Ovarian cancer care has shifted from hospitals to families and has resulted in an unanticipated cancer journey as survivability for women so diagnosed has increased. This research investigated the impact of this responsibility on selected aspects of family functioning. Eighteen families participated in 5 family research visitations over the first postdiagnostic year. Quantitative data were obtained on socioemotional responses, behaviors, and coping strategies. Accounts of family experiences were recorded in field notes and narrative descriptions. Descriptive and narrative analyses were used. Subject families were strong and experienced a mosaic of variations in socioemotional and behavioral responses. Coping responses relied primarily on reframing and spiritual support. Families had hope and optimism and received socioemotional support from kin and friends. Response patterns consisted of providing support and care to sick members; making transformative changes in family structures, roles, and functions; reorganizing daily living experiences to integrate new situations; and minimizing gaps between professional and familial perspectives and realities. On this journey, families could have used timely knowledge and professional expertise to plan care, balance illness and family needs, restructure roles and responsibilities, maintain family unity, and give meaning and wholeness to experiences. Family-based oncology nursing is essential for family well-being and growth.
Functional residual capacity (FRC) can be assessed reliably in young children using a helium gas dilution technique. The aim of the present study was to determine if differences in lung volume are found in asthmatic children of different ethnic origins. Eighty-eight children were studied, 53 of Caucasian origin and 35 of Afro-Caribbean origin. Their median age was 6.1 years (range, 5.3-9.0 years). FRC measured by helium gas dilution is reported as a percentage of predicted for height, using a published regression equation as well as regression equations appropriate for the ethnic origin of the child. In the majority of both groups FRC was elevated above the ethnically appropriate regression equation for healthy children. The Caucasian children apparently had higher FRCs than the Afro-Caribbean children if comparing the absolute lung volume, and if lung volume was expressed as percent of predicted for height, by a regression equation uncorrected for ethnic origin (P less than 0.02). This difference disappeared when ethnically appropriate regression equations were used. We conclude that lung volumes are similar in asthmatic children of different ethnic origin and that it is important to use ethnically appropriate regression equations.
Pelvic assessments should be reformulated to conceptualize early symptoms, risk factors, and family cancer history as a dynamic, interconnected whole to guide and interpret ovarian health.
Critical review of general health-seeking models showed a need for expansion to include the early and atypical symptom period associated with ovarian cancer and the role of self and primary care in the diagnostic process. Data from family functioning research showed that in the self-care phase, the initial gastrointestinal symptoms were unrecognized as serious, given common sense labels, and self-managed. When primary care provider care was sought, misdiagnoses occurred three fourth of the time. Diagnostic delays occurred in these 2 phases of care. An expansion of a model of health seeking links personal and family risks and adds early symptom data may be obtained through monthly self-monitoring by women using a symptom checklist. Organization of risks and symptom information assists in interpretation of disparate streams of data and gives a recommended outcome: high personal risk level + high family risk level + high early and persistent symptoms presence = high need for a prompt gynecological evaluation. The restructured health-seeking process requires women be taught how to monitor their ovarian health. Nurses and primary care providers need frequent continuing education updates and the health media need current and accurate information about this malignancy.
Women must be taught to self-monitor for early ovarian cancer symptoms. Primary care providers should be urged to attend frequent state-of-the-science updates that regard early symptoms as manifestations of ovarian cancer.
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