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PROFORMA FOR REGESTRATION OF SUBJECT FOR
DISSERTATION
MR.VIJENDRA SINGH RAJAWAT
1ST YEAR M.Sc NURSING
MEDICAL SURGICAL NURSING
YEAR 2008-2010
PADMASHREE COLLEGE OF NURSING
GURUKRUPA LAYOUT, NAGARBHAVI
BANGALORE-560072
1
RAJIV GANDHI UNIVERSITY OF HEALTH SCIENCES
BANGALORE, KARNATAKA
PROFORMA FOR REGISTRATION OF SUBJECTS FOR
DISSERTATION
1
NAME OF THE CANDIDATE Mr. VIJENDRA SINGH RAJAWAT
I YEAR M.sc. NURSING
AND ADDRESS
GURUKRUPA LAYOUT
NAGARBHAVI
BANGALORE-560072
2
NAME OF THE INSTITUTE
3
COURSE OF THE STUDY I Year M.sc Nursing
Medical Surgical Nursing
AND SUBJECT
Padmashree College of Nursing
Bangalore
03-06-2008
4
DATE OF ADMISSION
5
TITLE OF THE TOPIC
Assessment of Knowledge and Attitude
of caregivers in meeting the
Physiological needs of chronically ill
oncologic clients.
2
6. BRIEF RESUME OF THE INTENDED WORK
6.1 INTRODUCTION
Man is a social animal and was created by the nature thousand years ago. In
ancient period man was just similar like the animal was not having any culture and
surviving like the tribal’s. Later as every human has their own basic desires in
these desires first priority was given to the physiological needs.
Many author those who have given their various views about physiological
needs. Maslow was one among them who has given his own view about the basic
human needs and here Maslow gave the priority to the physiological needs.
Maslow has introduced the hierarchy model and described the basic needs of
the person. The basic needs were classified into the five levels. The most basic or
first level, includes the physiological needs, such as oxygen, nutrients, fluids, body
temperature, elimination, shelter, sex, obesity, position changing support,
medication etc.
Maslow hierarchy is extremely useful to caregivers to prioritize clients
nursing care needs. Basic physiological and safety needs are usually the first
priorities, especially when a client is severely dependent physically on others.
Oxygen is the important component of environment. It combined with globin
and forming oxyhemoglobin which is supplied to the tissue. The second
physiological need of the human is meeting adequate nutrition and fluids. Food
which is inadequately prepared or stored that is subjected to unsanitary conditions,
increase the client risk for infections and food poisoning and other symptomatic
3
conditions the cancer patients should be taken care for their better nutrition,
Pattern and nutritional needs.
The temperature and humidity management is another physiological need of
clients. If temperature is altering it indicates the infections in the body, so proper
maintenance of body temperature and humidity of the patient is very much
important.
Normal elimination pattern is included in the physiological needs which
balance the normal health of the person. Mobility, position changing, massage of
body, supporting and exercise are other physiological needs should be provided by
the care-givers if the client is unable to take self care who are chronically ill. There
should be some reasons for the caregivers to relive the pain of the patients.1
The word cancer, abbreviated ca, is a term that frightens most people. Cancer
is synonymous C the term malignant neoplasm. The word neoplasm is derived
from the Greek work which means new, and plasma which means growth of new
tissue (molding). A neoplasm is defined as an abnormal new growth of tissue that
serves no useful purpose and may harm the host organism.2
Other terms that suggest malignant neoplasm include tumor, malignancy,
carcinoma, and aberrant cell growth. Hippocrates coined the word carcinoma,
meaning a tumor that spreads and destroys the host. However Galen was the first
to describe cancer as being crab like in nature.3
Globally it is estimated that there are 7.6 million new cancer cases, of which
52% occurs in developing countries. The magnitude of problems of cancer in the
India subcontinent in terms of sheer number is most alarming. There is predicted
4
sharp increase in new cases from 10 million in 2000 to 15 million in 2020 in
developing and developed countries.
The population of India is now over billion with an estimated 1.5 million
cases of cancer diagnosed per year. The population of U.S is 295 million and yet
1.5 million cancer cases will be diagnosed .the estimated new cases of cancer in
India percent are newly 6.5 lacks and at the start of the next millennium estimated
806.000.
