The purpose of this pilot study was to evaluate the benefits of a message from a patient's physician audiotaped over music on reducing anxiety and side effects of patients receiving chemotherapy. A convenience sample of 97 adult patients receiving chemotherapy for the first time was assigned to either an experimental or control group. Before beginning the first chemotherapy treatment, all subjects completed a demographic questionnaire and the Spielberger State Anxiety Inventory (SSAI). Participants in the experimental group (n = 47) received taped music and a message from their physicians during the next four chemotherapy treatments. Participants in the control group (n = 50) received no intervention from the researchers and underwent their next four chemotherapy treatments as prescribed. After the fourth chemotherapy treatment, the SSAI and a side-effects self-assessment evaluation were completed by all subjects. A paired one-tailed t test found a significant difference between pre- and postintervention scores on the state anxiety scale (p < 0.001). In addition, anxiety remained the same over time in the control group. There was no significant difference in the severity of side effects experienced between control and experimental groups. These preliminary findings indicate that a simple and cost-effective intervention can decrease a patient's anxiety when receiving chemotherapy.

Chronic illness is currently the number one health problem facing the United States. Little is known about the experience of making chronic illness a part of one's life, particularly from the perspective of the chronically ill person. The purpose of this phenomenological inquiry was to explore how chronically ill adults integrate chronic illness into their lives. Seventeen chronically ill adults were interviewed by the researcher. Using a modification of Colaizzi's (1978) method of data analysis, 4 major themes emerged. These themes were: confronting loss, fluctuating emotions, making changes, and gaining control of an altered life direction. Some of the major recommendations and implications for nursing practice centered around perceiving the entire experience of chronic illness with an emphasis on the need to recognize and assess loss as an ongoing and unending experience, and how this loss influences a participant's willingness and ability to implement changes required by the medical treatment plan.

The use of classroom debates can be helpful in teaching ethical content that is often nebulous and difficult for students to comprehend and apply. Debates enhance critical thinking skills through researching issues and developing a stance that can be supported in scientific literature. The authors describe a student debate project involving ethical issues with chronically ill clients. Many students changed their views during the debates. Students evaluated the debates as a positive learning experience.

The diabetic patient receiving TPN presents a challenge to health care personnel. Usual protocols concerning TPN administration must be reevaluated given the special considerations associated with the pathology of diabetes mellitus. These patients are susceptible to the development of complications including those associated with glucose metabolism abnormalities and electrolyte imbalances. In addition, diabetic patients receiving TPN have the added stress of an acute illness complicating a chronic illness. An understanding of the interrelationships between the pathophysiology of diabetes mellitus and the stress response will provide the nutritional support team with the background information necessary to meet the challenges imposed by TPN administration. The health care team will be able to recognize early signs and symptoms of complications and implement appropriate interventions. Individualized care plans can be formulated as an extension of the basic plan that has been presented, thus providing optimum care to the diabetic patient receiving nutritional support.

The current healthcare environment requires diabetes educators to design their care and education programs around findings in scientific- and research-based literature. They must be confident that what they do makes a difference in terms of patient outcomes. Although diabetes educators recognize the importance of research as a basis for their practice, they often do not see themselves as responsible for participating in the process. Clinicians such as diabetes educators are in an ideal position to incorporate research into their practice because they are the most knowledgeable about the clinical problems that need to be solved. The challenges of conducting clinical research will be explored in this article along with ways to promote greater participation of diabetes educators in conducting research in their practices.