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Family caregivers of stroke survivors are at risk for negative health outcomes such as depression, psychosocial impairments, and even mortality as a result of providing care. Shortened hospital stays have [...]

Twenty parents (3 fathers and 17 mothers) engaged in caring for a child 2 to 14 months after renal transplant were studied to: (a) determine the kinds of caregiving tasks [...]

Using the Delphi technique, a panel of 575 nurses was surveyed to determine priorities for clinical research in cancer nursing. Of these, 254, of whom 62 were engaged at least half-time in direct care activities, completed all three survey rounds. A list of problem statements was generated from data supplied by the original panel of 575. Subsequent rounds were conducted to determine for each problem: 1) whether nursing should assume research leadership; 2) the potential value of the problem's solution for practicing nurses; and 3) the potential impact of research on the subject upon patient welfare. The majority of the items were regarded by the panelists as areas in which nursing should assume research leadership. In terms of potential impact on patient welfare, panelists placed highest priority on problems related to physiological responses to cancer treatment, especially chemotherapy, and relief of patients' physical discomforts, including pain. Items judged by the panel as having high value for practicing nurses focused predominantly on the need for organized support systems for the practitioner and on educational and communication needs. Comparative rankings for cancer center and general settings subgroups, and for education, administration, practice subgroups, are discussed.

Ambulatory treatment for cancer has increased patients' self-care requirements and placed demands on family members to manage the illness and treatment side effects at home. This exploratory study was undertaken to assess family caregiving demands (load) and to examine caregivers' appraisals of the illness/ caregiving experience. Forty-seven persons involved in the care of patients receiving radiotherapy for cancer were observed. Appraisal of stress was measured with the Appraisal of Caregiving Scale (ACS). This newly developed measure, derived from cognitive appraisal theory, is designed to assess the intensity of four possible appraisals of caregiving: harm/loss, threat, challenge, or benign. Participants also completed the Caregiver Load Scale, a measure of the time spent in caregiving activities. Satisfactory reliabilities were obtained for both measures. Family caregivers reported spending the most time in providing transportation giving emotional support, and in extra household tasks. They received the most assistance from family and friends, and made minimal use of professional services. Caregiver load was correlated positively with the length of time on treatment and with patient dependency. Caregivers in the poorest health, those with less education, and those of lower socioeconomic status had higher scores on the ACS appraisals of harm/loss and threat. Older caregivers had significantly higher challenge and benign appraisals. There was a strong positive correlation between caregiver load and the harm/loss and threat appraisals. Findings suggest a need for frequent reassessment of demands on family caregivers throughout the course of treatment and offer direction for future research.

This study was undertaken to describe the self-care burden (SCB) of persons receiving radiation as outpatients, to identify factors contributing to SCB, and to test a model of the effects of SCB, symptom distress, and appraisal of illness on mood. The subjects were 72 adults with cancer who had been in treatment an average of 4 weeks. Fatigue was reported to be the most distressing symptom. Among health deviation self-care tasks, coming for treatment was the most demanding, and self-treatment, such as administering medications, was the most difficult. Universal self-care activities most disrupted by treatment were social and recreational activities. Path analysis revealed that dependency was the primary predictor of health deviation SCB, while symptom distress was the best predictor of universal SCB. Universal SCB and family hardiness were the best predictors of appraisal scores. Symptom distress and somatic mood were highly correlated, suggesting collinearity between these factors. Four variables—appraisal, symptom distress, family hardiness, and health deviation SCB—explained 55 of the variance in affective mood scores. Theoretical and clinical implications are discussed.