In Karnataka state in the southern part of India, it is estimated that annually
there are 35,000 incident cancers, where at the prevalent cancer amounts to about
1, 50,000 more than one third of these cancer cases are seen and attended to
Kidwai Memorial Institute of Oncology.4
Psychosocial and behavioral aspect of cancer has increased steadily over the
last 40 years. Anxiety along with the depression, has been described the most
common psychosocial reaction among clients with cancer. It is vital to realize that
each client with cancer reacts to the diagnosis differently and has unique concerns
and problems regarding the diagnosis and treatments, each client copes with the
illness in his or her own way.5
Epidemiological studies suggest that the caregivers of chronologically ill
oncologic clients are having the poor knowledge and attitude in meeting the
physiological needs of oncologic clients.
In respect to knowledge and attitude of the care giver in meeting the
physiologic needs of chronically ill oncologic clients, cancer can have a serious
impact on caregivers as well as on the client. Caregivers also play the very
5
important role in the care of the client with cancer. So it is important to assess the
knowledge and attitude of caregivers in meeting the physiologic need of their
client, because inspite handling the patient they have many other duties in
household, work and leisure, and other constraint, which may give ill effect in
providing the care to client by the care givers.
6.2 NEED FOR THE STUDY
Cancer is a condition in the world which makes the person to suffer because
of bad impact of disease. All round 30 years have been almost crossed the cancer
is a condition which is more severely affecting the today’s population. It remains
the second leading cause of the death.
Cancer leaves the bad impact on the patient and his family members or
caregivers with respect to care of the client and meeting their physiological needs.
This is all because of the longitivity of the illness duration.
Physiological needs are one level of Maslow’s hierarchy of basic needs which
includes, the ventilation, food, fluids, body temperature, elimination, position
changing, pain management, shelter, sex, etc, which are very much essential for
the client who are chronically ill ,and due to their inability to reach these
physiological needs.1
Mainly the family members are the caregivers for the chronically ill oncologic
clients. Nurses are playing vital role in the care of the patient. But still there are
many needs of the patient which can be full filled by the care givers of the patient
such as feeding the patient, providing water for drinking, changing the
comfortable position, pain management, support, checking the body temperature
6
providing the elimination needs etc. these thinks cannot be reached by the patient
and some times there can be inability of the nurse also to reach the requirement of
client, so the family member are playing important role in providing physiological
needs of the patient.
Studies have shown that many care givers are available in the hospital with
the client to care him but still they do not have the adequate knowledge and
positive attitude in providing the care to the client. It is important for the care
givers to learn and understand the importance of those care and needs, which are
essential for the client to be provided. They can clarify these doubts from the nurse
so that they can reach the expectations of the clients.
Family care givers are available in the hospital but they do not know what the
main physiological needs are and what the prior physiological needs of the
patients are. Though they are in the hospital with the patient but it is unworthy for
the patient. These things are very essential for the care givers to learn from the
nurse and through other resources.
World wide there are over 10.9 million cases of cancer. Each year 4.7 million
are reported in developed countries and nearly 5.5 million are in the less
developed countries. In developed countries cancer is 2nd most common cause of
death and epidemiological evidence points to emergence of a similar trend is the
developing country. Cancer is currently the cause of 12% of ill death worldwide.
Approximately 20 years time the number of deaths annually due to cancer will
increase from about 6 million to 10 million.6
Lung cancer has been the most common cancer world wide. Since 1985 and
by 202 accounted for 1.35 million new cases (12.4% of world total) and 1.18
7
million deaths (17.6%) of world total. Although it is most frequent cancer in men
world wide. Lung cancer is second to produce cancer incidence is developed
countries. Breast cancer is by far the most frequent cancer of women, accounting
for 23% of all cancer because of its high incidence and relatively good prognosis
breast cancer is the most prevalent cancer in the world, with an estimated 4.4
million women alive who have had the disease diagnosed within the last 5 years
composed to 1.4 million survivors men and women from lung cancer.7
In India the estimated number of new cancer per year is about 7 lacks and
over 3.5 lacks people die of cancer each year, out of these 7 lacks new cancer
about 2.3 lacks (33%) cancer are tobacco related.8
The national cancer registry project (NCRP) initiated in 1981-82 continued to
collect authentic data on cancer occurrence in country. The data for the year 1996
showed a crude incidence rate (per 100000) in the metropolitan cities from 53.7 in
Bangalore to 76.6 in Chennai among men and from 68.7 in Bangalore to 93.6 in
Chennai among women.
