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PURPOSE: Oncology teams are challenged by BO, which may be alleviated by meaningful recognition. In this study, firgun-altruistic acknowledgment-was implemented on a pediatric hematopoietic cell transplant unit to evaluate its impact on staff and work environment. METHODS: In this longitudinal, mixed-methods pilot study, interdisciplinary inpatient hematopoietic cell transplant providers received web-based firgun education. Electronic administration of validated surveys occurred at baseline and 8 weeks, including Perceived Stress Scale, Professional Quality of Life Scale, Maslach Burnout Inventory, Workplace Civility Index, Areas of Work Life Survey, and WHO-5. Weekly e-mails reminded participants to practice and log firgun. Wilcoxon signed test for paired data compared pre/post results. Interviews conducted at project completion were coded using MaxQDA software. RESULTS: Forty-two participants enrolled; 25 completed pre/post surveys; eight were interviewed. At study end, participants reported feeling less nervous and stressed (P = .008), and less difficulty coping (P = .01; Perceived Stress Scale), while noting increased acknowledgment of others' work (P = .04) and seeking constructive feedback (P = .04; Workplace Civility Index). Marked BO was not evident overall on the Maslach Burnout Inventory; however, emotional exhaustion subscale mean (SD) scores improved from pre (19.4 [8.6]) to post (16 [6.3; P = .02]) and individual items illustrated decreased fatigue (P = .008), frustration (P = .04), and feeling "at the end of my rope" (P = .001). Postintervention participants noted increased receipt of recognition (P = .02; Areas of Work Life Survey), decreased feeling "bogged down" (P = .02), decreased affective stress (P = .04), and negative pre-occupations (P = .04; Professional Quality of Life Scale). Qualitative analysis revealed themes of improved confidence at work and enhanced feelings of trust and teamwork. CONCLUSION: Firgun is a tool that can potentially reduce BO and stress in interdisciplinary providers, facilitate teamwork, and promote positive work environments in clinical oncology and beyond.
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Agotamiento Profesional , Trasplante de Células Madre Hematopoyéticas , Humanos , Niño , Proyectos Piloto , Calidad de Vida , EmocionesRESUMEN
BACKGROUND: Academic leaders are concerned about the retention rate of nursing students; peer mentoring may be one strategy for student success. Research studies on mentoring indicate the benefits of mentoring accrue for both mentors and mentees. METHOD: A peer voluntary mentorship program operated in coordination with an academic resource center for a decade. It included training and weekly meetings. Mentors were senior nursing students who had a minimum B+ average and faculty recommendations. All mentors kept journal logs of their time and reflections of their experience. RESULTS: Journal statements revealed that mentored nursing students felt more successful in their coursework, gained test-taking skills, and did better on examinations. Mentors gained confidence about their skills and were better prepared for the NCLEX. Mentees formed a natural support group. Mentors expressed concern about their students' success beyond the program. CONCLUSION: This program generated a culture of caring and support to the nursing students, with the understanding that they would give back to others what they had received. [J Nurs Educ. 2018;57(7):430-435.].
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Bachillerato en Enfermería/organización & administración , Relaciones Interpersonales , Tutoría , Grupo Paritario , Estudiantes de Enfermería/psicología , Humanos , Investigación en Educación de Enfermería , Investigación en Evaluación de Enfermería , Cultura Organizacional , Apoyo SocialRESUMEN
This article describes the outcomes of nursing students taking a course in complementary and alternative therapies focusing on energetic modalities that were used as a means of self-care. Students kept journal logs and did a formal presentation for the class. Nursing students reported decreased stress and improved concentration, academic performance, productivity, and problem-solving while experiencing a greater appreciation of their clinical experiences. Using Therapeutic Touch and other subtle energy interactions, the students also cited improved interpersonal relationships, increased feelings of calmness, a higher degree of self-awareness and self-care, reduced physical pain, increased energy, and greater appreciation of the world around them. The theoretical framework was Margret Neuman's theory of health as expanding consciousness. While this is an elective nursing course, the nursing students were primarily juniors and seniors already taking clinical courses. A research study with a wide sample of student participants, especially freshmen, and using quantitative as well as qualitative measures would be beneficial to determine if such a course should be part of the standard nursing curriculum to not only expand nurses' understanding of complementary and alternative therapies but also to help students with their own self-care and influence their practice as clinicians.
