay found for DOAC-users operated with neuraxial anaesthesia should be interpreted with caution.publishedVersio
Evaluating the suitability of coupled biophysical models for fishery management
The potential role of coupled biophysical models in enhancing the conservation, management, and recovery of fish stocks is assessed, with emphasis on anchovy, cod, herring, and sprat in European waters. The assessment indicates that coupled biophysical models are currently capable of simulating transport patterns, along with temperature and prey fields within marine ecosystems; they therefore provide insight into the variability of early-life-stage dynamics and connectivity within stocks. Moreover, the influence of environmental variability on potential recruitment success may be discerned from model hindcasts. Based on case studies, biophysical modelling results are shown to be capable of shedding light on whether stock management frameworks need re-evaluation. Hence, key modelling products were identified that will contribute to the development of viable stock recovery plans and management strategies. The study also suggests that approaches combining observation, process knowledge, and numerical modelling could be a promising way forward in understanding and simulating the dynamics of marine fish populations
Validation of Doloplus-2 among nonverbal nursing home patients - an evaluation of Doloplus-2 in a clinical setting
In the present study, more patients were categorized as having pain while using Doloplus-2 compared with nurses' estimation of pain without using any tools. The fact that nurses could not report if the patients were in pain in one third of the patients supports the claim that Doloplus-2 is a useful supplement for estimating pain in this population. However, nurses must use their clinical experience in addition to the use of Doloplus-2, as behaviour can have different meaning for different patients. Further research is still needed about the use of Doloplus-2 in patients not able to self-report their pain.THE WORK (AS DEFINED BELOW) IS PROVIDED UNDER THE TERMS OF THIS BIOMED CENTRAL OPEN ACCESS LICENSE ("LICENSE"). THE WORK IS PROTECTED BY COPYRIGHT AND/OR OTHER APPLICABLE LAW. ANY USE OF THE WORK OTHER THAN AS AUTHORIZED UNDER THIS LICENSE IS PROHIBITED.BY EXERCISING ANY RIGHTS TO THE WORK PROVIDED HERE, YOU ACCEPT AND AGREE TO BE BOUND BY THE TERMS OF THIS LICENSE. THE LICENSOR GRANTS YOU THE RIGHTS CONTAINED HERE IN CONSIDERATION OF YOUR ACCEPTANCE OF SUCH TERMS AND CONDITIONS
Pain in older persons with severe dementia. Psychometric properties of the MobilizationâObservationâBehaviourâIntensityâDementia (MOBIDâ2) Pain Scale in a clinical setting
Background: To assess pain in older persons with severe dementia is a challenge due to reduced selfâreport capacity. Recently, the development and psychometric property testing of the MobilizationâObservationâBehaviourâIntensityâDementia (MOBID) Pain Scale was described using videoârecording. The purpose of this article was to present the further development of this instrument. In MOBIDâ2 Pain Scale, the assessment of inferred pain intensity is based on patientâs pain behaviours in connection with standardized, guided movements of different body parts (Part 1). In addition, MOBIDâ2 includes the observation of pain behaviours related to internal organs, head and skin registered on pain drawings and monitored over time (Part 2).
Objective: The aim of this study was to examine psychometric properties of the MOBIDâ2 Pain Scale, like interârater and testâretest reliability, internal consistency, as well as faceâ, constructâ and concurrent validity.
Subjects and Setting: Patients with severe dementia (nâ=â77) were examined by 28 primary caregivers in clinical practice, who concurrently and independently completed the MOBIDâ2 Pain Scale. Characteristics of the patientsâ pain were also investigated by their physicians (nâ=â4).
Results: Prevalence of any pain was 81%, with predominance to the musculoskeletal system, highly associated with the MOBIDâ2 overall pain score (rhoâ=â0.82). Most frequent and painful were mobilizing legs. Pain in pelvis and/or genital organs was frequently observed. Moderate to excellent agreement was demonstrated for behaviours and pain drawings (Îşâ=â0.41â0.90 and Îşâ=â0.46â0.93). Interârater and testâretest reliability for pain intensity was very good, ICC (1, 1) ranging 0.80â0.94 and 0.60â0.94. Internal consistency was highly satisfactory; Cronbachâs Îą ranging 0.82â0.84. Faceâ, constructâ and concurrent validity was good. Overall pain intensity by MOBIDâ2 was well correlated with physiciansâ clinical examination and defined pain variables (rhoâ=â0.41â0.64).
Conclusion: On the basis of pain behaviours, standardized movements and pain drawings, MOBIDâ2 Pain Scale was shown to be sufficiently reliable, valid and timeâeffective for nurses to assess pain in patients with severe dementia