A population revealed that the population of coverage of cancer cases was
72% in Bangalore, 100% in Chennai and 78% in Mumbai the five year relative
survival for female breast cancer was 46.8% in Bangalore, 49.5% in Chennai and
55% in Mumbai.
The age adjusted incidence rate of esophageal cancer in women in Bangalore
is one of the highest (8.3 per 100000) in the world, in women cancer of the cervix
and breast together account for over 40% of the cancer in urban women and 65%
of cancer in the rural registry in Barshi.9
8
In today’s world the people are very busy with their life style and the work.
They suffer with lot of stress and problems they do not find the time to care their
relatives even though they are critically ill. They are ready to leave their clients in
the hospice and palliative care center or old age center but they are unable to meet
the client requirement. There are many reasons which make such types of feeling
in the caregivers. They even forget that today to whom they are ignoring they had
given birth to them or have played a vital role for their life.
Statistics shows that men are more likely to develop cancer than women and
some cancers are more prevalent in particular races than others for example.
Bladder cancer is twice as common in white people as it is black people. White
women are more likely to develop breast cancer than are black women, but black
women are more likely to die of the disease.10
So the investigators main intension or motive behind this study is that there
are care givers of the client have lack of knowledge and attitude to provide the
basic physiologic need of their client they are unaware to provide the support,
checking the temperature they unable to give position, in managing the pain and
how to provide the elimination needs of the client so investigator took interest to
do some investigation in this side by which he can assess the knowledge and
attitude of the care givers.
6.3 STATEMENT OF THE PROBLEM
A study to assess the knowledge and attitude of caregivers in meeting the
physiological needs of the chronically ill oncologic clients admitted in selected
oncology hospital, Bangalore
9
6.4 OBJECTIVES
1.
Assess the level of knowledge of caregivers in meeting the physiological
needs of the chronically ill oncologic clients
2.
Assess the level of attitude of caregivers in meeting the physiological
needs of the chronically ill oncologic clients
3.
Co-relate the knowledge and attitude of caregivers of chronically ill
oncologic clients
4.
Association of the knowledge and attitude of caregiver with their selected
demographic variables
OPERATIONAL DEFINITIONS
1. Knowledge
Knowledge refers to awareness and understanding of caregivers regarding
meeting the physiological need of chronically ill oncologic clients admitted
in selected oncology hospital, Bangalore.
2. Attitude
It refers to opinion, belief and feelings expressed by the caregiver’s of
chronically ill oncologic clients regarding meeting the physiological needs.
3. Caregivers
Family member or close relatives who is in the age group of 20 to 50 years
caring for chronically ill oncologic clients admitted in the oncology hospital.
10
4. Physiological needs
Physiological needs are the basic human body requirements
such as oxygen, nutrition, fluid, temperature management,
elimination, position changing, body massages, sex, exercise and
medications etc.
5. Chronically ill oncologic clients
The clients who are suffering with cancer for a long period such as
gastrointestinal cancer, lung cancer, oral cancer, breast cancer brain
tumor and cancer of cervix since 3 years admitted in medical ward
of selected oncology hospital.
6.6 ASSUMPTIONS
1. Caregivers of oncologic clients may have knowledge regarding
Physiological needs of chronically ill oncologic clients to some extent.
2. Caregivers of oncologic clients may have favorable attitude regarding
meeting the physiological needs of the chronically ill oncologic clients.
6.7 NULL HYPOTHESIS
H01: There will not be any significant relationship between knowledge and
attitude of the care givers in meeting the physiological needs of the chronically ill
oncologic clients.
11
H02: There will not be any association of the knowledge and attitude of
caregivers in meeting the Physiological needs of the chronically ill oncologic
clients with selected demographic variables.
6.8 REVIEW OF LITERATURE
The term literature review refers to the activities involved in identifying and
searching information on a topic and developing an understanding of the state of
knowledge on topic.
Also review of literature is a written summary of the state and the art of a
research problem. Literature review is an essential step in the whole process of
research. Therefore the researcher has reviewed literature with regard to the
problem by referring books, journals, thesis, etc.
Literature review done for the study is presented under the following
heading.
1. Studies related to general information on cancer.
2. Studies related to changes in Physiological needs due to cancer and its
management.
3. Studies related to knowledge and attitude of caregivers in meeting the
Physiological needs of the chronically ill oncologic clients.
12
1. Studies related to general information on cancer
Although cancer is often referred to as a single condition, it actually consists
of more than 100 different diseases. These diseases are characterized by the
uncontrolled growth and spread of abnormal cells.
