Advancing the science of symptom management
Advancing the science of symptom management Abstract. Since the publication of the original Symptom Management Model (Larson et al. 1994), faculty and students at the University of California, San Francisco (UCSF) School of Nursing Centre for System Management have tested this model in research studies and expanded the model through collegial discussions and seminars. Aim. In this paper, we describe the evidence-based revised conceptual model, the three dimensions of the model, and the areas where further research is needed. Background/Rationale. The experience of symptoms, minor to severe, prompts millions of patients to visit their healthcare providers each year. Symptoms not only create distress, but also disrupt social functioning. The management of symptoms and their resulting outcomes often become the responsibility of the patient and his or her family members. Healthcare providers have difficulty developing symptom management strategies that can be applied across acute and home-care settings because few models of symptom management have been tested empirically. To date, the majority of research on symptoms was directed toward studying a single symptom, such as pain or fatigue, or toward evaluating associated symptoms, such as depression and sleep disturbance. While this approach has advanced our understanding of some symptoms, we offer a generic symptom management model to provide direction for selecting clinical interventions, informing research, and bridging an array of symptoms associated with a variety of diseases and conditions. Finally, a broadly-based symptom management model allows the integration of science from other fields.
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Other than loss of income to family members, little attention has been given to costs incurred by women with breast cancer and their families. Informal costs, such as the family labor for patient care and nonreimbursed out-of-pocket expenditures to care for the patient with breast cancer, need to be considered. Informal costs of women who survived for at least 3 months after the observation are compared with informal costs of a group of patients who died during the subsequent 3 months. Data for ...
Introduction Outcomes Research The Theory-Driven Approach to Effectiveness Research Characteristics of Clients Intervener and Setting Characteristics Intervention Variables Outcomes-Related Factors Implications for Effectiveness Research
Objective . To determine the effect of being in the neonatal intensive care unit (NICU) on pain responses in infants of 32 weeks9 postconceptual age (PCA). Design . A cross-sectional comparative design was used. Setting . Two level III NICUs, each in metropolitan, university teaching hospitals. Patients . Infants of 32 weeks9 PCA born within the past 4 days (the newly born group; n = 53) were compared with infants of the same PCA who had been born 4 weeks earlier (the earlier-born group; n = 36)...
Most studies of midlife women consist of samples between 40 and 60 years of age and describe their menopausal symptom experience as if it were one homogeneous group across two decades of life. Very little is known about the health and symptom experience of midlife women as They enter midlife or experience menopause. Therefore, the purpose of this paper is to describe and contrast selected symptoms, health status, and health care utilization of midlife women by 5-year increments from the age of 4...
ABSTRACT Objective: Most research on perimenstrual weight gain and swelling involves a biomedical perspective, often failing to also consider women's symptoms as experienced within a social context. The objective of this paper is to explore biopsychosocial correlates of perceived weight gain and swelling during the perimenstrual period. Design, Setting, Participants, and Outcome Measure: Data were gathered by use of a questionnaire containing primarily forced-choice items. This secondary analysi...
A detailed description of the newly revised and updated theory of unpleasant symptoms is provided.Revisions have resulted in a more accurate representation of the complexity and interactive nature of the symptom experience. Example are provided to demonstrate the implications of the revised theory for measurement and research, and its application in practice. A detailed exemplar describes how it guided the design of a multifaceted intervention to encourage successful breastfeeding.
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Type and course of symptoms demonstrated in the terminal and dying phases by people with dementia in nursing homesBackground In all, 39 % of people living in Swiss nursing homes suffer from dementia. Detailed data about type and course of symptoms displayed by these patients in their terminal phase are lacking.
Background: Self-care helps reduce the frequency of hospitalization and exacerbations, thereby enhancing quality of life (QOL) in heart failure (HF) patients. Objective: This study aimed to determine if gender differences exist in self-care and QOL in HF patients. Methods: Using a cross-sectional cohort study, 98 subjects participated in this study. Self-care attributes were measured using the Self-Care of Heart Failure Index. QOL was measured using a disease-specific instrument, the Minnesota L...
Medikamentenbezogene Non-Adherence stellt ein signifikantes Problem in der Langzeitnachsorge der Patienten nach solider Organtransplantation dar. Der Anteil der Patienten, die Schwierigkeiten bei der regelmasigen, punktlichen und korrekten Dosierung der Medikamente haben, muss mit etwa 20% kalkuliert werden. Non-Adherence resultiert in verkurzten Organ- und Uberlebensraten sowie erhohten Kosten fur das Gesundheitssystem. Symptombelastungen stehen in direkter Beziehung zu (Non-)Adherence. Die Ide...
Advances in symptom management strategies through a better understanding of cancer symptom clusters depend on the identification of symptom clusters that are valid and reliable. The purpose of this exploratory research was to investigate alternative analytical approaches to identify symptom clusters for patients with cancer, using readily accessible statistical methods, and to justify which methods of identification may be appropriate for this context. Three studies were undertaken: (1) a system...