When interviewed, patients ask the same questions and can not remember all the instructions given during the initial consultation. They state that they are so overwhelmed with information that they do not know what questions to ask. Once home, the person who would be involved in their care asks questions to which they have no answers. Patients also forget or do not think it necessary to involve anyone in their care; therefore, they come to the clinic visits alone (9 out of the 12 patients interviewed did not comply with this instruction).
It was also observed that patients are shocked and scared when told about the intravenous catheter that will be inserted into a vein in their chest. All tests and procedures are briefly covered, but 8 out of the 12 patients interviewed did not follow the instructions. The writer made these assumptions for non-compliance to the instructions: • The patients’ intelligence/educational level were too low. • The patients’ were not motivated. • The patients were incapable of learning the material. • The patients’ anxiety levels were too high. • The stress levels of the patients were too high. • Patients are embarrassed.
The literature search had minimal data on the feelings of patients with cancer who searched for treatment options when others have failed. It appeared that researchers are not asking patients their opinions and/or feelings about their diagnosis or treatment course. There was information on stress as it impacts the memory and how adults learn. IOL (2004) reported that stress impacts the memory by activating an enzyme in the brain that interferes with short-term memory loss. Comeau (2002) found in the research done by McGill and others that impaired memory has more to do with stress as well.
In the article, Dead Tired by Dr. Jane Poulson (1998), she chronicles her experience as a professional patient with other ailments until given the diagnosis of cancer of the breast. She reports that she had “difficulty thinking clearly and rationally”, said she was unable to concentrate sufficiently to read properly, and couldn’t follow in-dept conversations. “I also had trouble retaining information and instructions from my doctors. ” Although an older article, the emotions, feelings, and lack of brain functions with the diagnosis of cancer are still current.
In his article, Dr. Eysenbach found that “persons with breast cancer indicated that they ‘wished that they had help with knowing what questions to ask’” (2003). He was also asked, “What is the Effect of Information on Persons with Cancer? ”(This is information from the internet). His reply: Provision of information to persons with cancer has been shown to help patients gain control, reduce anxiety, improve compliance, create realistic expectations, promote self-care and participation, and generate feelings of safety and security.
Satisfaction with information has been shown to correlate with quality of life, and patients feel satisfied with the adequacy of information given are more likely to feel happy with their level of participation in the overall process of decision making. Although more than 15 randomized trials have evaluated interventions to provide information to persons with cancer, most focus on evaluating the effect of providing printed patient education pamphlets or computer-based personalized information to patients. Relatively little is known about the effects of general undirected ‘chaotic’ Internet information on persons with cancer.
Hitti summarizes that there was a “clear relationship between [mental skills] and stress levels” (2004). This summary appears to echo the remarks or findings by Dr. Poulson in her self-reflection article mentioned above. At last, an article written by Dr. Bittman, “the Stress-Memory Connection: Key insights for your future”, had a similar finding. He notes: “Stress coupled with anxiety and loss of control produces temporary memory problems” (2003). “Under a great deal of pressure, it’s not uncommon to forget even the simplest routines. ” These questions were asked of the 12 patients upon their subsequent visits
to the CAGT clinic. The number of patients interviewed was limited to 12 because these patients were most current after their initial consultation visit to the clinic. There was also a limitation on the time frame to complete the research proposal. Why are patients not retaining information or following instructions from the initial consultation? Is it the anxiety and stress? The two correct assumptions made by the writer were that patients exhibited high levels of stress and anxiety. Dr. Bittman suggests to “take time to distance yourself from the stressful stimuli or situation, even if done mentally” (2003).
Patients should not make decisions about their care or treatment options until they have gone home and thought about it. When in thought, they are to try slow deep breathing to calm themselves. People tend to hold their breath decreasing the amount of oxygen to the brain, thereby making it difficult to stay focused and concentrate. Ohio Health (n. d. ) had similar suggestions for reducing anxiety and stress by attempting to relax before the appointment by using imagery and meditation. Additionally, “prayer may not cure the disease, but it may reduce stress and promote a positive outlook and strengthen a person’s will to live. ”