Of the 89 patients with disseminated carcinoma of the breast treated with combination or sequential cyclophosphamide, fluorouracil and vincristine, 63 had received evaluable course of endocrine therapy and chemotherapy. The response to endocrine therapy, regardless of its nature or duration, failed to predict response to subsequent chemotherapy. Selection of the patients on the basis of pretreatment disease free interval, menopausal status or metastatic pattern showed the groups of patients to be homogeneous in distribution. In addition, evaluation for a disease free interval greater or less than two years, menopausal status and visceral or nonvisceral metastasis did not allow identification of groups predicting responsiveness to combination chemotherapy.
Using Orem's theory as the framework, two purposes guided the study: (a) to test the effectiveness of an audio-visual education program and behavioral contracting to promote self-care behaviors in managing radiation side effects and (b) to determine the extent to which low literacy affects self-care abilities. Seventy men diagnosed with prostate cancer participated in this experimental study. The nursing interventions of education and behavioral contracting significantly increased the self-care behaviors of men in managing radiation side effects. An increase in self-care behaviors was especially shown in men with low-literacy skills.
This article presents Orem's self-care deficit nursing theory as the conceptual framework in the development, design, selection, and evaluation of appropriate written patient education materials for patients with low literacy skills. The model, which includes essential evaluation factors used in literacy research, offers nurses and other professionals a more comprehensive means to judge the suitability of health information and instructional materials. Nurses have a critical role in educating consumers and their families and for providing patients with useful information that will influence their decision-making and participation in care.
Empathy refers to the of one person to the affective state of another, lannotti (1975) summarized the literature on em pathy by presenting four different definitions of the term based on the cognitive versus emotional nature of the and the egocentric or decentered basis for it. Borke (1971, 1973) treats as the cognitive ability of children to recognize the affective state of another in a familiar situa tion. Chandler and Greenspan (1972) regard as a cogni tive to another's perspective which is different from one's own. Burns and Cavey (1957) determine by the subject's cognitive to another's emotional reaction that is not ex pected from the situation. The latter two demand decentration while Borke's subjects can egocentrically respond without any perspective taking at all. Feshbach and her associates (Feshbach, 1973; Feshbach & Fesh bach, 1969; Feshbach & Roe, 1968) consider an emotional to another's affective state. She hypothesizes that empathy . . . may be contingent upon comprehension of a social event while social understanding may be independent of the affective response (Feshbach & Roe, 1968, p. 133). However, in these studies, like Borke's, the child can merely respond to the situation of the other without role-taking, lannotti (1975) devised measures of to fit his four definitions, three of which have been exemplified. The fourth, an emotional to another's affective state which is incongruous to the situation, is called decentered affect-matching. The present study examines the incidence of, as well as the rela tionship between, egocentric affect-matching and social comprehen sion in very young children. The term egocentric is used to denote the fact that the task employed does not require the child to take another's point of view. Using Borke's (1971) Interpersonal Perception Test, preschoolers were asked both how another feels (Borke's social comprehension) and how they feel (Feshbach's affect-matching).
Although gentamicin has been commercially available since 1969, reports concerning the incidence of nephrotoxicity from this drug and variables relating to this toxicity are still unclear and conflicting. In view of this, a prospective study of patients receiving gentamicin over a two month period was undertaken to determine the incidence of nephrotoxicity and to study the influence of several variables on the potential for developing gentamicin associated nephrotoxicity. The variables studied were patient's age; the total grams of gentamicin received; the total number of days the patient received gentamicin with a hemoglobin of less than 12 g%; sex; total days duration of therapy; hemoglobin prior to therapy; hematocrit prior to therapy; red blood cell count prior to therapy; albumin level prior to therapy; and if the patient received another potentially nephrotoxic drug concomitantly with gentamicin. Sixty patients in total were studied. However, in the “toxic” and “nontoxic” grouping process, seventeen patients were excluded from the study due to missing variables. Of the remaining sample, ten patients were classified as “toxic” and thirty-three were classified as “nontoxic.” Thus the incidence of nephrotoxicity was at least 10/60 or 16.7 percent. The data relating to the variables identified were analysed utilizing Chi-square, t-test, and multiple regression analyses. Two variables were found to be highly significant in relationship to the development of nephrotoxicity while receiving gentamicin therapy. These were (1) the albumin level prior to therapy (lower albumin level in the “toxic” group) and (2) the concomitant use of another potentially nephrotoxic drug. The mechanism behind the influence of albumin on gentamicin toxicity is unclear, but may be related to protein binding. The basis for nephrotoxicity relating to combined use of nephrotoxic drugs is probably additive or synergistic toxicity but this is also unclear. Until larger prospective studies concerning gentamicin associated nephrotoxicity provide more meaningful information concerning the significance of the variables involved in this adverse reaction, caution is recommended when using this drug in the albumin deficient patient or in combination with nephrotoxic drugs. In addition, it is further recommended that in patients receiving gentamicin, renal function should be closely monitored and the dosage regimen determined accordingly.
Purpose/Objectives: To investigate whether quality of life (QOL) assessed before weight loss intervention predicts weight loss and, in turn, what the effect of weight loss is on QOL measures after 12 months in early-stage breast cancer survivors.
A hypothesis proposing that preoperational egocentrism serves an adaptive function was used to predict the comprehension behavior of preschool children presented with sentences varying on a "personal" dimension. Personal sentences containing the subject's name were contrasted at 2 levels of syntactic complexity with impersonal sentences containing other familiar nouns. Significant effects were found for age, semantics, and syntax (all p's less than .001), with no sex effects or interactions. Personal sentences were better comprehended than impersonals at both levels of syntactic complexity. A second experiment was conducted to rule out "focusing of attention" as an alternative explanation. Variations in the likelihood of occurrence of the depicted event were added to the personal-impersonal contrast. High-probability personal sentences were significantly better understood than low-probability sentences, whether personal or impersonal (p less than .001). Results supported the adaptive egocentrism hypothesis in that sentence content describing the child and his personal experience facilitates the child's comprehension.
