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Full-Text Articles in Medicine and Health Sciences
Interventions To Improve Adherence And Symptoms For Oral Agents, Sandra Spoelstra
Interventions To Improve Adherence And Symptoms For Oral Agents, Sandra Spoelstra
Sandra L. Spoelstra, PhD, RN, FGSA, FAAN
Significance & Background:
With increased use of oral chemotherapy agents to treat cancer, patients are responsible for adhering to complex dosing regimens and to self-monitor symptoms.
Purpose:
This study determined through a three arm trial of 119 patients with solid tumors from four Cancer Centers, how an Automated Voice Response (AVR) system alone (n=40), or the AVR complemented by nurse strategies to manage symptoms and adherence (n=40), or to manage adherence alone (n=39), reduced symptom severity and non-adherence to oral chemotherapy.
Conceptual Framework:
This trial compared an educational approach to symptom management coupled with reminders to take medications …
The Influence Of Comorbidities On Use Of #11;Symptom Management Strategies, Sandra Spoelstra
The Influence Of Comorbidities On Use Of #11;Symptom Management Strategies, Sandra Spoelstra
Sandra L. Spoelstra, PhD, RN, FGSA, FAAN
This research examines 552 solid tumor cancer patients undergoing chemotherapy, the impact of comorbidities on patient’s use of management strategies for 15 common symptoms during treatment. After adjusting for age and intervention mode, number of comorbidities was significantly related to number of symptoms threshold; ranging from 5.5—7.5 (no comorbidity to 3+). However, numbers of comorbidities had no impact on patients trying proposed strategies. To determine if age adjusted numbers of comorbidities influenced proportion of symptoms, severe, moderate, mild cut-points were applied and responses were defined as moving from severe to moderate/mild, or moderate to mild. Mean response rates among patients …
Falls And Fractures In Community Dwelling Elderly Cancer Survivors, Sandra Spoelstra
Falls And Fractures In Community Dwelling Elderly Cancer Survivors, Sandra Spoelstra
Sandra L. Spoelstra, PhD, RN, FGSA, FAAN
Significance & Background:
Cancer survivors are living longer, but continue to encounter physical, psychosocial, and economic impacts of cancer until end of life. Of all types of injuries, falls pose the most serious threat to quality of life in the elderly.
Purpose: The purpose of this study was to examine the impact of a cancer diagnosis on falls and fractures.
Conceptual Framework: An aging and nursing model of care were synthesized.
Methods & Analysis:
This is a longitudinal, retrospective, study comparing 865 with cancer to 8617 without cancer. We analyzed data from the Michigan Home …
Explaining Transfers From Home And Community Based Waiver Program To Nursing Home: Can Patients Stay At Home?, Sandra Spoelstra
Explaining Transfers From Home And Community Based Waiver Program To Nursing Home: Can Patients Stay At Home?, Sandra Spoelstra
Sandra L. Spoelstra, PhD, RN, FGSA, FAAN
Purpose Among6,836 medically and economically vulnerable older persons enrolled in a Home and Community Based Waiver (HCBW) program between 2003 and 2007 we compare those who remain at home with those who transfer to a nursing home (NH).
Background NHs is costly, averaging over $70,000 per year. Beyond escalating financial concerns, there are a constellation of potentially negative outcomes associated with NH admission, and most older adults prefer to remain in their homes but are forced to transfer to NHs because community supports are inadequate to meet their needs.
Methods Those who remained at home (4343) and NH …