Effects of exercise on fatigue, sleep, and performance: a randomized trial.

Purpose/objectives: To compare usual care with a home-based individualized exercise program (HBIEP) in patients receiving intensive treatment for multiple myeloma (MM)and epoetin alfa therapy.

Design: Randomized trial with repeated measures of two groups (one experimental and one control) and an approximate 15-week experimental period.

Setting: Outpatient setting of the Myeloma Institute for Research and Therapy at the Rockfellow Cancer Center at the University of Arkansas for Medical Sciences.

Prophylactic recombinant erythropoietin therapy and thalidomide are predictors of venous thromboembolism in patients with multiple myeloma: limited effectiveness of thromboprophylaxis.

Background: Venous thromboembolism (VTE) is a significant but poorly understood complication in patients with newly diagnosed multiple myeloma (NDMM). As a result, most patients receive thromboprophylaxis with low molecular weight heparin (LMWH). The purpose of this retrospective study was to identify risk factors for VTE in NDMM and evaluate the effectiveness of LMWH.

Fatigue, sleep, pain, mood, and performance status in patients with multiple myeloma.

Background: Cancer-related fatigue and insomnia are common distressing symptoms and may affect mood and performance status.

Objective: The objective of this study was to describe fatigue, sleep, pain, mood, and performance status and the relationships among these variables in 187 patients with newly diagnosed multiple myeloma (MM) and conduct an analysis using the correlates of fatigue.

Methods: Data were from baseline measures from the study, using the Profile of Mood States and the Functional Assessment of Cancer Therapy-Fatigue to assess fatigue, the actigraph to measure sleep, the Wong/Baker Faces Pain Rating Scale to assess pain, the Profile of Mood States to assess mood, and the 6-minute walk test along with a back/leg/chest dynamometer to test muscle strength to assess performance status.

Effect of certification in oncology nursing on nursing-sensitive outcomes.

The study compared certified nurses with noncertified nurses for symptom management of nausea, vomiting, and pain; patient satisfaction; and nurse satisfaction to determine the effect of certification in oncology nursing on those nursing-sensitive outcomes. A total of 93 nurses-35 (38%) of them certified in oncology nursing-and 270 patients completed surveys. Chart audits provided additional data on symptom management.

Effect of certification in oncology nursing on nursing-sensitive outcomes.

The study compared certified nurses with noncertified nurses for symptom management of nausea, vomiting, and pain; patient satisfaction; and nurse satisfaction to determine the effect of certification in oncology nursing on those nursing-sensitive outcomes. A total of 93 nurses--35 (38%) of them certified in oncology nursing--and 270 patients completed surveys. Chart audits provided additional data on symptom management.

Effects of exercise in combination with epoetin alfa during high-dose chemotherapy and autologous peripheral blood stem cell transplantation for multiple myeloma.

Purpose/objectives: To determine the effect of aerobic and strength resistance training and epoetin alfa (EPO) therapy on transfusions, stem cell collections, transplantation recovery, and multiple myeloma treatment response.

Design: Randomized clinical trial.

Setting: A myeloma research and therapy center in the south central United States.

Back to basics: assessment, communication, caring, and follow-up: a lesson from a couple's journey with multiple myeloma.

Ian was a patient with multiple myeloma. His wife, Judi, chronicled their journey and experiences with myeloma and the healthcare system. Through her own eyes, Judi provides a view of the positive and negative consequences of actions or omissions by the healthcare team.

Keep moving: patients with myeloma talk about exercise and fatigue.

Purpose/objectives: To learn about the feelings, beliefs, and experiences of patients with multiple myeloma implementing an exercise program in the context of an aggressive tandem peripheral stem cell transplant protocol.

Research Approach: Qualitative naturalistic (constructionist).

Setting: International referral center for the treatment of multiple myeloma.

Exercise decisions within the context of multiple myeloma, transplant, and fatigue.

This constructivist (naturalistic) study explored the decision-making strategies of patients with multiple myeloma who were implementing a home-based exercise program intended to decrease cancer-related fatigue during therapy. A purposive nonprobability sample of 21 patients who were undergoing an aggressive tandem transplant protocol provided data through face-to-face and follow-up telephone interviews. Salient themes derived from the data through content analysis and constant comparison included intrinsic and extrinsic facilitators and barriers that influenced the participants' day-to-day decisions about exercise.

