Cohort Study Sample

Overall, 108,129 Service members enrolled in panels 1 and 2 of the Millennium Cohort Study and completed baseline survey. Service members who were not in active duty or National Guard/Reserves at baseline (n=5,079), who did not remain in the assigned separation category until end of study (n=37,922), who did not complete at least two follow-up surveys (n=27,984), and who had missing covariate data (n=5,974) were excluded from the study. Exclusion criteria resulted in 31,170 study participants among whom approximately 18% (n=5,510) were categorized as veterans.

This chapter written by Rose and Daste provide mental health professionals with information and recommendations to establish sensitivity within the make-up of the groups supporting those with cancer (Grief & Ephros, 2010). The authors also provide insight on the complexities and differences among a group of people that have a generally similar medical diagnosis, such as cancer, but a myriad of uniqueness (Grief & Ephros, 2010).

The purpose of the study article I chose, "Enhancing Caregiver Outcomes in Palliative Care," by McCorkle and Pasacreta (McCorkle, 2015) was twofold. The first was to define the negative experiences of untrained family members that care for a chronically ill patient and, second, intervene with a nursing care plan designed to prepare the caregiver for the consequences of those experiences. The statement of purpose is, "Families are increasingly replacing skilled health care workers in the delivery of unfamiliar complex care to their relatives with cancer, despite other obligations and responsibilities that characterize their lives" (McCorkle & Pasacreta, 2001).

In order to address the study objectives, Wolff and colleagues (2015) developed multiple outcomes to characterize informal caregivers. To evaluate the health and wellbeing of caregivers, the primary outcomes were self-reported financial, emotional, and physical difficulties that were related to caregiving activities. Additional indicators of health and wellbeing among caregivers that were utilized as primary outcomes

Unfortunately, 25-75% of patients will lose their capacity to make medical decisions at the EOL (Sudore et al., 2014). Therefore, family are involved to support the patient on their EOL journey by assisting them with medical decision making that is reflective of their wishes (Sudore, 2014). Therefore, as family involvement increases, patient advocacy improves (Sudore, 2014). Family involvement was unitedly defined as a family or friend caregiver who was most involved in the patient’s care. Caregiving tasks were direct, such as personal care and meals, or indirect, such as management and monitoring, and was provided on weekly to monthly basis (Williams et al., 2012). In the last month of life, 63% to 94.2% of decedents had family involvement with 87.5% of families being satisfied with the overall care they received (Sudore et al., 2014; Williams et al., 2012; Thompson et al., 2012). According to Williams et al. (2012), the indirect task of monitoring, such as advocating for medical care, diet and medication, had the highest involvement rate of

Setting: The interviews were conducted on palliative care hospital units, and in outpatient clinics, free standing hospice facilities, and home hospice.

Before recruiting the participants and staff for the intervention, hospital permission will need to be addressed. This includes permission from the hospital as well making sure the privacy rule and patient protected information regarding HIPAA are strictly followed. In order to gather participants for the intervention, staff within both hospitals will notify database cancer patients and their loved ones through calls or face-to-face for nursing staff. Information and details about the study will also be included in their hospital stay packet or information chart. If the patient is associated with either hospital, but is only being cared for at home, we expect that they be notified either by phone call or during their check-ups or treatments at the hospital. Oncology and cancer center staff that can be notified and are able to share brief information about the significance and protocol of this study.

This protocol seeks to support caregivers of hospice patients by promoting and improving problem –solving coping ability. Researchers have studied and found D’Zurilla and Nezu’s Problem-Solving Model effective when delivered to caregivers through supportive interventions. Problem-Solving Model (PSM) has now been applied with substantial success to caregivers of end of life hospice (D’Zurilla and Nezu, 2007). Theorists D’Zurilla and Nezu developed the Problem Solving Inventory (PSI) Scale, derived from their five factor Problem- Solving model. This instrument is a 35-item Likert-Type inventory that serves as a measure of problem-solving appraisal, or an individual’s attitudes, and perceptions of their problem solving behavior. The total score issued as an overall index of problem-solving ability, and the reliability and validity of this instrument have been documented extensively (Demiris, 2010). This scale will be one of the measurable outcomes used to determine the effectiveness of this protocol. In 2006, McMillan et al., developed and studied a coping skills nursing intervention labeled COPE that is based on some of the PST principles and “found that this intervention has the potential to improve quality of life for caregivers of hospice cancer patients,” (McMillan et al., 2006). The intervention “did not follow the entire PSM protocol and did not focus on caregivers’ own emotional needs, but rather focused only on practical challenges associated with caregiving tasks

This critique reviewed a quantitative study based upon palliative care and how it met emotional or spiritual needs of the families of patients with serious illnesses. The critique used eight criteria to analyze the quantitative study. The criteria include the identification of the problem, the determination of the purpose of the study, the review of the literature, the selection of the sample size and the research design, methods for collecting the data, the analysis of the data, study findings as well as the utilization of study findings.

If I was an epidemiologist and one day I suspected that smoke from the local toy factory connected to adverse health outcomes among the town’s residents, I would suspect a population-based cohort study. According to, Friis and Sellers (2014), “population-based cohort study is a type of study that includes either an entire population or a representative sample of the population.” In fact, this type of study collects data on the exposed and the non-exposed individuals within a population. In this situation, individuals would be tested on whether or not they developed adverse health outcomes due to the smoke from the toy factory. Every individual in the town would be examined and their medical histories would be taken into consideration in order

There are numerous factors contributing to psychological distress in cancer survivorship. Each factor or group of factors influence the cancer survivor individualistically, and the family collectively. The focus of the PICO is the cancer survivor and their family transitioning back to primary care. For this project, the family can be a patient, spouse or significant other, and family unit as the research focus. The emphasis on cancer survivorship and the psychological distress after treatment regimen, occurs when patients and their family unit must modify into a “new normal” of daily life. The NCCN’s validity of the DT instrument is rich in research however, this screening instrument is not in use when the patient shifts back to primary care contrary to research discussions expressing the need for continuity of use after transition.

Lung Cancer diagnosis are a critical part of the patient’s survivability. Approximately 57% of lung cancer patients are diagnosed in their advance stages. This article explores the decision-making process over the course of lung cancer. The study uses the method of patient-caregiver dyads, which basically identifies the patient caregiver, spouse or whomever it may be that enables them to discuss their needs. To identify current African American patients with lung cancer who had at least one visit with their oncologist within the safety net hospital system, the study team had to use the electronic medical record database. The one hundred patients who participated were asked to identify who their current caregivers were. Interview were scheduled

It think this would be useful to the clients because having them know the basics of their cancer pain can help the doctors in treating them and the caregivers in explaining, if needed. As far as the caregiver, they are going to have a lot of responsibility in regards to helping the client. The client may be in a lot of pain and cannot speak that well so they will have to step up and be the advocate for them in making sure the pain is under control and that the client is

Bibliographic information: Richard C. Cardoso & Peter J. Gerngross & Theresa M. Hofstede & Donna M. Weber & Mark S. Chambers. Support Care Cancer (2014) 22:259–267 DOI 10.1007/s00520-013-1960-y.

In developing the definition of the problem, I used my own personal perspective, values, and experiences. As a child, I was diagnosed with a form of leukemia. I grew up in southwest Nebraska and my mother and I were forced to drive five hours to treatment in Omaha, leaving at home my dad and brother. Therefore, I have my own personal perspective of what a cancer diagnosis does to a family. Other perspectives used include holistic, systems, and person in environment. Attention is put on the patient’s illness and other emotional and familial problems are overlooked. However, when the