RESUMEN
PURPOSE/OBJECTIVES: To compare the effects of partner-delivered foot reflexology and usual care plus attention on patients' perceived pain and anxiety. DESIGN: The experimental pretest/post-test design included patient-partner dyads randomly assigned to an experimental or control group. SETTING: Four hospitals in the southeastern United States. SAMPLE: 42 experimental and 44 control subjects comprised 86 dyads of patients with metastatic cancer and their partners, representing 16 different types of cancer; 23% of patients had lung cancer, followed by breast, colorectal, and head and neck cancer and lymphoma. The subjects had a mean age of 58.3 years, 51% were female, 66% had a high school education or less, and 58% were Caucasian, 40% were African American, and 1% were Filipino. METHODS: The intervention included a 15- to 30-minute teaching session on foot reflexology to the partner by a certified reflexologist, an optional 15- to 30-minute foot reflexology session for the partner, and a 30-minute, partner-delivered foot reflexology intervention for the patient. The control group received a 30-minute reading session from their partners. MAIN RESEARCH VARIABLES: Pain and anxiety. FINDINGS: Following the initial partner-delivered foot reflexology, patients experienced a significant decrease in pain intensity and anxiety. CONCLUSIONS: A nurse reflexologist taught partners how to perform reflexology on patients with metastatic cancer pain in the hospital, resulting in an immediate decrease in pain intensity and anxiety; minimal changes were seen in the control group, who received usual care plus attention. IMPLICATIONS FOR NURSING: Hospitals could have qualified professionals offer reflexology as a complementary therapy and teach interested partners the modality.
Asunto(s)
Ansiedad/rehabilitación , Masaje/psicología , Neoplasias/complicaciones , Dolor/rehabilitación , Esposos/psicología , Ansiedad/diagnóstico , Ansiedad/etiología , Ansiedad/psicología , Femenino , Humanos , Masculino , Masaje/métodos , Persona de Mediana Edad , Metástasis de la Neoplasia , Dolor/diagnóstico , Dolor/etiología , Dolor/psicología , Dimensión del DolorRESUMEN
This preliminary study tested the efficacy of a partner-guided cancer pain management protocol for patients who are at the end of life. Seventy-eight advanced cancer patients meeting criteria for hospice eligibility and their partners were randomly assigned to a partner-guided pain management training intervention, or usual care control condition. The partner-guided pain management training protocol was a three-session intervention conducted in patients' homes that integrated educational information about cancer pain with systematic training of patients and partners in cognitive and behavioral pain coping skills. Data analyses revealed that the partner-guided pain management protocol produced significant increases in partners' ratings of their self-efficacy for helping the patient control pain and self-efficacy for controlling other symptoms. Partners receiving this training also showed a trend to report improvements in their levels of caregiver strain. Overall, the results of this preliminary study suggest that a partner-guided pain management protocol may have benefits in the context of cancer pain at the end of life. Given the significance of pain at the end of life, future research in this area appears warranted.
Asunto(s)
Adaptación Psicológica , Neoplasias/complicaciones , Manejo del Dolor , Dolor/etiología , Esposos , Cuidado Terminal/métodos , Estudios de Factibilidad , Femenino , Humanos , Masculino , Persona de Mediana Edad , Dolor/psicología , Educación del Paciente como Asunto , Esposos/educación , Esposos/psicologíaRESUMEN
This preliminary study examined the self-efficacy of family caregivers with regard to helping cancer patients manage pain at end of life. A sample of 63 family caregivers of hospice-eligible cancer patients with pain provided ratings of their self-efficacy in assisting the patient in pain management and rated their own mood and level of caregiver strain. Patients completed measures of pain and quality of life. Data analyses revealed that caregivers who rated their self-efficacy as high reported much lower levels of caregiver strain as well as decreased negative mood and increased positive mood. Caregiver self-efficacy in managing the patient's pain was related to the patient's physical well-being. In dyads where the caregiver reported high self-efficacy, the patient reported having more energy, feeling less ill, and spending less time in bed. Considered overall, the results of this study suggest that caregiver self-efficacy in pain management is important in understanding how caregivers adjust to the demands of caring for cancer patients who have pain at the end of life.