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P63 The effect of meaning of the illness with cancer patients on anxiety depression and quality of life
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Abstracts and learning outcomes / European Journal of Oncology Nursing 14S1 (2010) S1–S62
Conclusion: Greater planned support for nurses who wish to work with patients who are suffering may assist in both the care of their patients and their ability to cope. P63 The effect of meaning of the illness with cancer patients on anxiety depression and quality of life A. Okanli1 , S. Asi Karakas2 . 1 Atat¨ urk University, Department of Psychiatric Nursing, Erzurum, Turkey; 2 Erzurum Regional Research Hospital, Department of Management, Erzurum, Turkey Introduction: Cancer is the second highest cause of death among adults in Turkey. Cancer is a life-threatening illness that can challenge the experience of meaning in life. The meaning given to an illness is shaped by the individual’s life experiences and includes cultural, spiritual, psychosocial, biologic, and economic factors. Depression and anxiety are generally considered to be the most important psychopathological co-morbidities of cancer patients. QOL is the impact of the disease and/or treatment on the functional status, physical symptoms, affective state, and interpersonal relationships, as evaluated by the person with cancer. In clinical applications, it is important to be known that how the patient should asses his/her disease. This study was carried out descriptively with the aim of assessment the meaning of illness with cancer patients on quality of life, anxiety and depression. An understanding of the relationships of all these factors in cancer patients is needed. This will provide direction for effective nursing interventions, for patients, to enhance their ability to successfully manage the cancer experience. Material and Method: The study content consisted of the patients hospitalized in the Medical Oncology Clinic of Ataturk ¨ University Yakutiye Research Hospital and receiving chemotherapy treatment. It was studied with 110 patients who receiving chemotherapy and being able to communicate and accepting to interview. The period of the data collection was realized between December 2006 and May 2007. The data were collected by means of question form, Meaning of Illness Scale (Mc Adams, Bryne et al. 1988), Hospital Anxiety and Depression Scale (Zigmond and Snaith 1983) and Quality of Life Scale (Padilla 1992). Result and Discussion: It was observed that the illness in patients with cancer affected family relationship (4.00±1.17) of the patients and occupation, school and home work (4.00±1.18). Anxiety score averages of the patients were higher of interns those of depression (8.54±4.72). It was found out according to Hospital Anxiety and Depression Scale cut point patient who receiving anxiety percent 58, depression percent 60. A total quality life score average of the patients was found 48.83±12.67. In the result of correlation analysis made among scales, it was found out that there was a statistically significant correlation between the meaning of illness and quality of life, anxiety and depression (p < 0.01). It was found out that there was a negatively statistically significant correlation between anxiety depression and quality of life (p < 0.01). As quality of life score average increases anxiety and depression score average reduces. Conclusion: This study results contribute to the evidence that meaning of illness has a direct impact on depression, anxiety and quality of life cancer patients in Turkey. P64 Coping of family caregivers of cancer patients in Turkey ¨ E. Yilmaz Karabulutlu. Atat¨ urk University Faculty of Health Science, Medical Nursing, Erzurum, Turkey Introduction: Cancer affects the functionality of the family system as well as the psychological and physical unity of the patient. Patient’s struggling with the illness, his harmony with the treatment and his development of any psychopathology interacts with family dynamics and support systems. It is stated that cancer patient caregiver family members mostly don’t feel ready; they don’t have sufficient information about
disease and care and take insufficient support from health care givers. The resistance of the caregivers coping with such negative effects should be supported, their bio-psychological unity should be proceeded and they should develop effective coping mechanisms. Purpose: This research has been made in order to determine the coping styles of the cancer patient caregivers. Material and Method: This study had descriptive design. The sampling of the research was composed of 127 cancer patient caregivers. The data was collected by Coping Behaviour Inventory (SBTE) and a questionnaire. The scale has 6 dimensions. These are active planning, outsourcing help, turning to religion, avoidance– isolation (emotional–actual), avoidance–isolation (biochemical) and acceptance–cognitive restructuring. Results and Discussion: When the coping sub dimension mean scores of the caregivers are examined, active planning is found to be 28.14±5.98, outsourcing help as 23.05±5.83, turning to religion as 17.52±4.18, avoidance–isolation (emotional–actual) as 13.98±5.24, avoidance–isolation as (biochemical) 3.31±3.20 and acceptance–cognitive