Transcript Presentations – Theory of Unpleasant Symptoms

Deborah Darnell
University of Central Florida
NGR5800
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Affects 10-20% adults worldwide (Ronnevig,
2009).
Diagnosis based on symptomology since
diagnostic examinations usually negative
Symptoms include: abdominal pain, diarrhea
and or constipation, distension, and bloating
Patients face frustration, lack of control,
disruption of daily routines
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Purpose:
To provide a basis for understanding of how
varied symptoms and associated experiences
affect patients.
To encourage development and design of
effective interventions to prevent, ameliorate,
or manage the negative effects associated
with symptoms (Lenz, 1997).
Performance
TIMING
Physiologic
Psychologic
Situational
DISTRESS
SYMPTOMS
QUALITY
INTENSITY
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Physiologic factors: pain, constipation,
diarrhea, bloating, urgent bowel movements
Psychologic factors: Feelings of frustration,
loss of control, anxiety
Situational factors: Disruption of ADLs and
normal lifestyle
Performance factors: Fear of traveling long
distances, being away from restroom,
untimely BMs lead to isolation
Isolation
Pain,
diarrhea,
bloating
Frustration,
loss of control
Disruption of
ADLs
TIMING
DISTRESS
SYMPTOMS
QUALITY
INTENSITY
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Research suggests patients suffering with IBS
can experience some relief of symptoms with
dietary modifications, stress relief, and
continued caregiver support (Ronnevig,
2009).
 Nutritional teaching
 Stress reduction teaching
 Proper prescribing of medications
 Allowing patient expression of concerns
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Brant, Beck & Miaskowski (2010) suggest that
improving patient outcomes is the ultimate
goal of symptom management research
(Brant, Beck,& Miaskowski, 2010, p. 238).
 Interventions should:
 Promote self-esteem
 Incorporate self-efficacy
 Increase healthcare interactions
 Incorporate attitudinal and motivational
behaviors
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Advanced practice nurses should become
familiar with the dimensions of symptom
burden experienced by patients with IBS in
order to properly assess and treat patients
with IBS.
 Recognize symptoms as subjective
 Understand the meanings attached to
symptoms experiences
 Focus on physical, psychological and
situational factors
Brant, J.M., Beck, S., & Miaskowski, C. (2010). Building dynamic models
and theories to advance the science of symptom management
research. Journal of Advanced Nursing, 66(1),228-240
doi:10.0000/j.1365-2648.2009.05179.x
Farrell, D., & Savage, E. (2010). Symptom burden in inflammatory
bowel disease: Rethinking conceptual an theoretical underpinnings.
International Journal of Nursing Practice, 16, 437-442 doi:
10.1111/j.1440-172X.2010.01867.x
Lenz, E.R., Pugh, L.C, Milligan, R.A., Gift, A., & Suppe,F. (1997). The
middle-range theory of unpleasant symptoms: An update. Advances
in Nursing Science,19(3), 14-27. Retrieved from
http://ovidsp.tx.ovid.com.ezproxy.lib.ucf.edu/
Ronnevig, M., Vandvik, P.O., & Bergbom, I. (2009). Patients’ living with
irritable bowel syndrome. Journal of Advanced Nursing,65(8), 167685. doi: 10.1111/j.1365-2648.2009.05030.x