Cancer develops gradually over many years due to the result of a complex mix
of environmental nutritional, behavioral and hereditary factors, the exact cause of
cancer is not known but certain life style choices can dramatically reduce the risk
of developing most type of cancer. Not smoking, eating, eating healthy diet and
exercising moderately for at least 30 minute each day reduce the risk of cancer by
more than 60%.
A study was conducted to know wish of people with cancer by which they are
cared for in primary care. In most economically developed countries patients, their
informed and professional carers and policy makers are calling for more Care in
the community to involve patients with cancer, and their carers in designing a
framework for providing effective cancer care in primary care. The study revealed
that patient with cancer and their carers believes that there is an important and
unique role for primary care in offering continuity of care and information that is
patient-centered and holistic, throughout the cancer trajectory, from first
presentation.11
A cross sectional study was conducted on quality of life of cancer survivors
and their family caregivers. Although survivor’s rates for all cancer continue to
increase, A stratified random sample of 128 cancer survivors and 123 family
caregivers (N=246) were interviewed in an exploration, cross sectional design 1-6
13
years after cancer treatment had ended. Approximately half (N=62) of the dyads
were white and half (N=61) were African American. Results indicated that cancer
survivors reported significantly higher quality of life, less fear of cancer
recurrence and were support than their family caregivers.12
A study was conducted on different percespectives between seriously ill
patients and their family caregivers. The study data were from a national random
sample of 988 terminally ill patients of whom 893 had caregivers who were also
interviewed. Frequencies and type’s non concordanace were computed for patient
caregiver’s pairs. Bivariate associations between patient and caregivers reported
on each item were tested. Logistic and conditional logistic regression analyses
assessed multiple predictors of non cordance for each item. The proportion of
concordant reports among pairs of patients and caregivers ranged from 53% to
66%. Among pairs showing non concordant patients, lower care giving needs, and
different fears about future few demographic or clinical predictors were associated
with nonconcordinance. Concordinance between patients and their caregivers
responses ranged widely and patients were more likely to express concern about
were more likely to express concern about patients physical suffering.13
Studies related to changes in physiological needs due to cancer and its
management
A study was conducted on decision making in palliative radiation therapy;
reframing hope in caregivers and patients with brain metastasis. Twenty patients
and 19 caregivers (including eight patient and caregivers pairs) were recruited into
the study. The study revealed that patients generally focus on current
informational needs while caregivers want more information about the future (e.g.:
life expectancy and anticipated symptoms) Caregivers expressed frustration when
14
unable to explore future needs because patients were unprepared to discuss
prognostic issues. Participants expressed substantial relief when offered whole
brain radiation therapy after the diagnosis.14
A cross-sectional study was conducted to explore fatigue levels and fatiguecoping strategies in lung cancer patients receiving chemotherapy. The data were
collected from 101 nursing cancer patients receiving chemotherapy. The study
revealed mean fatigue score for the total sample was 8.0 (SD=5.0, range =0.20)
indicating light-to-moderate fatigue. The majority of patients (n=76, 75.2%) had
baseline hemoglobin level of < or =12g/dl and significantly greater (t=2.7; P<0.01)
mean fatigue score (8.8 SD 4.6) than patients with hemoglobin >12 g/dl (6.2 SD
5.7) fatigues levels were significantly higher patients receiving a third course of
chemotherapy than in those receiving a first course (F=3.7, P=0.03). this study
highlighted the management of fatigue problems in lung cancer patient receiving
chemotherapy, especially in respecting patients self-report of fatigue-management
strategies.15
A study was conducted on effects of care giving demand, mutuality and
preparedness on family care giver outcomes during cancer treatment to test a
model of family care giving derived from the interactions approach. In this study
87 family caregivers of adult receiving treatments for solid tumors or lymphoma.