restructuring as 17.51±4.25. The most used coping methods by the care givers are active planning and least used method is (biochemical) avoidance–isolation. Caregivers mostly use active planning, outsourcing help, turning to religion and acceptance – cognitive restructuring as effective coping methods. It is considered that effective coping method using caregivers will be more interested in the care requirements of the patient, will decrease the stress of the patient and will help the patient develop effective coping strategies. The least used coping method is determined as avoidance. It has been stated in the literature that inconsistent and avoidance coping strategies affect psychological health adversely. Therefore, avoidance is suggested to be an inappropriate strategy for coping with stress. Caregivers less using avoidance (which is not an effective method) much as a coping method is a desired result. Conclusion: Caregivers use active planning, outsourcing help, turning to religion and acceptance–cognitive restructuring as coping methods. These results show that care givers use effective methods for coping with the patient problems. Educations related with least used non-effective methods can be suggested. P65 Using an executive coaching model to support the delivery of cancer care in an oncology/haematology department G. Urquhart1 , S. Urquhart2 . 1 Portsmouth Hospital Trust, Oncology/Haematology, Portsmouth, United Kingdom; 2 Coaching Clinic, Coaching, Portsmouth, United Kingdom Changes in clinical practice and more effective regimens are increasing demand for chemotherapy (Camburn, 2008). Caring for patients with terminal illness is particularly stressful (Hacket et al 2009). Studies continue to show high levels of burnout among nurses, doctors and managers (Davies, 2008), (Firth-Cozens, 2003), (Personnel Today, 2007). In response to this Portsmouth Hospitals Oncology team engaged an Executive Coach. Coaching is now increasingly used in the NHS for managers and clinical staff (Price, 2009). This despite the suggestion there is little supporting evidence published (Bono et al. 2009). There are some areas of emotional experience for which coaching is appropriate; others for which a psychotherapy is appropriate, with some overlap (Bono et al. 2009). Method: A trial programme commenced with an Executive Coach using an approach informed by NLP, psychometric testing, cognitive, person centred and social psychology theories. The coaching relationship started with an assessment to ensure the team could support an effective coaching relationship. Expected outcomes for the coaching were explored to ensure they were realistic. Challenges were identified, solutions negotiated, achievable, measurable and realistic outcomes agreed.
Abstracts and learning outcomes / European Journal of Oncology Nursing 14S1 (2010) S1–S62
Conclusion: Greater planned support for nurses who wish to work with patients who are suffering may assist in both the care of their patients and their ability to cope. P63 The effect of meaning of the illness with cancer patients on anxiety depression and quality of life A. Okanli1 , S. Asi Karakas2 . 1 Atat¨ urk University, Department of Psychiatric Nursing, Erzurum, Turkey; 2 Erzurum Regional Research Hospital, Department of Management, Erzurum, Turkey Introduction: Cancer is the second highest cause of death among adults in Turkey. Cancer is a life-threatening illness that can challenge the experience of meaning in life. The meaning given to an illness is shaped by the individual’s life experiences and includes cultural, spiritual, psychosocial, biologic, and economic factors. Depression and anxiety are generally considered to be the most important psychopathological co-morbidities of cancer patients. QOL is the impact of the disease and/or treatment on the functional status, physical symptoms, affective state, and interpersonal relationships, as evaluated by the person with cancer. In clinical applications, it is important to be known that how the patient should asses his/her disease. This study was carried out descriptively with the aim of assessment the meaning of illness with cancer patients on quality of life, anxiety and depression. An understanding of the relationships of all these factors in cancer patients is needed. This will provide direction for effective nursing interventions, for patients, to enhance their ability to successfully manage the cancer experience. Material and Method: The study content consisted of the patients hospitalized in the Medical Oncology Clinic of Ataturk ¨ University Yakutiye Research Hospital and receiving chemotherapy treatment. It was studied with 110 patients who receiving chemotherapy and being able to communicate and accepting to interview. The period of the data collection was realized between December 2006 and May 2007. The data were collected by means of question form, Meaning of Illness Scale (Mc Adams, Bryne et al. 1988), Hospital Anxiety and Depression Scale (Zigmond and Snaith 1983) and Quality of Life Scale (Padilla 1992). Result and Discussion: It was observed that the illness in patients with cancer affected family relationship (4.00±1.17) of the patients and occupation, school and home work (4.00±1.18). Anxiety score averages of the patients were higher of interns those of depression (8.54±4.72). It was found out according to Hospital Anxiety and Depression Scale cut point patient who receiving anxiety percent 58, depression percent 60. A total quality life score average of the patients was found 48.83±12.67. In the result of correlation analysis made among scales, it was found out that there was a statistically significant correlation between the meaning of illness and quality of life, anxiety and depression (p < 0.01). It was found out that there was a negatively statistically significant correlation between anxiety depression and quality of life (p < 0.01). As quality of life score average increases anxiety and depression score average reduces. Conclusion: This study results contribute to the evidence that meaning of illness has a direct impact on depression, anxiety and quality of life cancer patients in Turkey. P64 Coping of family caregivers of cancer patients in Turkey ¨ E. Yilmaz Karabulutlu. Atat¨ urk University Faculty of Health Science, Medical Nursing, Erzurum, Turkey Introduction: Cancer affects the functionality of the family system as well as the psychological and physical unity of the patient. Patient’s struggling with the illness, his harmony with the treatment and his development of any psychopathology interacts with family dynamics and support systems. It is stated that cancer patient caregiver family members mostly don’t feel ready; they don’t have sufficient information about
disease and care and take insufficient support from health care givers. The resistance of the caregivers coping with such negative effects should be supported, their bio-psychological unity should be proceeded and they should develop effective coping mechanisms. Purpose: This research has been made in order to determine the coping styles of the cancer patient caregivers. Material and Method: This study had descriptive design. The sampling of the research was composed of 127 cancer patient caregivers. The data was collected by Coping Behaviour Inventory (SBTE) and a questionnaire. The scale has 6 dimensions. These are active planning, outsourcing help, turning to religion, avoidance– isolation (emotional–actual), avoidance–isolation (biochemical) and acceptance–cognitive restructuring. Results and Discussion: When the coping sub dimension mean scores of the caregivers are examined, active planning is found to be 28.14±5.98, outsourcing help as 23.05±5.83, turning to religion as 17.52±4.18, avoidance–isolation (emotional–actual) as 13.98±5.24, avoidance–isolation as (biochemical) 3.31±3.20 and acceptance–cognitive restructuring as 17.51±4.25. The most used coping methods by the care givers are active planning and least used method is (biochemical) avoidance–isolation. Caregivers mostly use active planning, outsourcing help, turning to religion and acceptance – cognitive restructuring as effective coping methods. It is considered that effective coping method using caregivers will be more interested in the care requirements of the patient, will decrease the stress of the patient and will help the patient develop effective coping strategies. The least used coping method is determined as avoidance. It has been stated in the literature that inconsistent and avoidance coping strategies affect psychological health adversely. Therefore, avoidance is suggested to be an inappropriate strategy for coping with stress. Caregivers less using avoidance (which is not an effective method) much as a coping method is a desired result. Conclusion: Caregivers use active planning, outsourcing help, turning to religion and acceptance–cognitive restructuring as coping methods. These results show that care givers use effective methods for coping with the patient problems. Educations related with least used non-effective methods can be suggested. P65 Using an executive coaching model to support the delivery of cancer care in an oncology/haematology department G. Urquhart1 , S. Urquhart2 . 1 Portsmouth Hospital Trust, Oncology/Haematology, Portsmouth, United Kingdom; 2 Coaching Clinic, Coaching, Portsmouth, United Kingdom Changes in clinical practice and more effective regimens are increasing demand for chemotherapy (Camburn, 2008). Caring for patients with terminal illness is particularly stressful (Hacket et al 2009). Studies continue to show high levels of burnout among nurses, doctors and managers (Davies, 2008), (Firth-Cozens, 2003), (Personnel Today, 2007). In response to this Portsmouth Hospitals Oncology team engaged an Executive Coach. Coaching is now increasingly used in the NHS for managers and clinical staff (Price, 2009). This despite the suggestion there is little supporting evidence published (Bono et al. 2009). There are some areas of emotional experience for which coaching is appropriate; others for which a psychotherapy is appropriate, with some overlap (Bono et al. 2009). Method: A trial programme commenced with an Executive Coach using an approach informed by NLP, psychometric testing, cognitive, person centred and social psychology theories. The coaching relationship started with an assessment to ensure the team could support an effective coaching relationship. Expected outcomes for the coaching were explored to ensure they were realistic. Challenges were identified, solutions negotiated, achievable, measurable and realistic outcomes agreed.