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Autocuidado , Estrés Psicológico , Estudiantes de Enfermería/psicología , Tacto Terapéutico , Terapias Complementarias/educación , Bachillerato en Enfermería , Femenino , Enfermería Holística , Humanos , Masculino , Adulto JovenRESUMEN
PURPOSE: The purpose of this study was to explore the effectiveness of the aromatherapy product QueaseEASE (QE) for decreasing postdischarge nausea (PDN) in patients undergoing outpatient abdominal surgery. DESIGN: Prospective exploratory study. METHODS: Informed Consent was obtained preoperatively from a convenience sample of adult patients scheduled for outpatient abdominal surgery procedures. Prior to discharge, subjects were instructed in the use of QE and given instructions on how to rate their nausea on a 0-10 scale. They recorded nausea scales > 0 any time they occurred for the next 24 hours, used the QE, and recorded their nausea scales 3 minutes later. A study nurse called subjects the next day to collect the information. FINDINGS: The sample included 70 outpatients who underwent abdominal surgery. Twenty-five participants (36%) reported experiencing PDN and their concomitant use of QE. There was a significant difference in mean age of those reporting PDN (37 years) versus those without nausea (48 years, P = .004) as well as a significant difference in mean intravenous fluid intake during hospitalization of those reporting PDN (1,310 mL) versus those without nausea (1,511 mL, P = .04). The PDN group had more female participants (72% vs 42%, P = .02), more participants that were less than 50 years of age (84% vs 53%, P = .02), and received more opioids (100% vs 76%, P = .006) than the no nausea group. The 25 PDN participants reported 47 episodes of PDN in which they used QE. For all of the 47 PDN episodes experienced, participants reported a decrease in nausea scale (0 to 10) after the use of QE; for 22 (47%) of the PDN episodes experienced, a nausea scale of 0 after using QE was reported. The mean decrease in nausea scale for all 25 participants was 4.78 (±2.12) after using QE. CONCLUSION: This study found that the aromatherapy QE was an effective treatment of PDN in select same-day abdominal surgery patients.
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Abdomen/cirugía , Procedimientos Quirúrgicos Ambulatorios , Aromaterapia , Náusea y Vómito Posoperatorios/prevención & control , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Femenino , Humanos , Masculino , Persona de Mediana Edad , Alta del Paciente , Adulto JovenRESUMEN
BACKGROUND: Burnout, a syndrome of emotional exhaustion, depersonalization, and diminished feelings of accomplishment, is common among pediatric oncology staff. This study explores a mindfulness-based course (MBC) to decrease burnout in a multidisciplinary group of pediatric oncology staff members in the United States and Israel. MATERIALS AND METHODS: Forty-eight participants, mostly nurses, were randomized to either the MBC intervention or a control group. MBC participants received eight weekly sessions of mindfulness education. The primary outcome studied was burnout. Secondary outcomes studied included depression and perceived stress. RESULTS: Nearly 100% of the subjects exhibited signs of burnout at baseline and MBC did not result in any significant improvement in scores on burnout, perceived stress or depression scales. Qualitative analysis of diaries kept by subjects revealed reduced stress, improved inner peace, compassion and joy, better focus and self-awareness and less somatic symptoms in the intervention arm. CONCLUSIONS: Burnout is a major problem in pediatric oncology staff. Mindfulness practices can be taught in the workplace and may be a useful component of a multidimensional strategy to reduce burnout in this population.
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Agotamiento Profesional , Niño , Femenino , Humanos , Masculino , Oncología Médica , Enfermería , Pediatría , Proyectos PilotoRESUMEN
This article describes the use of energy dialogue technique (EDT), a healing intervention that provides awareness of imbalances in the energetic field that affect patients' health and guide the practitioner to sense and direct the frequency, vibration, intention, awareness, or consciousness to correct these imbalances. The authors document the effectiveness of this technique as it was used to treat side effects of the medical intervention for hepatitis C in a male with hemophilia. Following EDT, the client's symptoms of fatigue and pain improved by 30% to 40%; moreover, thyroid function returned to normal. The authors suggest that EDT be studied and explored for inclusion as a treatment modality.