The model explained statistically significant proportion of variance in each out
come, with different pattern of association across outcomes. Finally further
research should explore models that address implementation of the care giving
role to better elucidate how family caregivers learn and carry out the important
role.16
15
A study was conducted on chair massage for patients and carer’s together
patients and carer’s evolution of a 20 min chair massage treatment provided one
afternoon a week in an out patient waiting area. Both patients (n=224) and cases
(n=185) positively evaluated the treatment. The findings suggested that the service
was appreciated by patient and carer’s. The project was continued for a further
year with internal finding. Further research is warranted to ascertain the added and
longer term value of this intervention.17
A study was conducted on supportive care needs of people with brain tumors
and their carer’s to diagnosis and treatment of brain tumor may result in long term
changes in patient’s functional and social abilities. 18 patient and 18 cases
participated in focus groups or telephone interviews, following a structured
interview guide to elicit supportive care service of importance to these patients and
carers. Finally fire recommendations to improve service delivery were given and
found; provision of services along these recommendations could improve
supportive case of brain tumor patients and their carers .18
A study was conducted on psycho-social and supportive –care needs in high
grade glioma. It reveals that diagnosis and management of high grade glioma has
profound effects on patients and their families. The main research priorities are the
development and assessment of psycho-social or supportive interventions and the
investigations of service provision of specialist palliative and end of life care,
which have neither to been neglected.19
16
Studies related to knowledge and attitude of care giver in meeting the
physiological needs of the chronically ill oncologic clients
A study was conducted on knowledge and information needs of informal care
givers in palliative care to review current understanding of knowledge and
information needs. Seven electronic databases were searched for sample. The
evidence was strongest in relation to pain management, where inadequacies in care
giver knowledge and the importance to pain management, and the importance of
education were emphasized. The significance of effective communication and
information sharing between patient, care givers and service provider was also
emphasized. Finally as palliative care shifts into patient’s homes a more rigorously
researched evidence base devoted to understanding care givers knowledge and
information needs is required. 20
A study was conducted on attitude and beliefs regarding the role of
interventional pain management at the end of life among care givers. It revealed
that intrathecal and epidural opioid analgesia represents a major advance in the
management of cancer pain, adding a new dimension to opioid therapy by
allowing prolonged analgesia through the use of significantly lower doses than
those required for systematic administration. Researcher found that all care givers
were satisfied from using international pain relief techniques at the end of life.21
A comparative study was conducted on care givers assessment of patients
with advanced cancer to assess the validity of care giver reports of patient
concerns and the roles of care giver burden and positivity.
Agreement was
substantial for pain, moderate for four compared items, fair for three items and
slight for two items with patient self ratings, care givers described more problems
17
with information given and sharing feelings and were less likely the assess the
patient felt their life was worth while or felt good about themselves.22
A study was conducted to know the care giver perspective of providing care
while the patient was receiving chemotherapy as initial treatment for the brain
tumor. Interview data from 10 participants provided saturation and identification
three themes, the diagnosis of a brain tumor is a shock; immediately family role
changes occurring and there are psychosocial effects for the care giver, units or her
family and the person with the brain tumor.23
A study was conducted on the family contribution to the care of patients
hospitalized in an oncology hospital aim to explore the kind and frequency of care
provided to hospitalize cancer patients by relative, and reasons for providing this
care. The sample consisted of 150 informal care givers. The participants provide
sustained help to their patient daily. The participants offer informal care that
reflects specific nursing duties.24
A study was conducted on impact of family care giver cancer literacy on
patient health outcomes family care givers play a significant role in the diagnosis
treatment and recovery of individuals with cancer. Study revealed that family
members are important sources of health information, informal caregivers who
learn and enact medical procedures and influential aspects of patient’s health care
and treatment decision making but are not seriously considered by health care
practitioners or researchers in terms of assessing and improving health literacy.25
A study was conducted on family care giver burden and unmet needs of brain
tumor patient. The rapid onset and progression of a brain tumor, cognitive and
behavioral changes and uncertainty surrounding prognosis are issues well known
18
to health practitioners in neuro oncology. 25 sample for study were selected the
study revealed that the family care givers in this study provided extraordinary
uncompensated care involving significant amounts of time and energy for months
or years and requiring the performance of tasks that were often physically,
emotionally, socially or financially demanding.26
7. MATERIAL AND METHODS
7.1 SOURCE OF DATA
The care givers of the chronically ill oncologic clients admitted in the selected
hospital, Bangalore.
7.2 METHODS OF COLLECTION OF DATA
I. Research design
Non experimental - Descriptive approach will be used to assess the
knowledge and attitude of care givers of chronically ill oncologic clients.
II. Research variables
Study variables: knowledge and attitude of care givers of oncologic clients
admitted in selected oncology hospital
Extraneous variables: It includes the base line information of care givers of
oncologic clients such as age, gender, religion, education, occupation, marital
status, type of family, family income, family size, family history of cancer, and
relationship with the client.