Women's inhibitors and facilitators associated with making behavioral changes after myocardial infarction.

The researchers interviewed 40 women 6 to 24 months after their first myocardial infarction to determine facilitators and barriers to making desired health behavioral changes. Nurses at the bedside are in a unique position to discuss the importance of attending cardiac rehabilitation with women after myocardial infarction, assist them to assess their individualized barriers and facilitators to attending, and help them develop strategies to overcome barriers to promote attendance.

Feasibility of exercise during treatment for multiple myeloma.

Fatigue and insomnia are problems for patients with cancer. Research findings show that aerobic exercise decreases cancer-related fatigue. Because patients with cancer who have skeletal muscle wasting may not obtain maximum benefit from aerobic exercise training, exercise programs may need to include resistance training.

Facilitating exercise adherence for patients with multiple myeloma.

Physical exercise is becoming an accepted part of therapy for many patients with cancer. Exercise may alleviate patients' fatigue and improve physical performance and psychological outlook. Much of the research is limited to women with breast cancer and excludes patients with bone metastases.

Strategies for increasing physicians', nurses', and mammography technicians' participation in research.

Background: Breast cancer screening in physicians' daily practices needs greater emphasis. Increasing provider participation in research in this area can be a challenge as demonstrated in our study to test interventions targeting rural health care providers.

Method: Recruitment methods for the randomized controlled trial involving 27 counties in the Mississippi River Delta region of Arkansas included the following: introductory letters and return postcards, mailed questionnaires, telephone calls, attendance at local medical staff meetings, and telephoning the primary care offices to set a time to meet the providers at their practice sites.

The Delta project: increasing breast cancer screening among rural minority and older women by targeting rural healthcare providers.

Purpose/objectives: To test a multimethod approach designed for rural healthcare providers to increase breast cancer screening among low-income, African American, and older women.

Design: Two-year experimental pretest/post-test with random assignment by group.

Setting: Primary healthcare providers' offices.

Developing and testing lay literature about breast cancer screening for African American women.

Written materials about breast cancer screening for African American women with low literacy skills are needed. Available materials were not at or below third-grade reading levels, were not culturally sensitive, and were not accurate in illustrating correct breast self-examination (BSE) techniques. Focus groups representing the target population helped the authors design a pamphlet describing how to perform BSE and a motivational picture book to help women overcome barriers to screening.

Symptom management and successful outpatient transplantation for patients with multiple myeloma.

This retrospective descriptive study compared symptoms and symptom management in patients who completed autologous peripheral blood stem cell transplantation without hospital admission with those of patients who required unplanned hospital admission during the transplantation period. The sample consisted of 87 patients with multiple myeloma treated as outpatients during a 16-month period. Medical records and electronic database records review for each patient provided data on patient characteristics, medical factors, and symptoms/symptom management.

General characteristics and experiences of specialized standardized patients: breast teaching associate professionals.

Background: Standardized patients and teaching associates provide, reinforce, and evaluate the teaching of clinical skills to students and health care providers. As new needs and roles emerge for this method of teaching and evaluation, information is needed for recruitment, training, and retention.

Methods: This article addresses the general characteristics and experiences of 12 Breast Teaching Associate Professionals (BTAPs) in a two-year NCI-funded study aimed to improve breast cancer screening practices of rural primary health care providers in Eastern Arkansas.

An analysis of telephone interview data collected in 1992 from 820 women who reported problems with their breast implants to the food and drug administration.

How health care providers deal with concerns and feelings of women who have problems with their breast implants affects the women's satisfaction with their breast implants, yet in 1992 little was known about the concerns and feelings of these women. A qualitative analysis of in-depth telephone interviews conducted in 1992 with 820 women from all regions of the United States who reported problems with their breast implants to the Food and Drug Administration and responded to an invitation to be interviewed provided data. Respondents were primarily 40 to 69 years of age at the time of interview, Caucasian, married, and educated beyond high school.