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Antivirales/administración & dosificación , Hemofilia A/tratamiento farmacológico , Hepatitis C Crónica/tratamiento farmacológico , Relaciones Metafisicas Mente-Cuerpo , Enfermedades de la Tiroides/tratamiento farmacológico , Glándula Tiroides/efectos de los fármacos , Adulto , Quimioterapia Combinada , Hemofilia A/complicaciones , Hemofilia A/psicología , Hepatitis C Crónica/complicaciones , Hepatitis C Crónica/psicología , Humanos , Interferón-alfa/administración & dosificación , Masculino , Ribavirina/administración & dosificación , Enfermedades de la Tiroides/complicaciones , Enfermedades de la Tiroides/psicologíaRESUMEN
Insulin rapidly stimulates the tyrosine kinase activity of its receptor, resulting in the phosphorylation of insulin receptor substrates (IRS), which in turn associates and activates PI 3-kinase, leading to an increase in glucose uptake. Phosphorylation of IRS proteins and activation of downstream kinases by insulin are transient and the mechanisms for the subsequent downregulation of their activity are largely unknown. We report here that the insulin-induced IRS-1 tyrosine phosphorylation and PI 3-kinase association to IRS-1 were strongly sustained by the proteasome inhibitors, MG132 and lactacystin. In contrast, no effect was detected on the insulin receptor and IRS-2 tyrosine phosphorylation. Interestingly, lactacystin also preserved PKB activation and insulin-induced glucose uptake. In contrast, calpeptin, a calpain inhibitor, was ineffective. Tyrosine phosphatase assays were also performed, showing that lactacystin was not functioning directly as a tyrosine phosphatase inhibitor "in vitro." In conclusion, proteasome inhibitors can regulate the tyrosine phosphorylation of IRS-1 and the downstream insulin signaling pathway, leading to glucose transport.
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Acetilcisteína/análogos & derivados , Acetilcisteína/farmacología , Adipocitos/metabolismo , Inhibidores de Cisteína Proteinasa/farmacología , Insulina/farmacología , Leupeptinas/farmacología , Complejos Multienzimáticos/antagonistas & inhibidores , Fosfoproteínas/metabolismo , Proteínas Serina-Treonina Quinasas , Células 3T3 , Adipocitos/efectos de los fármacos , Animales , Transporte Biológico , Línea Celular , Cisteína Endopeptidasas , Inhibidores Enzimáticos/farmacología , Glucosa/metabolismo , Proteínas Sustrato del Receptor de Insulina , Cinética , Ratones , Fosfatidilinositol 3-Quinasas/metabolismo , Fosfoproteínas/química , Fosforilación , Fosfotirosina/metabolismo , Complejo de la Endopetidasa Proteasomal , Proteínas Tirosina Fosfatasas/antagonistas & inhibidores , Proteínas Proto-Oncogénicas/metabolismo , Proteínas Proto-Oncogénicas c-akt , Transducción de Señal/efectos de los fármacosRESUMEN
Five children with brainstem tumors and two control patients had magnetic resonance spectroscopy studies of the brainstem. Two of the malignant tumor patients had magnetic resonance spectroscopy studies before and after radiation therapy. The third was irradiated 14 years earlier but developed new symptoms and a new brainstem lesion on MRI. Magnetic resonance spectroscopy demonstrated a different degree of malignancy between the old and new lesion. The fourth patient had magnetic resonance spectroscopy of a chronic, large pontine lesion 6 years after diagnosis and radiation. The spectral pattern suggested a low degree of malignancy. The fifth patient had neurofibromatosis type 1 with brainstem lesions. Magnetic resonance spectroscopy suggested neoplastic tissue of low malignancy. These results suggest that magnetic resonance spectroscopy offers additional information for anticipating the degree of anaplasia in children with brainstem tumors.