19
III. Setting
The study will be conducted in medical ward of selected oncology
hospital Bangalore.
IV. Population
Refers to those care givers of all chronically ill oncologic clients admitted in
selected oncology hospital , Bangalore.
V. Samples:
Care givers of the oncologic clients, who fulfill inclusive criteria are
considered as sample and sample size is 60.
VI. Criteria for selection of the sample
Inclusion criteria: The Study including
1. The care givers of 20 to 50 years age group who is providing care for
chronically ill oncologic clients Admitted in medical ward of selected
oncology hospital.
2. Care giver who is closely related with oncologic clients admitted in
selected oncology hospital.
3. Caregivers of clients who are diagnosed to have gastrointestinal cancer,
lung cancer, brain tumor, and cancer of cervix since 3 years.
4. Able to read and understand Kannada or English
5. Who are responding and having interest.
6. Available at the time of the study.
20
Exclusion criteria:
1. The care givers who are taking care of the client for temporary period or
not regular care givers.
2. Care givers of clients diagnosed with other types of cancer.
VII. Sampling technique:
Non probability- convenience sampling technique is adopted for selecting the
sample.
VIII. Tool for data collection:
Section A: The structured interview schedule to assess the demographic data
Section B:
Interview schedule consisting of structured questionnaire to
assess the knowledge of care givers in meeting the physiological need of the
chronically ill oncologic clients admitted in selected oncology hospital.
Section C:
Likert(5point) scale to assess the attitude of caregiver’s in
meeting the physiological needs of chronically ill oncologic clients admitted in
selected oncology hospital.
IX. Methods of data collection:
Phase 1: After obtaining the permission from the significant authorities’
demographic data will be assessed for 15 minutes, followed by which structured
questionnaire will be administered for 45 minutes to assess the knowledge of care
givers of chronological ill oncologic clients admitted in medical ward of selected
oncology hospital.
21
Phase 2: Likert 5 point scale will be used to assess the attitude of caregivers of
chronically ill oncologic clients admitted in selected oncology hospital Bangalore.
Phase 3: Investigator may distribute the pamphlets at the end of the study
based on the results obtained.
Duration of the study is: 4 weeks.
X. Plan for data analysis: Data collected will be analyzed by means of
descriptive and inferential statistics.
Descriptive statistics: Mean, Percentage Distribution and Standard Deviation
will be used.
Inferential statistics: Correlation-co-efficient for correlating knowledge and
attitude of caregivers in meeting the physiological needs of chronically ill
oncologic clients.
And chi-square for association of the knowledge and attitude with selected
demographic variable will be used.
XI. Projected out come
After the study the researcher will know the level of knowledge and attitude
of care givers regarding meeting the physiological needs of chronically ill
oncologic clients. Based on the study results researcher may distribute pamphlets
to caregivers of chronically ill oncologic clients regarding the importance of
meeting the physiological needs of the clients.
22
7.3 Does the study require any investigations or interventions to the
patients or other human beings or animals?
No, the study does not require any investigation because the investigator is
planning only for descriptive study and no active manipulation is involved in the
study.
7.4 Has ethical clearance obtained from your institution?
Yes the ethical clearance will be obtained from selected oncology hospital
authorities, consent will be obtained from the subject and confidentiality will be
guarded.
23
REFRENCES:
1. Dorothy R Marlow, Barbara A Redding. Text Book of Pediatric Nursing. edth
. New Delhi: Harcourt India Pvt. Ltd; 2001; 20.
2. Luckmann and Sorensons. Medical Surgical Nursing. 4th ed. Philadelphia:
W.B Sounders Company; 1997;118-21.
3. Lewis, Colier, Hettkemper, Dirksen. Medical Surgical Nursing .6th ed. Mosby
Publication; 2000;261-62.
4. National cancer institute, kidwai memorial institute of technology. SEER
cancer statistics. Available at http: seer. Cancer. Gov.Acessed Jan 31, 2006
5. Joyce M Black Esther Mataserin Jacob. Medical Surgical Nursing .Clinical
Management for Continuity of care. 5 th ed. New Delhi: Harcourt Brace and
company
6. WHO, cancer statistic. GENEVA; 2002;4-6.
7. Parking DM, bray F, Pisani P. Global cancer statistics; 2002;74-184.
8. Dr k Ramchandra Reddy, Dr PP Basy. Population based cancer registry.
Kidwai memorial institute of oncology. Bangalore: available from
http://www.icmr. nic.in/
9. NRCP. Indian council of Medical Research; 2002;10-12.
24
10.ASC. Center statistics. American cancer society;2007: Available from
http://www.cancer.org/
11.Kendall M, Boyd K, Campbell C, Cormie P, Fife S, Thomas K, etal. How do
people with cancer wish to be cared for in primary care? Fam Pract. 2006
DEC; 23 (6):644-50.
12.Mellon S, Northouse LL, Weiss LK. A population based study of the quality
of life of cancer survivors and their family caregivers. Cancer Nurs. 2006
Mar – Apr; 29(2); 120-31
13. Hauser JM Chang CH, Alpret H, Baldwin D, Emanuel EJ, Emanuel L. Who
is caring for whom? Differing perspectives between seriously ill patient and
their family caregivers’ . AM J Hosp Palliate care. 2006 Mar-Apr;23(2) :
105-12.
14. Sze J, Marisett S, Williams D, Nyhof-young J, Crooks D, Husain A, etal.
Decision making in palliative radiation therapy: reframing hope in caregivers
and patient with metastasis. Support care cancer 2006 Oct; 14 (10):1055-63.
15. Lee YH, Tsai YF, Lai YH, Tsai CM. Hong Cheng Company, Taipei,
Taiwan. Fatigue experience and coping strategies in Taiwanese lung cancer
patients receiving chemotherapy’s Clin Nurs. 2008 Apr; 17 (7):876-83.
16. Schumacher KL, Stewart BJ, Arch bold PG. mutuality and preparedness
moderate the effects of care giving demand on cancer family caregiver
outcomes. Nurs res. 2007 Nov- Dec; 56 (6):425-33
25
17.Mackereth P, Campbell G, Maycock P, Hennings J, Breckons M. chair
massage for patient and caregivers; compliment Ther clin Pract. 2008 May;
14(2):136-42.
18. Janda M, Eakin EG, Bailey L, Walker D, Troy K. supportive care needs of
people with brain tumors and their carers. Support care cancer. 2006 Nov; 14
(11):1094-103.
19. Catt S, Chalmers A, Fallow Field L. Psycho-social and supportive- care
needs in high grade glioma. Lancet oncol. 2008 Sep; 9 (9):884-91.
20. Docherty A, Owens A, Asadi – Lari M, Petchey R, Williams J, Carter YH.
Knowledge and information needs of informal caregivers in palliative care: A
Qualitative systemic review. Palliate Med .2008 Mar; 22(2):153-71.
21. Cahana A, Arigoni F, Robert L. Attitude and Belief regarding the role of
interventional pain management at the end of life among caregivers: A 4 year
perspective. Pain Pract. 2007 Jun; 7 (2)103-9.
22. Higgnson IJ, GAO W. Caregiver’s assessment of patient with advanced
cancer: concordance with patients, effect of burden and positivity. Health
Qual life outcomes. 2008 Jun 2; 6:42.
23. Schmer C, Ward-Smith P, Salacz M. When a family member has a brain
tumor: the caregiver perspective. Neurosci nurs. 2008 Apr; 40 (2):78-84.
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24. Spountzi-Krepia D, Raftopoulos V, Psychogious M, Sakellari E, Toris A,
Vrettos A, et al. The family contribution to the care of patients hospitalized in
an oncologic hospital. Jclin nurs.2008 May; 17 (10);1287-94.
25. Bevan JL, Pecchioni LL. Understanding the impact of family caregiver
cancer literacy on patient health outcomes. Patient educ couns. 2008 Jun;
71(3):356-64.
26.Schubart JR, Kinzie MB, Farace E. Family caregiver burden and unmet
needs. Neuro oncol 2008 Feb; 10(1):61-72.
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9.
Signature of the candidate
:
10. Remark of the guide
:
The study is beneficial in
educating and changing the
attitude of caregivers to care
for their oncologic clients. It
has implication towards
Oncologic nursing.
11. Name of designation of
11.1 Guide
: Mrs. Fathima.L, Associate Professor
11.2 Signature
:
11.3 co-guide if any
: Miss. Shoba G, Senior Lecturer.
11.4 Signature
:
11.5 Head of the department
: Mrs. Fathima.L, Associate Professor
11.6 Signature
:
12.
12.1 Remark of the principal
: This study is feasible and
applicable for the
speciality chosen
12.2 Signature
:
28